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Local, state and national news of interest to the physician community September 25, 2019

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The Scientific Value of Your Academy

There’s science that proves that organizations like your Richmond Academy of Medicine benefit physicians. Check out this article in the Bulletin of the American College of Surgeons: It notes that beyond the benefits of educational resources, mentoring and networking, group membership has been shown to boost psychological well-being and self-esteem.

Group membership provides us with a common perspective, a lens that shapes our view of the world and moves us from isolation toward connection—from “me” to “we.” Active membership in groups ... provides members with intellectual stimulation, opportunities for collaborative learning, social companionship and emotional bonding.

The article says membership in societies has been well documented as a deterrent to burnout and a contributor to physician resiliency. Membership in these groups provides an opportunity to access resources on physician wellness and burnout and to collaborate with peers and mentors who have similar experiences and interests.

Ongoing engagement in societies and groups not only provides support for the individual, but also drives the individual’s engagement in the organization, resulting in ongoing contributions because of the fostered sense of community. Leg.Up Podcast Coming Soon

Starting next week, you'll be able to get The Leg.Up in a whole new way.

Thanks to our partner, Medical One Media, you'll be able to listen to Leg.Up as a podcast in a new pilot program. Medical One Media offers multimedia solutions for medical professionals.

Look for the audio link at the top of the next newsletter. We'll be tweaking as we go, so let us know your thoughts!

Listen to it as you drive to work, hit the treadmill at the gym or just kick back and relax.

How Anti-Vaccine Sentiment Took Over in the U.S.

As millions of families face back-to-school medical requirements and forms this month, the contentiousness surrounding vaccines is heating up again, with possibly even more fervor, says .

Though the situation may seem improbable to some, anti-vaccine sentiment has been building for decades, a byproduct of an internet humming with rumor and misinformation; the backlash against Big Pharma; an infatuation with celebrities that gives special credence to the anti-immunization statements from actors like Jenny McCarthy, and Alicia Silverstone, the rapper Kevin Gates and Robert F. Kennedy Jr. And now, the Trump administration’s anti-science rhetoric.

"Science has become just another voice in the room," Paul Offit, an infectious disease expert at Children's Hospital of Philadelphia, said. "It has lost its platform. Now, you simply declare your own truth."

Trauma Informed Care for the Adult Patient

Join RAM on Nov. 12 to hear Leslie Kimball, PhD, LCP discuss adverse childhood experiences, their impact on adult health outcomes, and trauma- informed care.

Dr. Kimball will help members understand trauma, its impact on the brain and at-risk health behaviors, and building individual and community resilience.

It's something all physicians should know!

CLICK HERE for information and registration

The Surgery Center Gold Rush

The number of procedures taking place in outpatient surgery centers — where people go under the knife and return home the same day — is expected to rise from 23 million in 2018 to 27 million in 2021, according to estimates from one consulting firm, reports Axios.

Surgeries in freestanding centers cost less than those that happen in hospital outpatient departments, which is why many insurers and policymakers are pushing for this shift. But that doesn't mean it's an unprofitable niche. Surgery centers would generate $43 billion worth of procedures if those estimates hold up.

Medicare has made it clear it will pay for more surgeries, especially orthopedic procedures like joint replacements, outside of the hospital. Industry giants have been placing their bets on these facilities for years.

VDH Issues Recommendations About E-cigarettes, Vaping

As of Sept. 19, the Virginia Department of Health had confirmed 16 cases of severe lung illness associated with e-cigarette use or vaping. Currently, there are also seven probable cases in Virginia. The case number is expected to rise as investigations continue.

In a press release last week, VDH said that while CDC investigations are ongoing, people should consider not using any e-cigarette products, but those who do should not buy these products off the street and should not modify e-cigarette products or add any substances that are not intended by the manufacturer.

At Raucous Hearing on Vaping, No Unity

Opposing views on e-cigarettes, witnesses interrupting members of Congress and even a wink. A hearing yesterday on the epidemic of respiratory injuries linked to vaping was one unusual show, reports Kaiser Health News.

Yet even these rising numbers of lung illness cases and stark warnings didn’t unify the often-contentious party lines at the House subcommittee hearing on vaping. Ostensibly about public health, the hearing grew tense and political at unexpected moments.

"These products flooded the market without anyone knowing how they would cause damage, and now we're trying to clean up a mess that involves a cocktail of mystery toxins and proprietary flavors," one witness said. "If this was romaine lettuce, the shelves would be empty."

Could AI Be as Good as Physicians at Diagnosis?

Artificial intelligence is increasingly being used in the clinic, and a new study finds that the technology may be as effective as humans when it comes to diagnoses, says Stat.

Researchers reviewed 14 studies that compared AI-based diagnoses to those made by health professionals and found that when it came to correctly diagnosing people who were sick, AI algorithms and people were correct roughly 86% of the time. Algorithms and health professionals were also evenly matched when it came to correctly identifying those who didn’t have a specific condition.

But the authors of the review found only a small number of studies sufficiently comparing AI diagnostics to those conducted by people — fewer than 1% of the more than 20,500 studies that were initially reviewed — and call for more thorough research to better evaluate the emerging technology.

WAIT! Don't Sign That Contract You're smart, but you're not immune from making mistakes when it comes to employment contracts. And unlike in medicine, you don't get the option of trying a new treatment plan if the first one doesn't work.

Even though you weren’t trained to read legal contracts in medical school, as a smart, educated physician, the courts expect that you have read and fully understand the terms of the contracts you sign.

