If Doctors Aren’t Happy, Where Does That Leave the Rest of Us?

A national survey of 500 physicians 40 years of age and younger showed that 49 percent believe federal health reform will have a negative impact on their medical practices, while just 23 percent believe Obamacare will be a net positive, according to a survey from The Physicians Foundation, an advocacy group.

On a similar note, 57 percent of young physicians said they’re pessimistic about the future of the U.S. healthcare system, while 22 percent consider themselves optimistic.

Responses ranged from “I think the government is destroying healthcare” to “The current administration is only concerned with money and maintaining their power and socialism,” with plenty of other similar highlights in between.

Why do physicians feel this way?  Jason Koma, a spokesman for the Ohio State Medical Association, the state’s largest trade group for physicians, pointed to excessive regulation. “Physicians are sometimes overcome by red tape, regulations and obstacles that prevent them from doing what they became physicians to do — deliver care to patients,” Koma said.

How does this knowledge affect the rest of us?  Will the fact that doctors are unsatisfied make any difference to “the man”?  Unfortunately, the moderate in me doubts it… Although my outspoken and very conservative husband could probably give you a twenty minute dissertation on how the current administration has destroyed our healthcare program (there was talk of selling everything and moving to a tropical island to get away from it all at one point), I prefer to remain blindly hopeful in the democratic process and hope that with the upcoming election we can do something to improve the outlook of our doctors and the rest of the country.

 

Drugs In Space

In case you have any plans to go up in space in the near future, be advised…

One of the first publications from the Stability of Pharmacotherapeutic and Nutritional Compounds project determined that after 28 months of storage on the International Space Station some medications degraded faster than controls stored in as similar environment as possible on the ground.

One of the authors, Lakshmi Putcha, Ph.D, said the differences between the ground and control environments “include, but are not limited to, ambient radiation, excessive vibrational forces, multiple gravity environments and carbon dioxide enrichment; this is in addition to unconventional packaging, resupply operations and other unknowns.”

Aside from alerting astronauts to the fact that they may have to plan ahead with their prescriptions, I’m really not sure the practical implications of this study for rest of us earth-bound folk.

 

 

Why Martinsville?

I live in Martinsville, and, I have to admit, I have often wondered why any doctor would want to come and work in our small burg when they could instead get a high-paying job in the “big city”.  I recently discovered that there is evidently some skill and planning involved in “luring” a doctor to small towns, particularly if, like Morgan Hospital, you have been bought by a much larger health organization such as Indiana University Health.

So how could the big boys entice doctors to the small towns? Avoid saying anything specific about the town, and instead tell doctors-to-be they can live somewhere else or go somewhere else.

Morgan Hospital and Medical Center in Martinsville, the latest acquisition by Indiana University Health, tried those tactics in a recent online posting seeking an internist.

“Enjoy a Norman Rockwell-like community with close access to more cosmopolitan environments for cultural events, concerts, museums, shopping, sporting events and dining,” the ad says.

And while it mentions a few things about the job itself and hospital itself—“great practice growth opportunity” and “one-stop primary care hospital!”—it spends most of the time talking about the attractions of Martinsville or, more precisely, not too far outside of Martinsville.

One big advantage a large health organization might have—something not mentioned in the advertisement—is the ability to pay higher salaries. Primary care physicians draw annual pay of about $170,000, but generate at least 10 times as much in revenue for a hospital by referring patients to the hospital for the more expensive surgeries and specialty care. Padding the pay a bit upfront can, therefore, be lucrative down the line.

As a resident of this “Norman Rockwell-like community”, I am hoping that this method of hiring works and that we get talented, quality medical staff in our hospital.  I remember when I was a kid and we had to go to Bloomington to have my broken wrist set because they didn’t have the capabilities to do it at Morgan County Hospital.  I’d like to think the hospital has come a long way since then…

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$10 million to replace a doctor with a robot?

I wrote a blog earlier this year in which I expressed how relieved I was that the robotic doctor, Watson from Jeopardy fame, could not replace a real, live doctor.  Imagine my chagrin when I disocvered an article titled “X-Prize competitioin will give $10 million prize for mobile diagnosing solution equal or better than physician.”

“ The Foundation is hoping the same transformative change will happen with mobile medical technology.  They are partnering with Qualcomm and announced the Tricorder X-Prize, a $10 million dollar prize to develop a mobile solution that can diagnose patients better than or equal to a panel of board certified physicians.”

