WEDNESDAY, SEPTEMBER 5, 2012
H E A LT H & S C I E NC E
Boomers retiring to rural areas won’t find doctors GRANTS PASS: Nina Musselman had no trouble finding a family doctor when she retired to rural Oregon nine years ago to be closer to her children. But then that doctor moved away, leaving her to search for another who would take Medicare. After a year of going from doctor to doctor, she finally found one who stuck. As record numbers of baby boomers go into retirement, many are thinking about moving from the places they needed to live to make a living, and going someplace warmer, quieter or prettier. If they choose small towns like Grants Pass, 250 miles south of Portland, they could well have a hard time finding a family doctor willing to take Medicare, even supplemental plans, rather than private insurance. “It’s a sad situation for seniors,” she said. There are several reasons boomers, the 78 million Americans born between 1946 and 1964, could face difficulties finding a doctor if they retire to small towns over the next 20 years. First, many primary care doctors prefer to live and work in urban areas because of
greater cultural opportunities, better schools and job opportunities for spouses. Also, Medicare pays rural doctors less per procedure than urban physicians because their operating costs are supposedly less. That makes rural doctors less likely to accept Medicare patients. With cuts to Medicare reimbursement for doctors targeted under the federal health care overhaul, the shortage is likely to get even worse, said Mark Pauly, professor of health care management at the University of Pennsylvania. That is, unless increasing reimbursements for nurse practitioners and physicians’ assistants encourages those providers to take up the slack, Pauly said. If the Medicare cuts go through, “the doctors are saying: “We’re out of here,’” Pauly said. “The least they are saying is: ‘We’ll treat Medicare patients like we treat Medicaid patients,’ which is mostly not.” Still, there is some good news, depending on where you live. Pauly said the Affordable Care Act “puts a lot of emphasis on wellness programs and primary care. Nurses, especially nurse practitioners, are intended to play a major role
there.”In Oregon, Washington and 14 other states, nurses and nurse practioners “can operate independently of doctors, writing prescriptions, ordering tests, and even running clinics,” Pauly said. Nationwide, the 22.5 percent of primary care doctors who practice in rural areas roughly matches the 24 percent of Medicare patients living there, said Dr Roland Goertz, chairman of the American Academy of Family Physicians board. A survey of academy members nationwide shows 83 percent take new Medicare patients. But there is an overall shortage of primary care physicians that still makes it hard for retirees to find a family doctor. The real problem, he said, is that the health care system “has not supported a robust, adequate primary care workforce for over 30 years.” According to the American Association of Medical Colleges, rural areas need about 20,000 primary care doctors to make up for the shortages, but only about 16,500 medical doctors and 3,500 doctors of osteopathy graduate yearly. “We are always trying to recruit doctors. We are barely keeping even,”
said Lyle Jackson, the medical director at the Mid-Rogue Independent Physician Association, a cooperative of doctors in Josephine County, where Musselman lives. Taking part in the Medicare Advantage program, which pays a higher rate to doctors than standard Medicare, helps, but is still not enough, said Jackson, a former family physician. A 2009 survey of doctors in the Oregon Medical Association showed concern over Medicare reimbursement rates topping the list of 23 issues, with 79 percent rating it as very important, said Joy Conklin, an official at the association. The survey showed 19.1 percent of Oregon doctors had closed their practices to Medicare, and 28.1 percent had restricted the numbers of Medicare patients. That really becomes evident in Josephine County, which attracted retirees after the timber industry collapsed. Low taxes, cheap housing, wineries, a symphony and low traffic put it in top 10 lists for retirement communities. The 2010 census puts the number of people older than 65 at 23
