Podcasts about American Medical Association

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Best podcasts about American Medical Association

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Latest podcast episodes about American Medical Association

Becker’s Healthcare Podcast
Navigating Healthcare Leadership: A Conversation with Jim Gilligan, VP of Health System Partnerships at AMA

Becker’s Healthcare Podcast

Play Episode Listen Later Dec 1, 2023 4:50


In this episode, join us for an insightful conversation with Jim Gilligan, Vice President of Health System Partnerships at the American Medical Association (AMA). Jim delves into his extensive professional background and provides a glimpse into his current role at the AMA. As someone deeply engaged with healthcare leaders, Jim shares valuable insights into their primary concerns and elucidates on how the AMA supports them in navigating the dynamic landscape of healthcare. Discover how the AMA opens doors for its partners to actively engage in crucial healthcare policy discussions, fostering collaboration and shaping the future of the industry. Jim also sheds light on what currently excites him the most, offering a compelling glimpse into the evolving world of healthcare. Tune in for a compelling exploration of the intersections between healthcare leadership, policy, and innovation.This episode is sponsored by American Medical Association.

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Toripalimab for Nasopharyngeal Carcinoma, Cervical Cancer Screening Strategies, Obesity Review, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Nov 28, 2023 14:34


Editor's Summary by Mary McGrae McDermott, MD, Deputy Editor of JAMA, the Journal of the American Medical Association, for the November 28, 2023, issue. Related Content: Audio Highlights

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Editor's Summary by Christopher W. Seymour, MD, MSc, Associate Editor of JAMA, the Journal of the American Medical Association, for the November 21, 2023, issue. Related Content: Audio Highlights

Gist Healthcare Daily
Friday, November 17, 2023

Gist Healthcare Daily

Play Episode Listen Later Nov 17, 2023 8:16


The American Medical Association releases its latest policy focuses…including pushing for diabetes drugs to be covered for weight loss. Medicare will cover navigation services for cancer patients under a new rule, And, around 36 million adults in the US have received the updated COVID shot. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The Albany Update with Jason McGuire
Episode 1808: Scholastic Sells Objectionable Books to Students

The Albany Update with Jason McGuire

Play Episode Listen Later Nov 17, 2023 14:38


Thank you for giving this week's episode of the Albany Update a listen. In this week's program we report on a children's book distributor that is selling pornographic materials to kids at school book fairs. Second, the crazy continues. Governor Kathy Hochul signed legislation that conceals a convict's record from people like employers and landlords who might want to know about it. Next up, the state is considering legalizing casino gambling on mobile devices. Then, how about some good news? The American Medical Association is holding the line against physician-assisted suicide. Finally, let's reflect on that first Thanksgiving and learn a lesson for this week's holiday in the process. Let's get started. --- Support this podcast: https://podcasters.spotify.com/pod/show/albanyupdate/support

America's Heroes Group
Ep. 561 - Navigating Aging

America's Heroes Group

Play Episode Listen Later Nov 16, 2023 20:53


This roundtable features Community Outreach, Veteran Legislative Voice, We are Globally Connected with KFF Health News, Military & Veteran Women's Coalition and Combat Sexual Assault.October is Breast Cancer, Mental Health, National Disability, and Domestic Violence Awareness Month Host: Cliff Kelley Co-Host: Col Dr. Damon Arnold Executive Producer: Glenda Smith Digital Media Producer: Ivan Ortega Scout's Honor Productions 5PMWe are Globally Connected with KFF Health News Panelist:Judith Graham, a contributing columnist, writes the “Navigating Aging” column for KFF Health News. She has covered health care for more than 30 years. She's been an investigative reporter, national correspondent and senior health reporter at the Chicago Tribune and a regular contributor to The New York Times' New Old Age blog. Judith was the first topic leader on aging for the Association of Health Care Journalists. Her work has appeared in publications including Stat News, The Washington Post, and the Journal of the American Medical Association. She is a graduate of Harvard College and has a master's in journalism from Columbia University.

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Vitamin C for COVID-19, Stool Test for Colorectal Cancer Screening, USPSTF on Oral Health, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Nov 14, 2023 14:01


Editor's Summary by Anthony Charles, MD, MPH, Associate Editor of JAMA, the Journal of the American Medical Association, for the November 14, 2023, issue. Related Content: Audio Highlights

Ask Dr. Drew
Global Elites Fear A “Population Bomb” Will End Humanity, and They'll Sacrifice You To Save Themselves w/ Dr. Clayton Baker & Dr. Kelly Victory – Ask Dr. Drew – Ep 284

Ask Dr. Drew

Play Episode Listen Later Nov 13, 2023 77:48


If you were a billionaire member of the global elite, and you became convinced that the greatest threat to humanity is overpopulation, how far would you go to “save” your species? In a recent article for Brownstone, Dr. Clayton Baker offers a possible explanation for the strange actions of the world's top health officials and authorities during the pandemic: they think they know something that we don't, and they believe we are too simple to understand the impending danger even if they tried to tell us. “The consensus, reached after lengthy consultations with these men and other luminaries, was that the worldwide human population must be reduced from 8 billion to 500 million units. But how?” writes Dr. Baker in his fictionalized account. War? A bomb? “A plague, a pestilence, a pandemic seemed more promising,” writes Dr. Baker. “Past naturally occurring pandemics had reduced human populations much more successfully than wars.” Dr. Clayton Baker (MD) is an internal medicine physician with a quarter century in clinical practice. He has held numerous academic medical appointments and his work has appeared in many journals, including the Journal of the American Medical Association and the New England Journal of Medicine. From 2012 to 2018 he was Clinical Associate Professor of Medical Humanities and Bioethics at the University of Rochester. Follow him at https://x.com/cjbakermd 「 SPONSORED BY 」 Find out more about the companies that make this show possible and get special discounts on amazing products at https://drdrew.com/sponsors • GENUCEL - Using a proprietary base formulated by a pharmacist, Genucel has created skincare that can dramatically improve the appearance of facial redness and under-eye puffiness. Genucel uses clinical levels of botanical extracts in their cruelty-free, natural, made-in-the-USA line of products. Get an extra discount with promo code DREW at https://genucel.com/drew • COZY EARTH - Trying to think of the right present for someone special? Susan and Drew love Cozy Earth's sheets & clothing made with super-soft viscose from bamboo! Use code DREW to save up to 40% at https://drdrew.com/cozy • PRIMAL LIFE - Dr. Drew recommends Primal Life's 100% natural dental products to improve your mouth. Get a sparkling smile by using natural teeth whitener without harsh chemicals. For a limited time, get 60% off at https://drdrew.com/primal • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at https://twc.health/drew • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get a discount on your first order at https://drdrew.com/paleovalley 「 MEDICAL NOTE 」 The CDC states that COVID-19 vaccines are safe, effective, and reduce your risk of severe illness. You should always consult your personal physician before making any decisions about your health.  「 ABOUT THE SHOW 」 Ask Dr. Drew is produced by Kaleb Nation (https://kalebnation.com) and Susan Pinsky (https://twitter.com/firstladyoflove). This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. 「 ABOUT DR. DREW 」 Dr. Drew is a board-certified physician with over 35 years of national radio, NYT bestselling books, and countless TV shows bearing his name. He's known for Celebrity Rehab (VH1), Teen Mom OG (MTV), Dr. Drew After Dark (YMH), The Masked Singer (FOX), multiple hit podcasts, and the iconic Loveline radio show. Dr. Drew Pinsky received his undergraduate degree from Amherst College and his M.D. from the University of Southern California, School of Medicine. Read more at https://drdrew.com/about Learn more about your ad choices. Visit megaphone.fm/adchoices

EWTN NEWS NIGHTLY
EWTN News Nightly | Friday, November 10, 2023

EWTN NEWS NIGHTLY

Play Episode Listen Later Nov 10, 2023 30:00


The question has been raised whether work permits should be granted to illegal migrants. The American Medical Association may reverse their stance on assisted suicide and take a neutral position. And a whistleblower claims social media giant META is failing to protect teens.

DocsWithDisabilities
Episode 78: Dr. Joanna Bisgrove

DocsWithDisabilities

Play Episode Listen Later Nov 9, 2023 32:27


Interviewee: Dr.  Joanna Turner Bisgrove Interviewer: Dr. Peter Poullos  Description: Today, we are joined by Dr. Joanna Turner Bisgrove. Dr. Bisgrove is a family medicine physician, Assistant Professor in Family Medicine at Rush University Medical Center, and the inaugural chair for the American Medical Association's Disability Advisory Group. Dr. Bisgrove has been involved in healthcare policy for several years and is a staunch advocate for disability inclusion. In this episode, she shares her story as a person with a disability, discusses her leadership at Rush University and in national organizations such as the American Medical Association, and her approach to advocating for students and physicians with disabilities.  Bio: Dr. Joanna Turner Bisgrove is a family physician and assistant professor of family medicine at Rush University Medical Center in Chicago, Illinois.  Prior to joining Rush, she spent the first 14 years of her career near Madison, Wisconsin, and held many local and state leadership positions.  She was medical advisor to her local school district for eight years and co-chaired the Legislative Committee for the Wisconsin Academy of Family Physicians for eight years, frequently working with state and federal legislators and their staff to develop evidence-based public health policy.  At the national level, Dr. Bisgrove is a delegate for the American Academy of Family Physicians to the American Medical Association's (AMA) House of Delegates. She is the inaugural chair for the American Medical Association's Disability Advisory Group, recently formed at the behest of the House of Delegates, the AMA governing and policy making body. The Disability Advisory Group will be tasked with helping the AMA increase accessibility and inclusivity for physicians, medical students and residents with disabilities, both within the AMA itself and as an advocate for increased accessibility across medicine. Dr. Bisgrove is a lifelong advocate for disability inclusion and the elimination of barriers in everyday society to help make this possible.  Born with a hearing loss that has worsened over time, Dr. Bisgrove is acutely aware of the barriers that persons with disabilities face and determined to fight for policies that are inclusive for everyone.   Dr. Bisgrove's other AMA roles include being a current member of the AMA's Council on Science and Public Health. She is also heavily involved in DEI initiatives as a whole. Upon her move home to Illinois in the summer of 2021, Dr. Bisgrove was appointed to the Legislative Affairs Committee of the Illinois State Medical Society and to the Diversity, Equity and Inclusion group of the Illinois Academy of Family Physicians.  At Rush, she is part of Rush's Pursuing Equity Governance Group and its Social Care and Health Equity team.  She is also currently working towards her Masters in Public Health with a focus on achieving health for disadvantaged children and their families.  Transcript: https://bit.ly/DWDI_Podcast_Ep78 Produced by: Lisa Meeks and Pranati Movva Audio editor: Jacob Freeman Digital Media: Katie Sullivan Keywords: disability, health equity, accessibility, family medicine, intersectionality, disability mentoring, medical education, hearing loss, accommodations Website: https://www.docswithdisabilities.org/podcast    