I breathed a sigh of relief as I read further on and discovered that “It doesn’t appear the X-Prize wants to replace a physician, rather, allow them to spend their time more efficiently”.  I’m all for advancement in technology, as long as there is still a warm-bodied human being to go along with it.

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Technology- 2, Moms Against Video Games- 0

I blogged last week about how the Nintendo 3DS had a use as a medical application.  According to imedicalapps, it seems that yet another “one of those blasted video games”, as I like to refer to them, is being used for medical purposes.

“An example of this is how Doctors in Toronto have transformed the X-box Kinect into a tool for use during surgeries. Microsoft’s Kinect, originally code named Project Natal, is a controller-free gaming system. The device enables users to interact with an Xbox 360 using hands free gestures and spoken commands.

The added medical functionality in this case: Surgeons can manipulate radiology images during surgery without having to break their sterile field.  Gowning and becoming sterile again can take up to 10 minutes alone.  Getting someone else to manipulate the CT images requires a fair amount of manipulation, and more time that the patient is on the OR table — time that can potentially be saved during an operation by using the Kinect system the team at the University of Toronto has designed.”

While I am impressed with the ability of scientists to adapt the existing technology for medical usage, the mom in me can’t help but think that someday, somewhere in the future, when I least suspect it, my child is going to use examples such as this against me to coerce me into purchasing the latest video game.

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The FDA as an Advocate for Children

The parent in me appreciated the following article in massdevice that talked about how the FDA was helping to get pediatric medical devices to market.

“Pediatric devices come out years after analogous devices for adults reach the market. del Nido spoke of the unique challenges behind this delay: Children differ in size, growth, and body chemistry; their activity levels vary greatly; the market for pediatric devices is small; reimbursement is limited. And because there are fewer patients, it can be difficult to gather the data required for FDA approval of high-risk devices.

“Designers often end up adapting the designs of adult devices for pediatric use,” he noted, “even though those designs may not be appropriate for use in kids.”

This is where the FDA’s advocacy role comes into play. In 2004 and 2007, Congress passed legislation that empowers the FDA to address the inherent obstacles and help new devices make it to the patient’s bedside. The two acts gave the FDA a number of duties – such as modifying safety and probable benefit guidelines, encouraging interactions between pediatric clinicians and industry, and creating networks of hospitals and other facilities with pediatric expertise – aimed at stimulating the development of devices for children.”

Since I have been writing for the med tech industry, I have seen plenty of articles that are not necessarily complimentary about the FDA.  It warmed my heart to see that this supposedly cold-hearted, rigid government agency is also an advocate, helping bring innovative devices for pediatric treatment into clinical practice.

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The Matrix- Thankfully Not Realistic

Since I started writing on the subject of life science, I have been excitedly telling people about some of the cool new medical devices I have discovered.  Perhaps I am a bit over zealous because finally, one day, someone said, “Pretty soon they’ll be replacing doctors with machines”, and he didn’t mean it in a good way.  Not only did this burst my bubble, it also made me wonder if perhaps we were taking technology a bit too far.  Would computers rule the world some day? I started replaying scenes from The Matrix in my head.  Were we all destined to be pacified and subdued by technological gizmos while our body’s heat and electrical activity were used as an energy source? Luckily, I came across this article in ImedicalApps before I got too worked up.

“Medicine cannot be reduced to a set of complex algorithms because much of the data for these algorithms cannot even be inputted.  Those without training in medicine do not understand the multifaceted “behind the scenes” analysis that actually occurs when talking to a patient.

When physicians are asking patient’s their symptoms, we’re analyzing a complex amount of information that is not tangible and cannot be spoken or inputted into an algorithm:  Eye contact; Subtle physical movements; How they respond to questions – does their tone change when describing a particular symtom, leading me to believe I’ll uncover more information if I ask more about this; How they smell; How they are sitting; The reaction of family members when the patient responds to a particular question; What they are wearing; Any signs of underlying trauma; and much more.

No matter how good you are at diagnosing and treating, unless you asked the right questions in a timely manner, all the knowledge in the world won’t be helpful.  I’m sure an artificial intelligence program could produce a rudimentary H&P (History and Physical), but far from a focused and disease specific H&P a trained physician produces hundreds of times a month.  Some would argue it’s why physicians have a minimum of 7 years of post-graduate training (medical school + residency) before we have the sole responsibility of a patient.”