percent, compared to 14 percent for the state. But the website County Health Rankings & Roadmaps, which gathers a wide range of health care data nationwide, shows 933 patients for every primary care physician in the county, nearly 50 percent higher than the national 631-to-one rate. At the Grants Pass Clinic, Dr Bruce Stowell said they are no longer taking new Medicare patients. Medicare pays about 45 percent of what commercial insurance pays. As it is, their proportion of Medicare patients is double that of a similar Portland practice. “We used to get a steady stream of highquality (resumes) from US-trained and USborn physicians,” he said. “Over the last year, that stream has declined into a trickle. Very few (doctors) are choosing to go into primary care.” Schools are turning out more nurse practitioners and physician assistants. How well they fill the doctor gap will depend largely on how much independence states give them to practice, said Tay Kopanos, director of health care policy for state affairs at the American Academy of Nurse Practitioners. — AP
US school spearheads designing for the deaf Special architecture aids easy communication
GE Healthcare launches cancer awareness, prevention campaign KUWAIT: GE Healthcare launched a global competition on multiple social media platforms - Twitter, Facebook and Sina Weibo - to raise public awareness about cancer prevention. Over the next couple of weeks, GE Healthcare’s “#GetFit” campaign will encourage people from all over the world to share their own health and fitness activities and what they are doing to help reduce their likelihood of developing cancer, a leading cause of death. According to the World Health Organization (WHO), about 30 percent of cancers are preventable through a healthy lifestyle and regular exercise. With the goal to spread a positive message across the world, for the second year #GetFit challenges participants to share their ways of staying healthy and getting fit. The campaign uses the power of collective wisdom propelled by social media networks to encourage healthier lifestyles. “Prevention and active participation in our own better health are the first steps in improving health outcomes,” said John Dineen, President and CEO, GE Healthcare. “Leveraging the power of gaming and social networks to encourage lifestyles that can help prevent cancer isn’t just a good idea - it’s part of our original healthymagination commitment to bring actionable health content to consumers and our employees.” Dineen continued, “At GE Healthcare, we also believe that our fight against cancer requires an ongoing investment in innovation. That is why we made a commitment of $1 billion in dedicated cancer-related research and development. With even faster and more effective technologies, we can enable clinicians with the powerful tools they need to accurately diagnose and treat million patients.” Participants in GE Healthcare’s #GetFit
competition require Internet access and a Twitter, Facebook or Sina Weibo account in order to play. By tracking progress against specific health challenges or by posting comments about healthier lifestyles (eg. cycling to work, eliminating smoking, eating a healthy meal), individuals and teams in countries throughout the world will compete against one another while accumulating “healthy” points and badges. #GetFit ambassadors real, inspiring people who have committed to healthy living and/or individuals who have made strides in the fight against cancer - will cheer players on and share their personal stories. At the close of the challenge, on Friday, September 28, the player and the team with the most points accumulated will be announced as the #GetFit champions. Ultimately, everyone will win - as people across the world join together to help spread healthy cancer awareness and prevention messages globally. GE’s HealthyShare App To help spread the cancer prevention message, GE is supporting the #GetFit campaign through its recently launched HealthyShare Facebook App. HealthyShare is a new tool on Facebook for people to share health goals, track progress against goals and use friends as sources of inspiration and motivation toward better health. The app features new challenges that encourage users to get fit and live a healthier lifestyle. The specific #GetFit challenges, updated weekly, will engage users to maintain a healthy lifestyle in ways that can help prevent cancer. The app can be shared with friends who will become a part of the journey to better health by following progress, providing encouragement and even participating alongside each other.
