It’s family vacation time, and I’ve taken the kids back to where I grew up — a small plot of land off a dirt road in Kansas.
For my city kids, this is supposed to be heaven. There are freshly laid chicken eggs to gather, new kittens to play with and miles of pasture to explore.
But we’re not outside.
I’m sitting in my childhood bedroom watching my 7-year-old son and his 11-year-old-cousin stare at a screen. The older kid is teaching the younger the secrets of one of the most popular games on Earth: Minecraft.
“You can’t mine ores unless you have a pickax,” explains my nephew to my son. “You need a wooden pickax to get stone, and you need a stone pickax to get iron, and you need an iron pickax to get gold,” and so on.
Minecraft is the megapopular video game that ranges from simple to complicated. But the basics are that players enter a world that looks sort of like Legos on a screen and build anything they want. Think houses, mountains and farms. Continue reading
Immunization update time for kids is now — beat the back-to-school rush
From the Washington State Department of Health
While kids across Washington are squeezing every ounce of fun out of summer, many parents are already looking forward to the beginning of the school year and planning for all that must be done before the first day of school.
Now is the time to get kids in to see their health care providers for required immunizations, yearly well-child checks, and sports physicals. Families can cut down on back-to-school stress by getting the right immunizations for their students well before school starts. Students who aren’t in compliance with required vaccines may be kept out of school if a disease epidemic occurs.
Parents can find the immunization requirements to start school and attend child care online. There are new changes to the requirements this year for the chicken pox vaccine. It’s also important that kids are current on their whooping cough shots. The disease is spreading in Washington and everyone can play a part in stopping it. Continue reading
By Anna Gorman
After taking a 10-year break from practicing medicine to raise four sons, Kate Gibson was ready to go back to work.
The family practitioner had been reading about a shortage of primary care doctors and knew she could help. But when Gibson, 51, applied to work at her former hospital near Los Angeles, she was turned away. She’d been out of clinical practice too long.
“I really thought it was not going to be that hard,” she said.
Like many professionals, physicians take time off to raise children, care for sick family members or to recover from their own illnesses. Some want to return from retirement or switch from non-clinical jobs back to seeing patients. But picking up where they left off is more difficult in medicine than in most careers.
In medicine, change occurs quickly. Drugs, devices and surgical techniques that were standard a decade ago may now be obsolete. Or a returning doctor’s skills may simply be rusty.
“My hands feel like those of an intern,” said Molly Carey, 36, an Ivy-League educated doctor who recently enrolled in a Texas retraining program after four years away from patients.
After extended leaves, doctors must convince medical boards to reissue their licenses, hospitals to grant admitting privileges and malpractice insurers to provide coverage. Only a handful of programs around the country are set up to help physicians brush up on their skills, and they can cost doctors thousands of dollars.
“Medical schools do a fantastic job graduating brand new medical students,” said Humayun J. Chaudhry, president of the Federation of State Medical Boards. “But what about people who have already graduated and need to get some retraining? There is a clearly a dearth of those kind of training programs.”
Policymakers and professional organizations are pushing to make the process less burdensome and costly – in part because it may help ease shortages of primary care doctors. Continue reading
By Sandra G Boodman
The patient was dying and she knew it. In her mid-50s, she had been battling breast cancer for years, but it had spread to her bones, causing unrelenting pain that required hospitalization.
Jeremy Force, a first-year oncology fellow at Duke University Medical Center who had never met the woman, was assigned to stop by her room last November to discuss her decision to enter hospice.
Employing the skills he had just learned in a day-long course, Force sat at the end of her bed and listened intently. The woman wept, telling him she was exhausted and worried about the impact her death would have on her two daughters.
“I acknowledged how hard what she was going through was,” Force said of their 15-minute conversation, “and told her I had two children, too” and that hospice was designed to provide her additional support.
Unlike sympathy, which is defined as feeling sorry for another person, clinical empathy is the ability to stand in a patient’s shoes.
Force credits “Oncotalk,” a course required of Duke’s oncology fellows, for the unexpected accolade.
Developed by medical faculty at Duke, the University of Pittsburgh and several other medical schools, “Oncotalk” is part of a burgeoning effort to teach doctors an essential but often overlooked skill: clinical empathy.
Unlike sympathy, which is defined as feeling sorry for another person, clinical empathy is the ability to stand in a patient’s shoes and to convey an understanding of the patient’s situation as well as the desire to help. Continue reading
The grant is Cambia’s largest ever given to any organization and will come in four separate parts, creating three endowments totaling $8 million and $2 million dedicated to immediately improving care at the center.