I know I, for one, will rest easier knowing that our human existence is not threatened by the advances of technology.

Medical Apps Galore

I subscribe to quite a few medical device-related blogs and newsletters. I’m amazed at how many articles and posts there are pertaining to medical related applications for smartphones. I decided to do a search on my Droid for “medical” apps and was amazed to see the quantity, with prices ranging from free to $59.95. I decided to downloaded a few to check out:

  • NICU Quick Drip Calculator – Appears to be an app providing drug dosages for neonates. One of the comments on the app page is concerning: “Incorrect dosage forms…dopamine, dobutamine and alprostadil are measured in mcg/kg/min, not mcg/kg/hour.”
  • Diagnosis & Therapy – Looks like a handy application for the common person to learn more about diseases, treatments, and other medical terminology. For example, I can learn more about antibiotics.
  • IV Infusion Rate Calculator – Claims this app helps the user calculate the right IV infusion rate. App has a disclaimer stating the authors make no claims of accuracy.
  • Skull – IMAGE Flashcards – Labels bones of the skull. Appears to be useful for medical students.
  • Medicinal Herbs – Provides a list of medicinal plants, herbal remedies, and natural supplements used to treat common ailments. I learned that cat’s claw  has been used for centuries in South America to prevent and treat disease.
  • Merriam-Webster Medical - A dictionary of medical terms.

I both concerned and amazed at the variety and complexity of medical-related applications available for smart phones. Many articles I’ve read have discussed the growing use of smart phones, iPads, and other computer technology within the medical profession. While I have no idea about the prevalence and use of these apps, I’m surprised FDA has been so silent on this.

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May 11, 2010 – Finding a strategic partner to take your product to market

Finding a strategic partner to take your product to market

Where: Riley Outpatient Center (Directions)
When: 5/11/2010 at 5pm

Learn how a strategic partner can help take your medical product to market. Email jabartek@prf.org for Jim Pearson’s slides from April. Cost is free, but registration is required.

Click to Register

Speaker(s):
Wade Lange, ImmuneWorks
Gary Noonan, Eli Lilly
Matt Call, Endocyte

Moderator(s):
Jack Pincus, Selican

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Life Science Job Opportunities

Ann Clifford, of Safari Solutions, asked that I share some job information with all of you. There are three open positions at Polymer Technology Systems that they are seeking referral candidates to potentially fill.

Polymer Technology Systems, Inc. (PTS) has played an active role in the life sciences industry since 1992.  Their revolutionary medical diagnostic devices test cholesterol and other indicators in the blood for cardiovascular disease, diabetes, and other chronic conditions.  Launched worldwide in 2003, the CardioChek family of diagnostic devices is now used by thousands of physicians, pharmacists, and wellness programs around the world.

Open positions include:

  1. Manager – Point of Care Testing
  2. VP of R & D
  3. Senior Engineer

You can view details of these positions on our Safari Solutions career site:  Job Opportunities for Polymer Technology Systems.

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April 21-22, 2010 – BIOMEDevice – An MD&M Event

BIOMEDevice – An MD&M Event

Find Unparalleled Resources at New England’s Industry Event for Medical Device and Biopharma Development and Manufacturing

Regardless of your particular product design, development, or manufacturing needs, BIOMEDevice offers the widest array of products and services for every medical specialty and application.

Fresh Ideas, Innovative Solutions, and a Wealth of Resources—All in One Place

A visit to BIOMEDevice is the most efficient way to explore the latest advances in medical-grade materials, assembly components, electronics, design and engineering support, production equipment including automation and controls, information systems, medical device software, clinical connectivity and device interoperability, regulatory compliance, packaging materials and machinery, sterilization systems, and a full complement of contract services for every aspect of the medical product development process…from initial start-up and R&D through end-product marketing.

The Nation’s Leading Suppliers and Industry Experts
BIOMEDevice exhibitors are ready to assist you in designing products that improve quality and reliability, shorten time-to-market, and are easier and more affordable to produce, reduce end-user costs, and enhance patient safety—all key advantages in positioning your products in today’s competitive marketplace.

NEW IN 2010! — Take advantage of FREE presentations right in the expo hall!
The new Innovation Briefs Theater features 30-40 minute presentations from leading OEM suppliers on the latest developments and technologies important to your industry. Uncover better processes, intelligence, and technology and return to your work place with the tools you need to make your business stronger! Admission is complimentary with your show badge.