Organic food is not lot more nutritious than non-organic NEW YORK: Organic produce and meat typically isn’t any better for you than conventional food when it comes to vitamin and nutrient content, although it does generally reduce exposure to pesticides and antibiotic-resistant bacteria, according to a US study. “People choose to buy organic foods for many different reasons. One of them is perceived health benefits,” said Crystal Smith-Spangler, who led a
PACIFICA: This file photo shows organic radishes at the Pacifica Farmers Market in Pacifica, Calif. — AP
team of researchers from Stanford University and the Veterans Affairs Palo Alto Health Care. “Our patients, our families ask about, ‘Well, are there health reasons to choose organic food in terms of nutritional content or human health outcomes?’” She and her colleagues reviewed more than 200 studies that compared either the health of people who ate organic or conventional foods or, more commonly, nutrient and contaminant levels in the foods themselves. The foods included organic and non-organic fruits, vegetables, grains, meat, poultry eggs and milk. According to US Department of Agriculture standards, organic farms have to avoid the use of synthetic pesticides and fertilizers, hormones and antibiotics. Organic livestock must also have access to pastures during grazing season. Many of the studies used, though, didn’t specify their standards for what constituted “organic” food, which can cost as much as twice what conventional food costs, the researchers wrote in the Annals of Internal Medicine. Smith-Spangler and her colleagues found there was no difference in the amount of vitamins in plant or animal products produced organically and conventionally - and the only nutrient difference was slightly more phosphorous in the organic products. Organic milk and chicken may also contain more omega-3 fatty acids, but that was based on only a few studies. More than one third of conventional produce had detectable pesticide residues, compared with 7 percent of organic produce samples. Organic pork and chicken were 33 percent less likely to carry bacteria resistant to three or more antibiotics than conventionally produced meat.— Reuters
WASHINGTON: With a funny anecdote, college football player Tony Tatum recently sparked a rousing round of applause. The only thing is, you couldn’t hear much clapping. But you could see it. Those listening to the charismatic student emphatically waved their hands in the air in a sign of appreciation-because Tatum and his audience were communicating via sign language. Tatum is hard of hearing and attends Gallaudet University, an institution of higher learning that offers programs specifically for the deaf. Located on a lush green campus in the US capital, the school whose charter was signed by then president Abraham Lincoln in 1864 has developed into a hotbed of architectural design geared toward a community that predominantly interacts through the motioned-not the spoken-word. The latest example is Tatum’s dormitory, an $18.5 million state-of-the art building with 175 beds. “It’s very deaf-friendly,” said Tatum, who sports prominent gold earrings in addition to a hearing aid. “You can see everything and that’s what I like about it.” What makes the Living and Learning Residence Hall 6 innovative is that it is built according to a set of design principles dubbed DeafSpace. “DeafSpace, in short, is a term that’s been coined here at the university to refer to a way of building buildings, designing buildings, and also just a way of thinking about creating an environment that’s conducive to, and really in tune with, deaf sensibilities,” said Hansel Bauman, Gallaudet’s director of campus design and planning. A tour of the five-floor building-which has a friendly, modern and airy feel-reveals how this notion is more than mere theory and extends well beyond visual alerts for fire alarms and doorbells. The most striking of the construction’s myriad of characteristics is an abundance of light that seeps in through wide windows or emanates from an array of lamps in a way to avoid glare. Large open spaces and even moveable walls on wheels, meanwhile, allow the formation of conversation circles that enable everyone in a group of deaf and hard of hearing people to visually take part in a dialogue. Then there are the wider hallways and sidewalks to accommodate signers as they stroll side by side while maintaining enough space between themselves to gauge facial expressions. Not to be forgotten are the sensor-operated front doors and ramps that promote continued
interaction often stymied-and even rendered dangerous-by steps or stairs. What also strikes visitors is that some walls are painted a special shade of blue-a color that serves as an agreeable backdrop for people whose eyes perform a key information-gathering role and can become strained, according to Bauman. “The color of the wall almost is the page that the visual word is written against,” he said, adding that blue, a cooler tone, contrasts with the warmer tones of skin and provides “crispness”. “All day, people are reading sign language and you’re also managing space visually-so that tends to create eye fatigue,” he said. While it may seem counterintuitive at first, acoustics play an important role among the deaf and hard of hearing. That’s because many wear cochlear implants or assistive hearing devices that turn reverberation found in tall spaces, for instance, into a type of echo. “That echo becomes noise rather than a signal, it clouds the spoken word or the specific sound you want to hear,” Bauman
