Health

May Physician Focus: Diabetes: Persistent Epidemic

Posted in Health, Physician Focus, Public Health on May 1st, 2015 by MMS Communications – Comments Off on May Physician Focus: Diabetes: Persistent Epidemic

Diabetes continues to be one of the most prevalent chronic conditions affecting Americans. Since 1980, the incidence of the disease has tripled; it now affects nearly 20 million adults 18 and older, according to the U.S. Centers for Disease Control and Prevention. And its spread is likely to continue: another 86 million Americans are living with pre-diabetes, and 90 percent of those are unaware of their condition.

The May episode of Physician Focus examines the current state of diabetes in the U.S., how and why it’s become so prevalent, and treatments for the condition. Guest is Michael Thompson, M.D., (right, photo) Ambulatory Physician Leader for the Diabetes Center of Excellence at UMass Memorial Health Care and Chief of Adult Diabetes Clinical Research at UMass Memorial Medical Center. Hosting this edition is primary care physician Bruce Karlin, M.D. (left, photo).

Among the topics of discussions are the risk factors, symptoms, and complications of the disease; how it is diagnosed; the importance of the hemoglobin A1C test; weight-loss surgery as a cure for diabetes; specific treatments for the disease; and the differences between Type 1 and Type 2 diabetes.

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus, and on YouTube.

April Physician Focus: The Causes of Cancer

Posted in Health, Physician Focus on April 2nd, 2015 by MMS Communications – Comments Off on April Physician Focus: The Causes of Cancer

Cancer is perhaps the diagnosis patients fear the most. Treatments can be long and exhausting, and the disease can bring anxiety and uncertainty for patients and their families. The disease is the second-leading cause of death in the U.S., surpassed only by heart disease, and claims nearly 600,000 lives each year. The American Cancer Society projects more than 1.6 million new cases of the disease will be diagnosed this year.

A recent study indicated that most cancers are the result of just “bad luck” in how our cells multiply and mutate, yet long-standing research shows that genetics, lifestyle issues, and environmental factors play important roles in developing cancer.

Public surveys, however, have shown a lack of understanding and many misperceptions about the causes of cancer. To raise public awareness about this common condition, the April edition of Physician Focus features Robb Friedman, M.D., (photo, right) a board-certified oncologist and hematologist and Director of The Cancer Center at Beth Israel Deaconess Medical Center in Needham, who joins program host Dale Magee, M.D., (left) a past president of the Massachusetts Medical Society.

Among the topics of conversation are how cancer develops and what patients can do not only to reduce their risks of getting the disease, but also to prevent some types of cancer from occurring.

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus, and on YouTube.

February Physician Focus: The Physician’s Perspective on Prescription Drug Abuse

Posted in Drug Abuse, Health, opioids, Physician Focus, Public Health on January 30th, 2015 by MMS Communications – Comments Off on February Physician Focus: The Physician’s Perspective on Prescription Drug Abuse

Health and governmental officials at all levels are struggling with solutions to what has become one of the nation’s most pressing public health problems: prescription drug and opiate abuse.

Addiction experts, public officials, and even some physicians, have pointed to the medical profession as one cause of the problem. Physicians write too many prescriptions, they say.  But the fact that more than three out of four people who misuse prescription pain medicines use drugs that are prescribed to someone else is one indication that the problem arises from more than a single cause.

The February edition of Physician Focus, with a discussion among three physicians knowledgeable about the treatment of pain, pain medications, and opioid abuse, offers the perspectives of physicians on prescription drug and opioid abuse.

Participating in this conversation are Richard Pieters, M.D., (center, photo) President of the Massachusetts Medical Society and Professor of Radiation Oncology and Pediatrics at the University of Massachusetts Memorial Medical Center in Worcester; Daniel Alford, M.D., (right) Director of the Safe and Competent Opioid Prescribing Education program at Boston University School of Medicine and the Director of the Clinical Addiction Research and Education Unit at Boston Medical Center; and Barbara Herbert, M.D., (left) Medical Director of Addiction Service at Commonwealth Care Alliance and President-Elect of the Massachusetts Chapter of the American Society of Addiction Medicine, who serves as host for this program.

All three physicians bring their personal experiences in treating patients with pain to the discussion. Among the topics they address are the physicians’ viewpoints on the causes of opiate abuse; the prevalence of pain as a medical condition; the elements of effective and safe pain management; the distinctions among different kinds of pain; what steps physicians and patients can take, both individually and collectively, to reduce the abuse of pain medicines; and how physicians view the use of the prescription drug Narcan to prevent deaths from overdoses.

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.physicianfocus.org, www.massmed.org/physicianfocus, and on  YouTube.

