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Vital Signs
Media Mentions: DMS and DHMC in the News
Among the people and programs coming in for
prominent media coverage in recent months
was a Dartmouth researcher whose work was key
in the development of a vaccine against cervical
cancer. "'This is the most significant advance in
cancer prevention in the last 50 years,' said lead
author Diane Harper, director of gynecologic cancer
prevention research at Dartmouth Medical
School" in Science Daily. The vaccine protects
against the human papillomavirus (HPV)—the
most common cause of cervical cancer—and can
be given to both males and females in their teens.
"These findings set the stage for
the wide-scale adoption of HPV
vaccination for prevention of
cervical cancer," Harper told
BBC. And she was quoted in
the Toronto Star as saying, "I
hope that by the time I die,
there are one or two cases of cervical
cancer [a year] and by the time my kids die,
cervical cancer will go the way of smallpox."
But there has also been political controversy over
the cervical cancer vaccine. New Yorker magazine
turned to another Dartmouth faculty member—a
former surgeon general—to explain
it. "'You have to separate
moral questions from the questions
of science,' C. Everett Koop
said." The article noted that although
some people "prefer to
rely on education programs that
promote abstinence from sexual
activity, and see the HPV vaccine as a threat to
that policy," Koop, who "will be 90 this year . . .
but remains active and runs an institute named
for him at Dartmouth, [says], 'One thing that I
have learned is that belief doesn't change reality.'"
"What Insiders Know about Our Health-Care System That the Rest of Us Need to Learn" proclaimed the May 1 cover of Time. The article noted that "it's hard to find a doctor who doesn't worry about how medicine is changing. . . . 'What scares me most about the current medical environment is complacency with the status quo,' says Dr. Martin Palmeri, an internal medicine resident at Dartmouth-Hitchcock Medical Center. . . .
'When I refer one of my family members to someone,' Palmeri says, 'I want to make sure that they are the type of physician who leaves no stone unturned and will burn the midnight oil if need be to ensure the highest-quality care possible.'"
The Wall Street Journal featured John Wasson, a Dartmouth
expert in practice redesign who is helping
to launch a national program to
expand the micro-practice concept—the idea that doctors may
do better with fewer rather than
more nurses, secretaries, and receptionists.
"The office practice
hasn't changed much in 50 years
. . . This is a disruptive innovation
[but one] that can lead to increased quality
and reduced costs," Wasson said. The concept
may "fix problems that have long frustrated patients,"
the Journal explained, including difficulty
making appointments, hours spent in waiting
rooms, too-brief visits, and the inability to reach
physicians by phone. "Dr. Wasson says the most
efficient way to offer same-day appointments is to
leave 60% to 70% of slots open all day, because in
a typical medical practice 30% to 40% of patients
will want a set future appointment, while the remainder will need urgent care."
The Toronto Sun also featured an article about
making health-care practices more efficient, in
light of a projected shortage of doctors in the U.S.
and Canada. "'It's how efficient
the physicians are, rather than
the number of physicians,' said
Dr. David Goodman, a professor of
community and family medicine
at Dartmouth." United Press International
(UPI) also interviewed
Goodman on the subject.
"Spending millions of dollars annually to expand
our capacity to train physicians will not
only create an oversupply," Goodman told UPI,
"but will also divert health-care dollars from
care that has been shown to improve the health
and well-being of patients."
In other news about medical finances, "'You can't
get any more effective care by spending more
money,' said John Wennberg, a professor who
studies health-care efficiency at Dartmouth,"
in a United Press International
(UPI) article. "The main culprit is what
Wennberg and others call
supply-driven care—care
that takes place much
more often in areas where
capacity is high," UPI
continued. "Health care is
not like any other market,"
Wennberg said. "It's
not like automobiles or supermarkets . . . no
one wants to see their hospital or their doctor
go out of business because it's not efficient
anymore." The New York Times also
quoted Wennberg on what he calls the "supply-
driven demand" of health care.
