‘Cervical Screening Saves Lives’ Campaign Launched by Public Health England

The campaign urges women to attend their cervical screening, with data revealing that the number of women attending screening has fallen to a 20-year low

Public Health England (PHE) has launched major new national campaign, ‘Cervical Screening Saves Lives’ to increase the number of women attending their cervical screening across England.

The campaign aims to encourage women to respond to their cervical screening invitation letter, and if they missed their last screening, to book an appointment at their GP practice.

Today we’ve launched a new campaign urging women to attend their cervical screening, with data showing that the number of women attending screening has fallen to a 20-year low. Read more: https://t.co/77wMh4rESQ pic.twitter.com/r5ynUEiaIe

— Public Health England (@PHE_uk)

Around 2,600 women are diagnosed with cervical cancer in England each year, and nearly 700 women die from the disease (an average of two deaths each day). It is estimated that if everyone attended screening regularly, 83% of cervical cancer cases could be prevented.

The new research from PHE shows that nearly all women eligible for screening (90%) would be likely to take a test that could help prevent cancer – and of those who have attended screening, 94% would encourage others who are worried to attend their own screening.

Despite this, screening is at a 20-year low, with one in four eligible women (those aged between 25 and 64) in the UK not attending their test.

‘Cervical Screening Saves Lives’ provides practical information about how to make the test more comfortable, and gives reassurance to women, who may be fearful of finding out they have cancer, that screening is, in fact, not a test for cancer.

Cervical screening can help stop cervical cancer before it starts. Regular screening, which only takes a few minutes, identifies potentially harmful cells before they become cancerous, ensuring women get the right treatment as soon as possible.

The PHE research shows that after attending their screening, the majority of women feel positive about the experience. 87% of women say they are “glad they went”, while 84% said that they were “put at ease by the nurse or doctor doing the test”.

Professor Anne Mackie, Director of Screening Programmes at PHE said: “The decline in numbers getting screened for cervical cancer is a major concern as it means millions of women are missing out on a potentially life-saving test.

“Two women die every day in England from cervical cancer, yet it is one of the most preventable cancers if caught early.

“We want to see a future generation free of cervical cancer but we will only achieve our vision if women take up their screening invitations. This is a simple test which takes just five minutes and could save your life. It’s just not worth ignoring.”

The campaign isn’t the first to encourage cervical screening, but it is a welcome addition to the conversation. In recent years we have seen an upturn in screening-related posts and campaigns on social media, including #SmearForSmear run by Jo’s Cervical Cancer Trust.

A post shared by @ zoella on

The campaign adverts will run on television, radio and online for eight weeks, beginning 5 March.

‘Cervical Screening Saves Lives’ is backed by Loose Women presenter Christine Lampard who said she will encourage her daughter, Patsy, to go for screening when she is eligible to do so.

“I can’t say I’m thrilled when my cervical screening invite is posted through my door, but I know how important it is that I get tested. It’s an awkward five minutes that could save your life,” she said.

“As a mother, I will never ignore my screening invitation and when my daughter, Patsy, is old enough, I’ll encourage her to attend her screenings too. As women we should talk positively about our bodies and the importance of cervical screening – it’s an important way to protect our health.”

The campaign is supported by a number of charities, including Jo’s Cervical Cancer Trust, Eve Appeal and Lady Garden. Activity includes new advertising on TV and other channels, together with the cascade of information through GP surgeries and pharmacies.

For further information about cervical screening, visit your GP or visit the NHS cervical screening resources. And speak to your friends and family if you’re nervous. Support each other, encourage each other to go and talk about your experiences.

Dr. Cedric Bright discusses his path towards medicine and the current medical landscape

One of the focuses of my blog is STEM (Science, Technology, Engineering and Mathematics), and my most central principle is “Creating Ecosystems of Success”. While we tend to think of clinical medicine as strictly a ‘Healthcare Profession’, its foundations are rooted in the Basic Sciences. Medical Doctors/Physicians are likewise scientists who specialize in patient care and healing sicknesses.

I recently met Dr. Cedric Bright in person through a mutual acquaintance at a family gathering. I’d heard of him through conversation, and I think I’d previously seen him before, as he was among the many physicians on Twitter using the ‘hashtag’ ‘#BlackMenInMedicine’. It turns out that Dr. Bright, the Associate Dean of Admissions at East Carolina University, coincidentally knew Dr. Qiunn Capers, IV, whom I first saw using the hashtag.

At the gathering, Dr. Bright eagerly answered the questions of numerous medical school hopefuls who were in attendance. As they asked him questions, he in turn asked them questions about their preparation, their academic performance, standardized test scores, experiences in clinics and overall ambitions. At the recommendation of the host of the gathering, I listened in on Dr. Bright’s discussions and was fascinated by what he had to say.

With my blog having both education and a science focuses, and with me also knowing many medical school hopefuls, I seized the opportunity to ask Dr. Bright for an interview and he agreed. In the following interview with Dr. Cedric Bright, we discuss his background, his path into medical school and his career, and finally the current landscape of medical education – specifically what medical schools are looking for in prospects. I hope you enjoy the interview as much as I enjoyed doing it.

Anwar Dunbar: Thank you for the opportunity to interview you, Dr. Bright. Medical school has long been the destination for many undergraduates, and many people will love to hear what you have to say about what the journey towards practicing medicine entails. With that, can you talk briefly about yourself? Where are you from? What got you interested in medicine?

Cedric Bright: I’m originally from Winston-Salem, NC. I grew up there and attended a private boarding school. My parents were both public school teachers and believed in trying to give me and my brother every advantage we could have to be the best that we could be. They were of the ilk where, ‘This generation needs to do better than the last generation,’ and my parents made sacrifices for us so that we could go to private boarding schools.

From there I was accepted to Brown University for my undergraduate studies. I returned to attend medical school at the University of North Carolina at Chapel Hill (UNC). I did my ‘Residency’ back at Brown. I stayed on as faculty there for four years, and I wrote a paper which was published in the Journal of the National Medical Association, looking at perceived barriers in medical education by race and gender. That led to me being recruited to Duke University and the Durham VA-Medical Center. I spent 13 years there before I was recruited to come back to Carolina (UNC). I spent eight years at Carolina, and just left three weeks ago to come here to East Carolina.