Sarah Westall - Business Game Changers
Mass Genocide ongoing, War is a Racket and COVID was and is a Scam – Sarah Westall w/ Dr. Dave Janda

Sarah Westall - Business Game Changers

Play Episode Listen Later Nov 8, 2023 23:58


Sarah Westall joins Dave Janda on his show Operation Freedom to discuss the war in Israel and the ongoing mass genocide in Gaza. We also discuss how it is impossible for Israel's supreme intelligence service and military to be caught off guard for hours while Israels were brutally murdered.  We lastly discuss the obvious efforts to start World War 3 by the .000001% controlling our world. You can see more of Dave Janda and his powerful radio show, Operation Freedom @ DaveJanda.com   Be sure to sign up for his insider shows and get access to information you will not see anywhere else, period: from former generals, congress members, and other D.C. insiders. Solutions to keep from getting sick and to reverse mRNA damage - Dr. Joe Nieusma Start your Journey towards better Health: ControlYourHealth.care - "You will see for the first time in your life what it feels like to completely nourish your body"!     Dr. Paul Janda Biography: David H. Janda, M.D. is an orthopedic surgeon based in Ann Arbor, Michigan and a member of a nine-member orthopedic surgery group. In addition, Dr. Janda is the director and founder of the Institute for Preventative Sports Medicine, based in Ann Arbor, Michigan, which is the only health care cost containment organization of its kind in North America. Dr. Janda's academic career has been highlighted by many awards and distinctions. In the early years, he was one of the winners of the Westinghouse Science Talent Search Competition, which was conducted in Washington, D.C. In addition, he obtained a Bachelor of Arts Degree majoring in Chemistry and in Economics and graduated Magna Cum Laude from Bucknell University in Lewisburg, Pennsylvania. He obtained his M.D. degree from Northwestern University Medical School in Chicago and served as one of the leaders within the medical school community as a member of the Senate for a three-year duration. Dr. Janda then completed an internship and residency at the University of Michigan in Ann Arbor, and then completed a fellowship in shoulder reconstructive surgery and sports medicine in London, Ontario, Canada. Dr. Janda, in addition to being a clinical orthopedic surgeon, has also distinguished himself in the research arena. One of his more notable works is based on an injury prevention analysis in the most popular team sports in the United States. Dr. Janda was the lead investigator in a series that was published in the Journal of the American Medical Association. The study completed by Dr. Janda and the research team realized a 98% reduction in injuries, along with a 99% reduction in health care costs. Based on an independent analysis by the Center for Disease Control and Prevention, the study translated into a prevention of 1.7 million injuries a year in the United States with a savings of two billion dollars in acute health care costs per year. After leaving the University of Michigan, Dr. Janda founded the Institute for Preventative Sports Medicine. Dr. Janda, through the Institute, has brought together leaders in injury prevention and sports medicine, and continues to produce high quality work that has an impact on the everyday lives of the public at large. Dr. Janda has been awarded the clinical research award by The American Orthopedic Society of Sports Medicine. The Canadian Academy of Sports Medicine has awarded him, the R. Tait McKenzie Award, which is given for outstanding clinical research on an international basis. He has also received recognition by the American Academy of Orthopedic Surgeons for his video presentations and research. In addition, Dr. Janda has had the opportunity to present before a sub-committee of Congress, which led to the utilization of preventative methods to reduce injuries within the Federal Government system. Dr. Janda's research has been given wide exposure by the electronic, as well as print media, and has gained wide public acknowledgement. Dr.

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Adding Tirzepatide vs Prandial Insulin to Basal Insulin, Beta-Blockers in Septic Shock, USPSTF on Oral Health Screening, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Nov 7, 2023 12:19


Editor's Summary by Kristin Walter, MD, MS, Senior Editor of JAMA, the Journal of the American Medical Association, for the November 7, 2023, issue.

Home Base Nation
Two Hats and Camo-Scrubs: A Conversation with US Navy Combat Veteran and Current President of the American Medical Association, Dr. Jesse Ehrenfeld

Home Base Nation

Play Episode Listen Later Nov 7, 2023 19:36


US Navy Combat Veteran Dr. Jesse Ehrenfeld has worn two hats, both literally and figuratively whether donning his surgical cap in the OR, or his camouflage cap down range, and they seem to blend together when you talk with him about humanity, what the right thing to do is when it comes to stigma, equity in healthcare and equality for all, no matter who we are, both at home and abroad. In this episode, host Dr. Ron Hirschberg talks with Dr. Ehrenfeld about his role as the current President of American Medical Association and how his military experience has shaped it, about stigma in mental health, about the fight for rights in the LBGTQ+ community - in and out of the military - and current issues in Israel and Gaza that are on all of our minds.        This episode was recorded on 10-23-23 at Home Base Center of ExcellenceMany thanks to our guest Dr. Jesse Ehrenfeld, Navy Veteran, and current president of the American Medical Association for being on the podcast and your visit to Home Base. Thank you for your service in many ways in the operating room both overseas and stateside, with your work in medical leadership hat that has been shaped by the military hat you have worn over your career.Home Base Nation is the official podcast for Home Base Program for Veterans and Military Families – Our team sees veterans, servicemembers and their families addressing he invisible wounds of war at no cost. If you are your loved one is experiencing any emotional, mental health struggles, you are not alone and please contact Home Base at (617) 724-5202, or visit www.homebase.org.To Donate to Home Base where every dollar goes to the care of veterans and military families that is cost to them, go to: www.homebase.org/donate.Theme music for Home Base Nation: "Rolling the Tree" by The Butler FrogsFollow Home Base on Twitter, Facebook, Instagram, LinkedInThe Home Base Nation Team is Steve Monaco, Army Veteran Kelly Field, Justin Scheinert, Chuck Clough, with COO Michael Allard, Brigadier General Jack Hammond, and Peter Smyth.Producer and Host: Dr. Ron HirschbergAssistant Producer, Editor: Chuck CloughChairman, Home Base Media Lab: Peter SmythHome Base Nation is the official podcast of Home Base Program for Veterans and Military Families, a partnership of the Massachusetts General Hospital and the Red Sox Foundation. To learn more and connect with us at Home Base Nation: www.homebase.org/podcastThe views expressed by guests to the Home Base Nation podcast are their own and their appearance on the program does not imply an endorsement of them or any entity they represent. Views and opinions expressed by guests are those of the guests and do not necessarily reflect the view of the Massachusetts General Hospital, Home Base, the Red Sox Foundation or any of its officials. 

Moving Medicine
Physicians leading through change, with AMA President Jesse Ehrenfeld, MD

Moving Medicine

Play Episode Listen Later Oct 30, 2023 50:53


Physicians today face disinformation, a critical shortage of medical professionals, policies that complicate patient care and more. In this episode, Jesse Ehrenfeld, MD, MPH, president of the American Medical Association explores strategies for addressing these issues with executive vice president at The Permanente Federation, Stephen Parodi, MD. This episode was created in collaboration with Permanente Medicine. Watch it on YouTube here: https://www.youtube.com/watch?v=3kPRxBAQ7ak

Mornings with Carmen
AMA considers supporting assisted suicide – Dr. Jeff Barrows | Helping youth find and keep strong friendships – Calyn and Blythe Daniel

Mornings with Carmen

Play Episode Listen Later Oct 24, 2023 48:33


Dr. Jeff Barrows of Christian Medical and Dental Association talks about the American Medical Association's considerations in support of assisted suicide, following the trend in Canada's growing Medical Assistance in Dying policies.  They also look at research on how faith and prayer can affect our health. Calyn Daniel and her mom Blythe, authors of "Let's Be Friends," talk about the challenges of forming friendships and how we support our kids in their development of strong, healthy friendships. Faith Radio podcasts are made possible by your support. Give now: Click here  

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Traditional Chinese Medicine for STEMI, Early Metformin for Gestational Diabetes, Review of Knee Pain, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Oct 24, 2023 14:13


Editor's Summary by Karen E. Lasser, MD, MPH, Senior Editor of JAMA, the Journal of the American Medical Association, for the October 24/31, 2023, issue. Related Content: Audio Highlights

I Thought You'd Like To Know This, Too
ITEST Webinar Surviving Abortion Inside and Out (October 21, 2023)

I Thought You'd Like To Know This, Too

Play Episode Listen Later Oct 21, 2023 119:02


DR. PATRICK CASTLELIFE Runners President & FounderREAL HEALTHCARE DEFENDS LIFE AT ALL STAGESABSTRACTDid you know that Hippocratic Oath specifically forbids abortion and euthanasia?Did you know the American Medical Association in 1859 unanimously voted that life begins at conception and that abortion is criminal?Did you know that Google makes it more difficult for mothers to find pregnancy help centers online?Did you know that the FDA removed the warning that Plan B can cause an abortion?Did you know that the current administration is working to repeal conscience protections for healthcare workers?Did you know that running is optional for LIFE Runners?And much more!GEORGE DELGADO, M.D.President of Steno InstituteABORTION PILL REVERSAL: GIVING WOMEN A SECOND CHANCE AT LIFEABSTRACTMifepristone chemical abortions account for about 60% of all abortions in the United States. Some women, after starting the chemical abortion process, change their minds and want to continue their pregnancies. Abortion Pill Reversal (APR) utilizes supplemental progesterone, the maintenance hormone of pregnancy, to out-compete the abortion drug. APR offers women a second chance at life. Women offered the option of reversing their chemical abortions are very grateful.Mainstream medical organizations, Planned Parenthood, and the ACLU have fought vigorously to discredit APR and make it less available. The evidence in the medical literature is very reassuring that Abortion Pill Reversal is safe and effective.DR. CYNTHIA TOOLIN-WILSONAcademic Dean – Pontifex UniversitySURVIVING ABORTION AS THE VICTIMABSTRACTThe most important event of my life occurred when I was eleven years old. That was when I found out that Ma and Grandpa tried to kill me, with the knowledge and agreement of many family members, including Pa.On a hot summer evening in her kitchen, Ma told me after several hesitations, that in 1949 Grandpa bought a chemical at the drugstore that would make her lose me. She was annoyed that I didn't understand what that meant. So, she told me that she didn't want a baby and the medicine would make me go away. I asked her why the medicine didn't work, and she explained that when she started bleeding, she was afraid she might die too, so she stopped drinking it. The fact that she was afraid of dying was the second most important event of my life.I never felt the same about her or the family members. I suspect that her cousin, who had married a Catholic man, and had used medicines for years to prevent a pregnancy, had told Ma what medicine to buy.Here I am 62 years later (that is, I am now 73 years old). I am the age my mother was when she passed. My husband Jimmy Toolin, a devout Catholic, died of cancer; my second husband Bill Wilson, who I managed to bring back to being a practicing Catholic, died of heart, liver, and kidney failure. Between them, if I count all the way to great grandchildren, I have 38 descendants.