By Pauline Bartolone, Capital Public Radio
KHN / AUGUST 7TH
Some doctors in the state of California will soon be able to practice after three years of medical school instead of the traditional four.
The American Medical Association is providing seed money for the effort in the form of a $1 million, five-year grant to the University of California at Davis.
In a traditional medical school, Nzigira wouldn’t be in a clinic until his third year. In this accelerated course, students can shave up to $60,000 off their education debt. Still, Nzigira initially had hesitations.
“I thought ‘Oh man, you want me to put the intensity and stress that is medical school in four years, you want me to condense it down to three years? I’m not sure about that,’” Nzigira says. But, after learning more, he became convinced it was a good path for him. Continue reading
By Julie Rovner
A high-level report recommending sweeping changes in how the government distributes $15 billion annually to subsidize the training of doctors has brought out the sharp scalpels of those who would be most immediately affected.
The reaction also raises questions about the sensitive politics involved in redistributing a large pot of money that now goes disproportionately to teaching hospitals in the Northeast U.S. All of the changes recommended would have to be made by Congress. Continue reading
An expert panel recommended Tuesday completely overhauling the way government pays for the training of doctors, saying the current $15 billion system is failing to produce the medical workforce the nation needs.
“We recognize we are recommending substantial change,” said health economist and former Medicare Administrator Gail Wilensky, co-chairwoman of the nonpartisanInstitute of Medicine panel that produced the report. “We think it’s key to justifying the continued use of public funds.” Continue reading
By Michelle Andrews
KHN/May 27, 2014
Some students headed for college this fall will get top-drawer health coverage at little or no cost, because Medicaid will pay the premium for the college’s student health plan.
The program is already being used at some Minnesota and Montana colleges.
Proponents say it gives students who are eligible for coverage under Medicaid, the state-federal health insurance program for low income people, access to a wider network of providers at the local, national and even international level. Continue reading
Someone who has a cardiac arrest in King County has a greater chance of survival than anyone else in the world, according an analysis by county officials.
The survival rate for cardiac arrest in King County hit an all-time high of 62 percent in 2013, the analysis found.
By comparison, the cardiac survival rates in New York City, Chicago, and other urban areas have been recorded in the single digits.
According to the analysis, the cardiac survival rate in King County has risen over the past decade or so, from an above-average 27 percent in 2002 to 62 percent in 2013.
Strategies that have contributed to the rise include: Continue reading
Washington is one of the few states that has made the Asthma and Allergy Foundation of America honor roll of states that have adopted comprehensive public policies supporting people with asthma, food allergies, anaphylaxis risk and related allergic diseases in schools.
By Michael Ollove
Stateline Staff Writer
April 16, 2014
In a valley wedged between the Mississippi and Missouri rivers, St. Louis often finds itself beset by a stationary air mass that only a severe storm of some kind can dislodge.
St. Louis is also an industrial city with high humidity, so it’s no wonder it usually makes the list of worst places for asthmatics to live.
But the state has also pioneered advances in addressing asthma treatment and costs. Two years ago, the Missouri legislature became the first to allow schools to stock quick-relief asthma medications for emergencies. Continue reading
January 14, 2014 — For Travis Hill, it was an offer too good to refuse. Last year when the 30-year-old neuroscientist was admitted to a new program at New York University that would allow him to complete medical school in only three years and guarantee him a spot in its neurosurgery residency, he seized it. Continue reading
By Jim Malewitz
Stateline Staff Writer
Marian Alicea, an engineering student who is slated to graduate from college this spring, needs a doctorate degree to achieve her lofty career goal of becoming a White House environmental adviser with scientific expertise.
But the budget battle in Washington is complicating her plans for getting there.
In normal times Alicea, who attends Southern Polytechnic State University in Marietta, Ga., would likely be a shoo-in for a full research stipend. She is an honors student who has snagged several prestigious internships. And as a Latina she belongs to a minority group that is underrepresented among engineers.
But because of the sequester—the automatic federal budget cuts that went into effect March 1—some of the schools that want Alicea can’t offer her the financial aid she needs.
Federal agencies pour billions each year into university research, largely through grants that allow student researchers to pay their bills as they work.
With less federal money to spend, some Ph.D. programs are delaying admissions decisions, while others have already cut positions amid the uncertainty.
In 2011, federal money accounted for more than $40 billion of the $65 billion universities spent on research. At several large research universities, including Johns Hopkins, the University of Washington, the University of Pennsylvania and Harvard, federal dollars comprised 80 percent of research spending.