AD: So, let’s go back to the beginning of your journey. Your parents – were they science teachers or were they teaching other subjects?

CB: They were general public school teachers. My father taught math and science in middle school, and my mother taught second grade in elementary school.

AD: What inspired you to become a medical doctor? Did you have mentor in medicine? Also, are you the first medical doctor in your family?

CB: I’ll tell you that I’m not the first doctor in my family, but I also never met the person who was. He is a distant cousin on my grandmother’s side. I don’t recall hearing stories of him, though I’ve seen pictures. In terms of myself, my father being an educator brought home books for me and my brother to read. It was a series describing what doctors, nurses, engineers, fireman, police, etc., “do”. After reading those books, I decided that I wanted to be a doctor, and my brother wanted to be an engineer. Fast forward 20 years, he’s become an engineer. Fast forward 25 years, I’ve become a doctor.

AD: During your journey, were there any challenges in your undergraduate studies or throughout medical school itself? Or were you a ‘straight A’ student where the road was all set for you?

CB: I was nowhere near a straight A student, but I was a hard worker. My parents put me in some courses that taught me how to study. In doing so, they helped me with my concentration. I probably would’ve been diagnosed as “Attention Deficit Disorder” (ADHD). I still have lot of ADHD tendencies now in my old life.

I learned techniques on how to manage my thoughts, my ability to focus, and even with that I had some academic difficulties. I learned how to use the system – how to ask for help – how to not be afraid to admit that I didn’t know something. I learned how to visit teachers during their office hours, and how to spend time after class working on things. I learned how to ask my colleagues who were willing to help – all those types of things.

I did reasonably well in high school. I particularly did well in Chemistry; my teacher was my football coach. I was quite fond of him and he helped me understand Chemistry very well, such that I did very well in it in college.

I did quite well my freshman year in college. Subsequently, I had the ‘sophomore slump’. I pledged a fraternity the spring semester of my freshman year, and I came back and ‘acted’ that fraternity the first semester of my sophomore year, and my grades summarily crashed. At that same point in time, I decided that I didn’t like Biology anymore and I didn’t want to do Chemistry. I decided that there must be something else that I could major in. Low and behold I’d taken some courses in Film because I’d been interested in it, and so I decided that I’d major in it.

AD: Oh, interesting.

CB: My Pre-Med Advisor said, ‘You don’t have to major in a science to go to medical school,’ and I said, ‘Okay, I’m going to take you at your word on that!’ So, I ended up majoring in Film (Semiotics), and what it taught me was how to understand non-verbal communication, understanding how the body moves and when a person’s body is or isn’t reflective of their verbal statements. Being able to interpret my patients better, I think that helped me in the long-term.

AD: Interesting.

CB: So, I pulled my grades up my next two years after my sophomore year, and I think that’s why I got into medical school. My grade point average (GPA) wasn’t great – it was less than a 3.0 and I’ll leave it at that. I had to take the Medical College Admissions Test (MCAT) three times to get a score that would at least get me noticed. I think the final score that I got was a 27. I only applied to two medical schools and I got into the UNC, which was crazy.

After getting in, I was advised to do a summer program and I’m grateful that I was. It surrounded me with like-minded individuals. The first thing I tell young people today is to make sure you do some type of summer program to surround yourself with other like-minded individuals. They become your colleagues of the future.

AD: Interesting.

CB: The program also helped me to understand the difference between undergraduate-level and graduate-level studying. Had I not done the program, I’m sure that I would’ve had more academic difficulty during my first year.

AD: So, you’re referring to the complexity of thought and….

CB: And the amount of time you must put into it. For instance, I was used to studying maybe an hour or two a day, and then ‘cramming’ towards the end and still being able to get a good grade. You can’t do that in medical school. In medical school you must put in four to five hours every day. You must put in six to eight hours on the weekend – it’s a ‘grind’ and you must get used to that grind. You have to become disciplined and not fall prey to the ‘Jedi-Mind Tricks’ that your classmates would throw on you by saying that they spent the whole weekend hiking the Appalachians. They might have hiked a mile, but they spent the rest of the time studying. They want you to think they didn’t. So learn not to fall for the Jedi-Mind Tricks. Everyone is working hard in medical school.

AD: Jedi-Mind Tricks (laughing). What was your ‘specialty’?

CB: My specialty ended up being ‘Internal Medicine’, but that’s another story.

AD: Okay.

CB: Let me finish this point. I prayed before I got into medical school. I said, ‘Lord, don’t let get into medical school if I’m not going to graduate!’ So, when I got in, that took a load off me because I knew that I’d prayed and that he’d answered my prayers and I knew that I would graduate. The question then became how. I’d done the summer program, but my first semester of medical school, seemingly on every test I was one to two points above passing and I wasn’t ‘killing’ it by any means.

I was the last man on the totem pole probably every time and on every test. At the end of my first semester, I passed three of my courses, but I failed one by less than a half a point. So, I ended up having to remediate that course during the summer, but after coming back from the Christmas break, I realized that I couldn’t do the same work that I’d been doing and working the same way. I had to change my study habits.

For the most part, I’d studied with one of my frat brothers. It worked well, but it didn’t work well enough. So I said let me branch out and see if I can study with some other people. So I started studying with some other people who didn’t look like me and I started finding ways in which they studied that reminded me of the study programs my father had put me in back in the day. I started re-utilizing those study techniques and suddenly, I began to thrive. I had to make an adjustment and go back to a study technique that really helped me out when I was younger, and it turned out to be the elixir that I needed in medical school.

From that point on in my second year, I moved into a house with six to seven other medical students. Each night we’d study until about 10 to 10:30 at night and we’d come out to the common area of this house and have this massive ‘Quiz Bowl’. The whole point of the Quiz Bowl was for me to take the most esoteric fact that I knew and try to stump them, and for them to take the most esoteric fact that they knew and try to stump me.

