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Dr. Colleen Kraft

The Leg.UpLocal, state and national news of interest to thephysician community June 20, 2018

 President Changes Course After Doctors Worry About 'IrreparableHarm' To Separated Children  

President Trump abruptly reversed course Wednesday, signingan executive order ending family separations at the U.S.-Mexicoborder. The new plan, as described by administration officials, would keepfamilies together in federal custody while awaiting prosecution forillegal border crossings.The policy change was announced after anationwide uproar about his administration's "zero-tolerance"immigration policy. Dr. Colleen Kraft, the current president ofthe American Academy of Pediatrics and aformer RAM member, said the policy "amountsto child abuse." Earlier this week, Kraft, in anappearance on CNN, described the many waysTrump's policy emotionally harms children andlaid out in detail what she witnessed when shetoured an immigration detention center. The number of migrant children in U.S.government custody recently soared into thethousands. After concerned pediatricians contacted her, Kraft flew toTexas to inspect a facility in South Texas. Afterwards, she discussedher findings with NPR, noting that facility staff told her that federalregulations prevented them from touching or holding a screamingtoddler to soothe her. Kraft says these shelters are not the right place for young children -especially kids who have fled dangerous countries and who have justbeen separated from their parents. "By separating parents andchildren, we are doing irreparable harm to these children. The long-term concern of what we call toxic stress is that brains are notdeveloped efficiently or effectively. And these children go on to havebehavior problems, to have long-term medical problems." Many medical professionals, members of Congress and religiousleaders - including the Sisters of Bon Secours, who issued thisstatement - implored the Trump administration to stop separatingmigrant families. And Gov. Ralph Northam called home a VirginiaNational Guard helicopter and crew. How stressful is life in these shelters? The U.S. Customs and BorderProtection Office released video this week showing the CentralProcessing Center in McAllen, Tex., during a media tour. But, reports The Washington Times, the government is paying $670 aday to make sure these children have near-unlimited food, sportsfields, cable television and field trips.

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U.S. Customs and Border Patrol released this image ofthe Central Processing Center in Texas.

President Trump and AttorneyGeneral Jeff Sessions havesaid the administration is justenforcing immigration law. Confused about the issue? TheLos Angeles Times has thishelpful Q&A.

Take Your Family Out To the Ball Game!

Summer is here and it's time to play ball! Make plans for you andyour family to join us this Sunday, June 24, for RAM Day at theDiamond as the Richmond Flying Squirrels take on the BowieBaysox.

We'll have a private area reserved in the ballpark for our group toenjoy lunch and refreshments prior to the 1:05 p.m. opening pitch.Families will also have the opportunity play catch on the field, runthe bases after the game, and enjoy fun balloon creations byBalloons by Extreme.

No cost to members and their families but tickets are limited, soplease reserve yours early to not strike out! Hope to see you there!

CLICK HERE for more info and to reserve!

VCU To Break Ground For New Outpatient Facility  VCU Health will build a 16-story, $349million outpatient facility on the site ofthe former Virginia Treatment Centerfor Children building at North 10th andLeigh streets. VCU Health officials said the building isthe largest capital construction projectin the medical center's history. The new facility will consolidate most ofVCU Massey Cancer Center's outpatientcare, on-site laboratory services,medical imaging, women's services andrehabilitation services. The project calls for a 603,000-square-foot outpatient building and a472,000-square-foot parking deck with more than 1,000 parkingspaces, according to VCU. The groundbreaking ceremony will be held later this week.

New Rule Rolls Back ACA Protections   

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A sweeping new rule issued Tuesday by the Trump administration willmake it easier for small businesses to join forces and set up healthinsurance plans that circumvent many requirements of theAffordable Care Act, cutting costs but also reducing benefits, reportsThe New York Times. President Trump said the new rule would allow small businesses to"escape some of Obamacare's most burdensome mandates" bycreating new entities known as association health plans. The new health plans may not have to provide certain "essentialhealth benefits" like mental health care, emergency services,maternity and newborn care, and prescription drugs. Labor Department officials said association health plans would not beable to deny coverage or charge higher rates to individual employeeswith pre-existing medical conditions. However, Democrats and others in the health industry say theinsurance plans are "junk" that will further destabilize themarketplace.