January Physician Focus: Chronic Kidney Disease

Posted in Health, Medicine, Physician Focus, Public Health on December 31st, 2014 by MMS Communications – Comments Off on January Physician Focus: Chronic Kidney Disease

The kidneys are vital organs in the human body, performing such critical functions as cleaning blood, removing waste, and controlling blood pressure. Yet more than 20 million Americans have chronic kidney disease, a serious condition that raises the risks of heart attack, stroke, and end-stage kidney disease.

To create awareness among patients about the condition, Physician Focus begins 2015 with a guest appearance by Martin Gelman, M.D., (photo, right) a board-certified internist and nephrologist who practices at Milford Regional Medical Center and St. Elizabeth’s Medical Center in Boston. He joins program host Bruce Karlin, M.D., (photo, left) a primary care physician in Worcester, in conversation about various aspects of the disease.

Among the topics discussed are the functions of the kidney in the human body, the major causes and effects of chronic kidney disease, who is most at risk for the condition, kidney dialysis and transplants, and a look at what the future might hold in renal replacement therapy with a bio-implantable artificial kidney that has just been approved for clinical trials.

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at  www.massmed.org/physicianfocus, www.physicianfocus.org, and on YouTube.

December Physician Focus: Food and Your Health

Posted in Health, Physician Focus, Public Health on December 1st, 2014 by MMS Communications – Comments Off on December Physician Focus: Food and Your Health

What we eat and drink has an enormous effect on our health, yet for many, it’s one of the least understood and perhaps most neglected areas in health care.

The December edition of Physician Focus – in a two-part program – offers some of the latest information on how food affects our health from nutrition and dietary experts.

Guests are Edward Saltzman, M.D., (center, photo) Academic Dean for Education and Associate Professor of Nutrition at the Tufts University Friedman School of Nutrition Science and Policy and Chief of the Division of Clinical Nutrition at Tufts Medical Center, and Amy Taetzsch, M.S., R.D., L.D.N., (right) a registered dietician and weight loss counselor in the Energy Metabolism Lab at the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University. Hosting this program is primary care physician Bruce Karlin, M.D. (left).

Among the topics of discussion are the elements of a healthy diet, the link between food and chronic disease, how consumers can make more informed choices about the foods they buy and eat, and expert opinions on more than a dozen individual topics, including gluten, vitamins, probiotics, “super foods,” genetically modified organisms, and organic food.

Physician Focus is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.massmed.org/physicianfocus, www.physicianfocus.org, and on YouTube (part one) and YouTube (part two)

November Physician Focus: Managing Your Chronic Disease

Posted in Health, Physician Focus, Primary Care on October 31st, 2014 by MMS Communications – Comments Off on November Physician Focus: Managing Your Chronic Disease

Chronic diseases such as asthma, heart disease, arthritis, and diabetes affect about half of all American adults, and their incidence is likely to increase as members of the baby boom generation reach the ages when chronic diseases become more prevalent.

Traditional care for these conditions has centered on the physician’s role, but a new model of care is emerging: that of patient self-management, where patients, in partnership with their physicians, become their own principal caregiver.

The November edition of Physician Focus examines this new model of care with representatives from the Healthy Living Center of Excellence. Robert Schreiber, M.D., (photo, right), Medical Director, and Jennifer Raymond, J.D., M.B.A., (center) Director of Evidence-Based Programs, join host B. Dale Magee, M.D., (left) a past president of MMS, in discussing the purpose, goals, and benefits of these self-management programs and how physicians and patients can participate.

The Healthy Living Center of Excellence is a collaborative effort of Elder Services of the Merrimack Valley in Lawrence, Mass. and Hebrew Senior Life in Boston. Through regional-based efforts with community organizations, health care providers, health plans, government, and foundations, the Center offers free programs in community-based settings from seven regional centers throughout Massachusetts that help patients 18 years of age and older with chronic conditions manage their own care.

Results of these programs have shown that patients have better health outcomes, better care experiences, better communication with their providers, and are much more able to manage their conditions.

Physician Focus is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.massmed.org/physicianfocus, www.physicianfocus.org, and on YouTube.

The President’s Podium: Reclassification of HCPs Reasonable

Posted in Drug Abuse, Health, opioids, Regulation on August 22nd, 2014 by MMS Communications – Comments Off on The President’s Podium: Reclassification of HCPs Reasonable

By Richard Pieters, M.D., President, Massachusetts Medical Society

The announcement today by the U.S. Drug Enforcement Administration that it is reclassifying hydrocodone combination products (HCPs) to a Schedule II drug – those substances with accepted medical uses deemed to have the highest potential for abuse and harm – is a reasonable step in the fight against prescription drug abuse – and long overdue.

