Residency Applications Down in States with Abortion Bans; Ascension Cyberattack Leads to More Pain for Hospitals; COVID-19 Data Reporting to CDC Expires; and Other Items of Interest
A new data snapshot developed by the AAMC Research and Action Institute provided an updated analysis of the training location preferences of U.S. medical school graduates two years after the U.S. Supreme Court overturned Roe v. Wade with the 2022 decision in Dobbs v. Jackson Women’s Health Organization. The data show that the number of new medical graduates from U.S. MD programs applying to residency programs decreased; and that those decreases were more pronounced in states that banned abortions compared to states without bans.
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NPR reported on the trend in residency applications, drawing heavily on AAMC data and findings. Its reporting notes there may be a gap in training for the next generation of physicians, not necessarily in abortion management, but in caring for miscarriages, ectopic pregnancies, and other potential medical complications that may accompany pregnancy. Additionally, residents are at an age where they may be considering starting their own families and may be concerned about the type of care available to them in the states where they are training.
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A cyberattack disrupted operations at Ascension this week, forcing the network of 140 hospitals in 19 states and the District of Columbia, to take steps to minimize the impact to patient care, including logging care on paper as the patient record systems were knocked offline, reported the Washington Post. Ascension is the largest chain of Catholic hospitals and the fourth largest hospital network in the United States.
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The privately owned Steward Health Care System filed for bankruptcy this week, putting 31 hospitals in eight states including Massachusetts, Florida, and Texas at risk of running out of cash, reported CBS News. Representing one of the largest hospital bankruptcies in decades, the system is hoping to auction off its hospitals and keep them open during a reorganization that will address $9 billion in debt.
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Rising costs from workforce shortages, major factures in the supply chain for drugs and health care supplies, high levels of inflation, increasing regulatory burden, and inadequate increases in reimbursement mean that hospitals are getting no relief from an array of cost pressures, reported Becker’s Hospital CFO Report.
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Some hospitals are going forward with surgeries only if the patient pays in full upfront to avoid having to locate patients afterward to have them pay for medical services after procedures, reported the Wall Street Journal. The article notes that procedures will be delayed if the patient is unable to pay prior, and if patients discover after being billed that they’ve been overcharged, they have to fight for refunds after the fact.
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The Medicare Hospital Trust Fund will stay solvent until 2036, reported MedPage Today.
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The government’s requirement that all hospitals report their number of COVID-19 patients to the Centers for Disease Control and Prevention (CDC) has expired, giving each hospital the choice either to report the data or not, reported the Atlanta Journal-Constitution. According to Fierce Health Care, which also covered the story, April 30 was the last day hospitals were required to report their COVID-19 data to the CDC's National Healthcare Safety Network). The CDC said it is encouraging “ongoing, voluntary reporting of hospitalization data” and will begin making those voluntary data available for online viewing beginning today, on its COVID Data Tracker webpage.
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The House of Representatives moved closer to advancing a bill that would extend expiring telehealth rules, hospital at home services, and other programs for rural hospitals, reported Modern Healthcare.
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More than 100,000 young immigrants who are recipients of the Deferred Action for Childhood Arrivals (DACA) program are now eligible to buy Affordable Care Act plans under a new rule from the Biden administration, reported NBC News.
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“Physicians who staff emergency rooms say this problem, known as ER boarding, is as bad as it’s ever been — even worse than during the first years of the covid-19 pandemic, when hospitals filled with desperately ill patients. While boarding can happen to all ER patients, adults 65 and older, who account for nearly 20% of ER visits, are especially vulnerable during long waits for care. Also, seniors may encounter boarding more often than other patients,” reported KFF Health News.
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Nearly 100,000 children in the United States lost a parent to a drug overdose or gun violence in 2020, reported CNN in coverage of a study that examined trends from 1999-2020. The study was published in JAMA.
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A study published in Nature Medicine suggested that genetics is a major cause for Alzheimer’s disease, finding that people with two copies of the gene variant APOE4 are almost certain to be diagnosed, reported the New York Times. The article reported that the new designation “could broaden the scope of efforts to develop treatments, including gene therapy, and affect the design of clinical trials. It could also mean that hundreds of thousands of people in the United States alone could, if they chose, receive a diagnosis of Alzheimer’s before developing any symptoms of cognitive decline, although there currently are no treatments for people at that stage.”
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In related news, Medscape discussed whether racism toward Black Americans increases the risk of Alzheimer’s.
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Even though the specialty of OB/GYN is dominated by women, sexual harassment and other abusive behaviors are prevalent in the specialty, suggesting power dynamics may play a greater role than gender in determining the level of harassment, reported MedPage Today in coverage of a study published in JAMA Network Open.
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Urologist Darius Paduch, who was affiliated with Weill Cornell Medicine, has been found guilty of sexually abusing seven patients, including five who were minors, reported the New York Times.