Ideas Wanted!  Help Shape MSV/RAM's Legislative Agenda 

  Do you have suggestions for new health care policy in theCommonwealth? Are there rules, laws, studies or other fair businesspractice issues that you would like to see the Medical Society ofVirginia address? If so, RAM invites you to offer resolutions for the consideration of our38 delegates who will represent Richmond-area physicians at theMSV Annual Meeting, October 19-21. These resolutions may end upas proposed legislation for the 2020 Virginia General Assembly or asa part of the MSV legislative package for 2020.

Please describe the problem, define the issue and propose a possiblesolution. Submit your work by fax to 788-9987 or by email tolknowles@ramdocs.org. All resolutions must be received byWEDNESDAY, AUGUST 15 to be considered.

Please consider serving as a delegate to the MSV Annual Meeting. Ifinterested, contact Lara Knowles at 622-8137 orlknowles@ramdocs.org.

Virginia Receives Applications for Cannabis Licenses   Virginia has received 49 applications from medical cannabiscompanies hoping to be among the first to set up shop in the state,giving officials plenty of options as they prepare to hand out fivelicenses this summer, reports The Richmond Times-Dispatch. The applications, which required a $10,000 filing fee, were due lastweek to the Virginia Board of Pharmacy, which is planning to issuelicenses to allow one medical cannabis oil dispensary in each of the

state's five health serviceareas. The state is not releasingthe applications themselvesbecause they containproprietary information.The service area that

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includes Richmond had nineapplications. The General Assemblyrecently passed legislationto allow in-state productionand sales of medicalcannabis oils to any patientwith a certificate from adoctor, expanding on a lawthat initially only provided

some legal protection for patients who wanted to use CBD oil orTHC-A oil to treat severe epilepsy. The legislature passed a law preventing epilepsy patients from beingcriminally prosecuted over cannabis oil, but several families saidthey still had to risk legal trouble by traveling outside Virginia to buythe oils and bringing them back across state lines.

New Proposal Could End Public Reporting of Infection Data    Federal health regulators will have to stop releasing data on hospitalinfections - which affect one in 25 hospital patients everyday - under a proposal set to take effect in November, according toan analysis by patient safety advocates, reports USA Today. The new CMS plan, part of a complex 500-page proposed rule, couldhalt the public disclosure of the "super bug" MRSA, post-operativesepsis and surgical site infections, as well as accidents and injuriesranging from bedsores to respiratory failure after surgery. If the proposed rule is finalized, CMS' website won't showthe infections or safety measures, as to do so, the data would haveto be in a program the Trump administration said hospitals should nolonger have to report infections and other safety problems to. More than 600,000 hospital patients a year contract an infection andsepsis alone kills about 270,000 people a year.

3 Ways to Reduce Your Med School Loan Repayment Period    Most young physicians know what it's like to feel overwhelmed bythe debt accumulated by medical school. This helpful blog fromKevin MD shares a few tips to cut years off the repayment loanperiod. And, when those loans start to seem more manageable, here's onedoctor's take on financial lessons he learned by racing bicycles.

Is Compulsive Gaming a Mental Health Problem?  The World Health Organization says some obsessive videogamers may really have an addiction, reports The Washington Post.

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In its latest revision to a disease classification manual, the U.N.health agency said that compulsively playing video games nowqualifies as a mental health condition. The statement confirmed thefears of some parents but led critics to warn that it may riskstigmatizing too many young video players. A 2017 report in the American Journal of Psychiatry found that veryfew people - between 0.3 percent and 1 percent of the generalpopulation might qualify for a diagnosis.

Patients' Gender Identity May Lead to EHRChanges    A new field is beginning to pop up on patientregistration forms: preferredpronouns. The healthcare industry,notoriously slow to change culturally andtechnologically, is beginning to speed up inboth areas when it comes to gender identity,says Modern Healthcare.

To do that, electronic health record vendors and health systems alikeare pushing to include gender identity alongside other patientinformation.

