Tag Archives: Medicine

Krauss Honored For Science

Scientific internship helps build Arizona’s biomedical workforce

Arizona’s future leaders in biology and medicine graduated today from one of the nation’s premier scientific internship programs, sponsored by Helios Education Foundation and the Translational Genomics Research Institute (TGen).

The 45 interns in the 2013 Helios Scholars at TGen summer internship program completed eight weeks of biomedical investigations and presented their findings at a daylong scientific symposium July 26 at the Renaissance Phoenix Downtown Hotel.
Under the mentorship of TGen researchers – who provide one-on-one instruction – Helios Scholars use cutting-edge technology to help discover the genetic causes of diseases such as diabetes, Alzheimer’s disease and cancer.

This is the seventh class of Helios Scholars at TGen, funded for 25 years by Helios Education Foundation. Helios is focused on creating opportunities for individuals to succeed in postsecondary education by advancing the academic preparedness of all students and fostering a high-expectations, college-going culture in Arizona and Florida.

“TGen’s summer intern program is one of the premier examples of how students can become immersed in the sciences and see a real connection between the work they’re doing in labs and future career opportunities in the field,” said Helios Education Foundation President and CEO Paul Luna. “At Helios Education Foundation, we believe in the transformational power of education. The Helios Scholars at TGen program is helping prepare students for academic success while potentially making scientific breakthroughs that could improve the lives of future generations.”

The program is open to high school, undergraduate and graduate level students, including those in medical school.

“Our partnership with the Helios Education Foundation is helping prepare a whole new generation of biomedical investigators for Arizona,” said Dr. Jeffrey Trent, TGen’s President and Research Director. “We help them explore the biosciences beyond the classroom, honing their skills through participating in potentially life-changing research projects.”

The internships help students from diverse backgrounds – selected from a competitive pool of nearly 500 applicants – sharpen their research skills as they prepare for careers in science and medicine.

In addition to technical skills, students participate in professional development seminars that broaden their knowledge and skills in science communication, networking, career development, business etiquette and public speaking. The ultimate goal of the seminars is to produce savvy, polished future scientists and physicians.

“Many of this year’s Helios Scholars were born after the start of the Human Genome Project,” said Brandy Wells, TGen’s Manager of Science Education and Outreach. “These students of the genome-age are torchbearers for future medical discoveries, based on a precise understanding of the genetic underpinnings of human disease.”

The program application opens in January of each year for the following summer at www.tgen.org/intern.

My Electronic Pillbox can help with complex medicine regimes

Cheap medicine more vital, study reveals

People may think it’s more vital to take their medicine, if that medicine is cheap. A new study from the W. P. Carey School of Business at Arizona State University shows consumers believe prices for lifesaving products are based on need and not profit. Therefore, they often assume their risk of getting a serious illness is higher when the medicine is less expensive, and they’re also more likely to plan to get the treatment, including flu shots.

“We find that people have a fundamental belief that everyone should have access to lifesaving care, such as vaccines, doctor’s visits, screening tests like mammograms, and cancer treatments,” says Assistant Professor Adriana Samper of the W. P. Carey School of Business. “Nobody wants anyone to die because they didn’t have the resources to cover the treatment. Therefore, they believe communal pricing (based on need), rather than the normal market pricing for other goods, applies in these situations. They expect medicine for a serious illness to be inexpensive.”

Samper’s new marketing study, co-authored with Assistant Professor Janet Schwartz of Tulane University, will appear in the April edition of the Journal of Consumer Research. In a series of experiments, the researchers demonstrated several interesting points about medication pricing, and those points held true, even if insurance — not the consumer — was going to pay for the treatments.

In the first experiment, participants in an online study were asked to evaluate 10 products and services based on whether they were priced for “communal” purposes or market value. Vaccines, doctor’s visits and drugs used to prevent serious illnesses all ranked as being driven by communal pricing, while items like tax-preparation services, restaurant menu items and home electronics all ranked as market-driven.