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Kimia Heydari and Romila Santra, first-year students at Harvard Medical School, wrote an opinion piece in STAT on caring for a particularly vulnerable but often unacknowledged population: young people who are caregivers for siblings with special health care needs, physically or mentally ill parents or grandparents.
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Rogue brokers are signing people up for Affordable Care Act plans without their permission, and federal regulators are trying to figure out a solution as people are enrolling in ACA plans at record numbers, reported NPR.
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Medscape discussed how the impact of climate change on respiratory care is likely to rise due to factors such as extreme heat and wildfires. Another piece in Medscape explored the question of whether people with diabetes need to fast longer before surgery.
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In news related to physician burnout, more than 70% of doctors in a recent survey reported they do work on a typical vacation day, turning PTO into “pretend time off” for many respondents, reported NPR in coverage of a study published in JAMA Network Open.
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An opinion piece in U.S. News & World Report discussed the difficulty of getting into medical school despite a projected physician shortage. The piece notes the problem of misaligned numbers between students, faculty, and training slots. “Solving the doctor shortage in the U.S. will take more than just increasing the number of spots available in medical school,” the piece notes. “That’s because there’s a bottleneck between medical school and graduate medical education.”
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Carl Elliott, PhD, a bioethicist and professor in the Center for Bioethics at the University of Minnesota, wrote a guest essay in the New York Times on abuse in medicine and how trainees can respond to it. “[I] started talking to insiders who had blown the whistle on abusive medical research. Soon I realized that I had overlooked the importance of moral perception. Before you decide to speak out about wrongdoing, you have to recognize it for what it is. This is not as simple as it seems. Part of what makes medical training so unsettling is how often you are thrust into situations in which you don’t really know how to behave. Nothing in your life up to that point has prepared you to dissect a cadaver, perform a rectal exam or deliver a baby. Never before have you seen a psychotic patient involuntarily sedated and strapped to a bed or a brain-dead body wheeled out of a hospital room to have its organs harvested for transplantation,” wrote Dr. Elliott.
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As AI proliferates through medicine, an opinion piece in Forbes explored who will face legal liability if the technology harms patients.
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In related news, Google unveiled AlphaFold3, a new AI system that could predict the behavior of human molecules, creating a better understanding of the human body and how to fight disease, reported the New York Times.
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Nature covered new efforts to highlight the “ugly side” of science – negative results that often don’t get published and can lead to publication bias for positive results in the scientific record. The piece highlighted how machine-learning tools are adding new urgency to addressing the problem.
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The Journal of the American College of Surgeons published an article this week, “Sustaining Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy,” which explores the difficult question of how surgeons are assessed as they progress to the later stages of their careers. CFAS has sponsored programming at past AAMC and CFAS meetings on exactly this topic. The collective review’s lead author is CFAS representative Todd K. Rosengart, MD, vice president for Hospital Operations and Quality Improvement, and professor and chair of the Michael E. DeBakey Department of Surgery at Baylor College of Medicine.
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A piece in Becker’s Health IT pondered whether EHRs have been good for health care.
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The Biden administration is moving to reclassify marijuana from a Schedule I controlled substance to a Schedule 2 controlled substance, reducing some, but not all restrictions for scientists hoping to study the drug, reported NPR.
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Join the next collaborative meeting of the Climate Action and Sustainability in Academic Medicine community on Tuesday, June 25, 2024, at 3 pm ET. The session will feature three experts on sustainable science and green labs discussing the opportunities to reduce energy usage and waste, promote recycling of lab materials, and foster innovation in laboratory processes. Registration for the event is required.
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AAMCNews offered 7 tips for rising first years at the start of their medical school journeys. Another AAMCNews article discussed 9 great summer reads for doctors — or anyone interested in medicine.
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A new study co-authored by the AAMC and published in JAMA Network Open examined data from the 2022 National Sample Survey of Physicians to determine respondents’ experiences with burnout. The sample included 5,917 physicians, 3% of whom reported having a disability, and burnout is measured as depersonalization (callousness towards people) and emotional exhaustion (feeling burned out from work). The findings illustrated that physicians with disabilities had significantly higher odds of reporting daily depersonalization than their nondisabled peers. Physicians with disabilities were also slightly more likely to experience daily emotional exhaustion than nondisabled physicians. The authors call on health care systems to consider a multifaceted approach to decreasing mistreatment, increasing a sense of belonging, promoting pay equity, and ensuring psychological and physical safety for physicians with disabilities.
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The AAMC has compiled resources for both individuals and institutions to support better approaches and policies for maternal mental health care, including research briefs, best practices, data from the AAMC Center for Health Justice, and resources from other organizations.
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The Health Resources and Services Administration (HRSA) National Maternal Mental Health Hotline’s counselors are available 24/7 by phone and text – in English and Spanish – to provide real-time emotional support, encouragement, information, and referrals to health care workers caring for pregnant or postpartum patients who are experiencing mental health challenges.