CHIP Health
The Obesity Dilemma

CHIP Health

Play Episode Listen Later Oct 17, 2023 28:30


The American Medical Association has recognized obesity as a disease. This controversial ruling adds pressure to health officials around the world to rethink how obesity is approached and treated. Dr. Diehl explains.

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Million Hearts Model and CV Events, Eplontersen for ATTRv Amyloidosis Polyneuropathy, Hyperthyroidism Review, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Oct 17, 2023 11:18


Editor's Summary by Kristin Walter, MD, MS, Senior Editor of JAMA, the Journal of the American Medical Association, for the October 17, 2023, issue. Related Content: Audio Highlights

Do you really know?
How does pollution affect my mental health?

Do you really know?

Play Episode Listen Later Oct 11, 2023 5:05


According to the government, air pollution is the “largest environmental risk to public health”, and accounts for between 28,000 and 36,000 deaths each year. But did you know that the air you breathe might be impacting not only your physical health but also your mental well-being? It's the largest environmental risk to public health because harmful pollutants like fine particulate matter, ammonia and nitrogen dioxide get into our bodies, affecting the eyes, nose and throat, heart and blood vessels and the respiratory system. But there are also risks regarding our mental health. A study published in the Journal of the American Medical Association in February 2023 reported on the link between air pollution and psychological disorders. What did the study find? Who can be affected by air pollution? And how can we protect ourselves then? In under 3 minutes, we answer your questions! To listen to the last episodes, you can click here: What is Hugh Jackman's 85% rule? What is burnout? What is the Werther effect? A podcast written and realised by Joseph Chance. In partnership with upday UK. Learn more about your ad choices. Visit megaphone.fm/adchoices

AMA COVID-19 Update
How to avoid burnout in medical education with Charlene Dewey, MD, MEd, MACP

AMA COVID-19 Update

Play Episode Listen Later Oct 10, 2023 14:58


What career has the highest burnout rate? Burnout among physicians, residents and medical students is one of the most pressing problems in medicine. However, medical faculty are also showing signs of burnout. Joining to discuss the current state of educator well-being and what can be done to address it is Charlene Dewey, MD, MEd, MACP, director of the Center for Professional Health and chair of the Faculty Wellness Committee at Vanderbilt University Medical Center. American Medical Association CXO Todd Unger hosts.

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
ICU Decolonization Strategies, Follow Up of Abnormal Cancer Screening Test Results, Bipolar Disorder Review, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Oct 10, 2023 12:08


Editor's Summary by Anne Rentoumis Cappola, MD, ScM, Associate Editor of JAMA, the Journal of the American Medical Association, for the October 10, 2023, issue. Related Content: Audio Highlights

My DPC Story
Episode 146: Understanding the DPC Laws with Jay Keese - Executive Director of DPC Coalition

My DPC Story

Play Episode Listen Later Oct 8, 2023 55:44 Transcription Available


Jay Keese is CEO of Capitol Advocates, a Washington D.C. based policy and advocacy firm specializing in healthcare issues. Jay has represented physicians for decades, starting with a career in government relations at American Medical Association. Over the years, he has won important legislative and regulatory battles for doctors, employers, payers, states, health technologists, hospitals, device and pharmaceutical manufacturers on critical health care delivery and payment reforms. During the COVID-19 pandemic, Jay worked closely with physician groups, Congress and both administrations on critical waivers to state and federal laws that allow practices to fully utilize digital health services such as telehealth and remote patient monitoring to provide better care in a public health emergency.Jay currently runs several national healthcare stakeholder coalitions. He serves as Executive Director of the Direct Primary Care Coalition. He was instrumental in drafting a provision in the Affordable Care Act (ACA) which defines Direct Primary Care (DPC) as a medical service offered outside of insurance which meets ACA Essential Health Benefits criteria. He then played a major role in the passage of over 30 related state laws and regulations clarifying the treatment of DPC medical services and bringing value-based primary care arrangements to Medicaid and State Employees' health programs. He also leads advocacy work for the Partnership to Fight Chronic Disease (PFCD), a coalition of patients, providers, community leaders, businesses, unions, and health policy experts, committed to improving health outcomes and controlling costs by slowing the spread of preventable chronic disease by implementing more value-based payment and delivery reforms. He played a role in shaping many of these innovative reforms in the ACA and has helped implement programs like physician direct contracting with the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center (CMMI).Jay has worked with doctors, health technologists and software manufacturers for decades to support the adoption of health information technology and patient care applications. He worked with a broad bipartisan group of stakeholders on the creation of a risk-based regulatory framework for smartphone apps adopted by the Food and Drug Administration—part of the Food and Drug Administration Safety and Innovation Act (FDASIA). He helped expand and implement many of these principles in provisions included in the 21st Century Cures Act. He began his career as an aide to the late Senator John Heinz (R-PA), a member of the Senate Finance Committee and Chairman of the Senate Aging Committee. Jay has been a guest lecturer at the Georgetown University School of Medicine and serves as an Adjunct Professor of Health Benefit Design at the University of Lynchburg, teaching a master's Download Hint's 2023 Employer Trends in Direct Primary Care here: https://bit.ly/3EZAYej Learn more about Med Mastery: HERESupport the showVisit the DPC SWAG store HERE!Let's get SOCIAL! Follow My DPC Story! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

Sensible Medicine
New Podcast -- Discussion with Rita Redberg and Angela Lu regarding Their Study on Conflict of Interest

Sensible Medicine

Play Episode Listen Later Oct 5, 2023 35:12


Angela Lu is training to be a physician. She's interested in public policy. As a third year medical student, she teamed up with established leaders to ask a unique question regarding public disclosure of financial relationships. When the Centers for Medicare & Medicaid Services (CMS) issues National Coverage Determinations (NCDs) for services or products, they mean business. Such decisions have huge implications. You cannot go against them. Think #HighConsequences.CMS studies the evidence and publishes a proposed decision. It then allows public comments. People care. The idea behind their study, which made it into the Journal of the American Medical Association, was to study how many commenters disclosed their financial conflicts. Dr. Lu went through more than 680 comments submitted on 4 NCDs—all of which were high cost invasive procedures. I won't spoil the conversation, but they found a very high percentages of comments asking to expand indications for these procedures and very very low percentages of people who disclosed their relevant relationships. This study was made possible by the Open Payments database. One important note: disclosure of relationships was voluntary. Enjoy the conversation. Thanks for listening. JMM This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Maintenant, vous savez
Comment la pollution agit-elle sur notre santé mentale ?

Maintenant, vous savez

Play Episode Listen Later Oct 5, 2023 4:22


En février 2023, une étude publiée dans le Journal of the American Medical Association menée sur 10 ans rend compte du lien entre pollution atmosphérique et troubles psychologiques. Au-delà des conséquences physiques, il serait donc important de prendre en compte l'aspect psychologique. Il est largement connu que la pollution provoque diverses pathologies physiques. D'après une étude du ministère de la Santé datant de 2019, la pollution de l'air tue 48 000 personnes par an sur le territoire. 30% de la population serait également atteinte d'allergie respiratoire. Mais cette question de santé publique ne s'arrête pas là. De récentes études sembleraient indiquer qu'elle aurait également des conséquences psychologiques. Comment la pollution fait-elle apparaître ce genre de troubles ? Qui est le plus touché ? Et comment se protéger ? Ecoutez la suite de cet épisode de "Maintenant vous savez". Un podcast Bababam Originals, écrit et réalisé par Samuel Lumbroso. A écouter aussi : Pourquoi la Turquie peine-t-elle à entrer dans l'Union européenne ? Qu'est-ce que le syndrome du visage vide ? D'où vient l'événement Octobre Rose ? Retrouvez tous les épisodes de "Maintenant vous savez". Suivez Bababam sur Instagram. Learn more about your ad choices. Visit megaphone.fm/adchoices

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Ischemic Conditioning for Stroke, Risk-Stratifying Pediatric Ovarian Masses, Adherence to CPAP and CV Events, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Oct 3, 2023 16:22


Editor's Summary by Anthony Charles, MD, MPH, Associate Editor of JAMA, the Journal of the American Medical Association, for the October 3, 2023, issue.

Passionate Pioneers with Mike Biselli
Pioneering Continuous Diagnostic Monitoring with Dr. Agim Beshiri

Passionate Pioneers with Mike Biselli

Play Episode Listen Later Oct 2, 2023 32:24


This episode's Community Champion Sponsor is Catalyst. To virtually tour Catalyst and claim your space on campus, or host an upcoming event: CLICK HERE---Episode Overview: During this episode, we spend time with Dr. Agim Beshiri, Chief Medical Officer of Nutromics, an international leader pioneering continuous diagnostic monitoring to transform personalized care. Bringing over 20 years of clinical and industry expertise, Agim is driven to advance patient-centric precision medicine. While together, Agim shares how Nutromics utilizes synthetic DNA sensors for real-time, first-order molecular recognition. Additionally, Agim unpacks the future of scaling personalized treatment through continuous multiplexed monitoring. We also discuss reinventing antiquated blood testing methodologies and paradigm shifts enabling preventative intervention. Join us as Agim outlines a vision for mimicking implanted diagnostic tools across diverse disease states and to gain inspiration from his dedication to elevating global standards of care through innovative diagnostics. Let's go! Episode Highlights:Agim brings deep medical affairs experience to transform diagnostic testingHow Nutromics uses synthetic DNA sensors for continuous, multiplexed monitoringWays in which Nutromics enables real-time precision dosing adjustments and early interventionsAgim envisions scaling continuous diagnostics across diverse disease statesHow Agim exemplifies commitment to profoundly advancing personalized medicine About our Guest: Agim Beshiri, M.D., is the Chief Medical Officer (CMO) at MedTech startup Nutromics. His passion is in elevating the standard of care for all patients. With over 20 years' experience in the IVD field both in the clinical setting and industry. Dr Beshiri developed methods and collaborations that enabled patient-centric application of diagnostics addressing underserved patients in disease states from cardiology to oncology.A leading industry expert in developing a medical affairs organization and driving medical research and education. With a broad background in internal medicine, hematology, general cardiology, and laboratory medicine, Dr Beshiri initiated and collaborated on research programs resulting in over 800 research collaborations and over 1000 publications.Prior to Nutromics, Dr Beshiri was Senior Medical Director at Abbott Laboratories where he developed supporting their Diagnostics organization for over 16 years. His clinical experience includes the Brooke Army Medical Center in Texas, the 452nd Combat Support Hospital in Wisconsin and Aurora/Advocate Clinical Laboratories in Wisconsin and Illinois, and South-eastern Europe.Dr. Beshiri is a member of several organizations, including the American Medical Association, American Heart Association, European Society of Cardiology, International Society for Laboratory Hematology, European Hematology Association, American Society of Hematology, and American Society of Clinical Oncology. He has also served on guideline subcommittees for the Clinical and Laboratory Standards Institute.Links Supporting This Episode:Nutromics Website: CLICK HEREDr. Agim Beshiri LinkedIn page: CLICK HERENutromics Twitter page: CLICK HERE Mike Biselli LinkedIn page:

The Autoimmune Hour
Reduce Chronic Pain in as Little as 15 Minutes a Day?