In the next experiment, online participants were asked about a fictitious cream described as either preventing skin cancer or preventing age spots. The cream was also offered at a low price of $25 or a high price of $250. Price had no effect on attitudes toward the cosmetic cream, but when the skin-cancer treatment was only $25, respondents believed they needed it more — that they were at higher risk for the disease.

“We see the same thing for a flu shot,” says Samper. “People are more concerned about getting the disease and addressing prevention if the vaccine is cheaper. That’s an important note for health officials during our especially tough flu season right now.”

A third experiment showed participants an ad for the same cream, with the same image, but slightly different versions of text, again reflecting whether the cream was for skin-cancer prevention or cosmetic purposes. The two different price points were offered in each case. Consumers were much more likely to keep reading the ad and planned to pursue the treatment in the case where the cream was for skin cancer and the price was lower. This happened even when insurance was going to pay for the cream at either price.

“This implies a possible problem with the recent push for price transparency,” adds Samper. “In some cases, high prices may signal lower self-risk, and people may not think it’s important to get needed treatments just because the cost is high.”

In the last experiment, the researchers tested the effects of different types of messages meant to encourage people to get flu shots. They used the two prices again and also varied whether the flu’s consequences were described as self-focused — such as missing work or paying medical bills if you got the flu — or societally-focused — such as getting other people sick or hurting economic productivity with the flu’s spread. Very clearly, individuals again increased their assumption of risk and intentions to get the vaccine in response to lower price, but only when the message focused on personal consequences of the flu.

“Therefore, public health officials should take note: Ads emphasizing the protection of other people do not appear to convince people to get vaccinated,” say Samper. “People respond best to messages that emphasize how illness will personally affect them.”

The full study can be found at http://www.jstor.org/stable/info/10.1086/668639.

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SCNM sets enrollment record

A record number of students have enrolled for the Fall 2012 starting class at the Southwest College of Naturopathic Medicine & Health Sciences (SCNM), continuing a consistent growth trend showing a 60 percent increase since 2008.

Nearly new 100 students have been accepted into the medical college’s four-year naturopathic physician degree program, which begins Oct. 1 at 2140 E. Broadway Rd. in Tempe, bringing the total number of students to 412.  Students accepted into the program must have previously earned a bachelor’s degree and completed science, English and humanities prerequisite coursework.

“During the past five years, there has been a steady increase in interest in naturopathic medicine and careers as naturopathic physicians,” said Melissa Winquist, SCNM Vice President of Student Affairs.  “We receive more than 8,000 inquiries a year into our program.  Students graduating from SCNM are the highest-trained experts in natural medicine.”

In 2008, 60 students were accepted into the fall class.  The next year, the number increased to 70, to 81 in 2010, 86 in 2009 and 97 this year.   Students this fall represent 27 states and Canada, where eight students live.  There are 26 students from Arizona.

Winquist said students spend the first two years studying basic sciences complemented by clinical observations.  Students begin seeing patients in their third and fourth years.  One-year post-graduate residencies provide hands-on practical experience.

SCNM, one of only five naturopathic colleges in the nation, will celebrate its 20th anniversary in 2013.

The college’s faculty includes naturopathic physicians, medical doctors, osteopaths, PhDs, and acupuncturists who teach in disciplines that include physical medicine, homeopathy, botanical medicine, mind-body medicine and environmental medicine.

“We train physicians by combining the best of conventional and alternative therapies with an emphasis on prevention,” said SCNM President and CEO Paul Mittman, ND, EdD.  “Our integrated curriculum exposes students to a diversity of medical knowledge, clinical applications, lab work and patient care that concentrates on whole-patient wellness to find the underlying causes of a patient’s condition rather than focusing strictly on symptomatic treatment.”

The college holds two open houses each year, called Discovery Days, when individuals interested in attending SCNM can learn more about the programs and the public can learn more about naturopathic medicine. Doctors will discuss natural options for pain management, fatigue, thyroid issues and digestion, among other subjects, and free activities include blood pressure checks, herb tea and green protein drink tastings, pulse ear acupuncture and chair massages.