Now here’s the key Dr. Dunbar. If I stumped them, I had to teach them. And if they stumped me, they had to teach me. The effect of that was that by the time we got to the exam, we’d asked so many questions of each other from so many different perspectives that there weren’t too many questions on the exam that we hadn’t already discussed. So like a ‘rising tide’, we all did very well. What that speaks to is how you work in medical school to get the ‘volume’. It’s not aptitude that impedes people’s progress in medical school, it’s dealing with the volume.

It’s kind of like trying to eat an elephant. If you’ve got one person trying to eat an elephant, it takes a long time to do it. But if you’ve got seven to eight people trying to eat the elephant with everyone describing what they’re biting and how it tastes, the texture of it, you get to know the whole elephant, but you just ate a part of it. Does that make sense to you, sir?

AD: Yes.

CB: So that’s one of the most valuable lessons I’ve ever learned about approaching large volumes of work. If you approached it first being responsible for taking care of your own individual preparation and coming together and working with other individuals who have put in their own individual preparation, you can work very effectively as a group. But it first starts with individual preparation.

AD: Okay, so there’s a component there that requires individual preparation and then there’s a teamwork component there.

CB: That’s correct. The individual preparation gets you to 50%, but that team component gets you to 90%.

AD: That makes sense. When I first got to graduate school, I was used to working by myself, and I discovered that I couldn’t do that and get the grades that I needed. Just quickly, which fraternity did you pledge?

CB: I pledged Omega Psi Phi.

AD: In term of my next question, you discussed this at the gathering where we met, and it really resonated with me. When I was an undergraduate student at Johnson C. Smith University in the late-1990s, many of us pondered practicing medicine, but few of us thoroughly understood what it took to get into medical school. Aside from the academic credentials, what are some of the personal qualities aspiring medical students need to be successful and, in general, what are you all looking for? I remember you saying that you want them to have touched patients before.

CB: That’s true. We want to see that you’ve had a journey of learning about the and the science component, yes, but also about the humanity – doing volunteer service for people less fortunate than yourself. This helps you to understand the social determinants and sometimes the behavioral determinants of health, and how they manifest themselves in our community.

We want you to have spent some time doing some type of hands on patient care, whether its learning how to take blood pressure, learning how to take vital signs in the doctor’s office, or being an Emergency Medical Technician (EMT), and helping to triage patients and get them to the emergency room. Or it could be just driving an ambulance to take people to their regular hospital visits, being a nurse, or being a Certified Nursing Assistant (CNA) doing the hands-on dirty work in the hospital. Lastly, it could be being a pharmacy tech spending time working in a pharmacy where people are coming in asking questions about their medications. And helping them understand the side effects, and reactions from other drugs and things of that nature or being a hospice volunteer to helping people with end of life issues.

These are the types of things we’re looking for hands-on wise. There are a lot of smart people in the world, but there’s a difference between being smart and having intelligence. We’re looking for more intelligent people than we are smart people. Smart people know how to answer questions. They can get a question right all the time, but they don’t know how to talk to people. They don’t know how to deal with the ‘human component’. Intelligence is knowing what you know and being able to apply it to the people in front of you at the right time, for the right person, for the right reasons.

AD: Now in that same vein, if I recall correctly, in terms of determining why students want to attend medical school, you’re not looking for canned, ‘cookie cutter’ answers. You want to hear some depth to their answers, right?

CB: Yes. The ‘depth’ comes in multiple ways. For example, when someone writes about their experiences, I don’t care so much about what they did, I want to know how it made them feel. I want them to be able to share with me if there was a significance that changed their view of death if they worked in a hospice; how they think the healthcare system works as the ‘donut hole’ as it goes to prescription drugs.

I want them to be able to share if they know the significance of how nurses are so overworked and have too many patients, such that a CNA becomes so very important; how to take care of people in the hospital, or how to take care of people in the clinic as a medical assistant. Why (what was your motivation)? What did you feel? What did you observe? What did you learn? That’s more important to me than what you did.

AD: So, this is my last question. The landscape of medical education and medical school, has it changed since you were a student yourself? We have a lot of technology now. People communicate differently. I’m sure the actual medical approaches have changed. Can you talk about how things have changed from then to now?

CB: I think when I was coming through, we didn’t have as many imaging tests and diagnostic procedures, so our touch to the patient became more important. Doing the appropriate physical exam was enough for you to come to a diagnosis. You didn’t have to have an X-ray. You didn’t have to have a ‘CT’, because if you did your exam right, you knew what your exam told you. Now we depend too much on technology to tell us what’s wrong with a person, and it doesn’t always equate to us finding the right answers on how to take care of people.

I also think that our technology and having to ‘keyboard’ so much on these electronic records takes us away from the human touch – the humanity of medicine which is the one-on-one conversation with our patients because we’re too busy ‘charting’. Our eyes don’t meet enough. Patients wait months to come see a doctor, not watch a doctor type. Seeing a doctor means we have eye-to-eye contact and we talk as two human beings intimately in one setting, and I think that’s becoming a lost art in medicine. Doctors are under time crunches to see more patients and to make the same amount of money, or to make more money.

AD: I think that rolls into my last two questions. I know that every student is different, but on average, what are the major learning points for the medical students when they come in, because I imagine that these are all very bright individuals. What are the main things they must learn? Is it what you described for yourself? Or is it something else?

CB: I think the main thing they need to learn is that it’s not their aptitude that’s going to determine their altitude, it’s their attitude. If they come in with the right attitude of wanting to learn, and sacrifice whatever it takes to learn, and not come in with the attitude of, ‘I’m not doing this or, I’m not doing that’. That just doesn’t work in medicine. They also must learn how to deal with failure. The thing about medicine as with all walks of life, Dr. Dunbar, is that we all fall down. There’s no shame in falling down and we shouldn’t fall apart the first time we fail.

But what we should do is learn from the mistakes that we’ve made. Learn from what has occurred, grow and move forward, and get back up. I like to say that there’s no shame in falling down. There is shame in laying there. And don’t let anybody fool you into thinking that their life is perfect. All that is, is a mask. We all fall down. We all have imperfections. We all fall short of the glory.

AD: My high school basketball coach used to tell us that exact same thing about attitude and altitude. My last question is going to be a little more global. Under the Obama Administration, we had the Affordable Care Act (ACA), and now that’s kind of been stripped down. In terms of the medical field itself, do we still have enough doctors? Is it still a thriving field?