The Autoimmune Hour

Play Episode Listen Later Sep 29, 2023 53:08


That's just one of the questions we ask tonight's guest, an expert in the field of clinical pain research, Dr. Afton Hassett, PsyD. She is the author of the new book Chronic Pain Reset: 30 Days of Activities, Practices, and Skills to Help You Thrive.
As a chronic pain researcher, Dr. Hassett noticed while studying established treatments for chronic pain and developing new approaches that exciting research discoveries rarely reach those who could benefit the most. Chronic pain affects nearly 50 million people in the U.S. alone. A recent study in the Journal of the American Medical Association showed that new cases of chronic pain occur even more frequently than new cases of diabetes, hypertension, and depression. Just like autoimmune, chronic, or long-term pain affects all areas of one's life, that's why Dr. Hassett promotes a multipronged approach to pain self-management. 
Research shows that simple, at-home changes, including effective and easy-to-implement habits such as paced breathing, easy sleep hacks, mindful walking, and even acts of kindness and gratitude, have been shown to reduce pain. Dr. Hassett shares with us a broader definition of chronic pain and how to implement several of her '30-Days' activities and strategies, including:
• How a pink Piggy Bank can change outcomes – yes, a real piggy bank…• How the medical community defines chronic pain and how it relates to autoimmune conditions such as fibromyalgia and arthritis• What neuroscience is now telling us about how our brain relates to pain• How using the principles of cognitive-behavioral therapy reduces long-term pain• Why doing simple activities that you enjoy and make life feel worth living is an excellent way to decrease pain, plus much more…
About Our Guest: Viewed as a leader in the field of chronic pain and resilience, Dr. Afton L. Hassett, PsyD, is an Associate Professor and Director of Pain and Opioid Research in the Department of Anesthesiology at the University of Michigan. She is a principal investigator at the Chronic Pain & Fatigue Research Center with research funding from the National Institutes of Health (NIH). She was the Keynote address at the 2023 Pain Consortium Symposium on Advances in Pain Research for the NIH.Dr. Hassett and her book Chronic Pain Reset brings evidence-based strategies from research and academic medical settings directly to people who live with chronic pain with the hope that they will gain new tools to lead more rewarding lives with less pain. Learn more at https://aftonhassett.com/ Share this link with your family and friends: www.UnderstandingAutoimmune.com/Pain_2023* Your host is neither a doctor nor medical professional. In the capacity of this presentation, we are everyday people trying to make sense of the world. The information presented in this interview cannot substitute for the advice of your physician or other trained medical, healthcare, legal, or other professionals. Host(s) and guest(s) are not diagnosing specific conditions during the show. This show is not intended to diagnose, prevent, or treat autoimmune diseases or other conditions or illnesses. The information provided on UnderstandingAutoimmune.com, Life Interrupted Radio.com and The Autoimmune Hour is for educational purposes only and opinion only. It is not a substitute for your own medical, legal, or other professional advice and care.©2023 Sharon Sayler and UnderstandingAutoimmune.com

A Quest for Well-Being
A Path To Positive Changes

A Quest for Well-Being

Play Episode Listen Later Sep 28, 2023 48:05


— In the history of mankind, hypnosis has been used for healing purposes for thousands of years. People have long known that their thoughts can influence their bodies' functions and behavior. In most cases, hypnosis has been mistakenly labeled a mystic practice. Using hypnosis, humans can change their beliefs and the commands they have given to their subconscious minds. For pain management and for the treatment of mental illness, hypnosis was used during World War 2 and the Korean War. In 1955, the British Medical Association recommended the use of hypnosis during childbirth. Several medical schools and post-graduate programs recommended instruction in hypnosis after the American Medical Association recognized hypnosis as a field of study on Sept. 13, 1958. Many countries around the world, including the royal family, have used hypnosis during childbirth since the 1950s.  The popularity of hypnosis continues to grow. In neuroscience, cutting edge research shows that hypnosis exists. Hypnosis is becoming increasingly accepted as a technique for improving a wide range of personal aspects in life through change work. The treatment is completely natural and free of drugs. Valeria interviews Renia Pruchnicki  — She is a clinical hypnotist and NLP practitioner (neuro linguistics programming). She is based in Paris, Ontario, Canada. Renia helps people make positive changes in their lives in the area of improving confidence, weight loss, smoking cessation, pain management and more. Amma has been her spiritual guide for years - She has seen her many times in Toronto Canada. To learn more about Renia Pruchnicki and her work, please visit: https://www.lovinghypnosis.com/ and https://truthbelts.com/             — This podcast is a quest for well-being, a quest for a meaningful life through the exploration of fundamental truths, enlightening ideas, insights on physical, mental, and spiritual health. The inspiration is Love. The aspiration is to awaken new ways of thinking that can lead us to a new way of being, being well.

POLITICO's Pulse Check
The American Medical Association's growing rift with Republicans

POLITICO's Pulse Check

Play Episode Listen Later Sep 27, 2023 7:12


The American Medical Association's shift on social issues has strained its ties to the GOP, risking influence on health care policy. Host Lauren Gardner talks with POLITICO health care reporter Daniel Payne about the growing divide between the influential doctors group and Republicans.    

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Lorundrostat for Hypertension, Autoimmunity After COVID-19, Childhood Cancer Survivor Care, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Sep 26, 2023 10:56


Editor's Summary by Anne Rentoumis Cappola, MD, ScM, Senior Editor of JAMA, the Journal of the American Medical Association, for the September 26, 2023, issue.

Arroe Collins
Dr Afton L Hassett Chronic Pain Reset

Arroe Collins

Play Episode Listen Later Sep 26, 2023 11:54


Chronic pain affects nearly 50 million people in the U.S. alone. A recent study in a Journal of the American Medical Association showed that new cases of chronic pain occur even more frequently than new cases of diabetes, hypertension, and depression. Many people are surprised to discover the most effective treatment for chronic pain involves a multipronged approach including pain self-management, that allows patients to function more effectively – but it takes time to learn the activities and time to practice the skills. Chronic Pain Reset: 30 Days of Activities, Practices, and Skills to Help You Thrive (Countryman Press, September 5, 2023) explores the key role that your brain plays in processing pain and how small, simple actions can make profound changes in how you experience chronic pain. Chronic Pain Reset is written for people with chronic pain and those who care for them by an expert in the field of clinical pain research, Dr. Afton Hassett. This guide will help you evaluate your pain and its triggers, then offer straightforward and often fun strategies to improve chronic pain.

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Muvalaplin Lipoprotein(a) Inhibition, Pediatric Sinusitis Antibiotics, Pregnancy Hypertension Screening, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Sep 19, 2023 8:17


Editor's Summary by Preeti N. Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for the September 19, 2023, issue. Related Content: Audio Highlights

The School for Humanity
The NTM Growth Marketing Podcast #61 “How to Succeed by Creating Belonging with Carrie Melissa Jones”

The School for Humanity

Play Episode Listen Later Sep 18, 2023 36:47


“When you're successful, you can open up doors for other people, you can encourage young people… the sky is really the limit.” -Carrie Melissa Jones Carrie Melissa Jones is the founder of Gather Community Consulting and the former COO and founding partner of CMX. Her work has helped build communities with Google, Patreon, the American Medical Association, Coursera, and DoSomething.org. In 2016, Salesforce named her one of three experts to follow in community management. She is the co-author of the book Building Brand Communities: How Organizations Succeed by Creating Belonging. In this interview, we will cover Carrie's book, her inspiration for it, and a lot of industry questions. Website: https://www.buildingbrandcommunities.com/ LinkedIn: https://www.linkedin.com/in/carriemelissajones/

Brain & Body Things
Power lifting for pain after age 40 and beyond with Dr. Neal Mesnick.

Brain & Body Things

Play Episode Listen Later Sep 18, 2023 58:27


Neal A. Mesnick, M.D., M.A., FAAPMR is board certified in Physical Medicine and Rehabilitation. He is a fellow of the American Academy of Physical Medicine and Rehabilitation, a member of the American Board of Physical Medicine and Rehabilitation, a member of the American Medical Association and a member of the Medical Society of the state of New York. He is an attending physician at New York Presbyterian Medical Center and is on the faculty at Weill-Cornell Medical College where he is an Assistant Clinical Professor in Rehabilitation Medicine. He has published abstracts and has presented at national conferences.Dr. Mesnick specializes in musculoskeletal injuries including neck and back pain, shoulder pain, knee and ankle pain. He believes and treating the patient as a whole in order to return them to full function.  Dr. Mesnick takes a thorough history and physical, including diagnostic testing if necessary, in order to oversee proper physical therapy. He may also prescribe medication or perform procedures such as injections to alleviate acute pain. He works closely with the licensed professionals at Advanced Sports Medicine & Rehabilitation to ensure the best possible outcome for his patients.Dr. Mesnick has his own practice conveniently located next to Union Square in NYC.In this episode we discuss:Dr. Mesnick's personal journey with strength training and reasons behind his preference for power lifting.The importance of strength training particularly for injury prevention with aging.Starting a power lifting program at any age.Programming strength, hypertrophy, and maintenance.The importance if recovery and how to individualize recovery time periods.Re-evaluating goals and metrics as we age.Considering mobility and cross training.Referenced in the podcast:Starting Strength by Mark RippetoeThe Barbell Prescription: Strength Training for Life after 40The podcast episodes drop weekly on Mondays in seasonal chunks. This is the last episode in season 2!Subscribe to stay up to date, and tune in when you can! Be sure to rate, review, and follow on your favorite podcast app and let me know what other brain & body things you'd like to hear about.For more information about me, check out my website, www.natashamehtamd.com.Follow me on Instagram, Twitter, or Tik Tok @drnatashamehta.Connect with Dr. Mesnick via his website.This episode is not sponsored.