The next Discovery Day is scheduled from 8:30 a.m. to 3:30 p.m. on Saturday, Nov. 3 on the campus in Tempe.

For information, visit www.scnm.edu.

Clinics help workers stay on the job

Convenience Care Clinics Help Workers Get Back On The Job Faster

While we all expect quality health care to be available when it’s needed, our future could be flat lining. According to the Association of American Medical Colleges, meager graduation and physician training rates in our country could cause a shortage of up to 150,000 doctors within the next 15 years.  As many of us are aware, Arizona already is battling an on-going primary care physician shortage, which will cause wait times and delays in care to grow in the coming years.  Because of this, no-appointment convenience care clinics have become an important and growing part of our healthcare landscape.

The Rand Corp. recently performed a survey which showed that convenience care clinics staffed by nurse practitioners or physicians assistants can treat acute, everyday illnesses in a way that is quick, convenient and significantly more affordable for the patient, without sacrificing quality. Convenience care clinics have shorter wait times than emergency rooms, help people avoid lengthy physician appointment scheduling delays, and in some cases, require a payment that is less than an office visit co-pay or co-insurance.  In short, convenience care clinics help people with minor illnesses return to good health and get back to their daily routine, and are efficient in doing so.

There are now 1,200 quick-care clinics operating in 32 states, according to the Convenient Care Association. In Arizona, Cigna Medical Group has opened nine CMG CareToday clinics since 2007, with at least two more planned this year and a newly opened facility off of the Metro Light Rail in down town Phoenix. Other health care organizations – including some Arizona hospitals – are recognizing that this facility model can help direct people to the right health resource based on the severity or simplicity of their symptoms.

According to the National Center for Health Statistics, seven of the 10 most common reasons people go to the doctor are for minor needs that can be successfully treated by a physician’s assistant or nurse practitioner. Yet to function optimally, the providers in convenience care clinics should be integrated into a large medical group or health system in two ways.  First, they should be programmatically linked with supporting primary care physicians in order to make the treatment of patients more effective.  Secondly, they should share electronic health records with these same primary care physicians to have direct access to the detailed patient records prior to providing the acute care and to communicate back to the physician who is providing ongoing care.  If a system like this were in place at more neighborhood walk-in clinics, it would become easier for patients to go to a convenience care clinic for quick treatment, and still be sure that their primary care physician will be updated about any important changes in their health.

Not only is this critical in our personal lives, but access to healthcare (or delays to it) also has deep implications in the workplace. During this time where businesses are facing a great deal of economic stress, many offices are operating as leanly as possible and the absence of just one sick co-worker disturbs an entire department.  Because of this fact, employees are trying to be fully productive.

According to a 2008 survey conducted by Yankelovich for CIGNA, about 61 percent of U.S. workers said they reported for duty while they were sick or coping with family and personal matters.  On average, they did this more than twice as often as they missed work.  Employees who are ill at work are not fully “at work.” Their productivity, morale and concentration drops. Employees realize that presenteeism affects the workplace. In the same survey, 62 percent said they were less productive on those days they came to work too distracted to perform at their fullest potential. Yet, convenience care clinics – especially when located near dense, urban employment hubs – make it possible for employees to receive medical care near the office and return to work that same hour, or return home with medicine in hand to assist a speedy recovery.

This convenience care clinic model is proving to be effective and under demand in Arizona because more than ever before, greater health care access is crucial. Arizona continues to experience a shortage of primary care doctors, with a physician-to-population ratio that is below the national average, according to the American Medical Association.

It is our hope that more healthcare organizations, employers and individuals will help advance a new, stratified level of service: convenience care clinics for minor ailments, physician offices for more complex or specialty needs, urgent care centers for serious wounds or injuries, and quality emergency rooms for life-threatening needs.

A cooperative effort toward better public education and understanding as to which type of facility to seek for the appropriate  level of care would be a valuable step towards preventing over-crowding at emergency rooms and physician offices. Such an effort would assure that each type of facility provides the right care at the right time when patients come through the door. This adaptability, along with innovation, can give the customer quality care every time.