CB: It’s very much a thriving field, and there will always be a need for doctors. I wholeheartedly believe in that. Artificial Intelligence will never be able to replace doctors, because they don’t have the touch. There’s more than enough need for physicians and, in many places, we’ve said there’s going to be a shortage of physicians in the future. That’s because we have areas where more physicians are passing away than physicians are being made.

The ‘Baby Boomers’ are probably a third of our physicians that we have in the workforce and they’re retiring at a rate of almost 1,000 every month. So, we’re going into a crisis of having more physicians retiring than those who are graduating. It’s a very interesting dichotomy and the American Association of Medical Colleges has been preparing different reports to show that. I was actually looking at one the other day.

The bottom line is that there’s a two-fold problem. We’re not making enough doctors and doctors are retiring, or we have enough doctors and there’s a maldistribution of doctors. Some would argue that theory. We have enough doctors, but all of our doctors want to practice where there are other doctors. But in actuality, we may need to redistribute them so that they practice in other areas that are rural and have less physicians in that area.

AD: Well, Dr. Bright that’s all the questions that I have. Thank you for your time and for sharing your path and knowledge and expertise about the medical field. A lot of people will benefit from this, and I look forward to doing it again.

Thank you for taking the time to read this interview. If you enjoyed it, you might also enjoy:

Dr. Quinn Capers IV discusses Implicit Bias and the #DropAndGiveMe20 campaign- Draft
Dr. Quinn Capers, IV discusses his path, #BlackMenInMedicine, and the present landscape of medical education
The story of how I earned my STEM degree as a minority
How my HBCU led me to my STEM career
Researching your career revisited: Wisdom from a STEM professor at my HBCU

If you’ve found value here and think it would benefit others, please share it and or leave a comment. Please visit my YouTube channel entitled, Big Discussions76. To receive all of the most up to date content from the Big Words Blog Site, subscribe using the subscription box in the right-hand column in this post and throughout the site. Lastly, follow me on the Big Words Blog Site Facebook page, on Twitter at @BWArePowerful, and on Instagram at @anwaryusef76. While my main areas of focus are Education, STEM and Financial Literacy, there are other blogs/sites I endorse which can be found on that particular page of my site.

Why public health officials have only ever eradicated one disease | Popular Science

Smallpox was successfully eradicated because it fit all the requirements for an eradicable disease: It’s only transmitted person-to-person, the distinctive rash makes diagnosis easy, and the vaccine against it worked incredibly well.

“In addition, there was a great understanding of the disease burden itself,” Goodson says. “Smallpox was horrific. There was lot of death.” The political circumstances were beneficial, as well. At the end of World War II, a number of global organizations formed, which created the opportunity for a global infrastructure under the WHO, he says.

After the eradication of smallpox, efforts turned to polio. The number of cases worldwide has dropped by 99 percent since the late 1980s, and 80 percent of the world’s population, including the United States, now live in regions free of the disease. In 2018, there were only 33 cases reported worldwide. .

But getting the number of cases from a handful to zero comes with its own set of challenges, says Stephen Blount, director of Special Health Projects at the Carter Center, a human rights and public health nonprofit organization started by former president Jimmy Carter.

When the number of cases gets this small, he says, political issues become increasingly important. “It takes more time and energy and effort to find the last one, two, or 20 cases than [to] find them when there are hundreds.” People who make decisions around resource allocation might also see getting rid of the last handful of cases as a low priority, as there are always other conditions having greater impact.

However, Blount says, the last remnants of a disease won’t go away on their own. “It’ll almost certainly start to get bigger if you discontinue the human effort to drive cases down.”

Once a disease is eradicated, there’s no longer a need for a public health infrastructure to try and beat back the progress of a virus: If it’s not around, there’s no need for anyone to be vaccinated. But until the number of disease cases hits zero, researchers must invest similar effort and resources to keep the condition from spreading.

Measles is a prime example of the importance of constant management. Even though the United States’ successful elimination means that the disease is extremely uncommon, it’s important to remember that elimination is not eradication. Right now, maintaining high vaccination rates is the only way to prevent it from creeping back. “If you turn your attention away to another problem, the old problem will just come back,” Blount says.

The America’s eliminated measles in 2016, but the virus has since reemerged, especially in Venezuela, where the state vaccination programs have been interrupted after healthcare infrastructure broke down. Because the virus has been circulating continuously for more than 12 months, by definition, it’s no longer eliminated.

“If you take action for a long period of time, and get numbers down, but stop the intervention, it almost certainly will come back,” Blount says.

After polio is eradicated—which likely isn’t far off, Goodson says—measles is likely the next candidate for focused eradication efforts. It might be an easier task than eradicating polio, he says, because cases are easier to identify and the vaccine is more effective. However, notes Orenstein, the measles is highly infectious, much more so than polio, which adds an additional hurdle.

The Arrogance of Public Health Advocacy

How a lack of humility and scientific rigor have led public health activists into dubious pronouncements on an ever-expanding array of controversial issues, from gun control to gender equality to foreign policy.

Early in my anesthesiology career, I took care of an elderly man who needed knee surgery but who smoked like a chimney. The surgical team feared he would suffer the usual smoker’s complications, so we told him to stop smoking a week before his operation. He refused. In the end we reached a compromise: On the day before surgery he would get by with nicotine patches.

After surgery we noticed him moving all around in bed, craving nicotine, as he had yet to receive his patch that morning. This was actually a good thing, as he risked forming blood clots if he remained immobile. We decided to deny him his patches for a few days to keep him jumpy until he could start physical therapy. Unfortunately, he tricked us: He found a way to sneak cigarettes into his room. His renewed smoking probably caused his incision to heal poorly, since the carbon monoxide in cigarette smoke interferes with oxygen unloading in the tissues. Nevertheless, when I took away his cigarettes he told me to go to hell.

