Blog - Health Professions Advising: Bev Sher's Homepage http://wmpeople.wm.edu/site/post/btsher en-us no Dr. Pauline Chen's NY Times blog http://wmpeople.wm.edu/site/post/btsher/drpaulinechensnytimesblog http://wmpeople.wm.edu/site/post/btsher/drpaulinechensnytimesblog <p>Dr. Pauline Chen blogs on medicine for the <em>New York Times</em>, and many of her posts are of interest to premeds. Her most recent post is on the culture of bullying in medical school, a problem that is of obvious relevance to premedical students. The url for her blog is the following:</p> <p>http://well.blogs.nytimes.com/category/doctors/doctors-and-patients/</p> <p>and the url for the post on medical school bullying is:</p> <p>http://well.blogs.nytimes.com/2012/08/09/the-bullying-culture-of-medical-school/</p> <p>Sobering, but worthwhile, reading...</p> <p>&nbsp;</p> Sat, 11 Aug 2012 14:50:43 -0400 New AAMC MCAT Preparation Materials http://wmpeople.wm.edu/site/post/btsher/newaamcmcatpreparationmaterials http://wmpeople.wm.edu/site/post/btsher/newaamcmcatpreparationmaterials <p>Are you planning to take the MCAT this year? If so, you should take a careful look at the preparation materials available from the AAMC, the organization that produces the exam. These materials include the very first book that you should read about the exam, <em>The Official Guide to the MCAT</em>, an exceptionally useful volume that includes information about the medical school application process as well as information about the test itself. Other AAMC materials include online practice tests that are based on real MCAT items; students tell me that the scores they earn on the practice tests are reasonably good predictors of the scores that they earn when they take the actual MCAT.</p> <p>Now, the AAMC has produced a useful package of self-assessment tools that will help you identify your strengths and weaknesses at the beginning of the MCAT preparation process. It includes hundreds of real MCAT questions. You can buy a full package that includes questions for each of the subtests, or buy materials for the subtests that most interest you individually. You can even buy a discounted package that includes the self-assessment materials, a practice test, and <em>The Official Guide to the MCAT</em>. See www.aamc.org/mcatsap for all of the details.</p> <p>&nbsp;</p> Thu, 02 Aug 2012 10:00:55 -0400 The Supreme Court Rules on the ACA http://wmpeople.wm.edu/site/post/btsher/thesupremecourtrulesontheaca http://wmpeople.wm.edu/site/post/btsher/thesupremecourtrulesontheaca <p>Given yesterday's Supreme Court ruling on the constitutionality of the Affordable Care Act, premedical students will need to learn more about the law's provisions in order to be ready for medical school interviews. Here are some useful resources for students:</p> <p>1) The health care reform background information on the non-partisan Kaiser Family Foundation website, available at www.kff.org. In particular, the short video describing the provisions of the law, available at http://healthreform.kff.org/theanimation.aspx will help students understand the basic provisions of the law quickly.</p> <p>2) The book <em>Health Care Reform: What It Is, Why It's Necessary, and How It Works</em>, by Jonathan Gruber et al, clearly explains the problems afflicting our health care system and the ways in which legislators have addressed these problems, both in Massachusetts and nationally via the ACA. Gruber is an economics professor at MIT who helped develop both the Massachusetts and national legislation, and his graphic novel-style book is a quick and accurate read.</p> <p>3) Atul Gawande, a surgeon and author whose work is very popular with premedical students at the College, wrote a thought-provoking essay for <em>The New Yorker</em> in response to the Supreme Court's decision. The essay, "Something Wicked This Way Comes," is available at http://www.newyorker.com/online/blogs/comment/2012/06/something-wicked-this-way-comes.html .</p> <p>Happy reading!</p> <p>&nbsp;</p> Fri, 29 Jun 2012 13:49:22 -0400 Paul Krugman on Health Care Reform http://wmpeople.wm.edu/site/post/btsher/paulkrugmanonhealthcarereform http://wmpeople.wm.edu/site/post/btsher/paulkrugmanonhealthcarereform <p><span style="color: #000000; font-family: verdana, helvetica, arial, sans-serif; line-height: normal; font-size: 11px; white-space: pre-wrap;">Here's yet more summer reading relevant to the health care reform debate. Paul Krugman, a Nobel Prize-winning economist and New York Times columnist, has been writing about health care reform for many years now. In a recent column, he talks about the reasons that he thinks that the free market cannot be used to fix the health care system. Here's the link: http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/ His 2006 article in the New York Review of Books on the virtues of a single payer system is also worth reading. Here's the url: http://www.nybooks.com/articles/18802</span></p> Tue, 28 Jul 2009 13:38:23 -0400 Dental Triage in Wise County http://wmpeople.wm.edu/site/post/btsher/dentaltriageinwisecounty http://wmpeople.wm.edu/site/post/btsher/dentaltriageinwisecounty <p>Every year, the Remote Area Medical group conducts a three-day health clinic at the county fairgrounds in Wise County, VA. This year, teacherken, a contributor to the Daily Kos site who also teaches AP Government in northern Virginia, volunteered with the clinic's dental group, and he posted this passionate <a title="teacherken on Wise County" href="http://www.dailykos.com/story/2009/7/24/757552/-A-different-perspective-on-the-health-care-debate">diary</a> about his experiences on July 25. For those of you who have not visited Daily Kos before, it is a progressive Democratic site, so teacherken's diary is not nonpartisan- but it is still worth reading.</p> Sat, 25 Jul 2009 06:27:55 -0400 Peter Singer on Health Care Rationing http://wmpeople.wm.edu/site/post/btsher/petersingeronhealthcarerationing http://wmpeople.wm.edu/site/post/btsher/petersingeronhealthcarerationing <p>Here's another interesting article relevant to health care reform for your summer reading pleasure. In yesterday's New York Times Magazine, Peter Singer, a professor of bioethics at Princeton, discusses the rationing of health care in an article entitled, appropriately, "<a title="Singer article" href="http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?_r=1&amp;hpw">Why We Must Ration Health Care.</a>"</p> <p>I should point out, as does Singer, that the American healthcare system already rations care in two ways: first, by a patient's ability to pay (we've all seen those pitiful little money collection jars with the picture of a child with a life-threatening health condition whose only chance at treatment is community charity) and second, by insurance company fiat: many insured people have insurance policies that do not cover procedures/ medications that their doctors would like them to have. Thus, physicians spend an inordinate amount of time figuring out what can be done for each patient based on which insurance company is involved.</p> <p>I thought that the article was interesting; I hope you will, too!</p> Mon, 20 Jul 2009 15:10:36 -0400 Bill Moyers interviews Wendell Potter http://wmpeople.wm.edu/site/post/btsher/billmoyersinterviewswendellpotter http://wmpeople.wm.edu/site/post/btsher/billmoyersinterviewswendellpotter <p>Here's another useful resource for understanding the issues involved in health care reform. Long Vinh, who recommends it to Health Careers club members, says:</p> <p>"</p> <div><br /></div> <div>I found this interview online between Bill Moyers and former V.P. of Cetna Wendell Potter quite informative on the relationship between the health insurance industry, politicians, stockholders, and health care reform.</div> <div><br /></div> <div><a href="http://www.pbs.org/moyers/journal/07102009/watch2.html" target="_blank">http://www.pbs.org/moyers/journal/07102009/watch2.html</a></div> <div><br /></div> <div>Some key tidbits:</div> <div><br /></div> <div><span style="font-family: Verdana; font-size: 11px;"><strong>WENDELL POTTER:</strong>&nbsp;Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.</span></div> <div><span style="font-family: Verdana; font-size: 11px;"> <p>So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.</p> <p>...</p> <p><strong>BILL MOYERS:</strong>&nbsp;And they do what to make sure that they keep diminishing the medical loss ratio?</p> <p><strong>WENDELL POTTER:</strong>&nbsp;Rescission is one thing. Denying claims is another. Being, you know, really careful as they review claims, particularly for things like liver transplants, to make sure, from their point of view, that it really is medically necessary and not experimental. That's one thing. And that was that issue in the Nataline Sarkisyan case.</p> <p>But another way is to purge employer accounts, that-- if a small business has an employee, for example, who suddenly has have a lot of treatment, or is in an accident. And medical bills are piling up, and this employee is filing claims with the insurance company. That'll be noticed by the insurance company.</p> <p>And when that business is up for renewal, and it typically is up, once a year, up for renewal, the underwriters will look at that. And they'll say, "We need to jack up the rates here, because the experience was," when I say experience, the claim experience, the number of claims filed was more than we anticipated. So we need to jack up the price. Jack up the premiums. Often they'll do this, knowing that the employer will have no alternative but to leave. And that happens all the time.