Co-located with the Nation’s Premier Executive-Level Conference
The BIOMEDevice Forum focuses on convergence and cross-sector collaborations among companies in the biotechnology, medical device, IVD, and pharmaceutical industries. This two-day event brings together key players involved in investing, partnering, licensing, and developing business opportunities in the rapidly growing market for innovative healthcare products.

Make Your Plans Today to Be a Part of BIOMEDevice Boston 2010.

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April 13-15, 2010 – Design of Medical Devices Conference

Design of Medical Devices Conference

The world’s premiere medical devices conference consists of three-days of multiple scientific poster sessions and technical/scientific sessions with topics such as:

  • Live Surgery
  • Cardiovascular Engineering
  • Neuroengineering
  • MEMS/Nano Devices
  • Medical Electronics
  • Technology Assessment
  • Human Factors
  • Orthopedics
  • Surgical Simulators
  • Health Informatics
  • Surgical Tools
  • Government Funding
  • Legal/Regulatory Issues
  • Innovation and Design
  • Tissue Engineering
  • Healthcare Reform
  • Medical Technology
  • Engineering in Urology

Get more information and register.

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FDA and the Mobile Med Device Movement

With med device application downloads to smartphones, such as iOncolex and CPR Training, and medical school PDA requirements, FDA compliance has got to be on the forefront. So will they be putting their foot down any time soon on compliance regulations of these mobile apps? And how does this affect the developers of medical devices or even the garage-developer/inventor?

According to MedGadget there are already thousands of apps that have been created for the medical device world. The dilemma on whether the FDA will begin requiring that all applications go through a clearance process is becoming an issue.

It’s important to understand what is considered a “medical device“. In mobile health technology an accessory or a component of a medical device is considered to be regulated as a medical device. Software can even be a medical device is it’s written on computer media versus printed on paper.

It’s a very interesting subject and one that you will see more of on our blog as new advances come out.

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Interview with Pete Kissinger of Prosolia

Interview with Pete Kissinger of Prosolia

Pete Kissinger

Pete Kissinger

CQ: Tell me about Prosolia.

Pete: Prosolia is a young company with operations in Indianapolis and West Lafayette.  Our expertise is in looking at organic and biochemical materials on surfaces.  For example, we’ve worked with the military and on forensic challenges in explosive detection and detection of drugs of abuse.  Counterfeit drugs is another key application.  Determination of drugs used in combination medical device/pharmaceutical products is a good topic as well.

CQ: What do you do?

Pete: I’m a part time chemistry professor at Purdue and am Chairman and CEO of Prosolia to help guide this young company as well as another, Phlebotics, Inc.  I enjoy watching ideas come out of research and move into commercialization where they can contribute to better health.  My special expertise is in making chemical measurements in biological goop. This is, of course, a very large part of diagnostic medicine, pharmacology, toxicology and documenting performance for FDA submissions to establish safety and efficacy. I’ve guided many studies both in preclinical and clinical medicine.

CQ: Who makes a good customer?

Pete: The customers for both our products and services are all trying to make a chemical measurement.  In order to know if our technology is likely to be helpful, we need to know what they want to determine in molecular terms, where it is located and how much (or little) they need to get a handle on.  The questions are pretty much the same for an antibiotic coated on a medical implant, a pesticide on an apple, a cancer drug in a dried blood spot or a gunshot residue on a piece of clothing.

CQ: What is your biggest obstacle today?

Pete: We are in a down period for commercial funding of medical innovation.  This is reflected in a decline in life science venture capital and the closing of many pharmaceutical R/D sites in the last several years.  Firms like Prosolia are clearly at the bottom of the food chain, but when innovation is discouraged at the largest entities, it is felt all the way down.  Capital expenditures for R/D equipment decrease and projects for outsourcing research also decrease as firms focus on fewer projects with the highest probability of success.  We are in a down cycle now, but historically, these have been followed by up cycles.  Thus guarded optimism is appropriate.

CQ: What three words describe Prosolia?

Pete: Innovative, ethical, bulldogs.

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Advancements In 3D Vascular Imaging

I’ve seen dozens of surgical procedures where the physician takes an angiogram of the patient. To me, it’s amazing that physicians can “read” the image and make determinations about blockages, issues, etc. Physicians are able to interpret two-dimensional images, visual three dimensions, and save lives.

Maybe the practice of angiography will become a little easier. I just read “Rotational Angiography for 3D Vascular Imaging” from the Advanced Medical Technologies.

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