The story is a metaphor for today’s counterproductive policy toward e-cigarettes. Companies like JUUL Labs have created an e-cigarette substitute for smokers to “vape.” Although the substitute contains nicotine, it lacks the carcinogens and carbon monoxide found in “real” cigarette smoke. Despite improvement over traditional cigarettes, many public health experts oppose vaping, thinking it represents more of a gateway to cigarettes than a liberation from them. Nor does the FDA allow e-cigarette makers to advertise their products as being safer than traditional cigarettes. This has caused the public to mistakenly view both products as equally bad.

E-cigarettes are like the nicotine patches in my patient story: While it is best for people to abstain from all cigarettes, better that they use a less dangerous form. The public health activists are like the surgical team that denied the man his patches: In their quest to bring perfect health, they sometimes end up causing worse health. The average American is like my patient: resentful toward those who tell him or her how to live.

Yet my story is also a lead-in to a major difference between doctors and public health activists that has consequences for our politics: Doctors tend to be far more humble than public health activists about what science can accomplish.

I and the other doctors on the surgical team referenced above soon recognized our mistake. We forgot that the foolishness of human beings is limitless; so is the malevolence of chance. The unexpected always happens. In hindsight, we should have just given the man his patch.

Real life often pushes doctors to be practical in this way. Doctors respect science, and most of what they do is anchored in science; but they will ignore science if the situation demands it. In my anesthesiology practice, for example, patient attitudes often force my hand in ways that science would consider suboptimal. In one case I used a breathing tube instead of a facemask to give anesthesia because the patient feared the mask’s pressure on her face would give her wrinkles. The patient had a history of asthma, which made a breathing tube risky, yet she was so nervous about her appearance that I relented. Human beings have certain repetitive characteristics, without which practicing medicine would be impossible; yet each patient has his or her own psychology and even physiology, and this sometimes makes the constancy and logic that one hopes for in medical practice impossible.

Ironically, while public health has a weaker link to science than anesthesiology, it is less humbled by science’s limitations. Indeed, lack of humility has emboldened public health to insert itself into practically every conceivable public policy debate. Along with its traditional menu of concerns, including sanitation and immunization, the public health field now voices opinions on such issues as gun control, mental health, drug abuse, domestic violence, social justice, gender equality, sustainability, wealth redistribution, children’s day care, and foreign policy.

This is arrogance of the long-sighted kind.

Ronald W. Dworkin – The American Interest – Feb 02, 2019

The post The Arrogance of Public Health Advocacy appeared first on RegWatch.

Woman Sues Northwestern Medicine After Her Medical Information Was Posted On Twitter

CHICAGO (CBS) — A woman at the center of a lawsuit says Northwestern Medicine Regional Medical Group did not inform her of a privacy breach of her medical records until she called after seeing the records posted on social media.

Gina Graziano calls it a breach of trust and said Northwestern should have better policies in place.

“I was humiliated,” she said. “Embarrassed.”

Graziano filed a lawsuit against Northwestern Medicine Regional Medical Group, her ex-boyfriend David Wirth and his girlfriend, Jessica Wagner.

“I did not know her,” Graziano said of Wagner. She says she also did not know Wirth and Wagner were dating.

The suit alleges Wagner, a hospital employee, used her credentials to log in and access Graziano’s medical records, charts and files, and then Wirth posted about procedures and treatments Graziano received at Northwestern Medicine Kishwaukee Hospital on social media.

“That point I know, that curiosity intrigued them enough to know more about me, and my name was searched in a database on two separate dates — March 5 and March 6,” Graziano said.

In a letter from Northwestern Medicine to Graziano, the hospital acknowledges after “a thorough investigation” there was “inappropriate access” to her medical record by an employee on March 5 and 6 of last year. The lawsuit says Wagner looked at the records for about 37 minutes and provided them to Wirth.

On March 5 the lawsuit says Wirth put Graziano’s private information on Twitter. A police report says Wagner was fired from Northwestern Medicine because of the incident.

In a video of Wagner being questioned by Bloomingdale Police, she told the officer someone must have used her computer to access the records after she logged in.

“Can you think of any scenario under which somebody else would search for your boyfriend’s ex-girlfriend’s medical history on your computer?” the officer can be heard asking.

“No, and that’s where I am coming to the point that I search a thousand charts a day,” Wagner said in the video.

“It’s a complete invasion of my client’s privacy,” said attorney Ted Diamantopoulos. “When a patient goes to a hospital, they expect to have their medical records private.”

“They were treating me for something I didn’t want anybody to know about,” Graziano said. “Northwestern needs better policies in place for their staff to understand what HIPAA really means.”

A lawyer for Wagner and Wirth did not respond to requests comment.

Neither has been charged with any crime in this case.

Wirth did receive six months’ probation and paid a fine for harassing Graziano in a separate case.

Northwestern issued the the following statement regarding the lawsuit:

“Protecting the confidentiality of patient information is essential to our mission. Employees are trained to comply with privacy laws and face disciplinary action in accordance with our privacy policy for any violation. Regarding this specific incident, we do not comment on pending litigation.”

Eighty-five medical students meet their matches | News Center | Stanford Medicine

Stanford’s 85 students matched in 19 fields of training: 15 in internal medicine, nine in dermatology, seven in general surgery, seven in obstetrics and gynecology, seven in anesthesiology, six in psychiatry, four in neurological surgery, four in radiology/interventional radiology, four in orthopaedic surgery, four in otolaryngology, three in pediatrics, three in emergency medicine, three in radiation oncology, two in plastic surgery, two in urology, two in family medicine, one in neurology, one in child neurology and one in ophthalmology. 

About 25 percent of the matching students will be staying at Stanford for their residencies, Gesundheit said. Another 25 percent will be staying in California but not at Stanford. The rest of the students will go to 13 other states.

It was the sixth Match Day at Stanford for Mijiza Sanchez, EdD, MPA, associate dean for medical student affairs. Her team — including student life manager Tanicia Perry and operations coordinator Dale Lemmerick — produces the event each year, ensuring it is unique for each class and also supportive of every student’s unique experience on such a fateful day.

“Match Day is a very highly charged and emotional event,” Sanchez said. “We provide rooms so that students can open their envelopes in private if they don’t want to do it in the large room.” From orientation to graduation, Sanchez and her team support the students’ progress. “The Office of Medical Student Affairs plays an integral role in each of the matching students reaching this milestone,” she said. “It’s a very happy day for all of us.”