Low Carb MD Podcast
Episode 297: Dr. John Schoonbee

Low Carb MD Podcast

Play Episode Listen Later Sep 18, 2023 55:57


Thank you for joining us for another episode of the Low Carb MD Podcast. Dr John Schoonbee is a medical doctor who has been working in the insurance field for over 20 years, and directly for reinsurers since 2005. Currently he is the Chief Medical Officer at Swiss Re for Europe, the UK and Ireland, Middle East, and Africa. Dr. Schoonbee is involved in many aspects of life insurance, including product development, risk and claims assessment, as well as helping with pricing some of the more complex medical life and health products. In this conversation, Drs. Tro and John talk about what made John initially interested in medicine, learning from the great Tim Noakes, why changing health outcomes is dependent upon changing diet and lifestyle, how it became clear through an analysis of the data that the American Medical Association's dietary guidelines are wrong, how Dr. John and his company work to make people healthier, the goal of the Society of Metabolic Health Practitioners, and the mental/emotional health improvements linked to low-carb diets. For more information, please see the links below. Thank you for listening! Links: Dr. John Schoonbee: Twitter Swiss Re Linkedin Food For Thought Conference Fixing Metabolic Health Conference Dr. Brian Lenzkes: Website Twitter Dr. Tro Kalayjian: Website Twitter Instagram Doctor Tro App Join a growing community of individuals who are improving their metabolic health; together. Get started at your own pace with a self-guided curriculum developed by Dr. Tro and his care team, community chat, weekly meetings, courses, challenges, message boards and more. Apple Google Learn more