But there's a problem: EHRs are structured to capture informationthat's binary, but patients are not always so easily classified.

So in the face of software that only has two options, health systeminformatics directors and others are demanding that their EHRvendors give them ways to describe people whose identities don't fit"male" or "female."

The government is demanding the same - if meaningful userequirements hold, that is. As regulations currently stand, providersmust use 2015 edition certified EHRs beginning in 2019; these EHRsmust provide fields for recording gender identity, as well as apatient's sex. The Joint Commission also recommends that providersincorporate gender information into patient records-when patientsare willing to disclose that information.

Herbs: There's an App For That Does Echinacea cure colds? Can flaxseed reduce hot flashes? Yourpatients, most likely, have lots of questions about herbs.

The National Institutes of Health'sNational Center on Complementary andIntegrative Health now has an app thatincludes information on the herbs' commonnames, history and uses, plus what thescience says about their effectiveness forhealth purposes. It also offers facts onpotential safety problems, side effects andherb-drug interactions.

Learn more here.

 A 'Familiar Stranger' That Could Ruin Your Summer        It was a close encounter in 2012 that made microbiologist JohnJelesko take an interest in poison ivy.

The Virginia Tech associate professor was cutting up a downed treewith an electric chainsaw. What he didn't realize was that his powercable had been dragging through poison ivy.

"Within 48 hours, I had your classic case of poisonivy on my arm. And as a scientist, I said, 'This isinteresting, how bad can it be? I'll just leave thisuntreated,'" he recalled, sheepishly. "In about twoweeks, I had learned just how uncomfortablepoison ivy rash could be."

The experience sparked years of research into a plant he calls a"familiar stranger." He has studied the chemical, urushiol, thattriggers that telltale rash and the plant's biology overall.

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Here, he offers insights into how to recognize Toxicodendron radicans,the scientific name of the plant, before you risk touching it - and whatto do if it's too late.

 

Study: Higher Vitamin D Levels Lower Colorectal Cancer Risk        Higher concentrations of vitamin D circulating in the bloodstream arelinked to a lower risk of colorectal cancer, according to a largeinternational study published last week.The researchers said the results strengthen the evidence that thevitamin may play a protective role against the disease, which is thethird-most common cancer in the United States, killing more than

50,000 people a year.

The latest research, which appears in theJournal of the National Cancer Institute, wasconducted by scientists from NCI, theAmerican Cancer Society, the Harvard T. H.Chan School of Public Health and 20 othermedical centers and organizations aroundthe world.

They concluded that "optimal" levels of the vitamin for colorectalcancer prevention are greater than those recommended by theNational Academies of Sciences, Engineering and Medicine, which arebased only on bone health.

 Can't Sleep? Let Bob Ross Help You Find Some Zzzs         For years, insomniacs have been lulled to sleep by the dulcet voice ofBob Ross, the bushy-haired painter whose PBS show, "The Joy ofPainting," rose to popularity in the 1990s and has lately enjoyed asecond life on YouTube. Now, the maker of a popular meditation apphopes Mr. Ross will put everyone else to sleep, too, reports The NewYork Times. Calm.com, which producesmeditation products, isrecasting classic episodes of"The Joy of Painting" into"Sleep Stories," an audioseries designed for restlessadults to ease the burden ofslumber. It is the first timethe company that managesRoss's estate has agreed tolicense audio of the showthat turned Ross into a celebrity and, after his death in 1995, a popculture favorite. "We asked ourselves, 'What would Bob do?'" said Joan Kowalski, thepresident of Bob Ross Inc., which oversees licensing of the artist'sbrand name. "Using his voice to help put people to sleep? Well, hewould love that."

Join the Discussion    The Leg.Up draws from a wide range of print, online and medicaljournals to bring you information we hope is relevant to yourpractice. We want to get the dialogue started. What's on your mind? Please feel free to contact me with your ideas, suggestions andconcerns. You can reach me by email or at (804) 622-8136. Thank you for being part of the Academy and itscontinuing conversation about the best practice ofmedicine.

Click here for past editions of The Leg.Up! Lisa Crutchfield BarthRAM Communications and Marketing Director

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