Christian O’Donnell, a fourth-year medical student who had been deployed to Iraq in the 1stInfantry Division in 2004, said he was “excited to move to the next phase of training.” His wife, Raphaelle, was at his side, and his parents, Fred and Peggy, and mother-in-law had also flown in from Boston and Chicago, respectively, to be there.

The envelope, please

As the hour approached, students were directed to the four corners of the room, where their academic advising deans — Susan Knox, MD, PhD, associate professor of radiation oncology; Nounou Taleghani, MD, PhD, clinical associate professor of emergency medicine; Eric Sibley, MD, PhD, professor of pediatric gastroenterology; and Amy Ladd, MD, professor of orthopaedic surgery and the Elsbach-Richards Professor of Surgery — were standing by with the envelopes. After the final seconds of countdown, the balloons dropped from the ceiling and students tore open their red envelopes. 

Hoboken Girl of the Week: Dr. Avisheh Forouzesh {of Advanced Infectious Disease Medical} – Hoboken Girl

Immigrating to the US as a child when you don’t speak the language is a DAUNTING experience. For Dr. Avisheh Forouzesh, however, she took that challenge as a twelve-year-old and made the best of it, always focusing on following her dreams of becoming a doctor. Today, she’s an Infectious Disease Specialist, the owner of her own practice, and an all-around inspiration living in the Mile Square. As this week’s Hoboken Girl of the Week, keep reading to find out all about Dr. Forouzesh’s most unique of specialties, what a typical day for her is like, and what she loves most about living in Hoboken. 

Tell us about yourself.

I am an infectious disease specialist/internist. Advanced Infectious Disease Medical – I opened my practice five years ago, however, I was doing mostly consultations at the hospital, in July 2018 I moved to a new office location and now I’m concentrating on building my outpatient practice.

“Gathering all the information and putting it all together to try to solve the underlying issue, is sort of like solving a puzzle.”

I concentrate more on providing preventative health care and I encourage my patients to be proactive. I believe the best medicine is prevention and hence it’s important to stay up to date with all the preventative screening exams and vaccinations.

Also, as an infectious disease specialist, I see a wide variety of different conditions including skin infections, Lyme Disease and other tick-borne illnesses, flu and viral illnesses, HIV, Hep C, and Hep B. I also provide travel medicine and travel vaccinations and pre-travel counseling.

I first became interested in infectious disease during my residency in internal medicine. I found it fascinating because it required gathering all the information and putting it all together to try to solve the underlying issue, sort of like solving a puzzle.

Who is your biggest source of inspiration? 

My biggest source of inspiration are my parents {they are amazing!} and also my patients; they inspire me to be the best physician I can be for them.

What are your goals for this year? 

My goal for this year is to be able to provide the best medical care to my patients and build my office practice, and also to be more involved in the local community by having lectures and talks at local venues to reach out to more people in the community as a source of information for them.

And to be better at time management. It’s an ever-evolving challenge to balance work/home/social life, but I believe if we can manage our time efficiently it is all possible.

I’m passionate about my field, it’s an ever-evolving field and I feel so lucky that I have the privilege to help people live better, healthier lives and that, honestly, is my passion. Also, on a side note – I love to travel and discover new cultures and to sing.

What does a typical day look like for you? 

A typical day for me includes going to the hospital to make rounds on my patients and then head to the office to see my office patients and vice versa depends on the schedule.

Once I’ve finished seeing my patients I start to f/u {Editor’s Note: f/u = follow up} with patient phone calls and pharmacy phone calls and finish paperwork and call patients with their lab results.

The highs of my day are when I see a really interesting, challenging case that usually really piques my interest. Also, when I hear positive feedback from my patients or when I’m able to make it makes me very happy and fulfilled. The lows of my day are paperwork.

“To accomplish my lifelong dream was a great sense of achievement.”

Once my work day is done, my husband and I try to make time to have dinner together and either watch a movie, or depending on the weather, go out for stroll by the waterfront or we make it a date night and go out to one of our local favorite places to eat or hop on the path and go to the city for a quick bite. Also, sometimes if we both get home at a reasonable hour, we go to the gym together.

What has been the highlight of your career so far?

The highlight in my career was when I finished med school; it was many years of hard work, sleepless nights, and sacrifices — but since it was always my childhood dream to be a doctor, it was a huge sense of achievement.

I came to the US from Iran when I was 12 without speaking any English, so to be able to not only overcome the language barrier but to accomplish my lifelong dream was a great sense of achievement.

What do you do on your days off? 

Days off {you never have real day off once you run your own practice}, however, on my weekend days that I’m not going to the hospital I love to explore new restaurants and just take long walks around the neighborhood or to go to the city with my husband and discover new cafes, restaurants, museums, as well as hang out with friends and family on the weekends. We also take short trips to discover the nearby small cities {loved Cape May}.

Hoboken + Jersey City Favorites

What is your favorite restaurant in Hoboken?

Top 5:

1. The Brass Rail
2. Elysian Cafe
3. My new favorite pizza/Italian place: Zero Otto Uno café
4. Seven Valleys – first Persian food in town – yay
5. La Isla

What’s your favorite boutique in Hoboken?

I don’t have a favorite boutique in town, but I do like Dor L’Dor and Anthropologie.

What do you love most about Hoboken?

Accessibility, walking by the waterfront, the view, and proximity to NYC.

How long have you lived in Hoboken?

I’ve lived and worked in Hoboken for 7 years.

What’s your favorite outdoor place to spend time in Hoboken?

Favorite Outdoor place – Pier A park. House of ‘Que outdoor seats in summer, and Pier 13 on summer nights. Also, I love Little City Books.

What advice would you give to someone just starting out their career? 

Be passionate about what field you want to pursue and do it for the right reasons.

Don’t compare your life to others, we all have a different journey to take and if you love what you do that is the measure of true success.

Be ready to make sacrifices to achieve your goals.

Be humble.

Want to be featured or nominate someone as an upcoming Hoboken Girl of the Week?

Email hello@hobokengirl.com about your/her story.