Congressional Dish
CD281: Private Policing of the Organ Transplant Network

Congressional Dish

Play Episode Listen Later Sep 18, 2023 75:35


The system for coordinating organ donations and transplants in the United States is broken, according to experts who have testified over the course of many years to Congress. In this episode, hear their testimony about what is wrong with the current system and then we'll examine the bill that aims to fix the problems. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via Support Congressional Dish via (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Background Sources August 3, 2022. Senate Finance Committee. Lenny Bernstein and Todd C. Frankel. August 3, 2022. The Washington Post. February 10, 2020. Senate Finance Committee. The Bill Audio Sources July 20, 2023 Senate Committee on Finance, Subcommittee on Health Care Witnesses: LaQuayia Goldring, Patient Molly J. McCarthy, Vice Chair & Region 6 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Matthew Wadsworth, President and CEO, Life Connection of Ohio Raymond J. Lynch, MD, MS, FACS, Professor of Surgery and Director of Transplantation Quality and Outcomes, Penn State Health Milton S. Hershey Medical Center Donna R. Cryer, JD, Founder and CEO, Global Liver Institute Clips 30:40 Sen. Ron Wyden (D-OR): HRSA, the Health Resources Agency, is on track to begin the contract process this fall and we're just going to be working here to complement their effort. 36:30 Sen. Chuck Grassley (R-IA): In 2005, I started the investigation of the deadly failures of UNOS, the monopoly tasked with managing the US organ donation system. Since then, more than 200,000 patients have needlessly died on the organ waiting list. There's a reason that I call UNOS the fox guarding the hen house. For nearly two decades, UNOS has concealed serious problems [at] the nation's organ procurement organizations, known as OPOs, instead of working to uncover and correct the corruption. This human tragedy is even more horrific because many of these deaths were preventable. They were the result of [a] corrupt, unaccountable monopoly that operates more like a cartel than a public servant. 44:45 LaQuayia Goldring: As a toddler, at the age of three, I was diagnosed with a rare kidney cancer that took the function of my left kidney. And when I was 17, I went back into complete renal failure and I received a first kidney transplant at that time. Unfortunately, in 2015, I went back into kidney failure. And at that time, I wasn't ready for another transplant, but I didn't have a choice but to go back on dialysis. I've been waiting nine agonizing years for a transplant, dependent upon a dialysis machine five days a week, just to be able to live. I was told that I would receive a kidney transplant within three to five years. But yet I am still waiting. I am undergoing monthly surgeries just to be able to get my dialysis access to work so that I can continue to live until I get a transplant. The UNOS waitlist is not like one to 100, where everybody thinks you get a number. I'm never notified on where I stand on the list or when I will get the call. I have to depend on an algorithm to make the decision of what my fate will be. 47:55 LaQuayia Goldring: Just a few weeks ago, a donor family reached out to me to be a directed kidney donor, meaning they chose me specifically for a kidney transplant. But unfortunately, due to the errors in the UNOS technology, I was listed as inactive and this was a clerical error. And all that they told me was this was a clerical error, and they could not figure out why I was inactive. But when it came down to it, I'm actually active on the transplant list. 51:45 Molly McCarthy: The Federal monopoly contractor managing the organ donation system, UNOS, is an unmitigated failure. And its leadership spends more time attacking critics than it does taking steps to fix the system. I've seen this firsthand in my five years as a patient volunteer with the OPTN and three years ago, I stepped into the role of Vice Chair of the Patient Affairs Committee, or PAC. 53:45 Molly McCarthy: Further, I have been called by a board member telling me to stop focusing on system outage and downtime of the UNOS tech system. He told me that having downtime wasn't a big deal at all, "the donors are dead anyway." That comment speaks volumes to me about the lack of empathy and respect UNOS has for donor families. 55:00 Molly McCarthy: Congress needs to break up the UNOS monopoly by passing 1668, ensuring that HHS uses its authority to replace UNOS as its contractor. 1:00:15 Matt Wadsworth: Break up the OPTN contract and allow for competition. 1:00:40 Matt Wadsworth: I commend this committee for introducing legislation to finally break up this monopoly and I stand ready to work with you in any way possible to ensure that this bill passes. It's the only way this industry will be able to save more patients' lives. 1:02:10 Dr. Raymond Lynch: I want to differentiate between organ donation, which is the altruistic decision of the donor patient and their family, and organ procurement, which is the clinical care provided by OPO staff. This is what turns the gift of donation into the usable organs for transplant. Organ procurement is a clinical specialty. It's the last medical care that many patients will ever receive. It's reimbursed by the federal government and it's administered by OPOs that are each the only provider in the territory to which they hold federal contracts. Right now patient care delivered by OPOs is some of the least visible in American healthcare. I can't tell you how many patients were evaluated by OPO workers in the US in 2022. I can't tell you how many patients were examined, or how many families were given information about donation, or how many times an OPO worker even showed up to a hospital to do this clinical duty. This lack of information about what OPO providers actually do for patients is a root cause of the variability in rates of organ procurement around the country. My research has shown that what we call OPO performance is a measurable restriction on the supply of organs that results in the unnecessary deaths of patients with organ failure. For example, if the lowest performing OPOs from around the country had just reached the national median over a recent seven year period, there would have been 4957 more organ donors, yielding an estimated 11,707 additional organs for transplant. Because many OPOs operate in a low quality data environment and without appropriate oversight, almost 5,000 patients did not get adequate organ procurement care, and nearly 12,000 other patients did not receive life saving transplants. 1:03:55 Dr. Raymond Lynch: OPO clinical work is currently not visible, it's not benchmarkable, and it's not able to be adequately evaluated, analyzed, or compared. However, much of the hidden data about how OPOs provide care to patients is known to one entity and that entity is UNOS. 1:05:20 Dr. Raymond Lynch: We need a new network of highly skilled specialist organizations, each attending to areas of expertise in the management of the OPTN contract. 1:21:15 Sen. Marsha Blackburn (R-TN): When we look at OPTN, and look at the Securing Organ Procurement Act, the bill would strip the nonprofit requirement for the manager of the Organ Procurement and Transplantation Network, which would open the door for profiting from organ procurement and donation. And to me, this is something that I think many people really fear, especially people that are on a waitlist. And so what I would like for you to do is to address that and address those concerns. And why or why not you think the Act has it right. Dr. Raymond Lynch: Thank you, Senator. I think it's unfortunate that people would be afraid of that and it needs to be changed. Many of the patients that you referenced are waitlisted at for-profit hospitals. For-profit is a part of American healthcare. And I can tell you that our not-for-profit entity doesn't work. And there are for-profit hospitals and for-profit transplant centers that do work. So patients don't need to be afraid of that. They do need to be afraid of the status quo. 1:28:30 Sen. Ben Cardin (D-MD): Ms. Cryer, do you have any views as to why it's much lower percentage chances for a racial minority to be able to have a transplant? Donna Cryer: Yes. And it really does come down to UNOS not doing its job of overseeing the organ procurement organizations. We know from many studies that black and brown communities donate organs in the same percentage they are the population. So it is not a problem of willingness to donate. It is a problem, as Miss Goldring was starting to discuss, about UNOS not ensuring that OPOs go out into the communities, develop relationships far before that horrible decision is needed to [be] made to donate the organs of a family member. 1:56:45 Sen. Elizabeth Warren (D-MA): And among the many reforms the legislation would support HRSA's proposal to break up the OPTN monopoly contract into multiple smaller contracts, which would allow some competition and allow the best vendors in the business to manage different parts of the transplant network operation. That means hiring IT experts to do the IT. It means hiring logistics experts to do logistics, and so on. 1:57:15 Sen. Elizabeth Warren (D-MA): UNOS does not want to lose control, so they're pushing to have the government limit eligibility only to nonprofit vendors that have worked in the past on organ donation, meaning, for instance, that the IT company that is hired to run OPTNs computers systems would have had to have worked on an organ transplant network in the past and be a nonprofit. So Ms. McCarthy, the requirement UNOS wants would seem to make it so that only one organization could apply for the new contract: UNOS. 1:58:35 Sen. Elizabeth Warren (D-MA): Right now, Congress has an opportunity to root out corruption in this system, but if we don't act before the current contract expires we won't have another shot for years. August 3, 2022 Senate Committee on Finance Witnesses: Brian Shepard, CEO, United Network for Organ Sharing (UNOS) Diane Brockmeier, RN, President and CEO, Mid-America Transplant Barry Friedman, RN, Executive Director, AdventHealth Transplant Institute Calvin Henry, Region 3 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Jayme Locke, M.D., MPH, Director, Division of Transplantation, Heersink School of Medicine, University of Alabama at Birmingham Clips 36:15 Sen. Ron Wyden (D-OR): A 1984 law created the first computerized system to match sick patients with the organs they need. It was named the Organ Procurement and Transplantation Network. Someone needed to manage that system for the whole country, so the government sought to contract an organization to run it. UNOS was the only bidder for that first contract in 1986. The contract has come up for bid seven other times, UNOS has won all seven. Today, the network UNOS overseas is made up of nearly 400 members, including 252 transplant centers, and 57 regional organizations known as Organ Procurement Organizations, or OPOs. Each OPO is a defined geographic service network. Families sitting in a hospital room thinking about donating a loved one's organs does not have a choice of OPOs. 37:40 Sen. Ron Wyden (D-OR): Between 2010 and 2020, more than 1,100 complaints were filed by patients and families, staff, transplant centers, and others. The nature of these complaints runs the gamut. For example, in a number of cases, OPOs had failed to complete critical mandatory tests for matters like blood types, diseases, and infection. Our investigation found one patient died after being transplanted with lungs that a South Carolina OPO marked with the wrong blood type. Similar blood type errors happened elsewhere and patients developed serious illness. Some had to have organs removed after transplant. Another patient was told he would likely die within three years after an OPO in Ohio supplied him with a heart from a donor who had died of a malignant brain tumor. UNOS did not pursue any disciplinary action. In a case from Florida, another patient contracted cancer from transplanted organs and the OPO sat on the evidence for months. In total, our investigation found that between 2008 and 2015, and 249 transplant recipients developed a disease from transplanted organs. More than a quarter of them died. 38:55 Sen. Ron Wyden (D-OR): Delivering organs has been another source of life threatening errors. We found 53 such complaints between 2010 and 2020, as well as evidence that this was just the tip of the iceberg. In some cases, couriers missed a flight. In others, the organs were abandoned at airports. Some organs were never picked up. Many of these failures resulted in organs being discarded. 39:20 Sen. Ron Wyden (D-OR): It's reasonable to assume that many more errors are going unreported. Why? Because filing official complaints with UNOS appears to accomplish zero productive oversight or reform. Organ transplant professionals repeatedly told the Finance Committee that the complaint process was, and I quote here, "a black hole." Complaints went in, UNOS went quiet. In interviews with the Committee UNOS leaders have dragged their feet, dodged tough questions, and shifted responsibility onto others. investigations and disciplinary measures rarely amount to much more than a slap on the wrist. Only one time -- just once -- has UNOS recommended that an OPO lose their certification. 55:05 Diane Brockmeier: We must update the archaic technology system at UNOS. As OPOs, we are required to work with UNOS technology DonorNet every day. DonorNet is outdated, difficult to us,e and often slow to function when every minute counts. Manual entry subjects it to error and OPO and Transplant Center staff are not empowered with the right information when time is critical. I did serve in leadership roles on the OPO Committee from 2017 to 2022. Committee members and industry leaders voiced repeated requests to improve DonorNet. The consistent response was UNOS IT did not have the bandwidth to address this work. The limitations of the UNOS technology are delaying and denying transplants to patients that are dying on the waitlist. Poor technology impacts the disturbingly high kidney discard rate in the United States, where one in four kidneys never make it to a patient for transplantation. Critical time is lost due to the inefficiency of DonorNet, wasting time on offers that will not be accepted. Of course an available organ should be offered to the patient in this sequence. However, far too much of the matching, particularly on older donors and organs that are difficult to place, are left to the individual OPOs and transplant centers to find each other despite, rather than facilitated by, UNOS technology. Mid-America Transplant intentionally identifies surgeons who accept kidneys that have been repeatedly turned down many times. These are life saving options for those patients. In May of 2022, one of these patients was number 18,193 on the list. Relying on DonorNet alone, that kidney would never had been placed and the chance to save a life would have been wasted. 55:20 Diane Brockmeier: UNOS lacks urgency and accountability around identifying and remediating this preventable loss of organs, and they are not required to publicly report adverse events when patients are harmed, organs are lost, or the quality of patient care is deemed unsafe. UNOS does not require clinical training, licensure, or certification standards for OPO staff delivering critical patient care. In this environment, who's looking out for the patient? Who's being held accountable for poor patient care? No OPO has ever actually been decertified, regardless of its performance or its safety record. 57:55 Diane Brockmeier: When an OPO goes out of sequence to place an organ that would otherwise be thrown away, UNOS requires an explanation; however, when organs are recovered and discarded, you must remain silent. 58:05 Diane Brockmeier: We must remove conflicts to ensure effective governance. From 2018 to 2020, I served as a board member for the OPTN. Serving on the board of the OPTN automatically assigns membership to the UNOS board. My board experience revealed that at times UNOS actions are not aligned with its fundamental vision of a life saving transplant for everyone in need. How can you fairly represent the country's interest and a contractor's interest at the same time? 58:35 Diane Brockmeier: Board members are often kept in the dark about critical matters and are marginalized, particularly if they express views that differ from UNOS leadership. Preparatory small group calls are conducted prior to board meetings to explore voting intentions, and if the board member was not aligned with the opinion of UNOS leadership, follow up calls are initiated. Fellow board members report feeling pressured to vote in accordance with UNOS leadership. 59:10 Diane Brockmeier: To protect patients, I urge Congress and the administration to separate the OPTN functions into different contracts so that patients can be served by best-in-class vendors, to immediately separate the boards of the OPTN and OPTN contractors, and to ensure that patients are safeguarded through open data from both the OPTN and OPOs. 1:00:45 Barry Friedman: Approximately 23% of kidneys procured from deceased donors are not used and discarded, resulting in preventable deaths 1:00:55 Barry Friedman: Organ transportation is a process left to federally designated Organ Procurement Organizations, OPOs. Currently, they develop their own relationships with couriers, rely on airlines, charter flights, ground transportation, and federal agencies to facilitate transportation. In many cases, organs must connect from one flight to another, leaving airline personnel responsible for transfers. While anyone can track their Amazon or FedEx package, there is currently no consistent way of tracking these life saving organs. 1:01:45 Barry Friedman: Currently there is no requirement for OPOs to use tracking systems. 1:02:20 Barry Friedman: I also believe there's a conflict of interest related to the management of IT functions by UNOS, as the IT tools they offer transplant centers come with additional costs, despite these being essential for the safety and management of organs. 1:02:35 Barry Friedman: UNOS is not effectively screening organ donors so that they can be quickly directed to transplant programs. UNOS asks centers to voluntarily opt out of certain organs via a filtering process. As a result, OPOs waste valuable time making organ offers to centers that will never accept them. Time wasted equates to prolonged cold ischemic time and organs not placed, resulting in lost organ transplant opportunities. 1:03:10 Barry Friedman: Due to the limited expertise that UNOS has in the placement of organs, it would be best if they were no longer responsible for the development of organ placement practices. The UNOS policy making [process] lacks transparency. Currently OPTN board members concurrently serve as the board members of UNOS, which creates a conflict of interest that contributes to this lack of transparency. UNOS committees are formed in a vacuum. There is no call for nominations and no data shared with the transplant community to explain the rationale behind decisions that create policy change. 1:11:35 Dr. Jayme Locke: The most powerful thing to know about this is that every organ represents a life. We can never forget that. Imagine having a medication you need to live being thrown away simply because someone took too long to get it to you. Your life quite literally in a trash can. Organs are no different. They too have shelf lives and they are measured in hours. Discarded organs and transportation errors may sound abstract, but let me make this negligence real for you. In 2014, I received a kidney that arrived frozen, it was an ice cube you could put in your drink. The intended recipient was sensitized, meaning difficult to match. The only thing we could do was tell the waiting patient that due to the lack of transportation safeguard, the kidney had to be thrown in the trash, the final generous act of a donor in Maryland. In 2017, I received a kidney that arrived in a box that appeared to have tire marks on it. The box was squished and the container inside had been ruptured. We were lucky and were able to salvage the kidney for transplant. But why should luck even play a role? 1:12:45 Dr. Jayme Locke: In one week, I received four kidneys from four different OPOs, each with basic errors that led to the need to throw away those life saving organs. One due to a botched kidney biopsy into the kidneys collecting system, another because of a lower pole artery that had been cut during procurement that could have been fixed if someone involved had assessed the kidney for damage and flushed it before packing, but that didn't happen. Two others arrived to me blue, meaning they hadn't been flushed either. 