"Researchers found that Botox was 80% to
90% effective in [treating] radiating pain in
the head," noted ABC News. The story—titled
"Can a Beauty Treatment
Banish Both Wrinkles
and Headaches?"— reported on a study of
Botox as a treatment for
"imploding headaches," in
which sufferers feel pain
moving from the outside
to the inside of the brain. "'There may be
something to the character of the pain,' said
Dr. Thomas Ward of Dartmouth. . . . 'Botox may
actually prevent the release of substances
that can radiate and drive the pain.'"
For a report titled "Driving under the influence—of sleeping pills," MSNBC turned to
Dartmouth "sleep specialist
Dr. Brooke Judd." The report
noted that the prescription
sleeping pill Ambien
is one of the top 10
drugs found in impaired
drivers. Some drivers even
take Ambien behind the
wheel on the way home, MSNBC noted, in
hopes the drug will kick in by bedtime.
"Wow, that's a really bad idea," Judd said.
"These newer sleep medications have a rapid onset, so people can get to sleep quickly. You shouldn't take them until you are really ready to go to bed," she advised. The report said that "Judd also warns sleeping-pill users to get at least eight hours of shut-eye. That's how long the sedative effect can last. An early riser who hits the road might still be too groggy to drive, she said."
Even taken properly, sleeping pills
can cause
problems. "Ambien may render some people
unable to awaken completely even when
something significant disturbs their sleep,"
the Washington Post reported.
"'It is the case, perhaps,
of an unstoppable force
meeting an immovable object,'
said Michael Sateia, chief
of sleep medicine at Dartmouth-
Hitchcock Medical
Center." Ads for the drug
give "'the impression that the management
of [sleep] problems is as simple as giving
someone a prescription for a sleeping medication
and sending them on their way,'
Sateia said. 'It's not that simple.'"
In an article about the much-publicized results
from the Women's Health Initiative
(WHI) clinical trial, the
Wall Street Journal quoted
a DMS faculty member as
to why the study had yielded
such confusing results.
" 'Being in a trial can be
work,' says John Baron, a researcher
at Dartmouth
Medical School. . . . 'You fill out stupid
forms, people are calling you to do this and
do that. It's a burden to do this. Maybe participating
in two trials is just too much to
ask,'" he said. The article explained the ambitious
scope of the WHI, which encompassed
three different studies—one of hormone
replacement therapy, one of diet, and
one of calcium supplementation—with a
smaller number of patients, each of whom
was involved in multiple trials. However,
concluded the
Journal, "the
hassles of being in
multiple trials may
have contributed to compliance
problems that plagued all three [trials]
and hurt the reliability of their results."
For an opinion on how to get the best mental-health care, National Public Radio's Talk
of the Nation interviewed
"Dr. Allen Dietrich, a practicing
primary-care physician and
codirector of the MacArthur Foundation's Initiative
on Depression and
Primary Care at Dartmouth
Medical School."
When asked why he advocates consulting
one's regular doctor before seeking treatment
for mental illness, Dietrich said that
"primary-care physicians today . . . are quite
well-trained for assisting people to make early
decisions about whether they have a mental-
health problem." He went on to say that
"a primary-care physician may actually be in
a position to have a protective role. When
I was in training, one of the things that I
learned was to not be the first doctor on my
block to prescribe a new medication."
The Hindustan Times recently interviewed
Dr. Auden McClure about a study of the association
between alcohol-branded merchandise
and alcohol use in teens.
"Adolescents who own tshirts,
hats, and other merchandise
with an alcohol
brand name on it are more
likely to begin drinking
than kids who do not own
these items," noted the article.
The study, which surveyed over 2,000
northern New England middle-school students,
was published in the American Journal
of Preventive Medicine. " 'This study raises
concern about the relationship between the
products that promote alcohol brands and
early teen drinking,' said McClure."
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