The reclassification does raise important concerns for physicians and patients alike about access to appropriate treatment. Patients may have to make more visits to providers and pharmacists.  Physicians may have to write more prescriptions for shorter durations, and some physicians may prescribe alternative drugs that may be less beneficial or have adverse effects.

The Massachusetts Medical Society shares those concerns.  Physicians – always aware of the need to balance the alleviation of pain and the risks of addiction – recognize that patients who experience severe pain will always require treatment and should be able to get appropriate care and relief.

I have previously written about the challenges of prescription drug abuse, noting that the problem is severe, that addiction is a major public health problem that needs prevention and treatment, and that physicians must be part of the solution at the same time as the care and treatment of our patients remain paramount.

DEA has recognized the critical concern of physicians in issuing its new rule, by clearly stating that it “does not intend for legitimate patients to go without adequate care” and that “controlling HCPs as a schedule II controlled substance should not hinder legitimate access to the medicine.”

Further, DEA recognizes the role and responsibility of the physician in caring for his or her patient: “When a practitioner prescribes a medication that is a controlled substance for a patient,” it writes in its new ruling, “it must be because he/she has made a professional medical determination that it would be medically appropriate for the patient’s medical condition to treat with that specific controlled substance.”

The DEA’s reclassification of the most frequently prescribed opioid in the United States (nearly 137 million prescriptions for HCPs were dispensed in 2013), at the same time acknowledging physician concerns and professional judgment, is a sensible action in the face of a nationwide public health emergency of prescription drug abuse.

The complete DEA rule on the reclassification of HCPs is available here.

The President’s Podium appears periodically on the MMS Blog, offering Dr. Pieters’ commentary on a range of issues in health and medicine. 

Commentary: Baseball, Youth, and Smokeless Tobacco

Posted in Health, Public Health on August 22nd, 2014 by MMS Communications – 1 Comment

By Richard Pieters, M.D. and Anthony Giamberardino, D.M.D.

Versions of the following joint commentary by the presidents of the Massachusetts Medical Society and the Massachusetts Dental Society, calling attention to the dangers of smokeless tobacco, were published in several newspapers across the Commonwealth during July and August. 

Richard Pieters, M.D.

The headlines first came with baseball Hall of Famer Tony Gwynn. His all-too-early death at 54 was attributed to the long-term use of smokeless tobacco.  Now it’s former Red Sox pitcher Curt Schilling, who revealed August 20 that he was diagnosed in February with mouth cancer.  “I do believe without a doubt, unquestionably,” said Schilling when making his condition public, “that chewing [tobacco] is what gave me cancer…I did it for 30 years. It was an addictive habit.” His physician agreed.

Many of us who grew up with the game are used to seeing players chewing tobacco, but a new generation of children watching in the stands and on television may be seeing smokeless tobacco used for the first time. They are the ones most influenced by what baseball players do both on and off the field. And that behavior by professional athletes can be more powerful in shaping behavior than any advertising campaign by the tobacco industry.

Anthony Giamberardino, D.M.D.

Although cigarette smoking in the United States continues to decline, a report from the U.S. Centers for Disease Control and Prevention (CDC) indicates that the use of smokeless tobacco has held steady over the past nine years.  CDC says that 14.7 percent of high-school boys, and 8.8 percent of all high-school students, reported using smokeless products in 2013.

The CDC further states that smokeless tobacco contains 28 carcinogens, which can cause gum disease, stained teeth and tongue, a dulled sense of taste and smell, slow healing after a tooth extraction, and, worst of all, oral cancer.

Smokeless tobacco is not harmless. According to the National Institute on Drug Abuse, it delivers more nicotine than cigarettes and stays in the bloodstream longer. Clearly, tobacco use is both a serious medical problem, as well as an oral health problem.

In a letter to baseball commissioner Bud Selig following the death of Tony Gwynn, nine leading health care organizations, including the American Medical Association and the American Dental Association, stated, “Use of smokeless tobacco endangers the health of major league ballplayers. It also sets a terrible example for the millions of young people who watch baseball at the ballpark or on TV and often see players and managers using tobacco.”

Oral cancer continues to be a serious problem in the U.S. More than 30,000 new cases are diagnosed each year, and the five-year survival rate is only around 50 percent. While a batting average of .500 would be considered outstanding in baseball, 50/50 odds aren’t very good in the game of life.

The connection between oral health and overall health is well documented. What happens in the mouth can affect the entire body. Physicians are now being trained to examine the mouth and to work with dentists to make patients more aware of the importance of oral health as it affects their overall health and well-being.