1:13:15 Dr. Jayme Locke: Opacity at UNOS means that we have no idea how often basic mistakes happen across the country, nor can we have any confidence that anything is being done to redress such errors so they don't keep happening. 1:13:40 Dr. Jayme Locke: Women who have been pregnant, especially multiple times, are harder to match, contributing to both gender and racial disparities in access to transplant. This is a very real example of how a constrained pool of organs and high discards disproportionately hurt women and women of color, who are more likely to have multiple pregnancies. 1:14:25 Dr. Jayme Locke: Number one, immediately separate the OPTN board from any of the boards of any contractors. Number two, bring in real experts to ensure our patients are served by the best of the best in each field, separating out key functions of the OPTN, including policy, technology, and logistics. And number three, ensure that patients are safer by holding all contractors accountable through public adverse event reporting and immediate redressing of problems. 1:22:00 Sen. Chuck Grassley (R-IA): The system doesn't seem to be fair to racial minorities or people living in rural communities. So what are your efforts underway to understand the root causes and help make the system fairer to patients on the waiting list to explain the factors that result in the disparity for minorities in rural populations in the process? And how can the federal government address a problem if we have to be involved in addressing it? Dr. Jayme Locke: One of the most important things that we don't currently do is we don't actually account for disease burden in terms of examining our waiting lists. So we have no way of knowing if we're actually serving the correct people, if the correct people are actually making it to the waiting list. Disease burden is super important because it not only identifies the individuals who are in need of transplantation, but it also speaks to supply. So areas with high rates of end stage kidney disease burden, like the southeastern United States are going to have much lower supply. And those waiting lists predominantly consist of African American or Black individuals. So if you want to make a truly equitable organ system, you have to essentially get more organs to those areas where there are higher disease burdens. I think the other thing is that we have to have more focus on how we approach donor families and make sure that we have cultural competence as a part of our OPOs, and how they approach families to ensure that we're not marginalizing minority families with regard to the organ donation process. 1:30:00 Brian Shepard: The OPTN IT system that UNOS operates has 99.99% uptime. It is a highly reliable system. We are audited annually by HRSA.... Sen. Ben Cardin (D-MD): My information shows it's had 17 days down since I think 1999. That's not correct? Brian Shepard: In 23 years, yes, sir. Sen. Ben Cardin (D-MD): Okay, well, every day there's a loss of life, isn't it? Brian Shepard: That's the total amount of time over the couse of -- Sen. Ben Cardin (D-MD): I hope our national event system isn't down 17 days a year. Brian Shepard: The system has never been down for a day. And to my knowledge, and I have not been at UNOS since 1999, there's been maybe one event that was longer than an hour, and that was three hours. But the total amount of time since 1999 -- Sen. Ben Cardin (D-MD): So you're satisfied with your technology? You think you have the right technology? You're satisfied with your tracking systems now? You think everything is okay? Brian Shepard: We constantly improve our technology. We're subjected to 3 million attempts a day to hack into the patient database and we successfully repelled them all. So we are never satisfied with our technology, but we do maintain 99.99% uptime. We disagree with the USDS analysis of our systems. 1:37:25 Brian Shepard: If you're asking whether UNOS can prevent an OPO from operating or for being an OPO -- Sen. Rob Portman (R-OH: Well not prevent them, but require them to do something .You don't have the ability to require them...? Brian Shepard: The peer review process has significant persuasive authority, but all the payment authority and all the certification and decertification authority live at CMS. 1:39:00 Sen. Rob Portman (R-OH: Do you think there should be tracking of organs in transit? Brian Shepard: I think that's a very beneficial thing. UNOS provides an optional service that a quarter of OPOs use. Many OPOs also use other commercially available trackers to do that. There is not a single requirement to use a particular system. 1:41:55 Sen. Elizabeth Warren (D-MA): Mr. Shepherd, you are the CEO of UNOS. We have documented these problems and you've received more than 1000 complaints in the last decade alone. So tell me, in the 36 years that UNOS has had the contract to run our national organ system, how many times has UNOS declared its OPO Members, any OPO members, not in good standing. Brian Shepard: Two times, Senator. 1:43:20 Sen. Elizabeth Warren (D-MA): How many times has UNOS put an OPO on probation? Brian Shepard: I don't know that number off the top of my head, but it's not a large number. Sen. Elizabeth Warren (D-MA): It's not large, in fact it's three. 1:45:20 Brian Shepard: Approximately 10% of the budget of this contract is taxpayer funded. The rest of that is paid by hospitals when they list patients. 1:49:30 Sen. Todd Young (R-IN): Once an OPO is designated not in good standing, Senator Warren referred to this as toothless. It does seem toothless to me. I'll give you an opportunity, Mr. Shepherd, to disabuse me of that notion and indicate for me what penalties or sanctions are actually placed on an OPO when they are designated not in good standing. Brian Shepard: The statute does not give UNOS any authority to offer sanctions like that. The certification, decertification, payment authorities belong entirely to CMS. UNOS's statute doesn't give us the ability -- Sen. Todd Young (R-IN): So it is toothless in that sense. Brian Shepard: It is designed to be, by regulation and contract, a quality improvement process, in contrast to the oversight process operated by a federal agency. 1:51:15 Sen. Todd Young (R-IN): To what extent is UNOS currently tracking the status of all the organs in transit at any given time? Brian Shepard: UNOS does not coordinate transportation or track organs in transit. We do provide a service that OPOs can use to use GPS trackers. Some of the OPOs use ours and some use other commercially available products. Sen. Todd Young (R-IN): So why is it, and how does UNOS plan to optimize organ delivery if you don't have 100% visibility into where they are at any given time? Brian Shepard: I think that the GPS products that we offer and that other people offer are valuable, they do help in the delivery of kidneys. Only kidneys travel unaccompanied, so this is a kidney issue. But I do think that GPS trackers are valuable and I think that's why you've seen more and more OPOs use them. 1:52:50 Sen. Ron Wyden (D-OR): Mr. Shepherd has said twice, with respect to this whole question of the power to decertify an OPO, that CMS has the power to do it. UNOS also has the power to refer an OPO for decertification under the OPTN final rule. That has been done exactly once. So I just wanted it understood with respect to making sure the committee has got what's really going on with respect to decertifying OPOs. 2:00:15 Dr. Jayme Locke: Obviously people have described that we have about a 25% kidney discard, so one in four. So if you look at numbers last year, these are rough numbers, but that'd be about 8000 kidneys. And really, I think, in some ways, these are kind of a victim of an entrenched and cumbersome allocation algorithms that are very ordinal, you have to go sort of in order, when data clearly have shown that introduction of multiple simultaneous expiring offers would result in more efficient placement of kidneys and this would decrease our cold ischemia time. 2:00:50 Dr. Jayme Locke: So if you take UNOS's organ center, they have a very rigid system, for example, for finding flights and lack either an ability or interest in thinking outside the box. So, for example, if there are no direct flights from California to Birmingham, Alabama, instead of looking for a flight from San Francisco to Atlanta, understanding that a courier could then pick it up in Atlanta and drive it the two hours, they'll instead put on a flight from SFO to Atlanta and allow it to go to cargo hold overnight, where it literally is rotting, if you will, and we're putting extra time on it. Sen. Ron Wyden (D-OR): Just to make sure everybody gets this. You're saying you've seen instances of something being put in cargo hold when it is very likely to rot? Dr. Jayme Locke: That is correct. So if the kidney arrives after 10pm at the Atlanta airport, it goes to cargo hold. We discovered that and made calls to the airlines ourselves and after several calls to the airlines, of course they were mortified, not understanding that that was what was happening and actually had their manager meet our courier and we were able to get the kidney out of cargo hold, but this went on before we figured out what was happening because essentially they fly it in, it sits in cargo hold, it comes out the next morning to catch the next flight. Instead of thinking outside the box: if we just get it to Atlanta, it's drivable to Birmingham. And those hours make a difference. Sen. Ron Wyden (D-OR): That sounds way too logical for what UNOS has been up to. 2:03:05 Sen. Ron Wyden (D-OR): Miss Brockmeier, UNOS has developed this organ tracking system. Do you all use it? I'm curious what you think of it. Diane Brockmeier: Thank you for the question, Senator. We did use and participate in the beta pilot through UNOS and made the decision to not move forward using their product, and have sought a commercial alternative. Sen. Ron Wyden (D-OR): And why was that? Diane Brockmeier: Part of the issues were some service related issues, the lack of the interconnectivity that we wanted to be able to facilitate a more expedited visual tracking of where the organ was. Sen. Ron Wyden (D-OR): Was the tracking technology low quality? Diane Brockmeier: Yes, sir. 2:11:25 Sen. Ron Wyden (D-OR): All right, let's talk for a moment about the boards that are supposed to be overseeing these, because it looks to me like there's a serious conflict of interest here and I'll send this to Ms. Brockmeier, and perhaps you'd like to get to it as well, Mr. Friedman. The Organ Procurement and Transplantation Network, which is the formal title of the organ network that operates under federal contract administered by HHS, and UNOS, which is the contractor that operates the network and controls information about the network, have the same boards of directors, despite efforts by the government to separate them. That means the people who look out for the best interests of UNOS, the multimillion dollar nonprofit, are the same people who look out for the interests of the entire organ transplant network. Sure sounds like a conflict to me. 2:12:55 Diane Brockmeier: I think there should be an independent board. I think the division of the responsibilities of the board and by the inherent way that they're structured, do pose conflicts. It would be like if you had an organization that was a supporting organization, you'd want to hold it accountable for its performance. And the current structure really limits that opportunity. 2:19:50 Dr. Jayme Locke: And if you think about IT, something as simple as having a system where we can more easily put in unacceptable antigens, this was a debate for many years. So for context, we list unacceptable antigens in the system that allows us to better match kidneys so that when someone comes up on the match run, we have a high probability that there'll be a good tissue match. Well, that took forever and we couldn't really get our unacceptable antigens in, so routinely people get offered kidneys that aren't going to be a match, and you have to get through all of those before you can get to the person that they really should go to. Those are simple examples. But if we could really have transparency and accountability around those kinds of things, we could save more lives. 2:23:10 Sen. Ron Wyden (D-OR): Mr. Shepherd told Senator Warren that only 10% of UNOS funds come from taxpayer money and the rest comes from fees paid by transplant centers who add patients to the list. But the fact is, Medicare is the largest payer of the fees, for example, for kidneys. So we're talking about inefficiency, inefficiency that puts patients at risk. And certainly, taxpayer dollars are used to cover some of these practices. May 4, 2021 House Committee on Oversight and Reform, Subcommittee on Economic and Consumer Policy Witnesses: Tonya Ingram, Patient Waiting for a Transplant Dr. Dara Kass, Living Donor and Mother of Transplant Recipient LaQuayia Goldring, Patient Waiting for a Transplant Steve Miller, CEO, Association for Organ Procurement Organizations Joe Ferreira, President, Association for Organ Procurement Organizations Matt Wadsworth, President and CEO, Life Connection of Ohio Dr. Seth Karp, Director, Vanderbilt Transplant Center Donna Cryer, President and CEO, Global Liver Institute Clips 5:15 Tonya Ingram: The Organ Procurement Organization that serves Los Angeles, where I live, is failing according to the federal government. In fact, it's one of the worst in the country. One analysis showed it only recovered 31% of potential organ donors. Audits in previous years found that LA's OPO has misspent taxpayer dollars on retreats to five star hotels and Rose Bowl tickets. The CEO makes more than $900,000. Even still, the LA OPO has not lost its government contract and it has five more years to go. 30:00 Rep. Raja Krishnamoorthi (D-IL): Unusual among Medicare programs, their costs are 100% reimbursed, even costs unrelated to care. So, extravagant executive compensation and luxury perks may be passed off onto the taxpayer. 46:55 Dr. Seth Karp: We have 10 hours to get a liver from the donor to the recipient, and about one hour to sew it in. For heart, we have about six hours. Time matters. 47:55 Dr. Seth Karp: Last year, I had the opportunity to co-write a viewpoint in one of the journals of the American Medical Association with TJ Patel, former Chief Data Scientist of the United States. In that article, we provided evidence that the metrics used to judge the performance of organ procurement organizations are basically useless. Until the recent OPO Final Rule, performance was self-reported, and OPO employees admitted to having gamed the system. When threatened with decertification, one of the OPOs themselves successfully argued that because the performance data were self reported and unaudited, they failed to meet a reasonable standard and the OPO should not be held accountable. In other words for decades, the metrics supposed to measure performance didn't measure performance, and the results have been disastrous, as you have heard. 49:45 Dr. Seth Karp: Whenever I, and quite frankly most everyone else in the field, gives a talk on transplantation, we usually make two points. The first is that organ transplantation is a miracle of modern medicine. The second is the tragedy that there are not enough organs for everyone who needs one. I no longer use the second point, because I don't believe it. Based on my work, I believe that there are enough organs for patients who require hearts, lungs, and probably livers, and we can make a huge improvement in the number of kidneys available. In addition to improving OPO performance, new technologies already exist to dramatically increase the organ supply. We need a structure to drive rapid improvement in our system. 54:00 Joe Ferreira: One common misconception is that OPOs are solely responsible for the entire donation and transplantation system, when, in fact, OPOs are the intermediary entity and their success is highly dependent on collaborations with hospitals and transplant programs. At the start of the donation process, hospitals are responsible for notifying any OPO in a timely manner when a patient is on a ventilator and meets medical criteria to be an organ donor. Additionally, transplant centers must make the decision whether to accept or decline the organs offered by OPOs. 57:55 Matt Wadsworth: As geographic monopolies, OPOs are not subject to any competitive pressure to provide high service. As the only major program in all of health care 100% reimbursed for all costs, we do not face financial pressures to allocate resources intelligently. 1:02:10 Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, I'd like to turn to you. You run the OPO called the Nevada Donor Network. I have your OPO's 2019 financial statement filed with the CMS. It appears that your OPO spent roughly $6 million in 2019 on administrative and general expenses. Interestingly, in 2019, I see your OPO spent approximately $146,000 on travel meetings and seminars alone. And your itemization of Administrative and General has an interesting line item for $576,000 for "ANG". It took me a minute but that means you have an "Administrative and General" subcategory in your "Administrative and General" category. Very vague. Now Mr. Ferreira, I was informed by Mr. Wadsworth, a former executive of yours at the Nevada Donor Network, that your OPO has season tickets to the NHL's Las Vegas Golden Knights, isn't that correct? Joe Ferreira: That is correct, Mr. Chairman. Rep. Raja Krishnamoorthi (D-IL): And you also have season tickets to the Las Vegas Raiders too, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And according to Mr. Wadsworth and others, your OPO took a board retreat to Napa Valley in 2018. Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And Sonoma in 2019, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, what you're spending on the Raiders, the Golden Knights, Napa Valley and Sonoma have one thing in common: they have nothing to do with recovering organs. 1:10:30 Dr. Seth Karp: In 2019, there were six heart transplants that were performed using donors after circulatory determination of death. And I don't want to get into the technical aspects of that. But in 2019, that number was six. In 2020, that number was 126. This is a new technology. This is a way that we can increase the number of heart transplants done in United States dramatically. And if we think that there were 500 patients in the United States waiting for a heart in 2020, 500 patients that either died or were delisted because they were too sick, and you think in one year, using a technology, we got another 100 transplants, if we could get another 500 transplants out of that technology, we could almost eliminate deaths on the on the heart transplant waiting list. That technology exists. It exists today. But we don't have a mechanism for getting it out to everybody that could use it and it's going to run itself through the system, it's going to take too much time. 1:24:05 Rep. Andrew Clyde (R-GA): You know, I'm a little disappointed that we're discussing race as a factor in organ transplant. We're all one race in my opinion; color makes no difference to me. We're the human race. And to me, the interjection of race into this discussion is very concerning. Discrimination based on race was outlawed almost 60 years ago through the Civil Rights Act of 1964. Now, I'm not a medical doctor, and I have very little knowledge of medicine. But last year, there was an article that came out in LifeSource and it says, "Does my race and ethnicity matter in organ donation?" And so my question here is for Dr. Karp. In your experience, would you agree that a donor's organs are more likely to be a clinical match for a recipient of the same ethnicity? Could you comment on that? Is that actually a factor, or not? I mean, we're all human beings, we all, you know, have similar bodies. Dr. Seth Karp: Yes. So there definitely are certain HLA types that are more common. That is race-based. So the answer to that question is yes. Rep. Andrew Clyde (R-GA): Okay. All right. And so if you have more of one particular race, more donations of one particular race, then naturally you would have more actual matches of that particular race. Is that correct? Dr. Seth Karp: That would tend to be the case. Rep. Andrew Clyde (R-GA): Okay. All right. All right. Okay, that's just a question that I wanted to clear up here. 1:34:20 Donna Cryer: We'd like to see investments in languages that are spoken by the community. Educational resources should be, as required by law, for those with limited English proficiency. They should be in the languages spoken by the community. They should be hiring diverse staff to have those most crucial conversations with families. The data shows, and certainly experience and common sense shows as well, that having people of color approaching families of color results in more donations. Executive Producer Recommended Sources Music by Editing Production Assistance