Like most other federal agencies, the National Institutes of Health must cut 5 percent of its budget to comply with sequestration. Because NIH funnels about 85 percent of its budget to researchers, it is already scaling back some grants, according to director Francis Collins.
Meanwhile, the National Science Foundation, facing similar cuts, estimates it will give out about 1,000 fewer research grants and awards this year, affecting as many as 3,000 researchers.
Researchers and university officials worry the lost funding will slow or halt research on everything from cancer treatments to contaminated soil and water.
They also fear it will dissuade young scholars from pursuing scientific careers.
“It will be profoundly devastating for this generation of students,” said Michael Reid, head of the physiology department at the University of Kentucky’s College of Medicine.
Alicea was accepted into four of the dozen programs she applied to, but only two —Virginia Tech and Auburn — offered her financial help.
The other universities, Maryland and Illinois, said they could not guarantee her money because the sequester had muddled their budgets.
Enrollment in graduate schools was already lagging amid growing concerns about student debt. Between 2010 and 2011, first-time U.S. enrollment across programs fell by 1.7 percent, following a decade of gains, according to a survey by the Council of Graduate Schools.
“This financial stress on institutions comes at a really tough time,” said Debra Stewart, the council’s president. “It has a chilling effect on what was already a chilly situation.”
For all university students, sequestration will mean higher fees on Stafford Loans and reduced payments from some grants, including federal work study.
Some educators worry that the prospect of amassing higher debt will scare students away, particularly as institutions hike tuition amid eroding state funding.
But the economic forecaster Moody’s expects universities as a whole to face only “minimal” immediate effects from sequestration as they turn to other revenues.
For graduate students in the sciences, the impact will be more dramatic. A lack of federal money prompted the University of Kentucky’s College of Medicine to admit about a third fewer students to its Ph.D. program in physiology, according to department head Reid.
“There were a number of qualified candidates we had to turn away,” he said.
Reid, who oversees a lab studying how chronic disease, such as cancer, speeds up muscle deterioration, said one of his lead doctoral students will lose his grant if sequestration continues, threatening to halt his education and dramatically slowing down the line of work.
If the politicians in Washington can craft a budget deal that replaces the sequester, Reid’s lab could immediately resume some of its stalled research, he said. But when it comes to genetically engineering mice, a process that can take years, it would likely have to start from scratch. When that type of research is halted, Reid said, “That’s it. You’re toast.”
A “grim fate”
Alicea has no qualms about taking the offer from Virginia Tech, but she is frustrated by her constricted choices and troubled by what it says about lawmakers’ support for the sciences.
Experts consider investment in those areas to be essential for the country’s economic competitiveness and ability to improve health and technology.
Consider Lucas Arzola, founder and head of Inserogen, a biotechnology startup that uses tobacco leaves to speed up the development of human and animal vaccines. He originally developed the technology as a Ph.D. student at the University of California-Davis, largely supported by federal grants.
If Congress doesn’t act, “how many graduate students will no longer have the support to make that next critical discovery?” Arzola said in a video testimony shortly before sequestration took effect.
Major drug, energy and engineering companies are increasingly relying on universities to build on their research and develop new products, said Robert Duncan, vice chancellor for research at the University of Missouri.
Duncan says sequestration “is terrible for U.S. competitiveness,” pointing to a 2010 National Academies of Sciences studythat showed the U.S. has begun to lag behind other countries in math and the sciences.
“In spite of the efforts of both those in government and the private sector, the outlook for America to compete for quality jobs has further deteriorated,” the authors concluded. They called for more spending on research and education.
Furthermore, many economists argue it is misguided to curb research spending to address the nation’s budget crisis, because several studies have shown such spending spurs economic activity far greater than what is invested.
Last fall, an analysis by the Information Technology and Innovation Foundation, a non-partisan think tank in Washington, estimated cuts to research and development funding under sequestration would reduce GDP by as much as $860 billion over nine years.
“If we want to see our still somewhat lagging economy pick up again, (investing in research) is one of the major ways to achieve it,” said Collins, the NIH head.
At NIH, the cuts follow a decade in which funding stayed static despite inflation, and could result in the elimination of as many as 20,500 U.S. research jobs, according to an analysis by United for Research, a coalition of research institutes and patient advocates.
“It is a paradoxical thing that we are both at a time of remarkable and almost unprecedented scientific opportunity,” Collins said, “and we‘re also at a time in the United States of unprecedented threat to the momentum of scientific progress.”
Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.