Writer-in-Training, Columnist and in-Training Staff Member
Philadelphia College of Osteopathic Medicine
Aishwarya is a second year medical student at the Philadelphia College of Osteopathic Medicine. She relishes any opportunity to talk policy, social determinants of health, mental health parity and inclusion topics. Outside of school, Aishwarya enjoys yoga, green tea with lemon and copious amounts of dark chocolate.
Doctor of Policy
Doctor of Policy is a column dedicated to exploring and challenging contemporary health policy issues, especially in the fields of behavioral health, health care access, and inclusion, all from the eyes of a public health girl in a basic sciences world
Recently, Congress passed the so called “Doc-Fix” bill bringing about changes to the Medicare reimbursement structure. Understandably, there has been great confusion about what the implications of these changes are, particularly for future and current physicians. Here are some of the key changes taking place as a result of the bill’s passage.
So now that we have discussed the many benefits of exercise, how much is recommended? National organizations such as the American Heart Association (AHA) have created evidence-based guidelines describing the minimum amounts and types of physical in which adults should regularly engage.
Cognition affects memory, attention, concentration, judgment and evaluation, and so it is no surprise that deterioration of these facilities can be extremely disturbing to patients and their families. Cognitive decline is a natural part of aging, and results from decreased white matter integrity over time. As the average lifespan continues to increase, dementia grows as a source of morbidity. Pharmacotherapy for dementia is still in its infancy, and while the commonly prescribed drugs have shown efficacy in slowing the progression of dementia, they do little to improve patients’ cognition. Thus, preventative steps to maintain cognition in the elderly are imperative. Exercise can play an important preventative role in this process; in addition, research has shown it to have the potential to reverse cognitive decline — an outcome that still eludes traditional pharmacotherapy.
The traditional structure of medical education begins with teaching normal anatomy and physiology followed by the various pathologies and treatments. Once students reach the clinical years, we are taught to think in the form of a SOAP note. First, perform a history and physical; then, order the necessary diagnostic tests to obtain your subjective and objective information. Next, form your assessment and plan — what is the problem, and how do you fix it?
Good sleep goes hand in hand with good health; after all, one-third of the day is spent in the state of non-wakefulness know as sleep. Whether this sleep is a peaceful slumber or ridden with multiple awakenings has great consequences for productivity, learning, attention and demeanor throughout the day. Thus, it is essential to maintain adequate sleep hygiene, and exercise can play a role in increasing restorative sleep — if done at the right time.
Whether you’re a first-year trying to survive the last few hours, days or weeks of school, or you’re a seasoned third-year ready to start applying for residency programs, a crucial piece of legislation was just brought to Congress and it’s time to talk about it. As you may know, funding for residency programs has remained virtually stagnant since 1997. While the funding has remained consistent, enrollment in medical schools has increased nearly 30% since 2002. How have we accommodated the increased number of entering medical students in residency training programs?
Anyone who has come face to face with a bear can attest to the fact that our bodies can respond physiologically to emotional stimuli in the environment. A racing heart rate, rapid breathing and pounding cardiac output are all physiological responses that may take place during such an encounter. But we do not necessarily need to run into a bear to dramatically affect our cardiovascular (CV) health.
“Write your name on the paper,” he said. Since he was a senior who’d just gotten into medical school, and I was a simple sophomore who’d chosen to attend the session, I did. “Now write Dr. in front of it.” I complied. “If you’re reading that and you don’t feel anything, medicine isn’t for you,” he said. I looked at it again, my name with a Dr. in front of it. I didn’t feel a thing. I crumpled up the paper, chucked it in the trash and didn’t give it another thought.
In his Pulitzer-prize winning book, Siddartha Mukherjee, MD sets an ambitious, seemingly impossible goal: to tell the story of cancer, a prevalent disease in modern medicine as well as the public mind, in a way that is both technically accurate and accessible to readers of all levels. This goal is complicated by the breadth of background details, years of medical research and countless scientific papers that are woven into the connotations of the word ‘cancer’ — connotations that for many are terrifying, confusing and depressing.
A few weeks ago, I was describing my team’s discharge plan to the patient I had been following all week. We had found an anterior mediastinal mass on imaging, and the pulmonologist wanted to follow-up in a week after immunohistological staining came back. I told him we felt he was now stable, and that we would like him to follow up with the lung doctor as an outpatient within the week. He asked me if he should return to the ER to get his appointment.
In the past few weeks, there has been considerable press surrounding needle exchanges and the recently declared HIV epidemic in Indiana.
The first time I talked with my friends about needle exchanges, I had a visceral reaction. “Why would you give people new needles?” I asked, completely outraged. “Isn’t that enabling and therefore doing a disservice to the very people you’re trying to help?”
A torrential thunderstorm forced nearly the entire homeless population of Tampa Heights out from under their tents and awnings in favor of the more generous cover of a highway overpass. It was the closest Tampa had come to a publicly funded homeless shelter.
Columnist and in-Training Staff Member
Morsani College of Medicine at the University of South Florida
Ajay is a pediatric resident and a Class of 2017 graduate of the SELECT MD program at the University of South Florida. He is passionate about delivering primary care to underserved populations—specifically, low-income and homeless patients in urban centers. Ajay will be specializing in pediatrics, with a particular interest in child maltreatment.
M.D. or Bust
Numerous studies have documented that medical students lose empathy during clinical years, becoming jaded and pessimistic. This has been linked not only to diminished enjoyment of our work, but also to worse patient outcomes. My goal is to sustain the humanistic values that drive so many of us to medicine, so that, instead of being quelled by cynicism, our idealism can be refined by wisdom.