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Registration is now open for an interactive discussion on June 5 with the AAMC Center for Health Justice to explore public perspectives on reparations in America. The virtual discussion will provide an overview of 2024 reparations polling data, as well as how it impacts the work of health justice. Registration is free but required.
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On June 12, the AAMC will host a webinar on integrating arts and humanities into medical education to promote awareness and understanding of concepts in health equity as part of its Fundamental Role of Arts and Humanities in Medical Education (FRAHME) initiative. In recognition of Juneteenth, speakers will also share ways they have empowered learners to provide and advocate for equitable health care access and outcomes for Black patients.
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Isaac Opole, MD, PhD, has been named president of the American College of Physicians (ACP). Dr. Opole serves as the associate vice chancellor for student affairs and Ruth Bohan Teaching Professor of Medicine at the Kansas University Medical Center and has been an ACP fellow since 2008. ACP is a CFAS-member society.
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In other CFAS society news, Claire Henchcliffe, MD, DPhil, has been named president-elect of the Association of University Professors of Neurology (AUPN), also a CFAS-member society. Dr. Henchcliffe is the Stanley van den Noort Professor and Chair of Neurology at UC Irvine School of Medicine and has served on the AUPN executive council since 2021.
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Yoon Kang, MD, has been appointed inaugural vice dean for education at Albert Einstein College of Medicine, effective July 22. Dr. Kang is the senior associate dean for education at Weill Cornell Medicine.
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David Naeger, MD, has been named chair of the Department of Radiology at Dartmouth Health’s Dartmouth Hitchcock Medical Center, Dartmouth Hitchcock Clinics, and Dartmouth’s Geisel School of Medicine. Dr. Naeger serves as professor and vice chair in the Department of Radiology at the University of Colorado School of Medicine.
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Ashley Wysong, MD, is stepping down from her role as professor and chair of the Department of Dermatology at University of Nebraska Medical Center, effective July 1. Jennifer Adams, MD, currently vice chair of the department, associate professor and residency program director, will serve as interim department chair following Dr. Wysong’s departure. Dr. Wysong has served as chair of the department since 2018.
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Mauricio Garcia, MD, has been named the Jerome S. Levy, M.D., Chair in Gastroenterology and Hepatology at the University of Arkansas for Medical Sciences (UAMS) College of Medicine. Dr. Garcia is associate professor and chief of the UAMS Division of Gastroenterology and Hepatology in the College of Medicine’s Department of Internal Medicine.
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Christian Pettker, MD, has been appointed chair and department executive officer of the Department of Obstetrics and Gynecology at the University of Iowa Carver College of Medicine, effective July 1. Dr. Pettker is a maternal-fetal medicine specialist who serves as professor in the Department of Obstetrics, Gynecology and Reproductive Sciences and vice chair of quality and patient safety at the Yale School of Medicine.
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Hesham Sadek, MD, PhD, has been appointed director of the Sarver Heart Center and chief of the Division of Cardiology at the University of Arizona College of Medicine – Tucson. Dr. Sadek previously served as associate director of the Center for Regenerative Science and Medicine at UT Southwestern Medical Center.
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Want to live a few a few years longer than the average person? Don’t sweat it! Or rather, really sweat it – a lot. A new study published in the British Journal of Sports Medicine looked at a group of elite runners – the first 200 documented sub- four-minute milers – and discovered that as a group, they defied longevity trends by a notable amount, living about 5 years longer than average.
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Nature photographer Johanna Turner captured a “smiling” black bear with a motion-activity camera high above suburban Los Angeles, with the city lights sparkling below in the background. Cute and worth a click.
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And finally (as in the final finally), bioethicists at the University of Cambridge are drafting standards to protect people from being “haunted” by “dead bots” or “grief bots” – AI-generated hucksters deviously constructed to market products to people by reproducing speech patterns of a deceased relative. Companies already exist that employ AI to offer a comforting message from a loved one who has just died. But the concern is that the technology may be taken a step further where an AI-generated avatar may attempt to persuade survivors to purchase an extended warranty, for instance. “People might develop strong emotional bonds with such simulations, which will make them particularly vulnerable to manipulation,” said study co-author Tomasz Hollanek, PhD, of the University of Cambridge. “It is vital that digital afterlife services consider the rights and consent not just of those they recreate, but those who will have to interact with the simulations.” Buyer beware of beyond the grave sales pitches.
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Visit the CFAS Resources page for an archive of the previous edition of CFAS News as well as our People of Academic Medicine page, which features a running list of academic promotions, appointments, and departures.
Your comments and news tips are always welcome. Please email them to Eric Weissman at eweissman@aamc.org.
Read the previous edition of CFAS News.
Eric Weissman
Senior Director, Faculty and Academic Society Engagement
AAMC
eweissman@aamc.org
www.aamc.org/cfas