Programs such as the Massachusetts Dental Society’s Connect the Dots, in which physicians and dentists work together in the community, and the Massachusetts Medical Society’s establishment of a Committee on Oral Health mark the beginning of a growing relationship between physicians and dentists to promote oral health in the Commonwealth.

But oral cancer isn’t the only health risk from smokeless tobacco. Users have an increased risk of heart disease, high blood pressure, heart attacks, and strokes.

Many health issues are preventable, especially those related to tobacco use. The medical and dental professions can play a key role by providing education and screening for oral cancer.

Major league baseball players have an important opportunity to contribute to this educational process by aiding in prevention efforts, particularly aimed at impressionable young people. For the past four years, the Massachusetts Dental Society, in partnership with NESN and the Boston Red Sox, has produced TV campaigns on the dangers of smokeless tobacco.

The Massachusetts Medical Society and the Massachusetts Dental Society are committed to reducing tobacco use in all its forms and welcome the continued participation of the Red Sox and all of major league baseball. In 2014, chewing tobacco continues to be as much a symbol of baseball as the actual action on the field.

For the health of our children, shouldn’t this image of our national pastime now be considered past its time? The cases of Tony Gwynn and Curt Schilling should serve as a warning to us all.

Richard Pieters, M.D., a radiation oncologist at the University of Massachusetts Memorial Medical Center in Worcester, is president of the Massachusetts Medical Society. Anthony Giamberardino, D.M.D. practices general dentistry in Medford and is president of the Massachusetts Dental Society.

 

Physician Focus for July: Boards of Health

Posted in Health, Physician Focus, Public Health on July 1st, 2014 by MMS Communications – Comments Off on Physician Focus for July: Boards of Health

In 1799, Paul Revere was appointed chairman of the Commonwealth’s first Board of Health in Boston and was given broad authority to control deadly epidemics and environmental contamination. More than 200 years later, today’s health boards, while charged with many more responsibilities, have much the same purpose: to provide for the public’s health and safety.  They have been given the obligation and authority by the state legislature to protect the public health and welfare, similar to powers given to local police and fire departments.

The July episode of Physician Focus examines how public health efforts are conducted at the community level with senior executives of the Massachusetts Association of Health Boards (MAHB).  The program discusses the responsibilities of the boards, their enforcement powers, how they’re managed and operated, the challenges they face in performing their duties, how they balance individual rights and behaviors while maintaining standards of health and safety for the entire community, and how they relate to other local and state agencies.

Guests are Christopher Quinn, M.D. (photo, center) and Ms. Cheryl Sbarra (right).  Dr. Quinn is Director of Occupational Health Services at Sturdy Memorial Hospital in Attleboro, Mass., a physician with the Attleboro Health Department, and President of MAHB. Ms. Sbarra is the staff attorney for MAHB and provides legal consultation, policy guidance and technical assistance to boards of health and municipal governments throughout the Commonwealth.  Hosting this edition is B. Dale Magee, M.D. (left), MMS past president.

Physician Focus is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.massmed.org/physicianfocus, www.physicianfocus.org and on YouTube. 

June Physician Focus: Infectious Diseases

Posted in Health, Physician Focus, Public Health, Uncategorized on May 30th, 2014 by MMS Communications – Comments Off on June Physician Focus: Infectious Diseases

Measles has hit a 20-year high in the U.S., and mumps and whooping cough are likewise reappearing with disturbing frequency.  Warm weather approaches, raising the threat of mosquito- and tick borne illnesses, and new, emerging diseases such MERS and dengue are now reaching the U.S.

A stubborn resistance to immunization, global travel, and the seasonal return of mosquitoes and ticks are contributing to an increased threat of infectious disease this year.

The June episode of Physician Focus highlights several common and emerging infectious diseases, discussing their origins, symptoms, effects on health, and the steps patients can take to safeguard themselves from infection.  The conversation also covers the critical role vaccines play in preventing infectious diseases and what people should do prior to international travel to minimize the risk of disease.

The guest for this program is infectious disease specialist George Abraham, M.D., M.P.H., F.A.C.P. (seated, photo), who joins program host B. Dale Magee, M.D., past president of the MMS for the discussion.  Dr. Abraham is Associate Chief of Medicine at Saint Vincent Hospital in Worcester, Professor of Medicine at the University of Massachusetts Medical School, and Massachusetts Governor for the American College of Physicians.

Dr. Abraham earned a master’s degree in public health in infectious disease epidemiology from the Johns Hopkins School of Public Health and has served as a World Health Organization fellow in HIV disease in Uganda and as an infectious disease fellow at the Communicable Disease Center in Singapore.

Physician Focus is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.massmed.org/physicianfocus, www.physicianfocus.org, and on YouTube.