At your service 2008

At Your Service

By Kerry Duff

When Margret Thomas of Tucson was suffering from an agonizing headache in the middle of the night, her husband, Harold, called their primary care physician on his cell phone. The doctor met them at the hospital and an hour later she was in surgery having a brain aneurysm removed. Without the surgery, Margret would have died.

The Thomases were able to reach their doctor after hours because they contract directly with Dr. Steven D. Knope, an internist and sports medicine expert in Tucson, for concierge medical care. The couple pays him an annual out-of-pocket fee in exchange for personalized medical services such as 24/7 accessibility by beeper or cell phone and house calls.

“My wife and I can’t live without Dr. Knope,” says 76-year-old Harold. “Whether we’re at home in Tucson, Cincinnati or somewhere else, we can call him day or night and he gets back to us in 10 minutes or less. That’s worth a lot to us. A concierge doctor is like having insurance.”

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Knope has been a concierge physician in the Tucson area for eight years. He has 125 patients that pay $6,000, or $10,000 per couple for concierge care. The fee includes a two-hour comprehensive physical, stress test, full cancer screening, health and fitness consultation and a personalized exercise and nutrition program. The doctor also accompanies patients to see specialists, and if they are hospitalized, he is the attending physician at the hospital — not a hospitalist who is unfamiliar with their health care, he says.

“Concierge medicine is very much patient driven,” Knope says. “Patients want a different model of care today and they’re willing to pay for it. The difference between concierge medicine and fast-food medicine is that the concierge doctor has time to perform correctly. If a doctor only has seven minutes to deal with a complex patient, he can only do so much. Doctors need time with their patients to do a good job.”

Scottsdale internist and geriatric physician, Scott Bernstein, converted his 2,000-patient practice to concierge medicine in July. What pushed him in that direction, he says, were Medicare constraints and the rising costs of running his practice.

“I was being squeezed from both ends,” Bernstein admits. “Now my patients and I contract directly without the constraints of the Medicare program. I can see patients the same day they call and I have time to provide the type of care they need and I want to provide. I can also do house calls and telephone appointments, which are not covered by Medicare.”

Bernstein sent a letter to his patients in April to let them know he was converting to concierge medicine. Since then, more than 200 people have joined the practice and agreed to pay his $2,000 annual fee.

“It was very bold to make this kind of change after working so hard for 12 years to build my practice,” he says. “I had to say goodbye to 80 percent of my patients and that was scary. But now I couldn’t be more thrilled. I give my patients the time and care they need, and most nights I have dinner with my family, which never happened before.”

Douglas Liebman of Scottsdale, a longtime patient of Dr. Bernstein’s, says he fully supports this type of care, but had to carefully weigh the costs before making a decision.

“I had to think about this carefully because I already have a $2,500 annual payout to Blue Cross Blue Shield,” Liebman says. “But then I realized that staying with Dr. Bernstein was a quality decision at any cost because it concerns my health care. He is genuinely concerned about my well-being and that’s really important to me. I also like being able to reach him after hours and weekends. But what I like most is the house calls. In the world of medicine today, it’s amazing that a doctor will come to your house if you can’t make it to the office.”

Bernstein transitioned to concierge care with the help of Dr. Helene Wechsler, a family physician in Scottsdale, who after 15 years of being in private practice with four other doctors started her own concierge practice in 2004. Wechsler’s practice is limited to 300 patients who pay $2,000 ayear.Patients with children under 18 pay $1,000 annually per child.

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“When I first started practicing 19 years ago, I scheduled patients for 30-minute appointments,” Wechsler says. “But when the healthcare system moved to managed care, I could only see each person 15 minutes or less. In that amount of time you can only treat part of a person and I like to treat the whole person. As a traditional family physician, I also had mountains of paperwork and stress. But I eliminated both when I reduced my patient load and stopped accepting insurance and Medicare. “My concierge practice is peaceful and happy, and when patients walk in the door it’s a pleasant experience,” she adds.