Written by:

Arielle is a born-and-bred Jersey girl and like a true NJ native, half her diet consists of bagels and the other half pizza. As a graduate of both American University and City, University of London, she’s been a passionate writer ever since she wrote her first “book” in the first grade. When she’s not furiously typing away at her keyboard, she spends her time ticking places off of her “to travel to” list, trying any and all new foods, and trying to stop herself from spending too much money at Zara.

Move Aside, CBD: New Data Finds THC Is the Real Medicine in Medical Marijuana

5 min read

A simple narrative has emerged about cannabis: CBD is the medicine in medical marijuana now available in 33 states and THC is the intoxicant in adult use marijuana available in 10 states. New research suggests that simplistic duality is not shared by people whose opinions can’t be easily overlooked — thousands of patients who use medical marijuana.

Two University of New Mexico researchers, Jacob Miguel Vigil and Sarah See Stith, assistant professor in the University of New Mexico Department of Economics, analyzed data from more than 3,300 medical marijuana patients who use the Releaf app to track how various products — flower, tinctures, edibles, etc. The data showed that regardless of what patients consumed, they got more relief from higher levels of THC while the amount of CBD appeared to be irrelevant.

The app allows patients to easily record the severity of their symptoms, the product they consumed (whole flower, tincture, concentrate, etc), the ratio of THC to CBD listed on the label and the speed and extent of relief from symptoms on a scale of zero to 10 for 27 categories of symptoms ranging from anxiety and depression to chronic pain and seizures. In nearly 20,000 sessions recorded by patients the average symptom improvement was 3.5 points on the 10-point scale, with more relief correlating to higher THC levels. Symptom relief had no correlation with how much or how little CBD was in the product.

“What we are finding goes against the common dogma,” said Stith. “The app is measuring immediate symptom relief, and it might be that CBD has a more subtle, long term effect or that to be of benefit the THC needs a threshold amount of CBD. We just don’t know, but when you compare flower and concentrates the THC is what jumps out as having an effect.”

The patients mostly consumed dried flower, which is usually the least expensive cannabis product available, and that flower was associated with the greatest symptom improvement of any product used, but in whatever form they ingested cannabis the pattern of more THC, regardless of CBD content, correlating with more relief was unchanged.

“Despite the conventional wisdom, both in the popular press and much of the scientific community that only CBD has medical benefits while THC merely makes one high, our results suggest that THC may be more important than CBD in generating therapeutic benefits,” said Vigil. “In our study, CBD appears to have little effect at all, while THC generates measurable improvements in symptom relief.”

Popular belief in the curative properties of CBD drove nearly $600 million in sales in 2018 as the recently legalized but erratically regulated cannabinoid is added to every sort of food, beverage, cream, potion and cure-all. The market for CBD is projected to grow to $22 billion by 2022, according to an analysis by the Brightfield Group.

The most significant regulatory caveat for producers of all things CBD is there must be no THC in the product, a restriction that begins the requirement hemp is legal only if it contains no more than .03 percent THC. The finding that patients reported the best results from smoking or vaping dried whole flower calls into the question assumptions that underlie the industry of isolating CBD for use as an ingredient in health products containing no THC, said Franco Brockelman, founder and CEO of Releaf. He and two other developers of the app, Keenan Keeling and Branden Hall, are co-authors of the study.

“Reformulation makes business sense, but if you think about nature and plants, there is a lot of inherent nature design in cannabis and it’s a bit of hubris to think at this point you can improve on that by dissecting it,” says Brockelman, who is a co-author on the study. “There is a lot to be said for whole-plant medicine and using it that way.”

Brockelman got the idea for app in 2014 when his mother agreed to explore legal medical marijuana after many years and many failed conventional treatments for her psoriatic arthritis. His mother, who had never smoked or drank in her life, received a Massachusetts medical marijuana card that allowed her access to a dispensary but without any guidance for selecting an effective product.

“I thought it would be good to create a company that is entirely patient focused,” Brockelman says. “We realized if we could provide patients with a good journal they could help themselves and we could look at that aggregate data to help dispensaries to know more about their products.”

Releaf has mades the data in anonymous form available to the University of New Mexico researchers for studies that are ongoing. Vigil argued the data already makes a compelling case for federally legalizing THC.

“It is curious that in this big data set THC shines through but that is still the single chemical that is illegal. In this new (Hemp Farming Act) all the thousands of chemicals in the plant are available for research, except THC and that is the one with the most therapeutic potential,” Vigil says.

Maternal gratitude linked to improved medical staff functioning | 2 Minute Medicine

Neonatal intensive care unit (NICU) medical staff who were exposed to maternal expressions of gratitude had higher scores in procedural and therapeutic planning and prosocial behaviors in response to neonatal medical emergency scenarios when compared to medical staff who were exposed to neutral maternal statements.

Evidence Rating: Level 1 (Excellent)

Study Rundown: Interactions in medicine impact medical team cognitive and communication processes. Rudeness, for example, has been associated with lower individual and team diagnostic performance. On the other hand, little is known about the effects of gratitude on medical team functioning. The purpose of this randomized controlled study was to evaluate how expressions of gratitude shape NICU medical staff diagnostic and therapeutic performance and prosocial behaviors. Medical staff reported high perceived levels of gratitude when expressed from mothers compared to the control group (same agent with neutral statement). There was no difference in medical staff perceptions of gratitude when expressed from expert physicians compared to the control group. Teams in the maternal gratitude group demonstrated higher scores for therapy plans, procedures, general therapeutic scores, information sharing, and workload sharing. There were no significant differences between the maternal gratitude and control group with regards to diagnostic scores and confidence in diagnosis. In mediation analysis models, information sharing was found to affect both team and diagnostic procedural performance. For providers, increased face-time with families may allow for exchanges in gratitude that may boost diagnostic/treatment outcomes and prosocial team behaviors.