In response to RAM members' interest in this column that ran in The Leg.Up in May, RAM will present a program featuring Rebecca Gwilt, partner with the Nixon Law Group, who will discuss avoiding common pitfalls when signing a contract. Join RAM on Oct. 1, 6 p.m., at the Westwood Club; the cost to attend is $20 for members and $40 for guests.

Learn more.

Who's Using Medical Marijuana?

RAM members who attended our meeting this month learned a lot about the science of medical cannabis. If you missed it, here's a link to the presentation slides.

Meanwhile, combing through a large national survey from 2016-2017, researchers have gleaned that people with medical conditions — notably asthma, chronic obstructive pulmonary disease, arthritis, cancer, and depression — are more likely to say they use marijuana than people without such illnesses, says Stat. Those numbers skew young: A quarter of people age 18 to 34 reported current marijuana use but that shrank to 2.4% for people 65 and older.

​"Clinicians should screen for marijuana use among patients, understand why and how patients are using marijuana, and work with patients to optimize outcomes and reduce marijuana-associated risks," the authors urge. They also caution that because the study was observational, they can’t establish cause and effect between medical conditions and marijuana use.

Meanwhile, the U.S. government will spend $3 million to find out if marijuana can relieve pain, but none of the money will be used to study the part of the plant that gets people high, reports NBC News.

Do You Have Feedback on MSV Resolutions?

The Medical Society of Virginia will consider 32 resolutions at its annual meeting next month (Oct. 18–20) at The Homestead. They'll help guide MSV policy moving forward.

Please CLICK HERE to review the resolutions and add a comment, if you choose (the comment area will be at the end of the resolution).

Interested in serving as a RAM Delegate? Contact Lara Knowles at 804-622-8137 or [email protected]. We still have open delegate slots.

Opioid Litigation Has 2,000+ Plaintiffs

More than 2,000 state, local and tribal governments are suing two dozen pharmaceutical manufacturers and distributors, arguing that they’ve helped create an opioid crisis that has claimed hundreds of thousands of American lives. The suits include claims that the industry misled doctors and consumers about the drugs’ safety and negligently allowed opioids to fall into the wrong hands, says The Washington Post. Most of the litigation has been consolidated in federal district court in Ohio, where trial is set to begin Oct. 21. The government plaintiffs agree that the industry is complicit in the crisis, but the public officials involved disagree on a variety of issues. Several state attorneys general recently criticized the tentative deal between most of the government plaintiffs and OxyContin manufacturer Purdue Pharma. The states and localities have also tangled over who will control the litigation.

Executive Order May Spur Development of Better Vaccines

Reuters reports President Trump signed an executive order last week aimed at spurring the development of better vaccines to protect against seasonal influenza as well as a potential pandemic flu outbreak.

The order does not allocate additional funding for now, but calls for an evaluation of current flu vaccine manufacturing abilities and a task force report including cost estimates, administration officials said.

The Department of Health and Human Services will coordinate government efforts to modernize influenza vaccine production. The focus will be on recombinant technologies to quickly produce reliable vaccines as well as “universal” vaccines that would elicit immunity against parts of the virus that do not change from year to year.

Low Screening Rates for Social Determinants of Health

Most providers aren't asking their patients about the five key social needs that are associated with health outcomes, according to a new study in JAMA Network Open, reports Axios.

Only 24% of hospitals and 16% of physician practices screened for food insecurity, housing instability, utility needs, transportation needs and interpersonal violence.

"Social needs ... are linked to health outcomes. Identifying patients with unmet social needs is a necessary first step to addressing these needs," the authors write. As they note, as much as 90% of a patient's health outcomes are a result of social, behavioral and economic factors — not medical care.

Rising Crime May Equate to Hypertension

Reuters reports that people living in communities with rising crime rates may be more likely than those in safer neighborhoods to develop hypertension, research indicated.

​The findings of the 17,783-adult study revealed that each increase of 20 incidents/1,000 in violent crime rates in Chicago was associated with 3% higher odds of having blood pressure that was elevated above 140/90 mmHg, which is just above the range considered healthy. The findings were published online in the American Journal of Hypertension.

Don't Miss the Fun at RAM's Fall Family Event

Time's running out to register!

Come get your pumpkins and enjoy an autumn afternoon on the farm at RAM's 2019 Fall Family Event. We'll return to Lloyd Family Farms on Sunday, Oct. 6 from 2 to 5 p.m.

The cost is $20 for RAM members and their families. Children will receive a free pumpkin and either a pony ride or crafting activity.

Pre-registration is required. Learn more and register here.

It's Official: Hangovers Are an Illness

Just in time for Oktoberfest, the excuse employees around the world have used after a night of drunken antics is legit: A German court has ruled that hangovers are a disease, says CNN.

The Higher Regional Court of Frankfurt made the decision in a case against an unnamed company that sold "anti-hangover" products.

According to the court, any minor disturbance in the body's normal functioning is considered an illness. Hangovers, which manifest in headaches, nausea and exhaustion (and often regret and a temporary disdain for booze, though those typically go undiagnosed), deviate from the bodily norm.

Thanks for Reading The Leg.Up!

We're excited to debut our new Leg.Up podcast next week. Be sure to let me know what you think.

Meanwhile, feel free to contact me with your ideas, suggestions and concerns (or complaints). You can reach me by email or at (804) 622-8136.

Click here for past editions of The Leg.Up.

Lisa Crutchfield Barth RAM Communications and Marketing Director

Richmond Academy of Medicine www.ramdocs.org

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