</p> <p>They'll resort to things like the rescissions that we saw earlier. Or dumping, actually dumping employer groups from the rolls. So the more of my premium that goes to my health claims, pays for my medical coverage, the less money the company makes.</p> <p>...</p> <p><strong>WENDELL POTTER:</strong>&nbsp;It's true. And that same thing happened, in the Nataline Sarkisyan case. You had a corporate bureaucrat making a decision on coverage. So, they are trying to make you worry. And fear a government bureaucrat being between you and your doctor. What you have now is a corporate bureaucrat between you and your doctor.</p> <p>&nbsp;</p> <p><span style="font-family: arial;"><span style="font-size: small;">I</span><span style="font-size: small;">f</span><span style="font-size: small;">&nbsp;</span><span style="font-size: small;">y</span><span style="font-size: small;">o</span><span style="font-size: small;">u</span><span style="font-size: small;">&nbsp;</span><span style="font-size: small;">t</span><span style="font-size: small;">h</span><span style="font-size: small;">i</span><span style="font-size: small;">n</span><span style="font-size: small;">k</span><span style="font-size: small;">&nbsp;this is relevant, please pass the think on to our Health Careers Club. &nbsp;Thanks!</span></span></p> <p><span style="font-family: arial; font-size: small;"><span style="font-size: 13px;">-Long"</span></span></p> </span></div> <hr size="1" noshade="noshade" /> Sat, 11 Jul 2009 19:49:05 -0400 Sick Around the World http://wmpeople.wm.edu/site/post/btsher/sickaroundtheworld http://wmpeople.wm.edu/site/post/btsher/sickaroundtheworld <p>The US currently spends about 16% of its GDP on health care, yet approximately 46 million people in our country lack health insurance, and medical problems are a leading cause of bankruptcy for Americans. How is it that other developed countries manage to spend a much lower fraction of their GDP's on health care, yet cover everyone? <a title="Sick Around the World" href="http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/"><em>Sick Around the World</em></a>, TR Reid's excellent Frontline documentary, provides the answers. If you are interested in the future of health care in the United States, you need to watch this program, as well as read the fascinating background material on the Frontline website.</p> Sun, 05 Jul 2009 13:01:40 -0400 Atul Gawande: "The Cost Conundrum" http://wmpeople.wm.edu/site/post/btsher/atulgawandethecostconundrum http://wmpeople.wm.edu/site/post/btsher/atulgawandethecostconundrum <p><span id="news_content" class="text12"> <p>Are you planning to become a physician? If so, you need to know more about how the American health care system works and about the current debate over health care reform: the changes that could be coming may well affect you for the rest of your professional life.</p> <p>A recent article in The New Yorker, <a title="The Cost Conundrum" href="http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all">"The Cost Conundrum: What a Texas Town Can Teach Us About Health Care,"</a> by Atul Gawande, a surgeon, writer, and advocate of increasing the quality of American medicine, gives a readable and succinct account of some of the factors that make the U.S. health care system the most expensive in the world. In the article, he also discusses changes that could reduce its cost and increase its quality.</p> <p>Update: Wes Northam recommended the following <a title="Gawande NPR interview" href="http://www.npr.org/templates/story/story.php?storyId=105483669">NPR interview</a> with Atul Gawande about this article. Happy listening!</p> </span></p> Sun, 05 Jul 2009 12:44:18 -0400 Outbreak Investigations... http://wmpeople.wm.edu/site/post/btsher/outbreakinvestigations http://wmpeople.wm.edu/site/post/btsher/outbreakinvestigations <p>Are you interested in infectious disease? If so, the new book, <em>Outbreak</em> <em>Investigations Around the World: Case Studies in Infectious Disease Epidemiology</em>, edited by Mark S. Dworkin, might be just the beach book for you this summer. Each chapter describes a separate outbreak, ranging from a measles outbreak at a Christian Science college to an enormous outbreak of cryptosporidiosis in Milwaukee to the anthrax attacks of fall 2001. The chapters are written by public health professionals involved in the investigations, giving readers a firsthand look at what's it's like to work in public health as well as what can be learned about outbreak management from each investigation. The book is worth your time!</p> Sun, 05 Jul 2009 12:26:22 -0400