Study Author, Dr. Arieh Riskin, MD, MHA, talks to 2 Minute Medicine: Department of Neonatology, Bnai Zion Medical Center, Haifa, Israel:

“I think our article is important to read because our findings indicate that while patient/family-expressed gratitude may not necessarily boost the motivation of medical personnel to provide high quality care, it does boost their collective ability to do so. Accordingly, while the encouragement of gratitude and other small, positive interpersonal gestures may demand nothing short of culture change on the part of the medical community and those they serve, our findings suggest that the benefits may well be worth the effort. This reminds me of the Chinese proverb: “Every smile makes you a day younger” – small positive gestures, like expressions of gratitude from our patients and families, make a lot for us, and help us do our work better, providing better care to our patients (in my case our very tiny fragile preemie patients).”

In-Depth [randomized controlled trial]: Teams consisting of 2 physicians and 2 nurses were randomized into 4 video exposure conditions: maternal gratitude (N = 42), expert physician gratitude (N = 43), maternal/expert physician gratitude (N = 40), and control (same agents communicated neutral statements, N = 38). Teams were then directed to identify a diagnosis and establish a treatment plan in four neonatal medicine emergency scenarios. Two NICU staff (senior physician, senior nurse) who were blinded to the exposure condition, then observed and rated team performance on a 5-point Likert scale. Interrater agreement was deemed sufficient (RWG > 0.75). Teams were rated on diagnostic score, therapy plans, procedural score, general therapeutic score, confidence in diagnosis, information and workload sharing. For data analysis, the control data included the neutral group and expert group (N = 22 teams), and the gratitude group included maternal and maternal/expert physician gratitude (N = 21 teams).

Age and team experience did not differ significantly between groups. In validity analysis, medical staff in the maternal gratitude exposure had higher perceived scales of gratitude compared to control (4.8 ± 0.4 vs 4.5 ± 0.6 P < 0.001) – a finding that was not present for the expert physician gratitude group (P > 0.10). There was no significant difference between groups for diagnostic score and confidence in diagnosis. However, the gratitude exposure group in comparison to the control group had higher ratings for therapy plans (3.9 ± 0.9 vs 3.6 ± 1.0, P = 0.08), procedural scores (3.9 ± 0.9 vs 3.6 ± 1.0, P = 0.008), general therapeutic score (3.9 ± 0.9 vs 3.6 ± 1.0, P = 0.04), information sharing ( 4.3 ± 0.8 vs 4.0 ± 0.8, P = 0.03), and workload sharing (4.3 ± 0.8 vs 4.0 ± 0.9, P = 0.02). While the gratitude condition positively affected both information and workload sharing, in mediation analysis, it was primarily information sharing that explained the positive effects of gratitude on diagnostic and procedural performance.

Image: CC

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Learning About Medical Marijuana and Parkinson’s Disease With Dr. James Beck | Westword

For scientists and physicians, medical marijuana is both fascinating and frustrating: While many see the plant’s potential, there’s little clinical research to document the efficacy of MMJ.

Although medical marijuana has been shown to have antioxidant and anti-inflammatory properties that protect brain cells, studies of the plant’s potential in easing the muscle and tremor afflictions of Parkinson’s have registered mixed results — and as with most diseases, the level of cannabis research around Parkinson’s is still extremely limited. Physicians who treat Parkinson’s, however, note that patients are often using cannabis for self-medication whether a doctor recommends it or not, forcing the health-care community to seriously consider medical marijuana despite the plant’s federally illegal status.

The Parkinson’s Foundation, an organization that’s been dedicated to fighting the disease for over six decades, has recently stepped up its involvement with cannabis education and held its first conference on the subject in Denver on March 6 and 7. The conference is closed to the general public, but it marks a new step in studying solutions for the country’s second-most-common neuro-degenerative disease, right behind Alzheimer’s.

Westword checked in with Dr. James Beck, chief scientific officer for the Parkinson’s Foundation, to learn more about what the organization hopes to gain from its time in Denver, as well as what kind of studies need to be done going forward so that medical professionals can properly evaluate the effects of cannabis on Parkinson’s.

Marijuana Deals Near You

Westword: Why choose Denver for the foundation’s first conference about medical marijuana?

Dr. James Beck: We needed a location that is centrally located to ensure that experts from academia, clinics, industry, government and the Parkinson’s disease (PD) community can easily get to our first-ever medical marijuana and PD conference.

Being that the conference is invite-only, is there any way that patients or those interested in medical marijuana and Parkinson’s disease can learn more after the conference?

In addition to Parkinson’s specialists, seven Parkinson’s advocates living with PD will participate in the conference to provide their perspective. The foundation will publish more information and research recommendations for marijuana and PD following the conference this summer on our website, at Parkinson.org/marijuana.

Dr. James Beck
Courtesy of the Parkinson’s Foundation

Is medical marijuana a popular form of self-medication for Parkinson’s disease? If so, why?

In a study we did with Northwestern University, 95 percent of neurologists have been asked to recommend medical marijuana. While it’s never supposed to be used as a substitute to medication, marijuana is a popular topic in the PD community. People with Parkinson’s have reported improvement in pain management, sleep dysfunction, weight loss and nausea after using marijuana. However, clinical studies have not proven that cannabis can directly benefit Parkinson’s symptoms.

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Has there been enough research on medical marijuana and its effects on Parkinson’s disease to form an opinion?

Unfortunately, no. Studies have not clearly supported the use of marijuana for PD, and are often not conducted on a large enough scale; some studies have as few as five subjects. While some study results have been positive, others show the downsides for people with Parkinson’s, like impaired cognition, dizziness and loss of balance. The Parkinson’s Foundation believes in research. Through this conference, we hope to find out if and how medical marijuana can make life better for people with Parkinson’s. Getting experts together in one room can get us on the path to make research recommendations that can lead to answers.

What specific areas of research regarding Parkinson’s disease and medical marijuana need to be expanded upon most?

We need research to help us determine how medical marijuana should be administered and how its long-term use can affect PD symptoms. There are hundreds of strains and various ways to use medical marijuana, and it can all differ from state to state. To ensure safety for people who use medical marijuana, states that legalize medical marijuana will eventually need to develop training programs for doctors and medical teams that prescribe medical marijuana.

Thomas Mitchell has written about all things cannabis for Westword since 2014, covering sports, real estate and general news along the way for publications such as the Arizona Republic, Inman and Fox Sports. He’s currently the cannabis editor for westword.com.