Minnesota Now
Mayo doctor discusses rise in cancer rates among people under 50

Minnesota Now

Play Episode Listen Later Sep 14, 2023 7:16


More and more younger people are getting cancer. If that sentence pulls you up short, it should.A new study published in the Journal of the American Medical Association shows cancer in people younger than 50 has increased over the last ten years, especially among women ages 30 to 39.The highest increases were in gastrointestinal, endocrine and breast cancers. Dr. Kathryn Ruddy, Medical Oncologist and Director of Cancer Survivorship at Mayo Clinic, joined MPR News host Cathy Wurzer to talk about what may be causing the trend. Use the audio player above to listen to the full conversation.Subscribe to the Minnesota Now podcast on Apple Podcasts, Google Podcasts, Spotify or wherever you get your podcasts.   We attempt to make transcripts for Minnesota Now available the next business day after a broadcast. When ready they will appear here.

Beyond the Body with Kimiyummy
# 20. بیماریهای مرتبط با چاقی _ فشار خون و بیماریهای قلبی

Beyond the Body with Kimiyummy

Play Episode Listen Later Sep 13, 2023 38:13


کتاب سلامتی در هر سایز https://www.amazon.com/Health-At-Every-Size-Surprising/dp/1935618253 اسامی مقالات ذکر شده Akram, D. S., et al. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity. Geneva, Switzerland: World Health Organization, 1997 Ernsberger, Paul and Richard]. Koletsky, "Biomedical Rationale for a Wellness Approach to Obesity: An Alternative to a Focus on Weight Loss," journal of Social Issues 55, no. 2 (1999) Ernsberger, Paul and D. 0. Nelson, "Effects of Fasting and Refeeding on Blood Pressure Are Determined by Nutritional State, Not by Body Weight Change," Americanjoumal of Hypertension (1988) Guagnano, M. T., et al., "Weight Fluctuations Could Increase Blood Pressure in Android Obese Women," Oinical Sciences (London) 96, no. 6 (1999) Ernsberger, Paul, et al., "Consequences of Weight Cycling in Obese Spontaneously Hypertensive Rats," American journal of Physiology: Regulatory, Integrative and Comparative Physiology 2 70 ( 1996): Ernsberger, Paul, et al., "Refeeding Hypertension in Obese Spontaneously Hypertensive Rats," Hypertension 24 (1994) Chernin, K., The Obsession: Reflections on the ryranny of Slenderness. New York: Harper&. Row, 1981. Barrett-Connor, Elizabeth and K. T. Khaw, "Is Hypertension More Benign When Associated with Obesity?" Circulation 72 (1985) Cambien, Francois, et al., "Is the Relationship between Blood Pressure and Cardiovascular Risk Dependent on Body Mass Index?" American journal of Epidemiology 122 (1985): 434-42. Weinsier, Roland L., et al., "Body Fat: Its Relationship to Coronary Heart Disease, Blood Pressure, Lipids, and Other Risk Factors Measured in a Large Male Population," American journal of Medicine 61 (1976): 815-24. Uretsky, Seth, et al., "Obesity Paradox in Patients with Hypertension and Coronary Artery Disease," American journal of Medicine 120, no. 10 : 863-70. Kang, Xingping, et al., "Impact of Body Mass Index on Cardiac Mortality in Patients with Known or Suspected Coronary Artery Disease Undergoing Myocardial Perfusion Single-Photon Emission Computed Tomography," journal of the American College of Cardiology 47, no. 7 (2006): 1418--26. Nowson, Caryl A., et al., "Blood Pressure Change with Weight Loss Is Affected by Diet Type in Men," American journal of Ginical Nutrition 81, no. 5 : 983--89. McDonald, K. Colleen, Jean C. Blackwell, and Linda N. Meurer, "dinical Inquiries. What Lifestyle Changes Should We Recommend for the Patient with Newly Diagnosed Hypertension?" journal of Family Practice 55, no. ll (2006): 991-93. Delichatsios, Helen K. and Francine K. Welty, "Influence of the Dash Diet and Other Low-Fat, High-Carbohydrate Diets on Blood Pressure," no. 6 (2005): 446-54. Gregg, Edward W, et al., "Secular Trends in Cardiovascular Disease Risk Factors According to Body Mass Index in Us Adults," journal of the American Medical Association 293, no. 15 (2005): 1868--74. McGill, Henry C.,Jr., The Geographic Pathology of Atherosclerosis. Baltimore: Williams and Wilkins, 1986. Montenegro, M. R. and L. A Solberg, "Obesity, Body Weight, Body Length, and Atherosclerosis," Laboratory Investigations 18 (1968): 134-43. A Study of Interassociations," Atherosclerosis 36, no. 4 (1980): 481-90. Warnes, C. A. and W C. Roberts, "The Heart in Massive (More Than Pounds or 136 Kilograms) Obesity: Analysis of 12 Patients Studied at Necropsy," Ameri.canjourncll of Cardiology 54, no. 8 (1984): 1087-91. Chambless, Lloyd E., et al., "Risk Factors for Progression of Common Carotid Atherosclerosis: The Atherosclerosis Risk in Communities Study, 1987-1998," American journcll of Epidemiology 155, no. l (2002): 38-47 Salonen, Riitta andJukka T. Salonen, "Progression of Carotid Atherosclerosis and Its Determinants: A Population-Based Ultrasonography Study," Atherosclerosis 81, no. l (1990) Applegate, William B.,]. P. Hughes, and R. Vander Zwaag, "CaseControl Study of Coronary Heart Disease Risk Factors in the Elderly," journal of Clinical Epidemiology 44

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.
Afib Ablation and Mental Health, Sedentary Behavior and Dementia, Ulcerative Colitis Review, and more

JAMA Editors' Summary: On research in medicine, science, & clinical practice. For physicians, researchers, & clinicians.

Play Episode Listen Later Sep 12, 2023 9:20


Editor's Summary by Christopher W. Seymour, MD, MSc, Associate Editor of JAMA, the Journal of the American Medical Association, for the September 12, 2023, issue. Related Content: Audio Highlights

Behavioral Health Today
Changing the Paradigm & Advancing Population Health with Dr. Arthur Evans – Episode 248

Behavioral Health Today

Play Episode Listen Later Sep 12, 2023 38:11


If we are willing to change the paradigm, shifting our focus from treating illness at the individual level to focusing on improving the psychological health of all people in our neighborhoods and communities, we can create a system of interventions across the continuum of the population that is all aimed at everyone's health no matter where they're at. In this episode, Dr. Graham Taylor speaks with Dr. Arthur Evans. Arthur is a clinical and community psychologist, healthcare innovator, policymaker, and the Chief Executive Officer and Executive Vice President of the American Psychological Association, the leading scientific and professional organization representing psychology in the United States. Before joining APA in March 2017, Arthur spent 12 years as commissioner of Philadelphia's Department of Behavioral Health and Intellectual Disability Services transforming that agency's approach to serving a wide range of individuals with complex needs. Arthur has received national and international recognition for his work, including being recognized as an “Advocate for Action” by the White House Office of National Drug Control Policy, receiving the American Medical Association's top government service award in healthcare, receiving the National Council of Behavioral Health's Visionary Leadership Award, and more. Together Graham and Arthur discuss fostering equitable health, challenges of our current system of treatment, and strategies to addressing population health. We can look at the world differently. If we can see the value we bring as mental health professionals, and we're partnering with people to really address the broader mental needs of the community, we can get out of the current system and bring our expertise in fulfilling ways.   For more information about the American Psychological Association, please visit: https://www.apa.org For more information about population health please read the article Psychology's Role in Advancing Population Health: https://www.apa.org/about/policy/population-health-statement.pdf To contact Dr. Arthur Evans, please email: aevans@apa.org  

Autism Science Foundation Weekly Science Report
Now you know the reason for decades of eye tracking research

Autism Science Foundation Weekly Science Report

Play Episode Listen Later Sep 10, 2023 22:15


Can biomarkers that measure things like visual social attention be a good proxy for an in person behavioral diagnosis? Why would this be important? This week's podcast explores two new studies the the Journal of the American Medical Association that show a simple device called EarliPoint can be used to shorten the wait times to … Continue reading "Now you know the reason for decades of eye tracking research"

Think Neuro
46. Psilocybin for Major Depressive Disorder | Guest Podcast

Think Neuro

Play Episode Listen Later Sep 6, 2023 29:39


In a study published on August 31, 2023, in the Journal of the American Medical Association, psilocybin showed promise as a treatment for major depressive disorder (MDD). JAMA Associate Editor Dr. Donald C. Goff, speaks with publication author Dr. Charles L. Raison, from the Usona Institute, about the study, as well as Dr. Rachel Yehuda from Mount Sinai School of Medicine, who wrote an accompanying editorial about the potential benefits of psychedelic therapies. Pacific Neuroscience Institute's director of Treatment & Research In Psychedelics Center, Dr. Keith Heinzerling and PNI director Dr. Daniel Kelly were a co-investigators in this study.