explained, motioning to dark insulation panels on the ceiling meant to minimize the phenomenon. Sometimes, it’s the little things that have the most impact. Tatum for one, pointed out that the light switch for the bathroom he shares with his suite mates is positioned in the communal spacereplacing a bang on a closed door when duty calls with the flicking of the switch. David Lewis, partner at LTL Architects who was picked for the project and whose team spent “thousands” of hours on it until completion, wants the residence to become a research tool. “I very much hope that this building can not only become a home and a site for living and learning but also a real testing ground, a place to learn from,” he said. Howard Rosenblum, chief executive officer of the National Association of the Deaf, praised Gallaudet’s staff, calling them “pioneers”. “Architecture has come a long way in terms of universal design, and only recently has DeafSpace design been considered,” he said. “This consideration is long overdue.” —AFP
WASHINGTON: Tony Tatum, a senior student at Gallaudet University, a liberal arts college with an emphasis on career development for deaf and hard of hearing students, sits in his dorm room. — AFP
In Havana, birds’ best friend hails role HAVANA: A retired Cuban veterinarian has found a new direction rescuing rare birds, breeding parrots and peacocks, winning enough feathered-world fame to swap fowl with Venezuela’s Hugo Chavez. In the 1950s, Maique Lores fought with rebels who brought the Cuban regime to power, before enjoying a long career as a vet. These days, however, he has his mind on all corners of the avian world, from exotics to fowl to his “endangered birds rescue and care unit,” with hundreds of feathered friends thriving at his home. “We rescue endangered birds, breed them and then release them in protected areas so they do not end up on someone’s plate,” said Lores, 68. At dawn, Lores and his wife Marilyn, a fellow veterinarian and bird fan, wake to the cocks crowing in the garden of their home just
west of Havana, not far from where revolutionary icon Fidel Castro lives. Some hens roam freely. One named Cuqui makes itself at home and lays eggs on the staircase of the two-story house. Exotics dot the grounds, some in corrals and others in cages, like white peacocks from India and a yaco from Africa-Lores says they are among the world’s smartest birds. His dining room table is stacked with bags of corn feed, and two rooms are crowded with cages of orioles, a nightingale and parrots large and small. But the favorite of the house is a chatty if occasionally shy parrot called Paquito, whom they consider a member of the family. “Say hello, Paquito, come on,” his master said affectionately, but the bird had no comment to make to a visiting reporter. Lores has two Cuban
HAVANA: Cuban Maique Lores, 68, gets a kiss from his parakeet. — AFP
parrots called cateys, locally famous for mating for life. Often, when one of a pair dies, the other will refuse to mate again. Despite all these efforts and his professed love of animals, Lores nonetheless admits he still loves chicken soup. A pair of white peacocks for Chavez Corrals at the facility are a frenzied dance of parrots and macaws, and fowl from quail to hens ordinary and exotic like Polish hens, with bright plumage and outsized crests, and Paduans, an old breed that is bearded without wattles. Another enclosure holds the unusual sight-at least in these parts-of white peacocks, which originally came from India. Due to their relative novelty in the West, Lores sent a pair to the leftist firebrand Venezuelan president Hugo Chavez. Chavez, a key political and economic ally of communist Cuba. often travels to Havana, including recently to treat a cancerous tumor. “I sent off a male and female to Venezuela for resident Chavez. He sent me back a pair of macaws,” Lores recalled fondly. He built a large special cage for his gift macaws from Chavez, but the female pulled its own feathers out from stress and no longer can fly. “I have had to separate the male and female because otherwise she will go eat his feathers,” Lores explained. Though he did not get into the bird business for money, his road to financial success has been paved with feathers. To fund his facility, he sells fowl and eggs, and even sells feathers that fall off his birds. Many of the feathers are used in Afro-Cuban Santeria religious rites, and can sell for up to $10 a piece-half of an average Cuban worker’s monthly salary. But Lores insists he would never pluck one, no matter how precious or valuable, before it’s natural molting time. The birds enjoy fresh fruit-which is also frozen and thawed for times of the year when it is out of season-such as mangoes and tamarinds, mamey sapote and avocados. “It’s a lot of work, but everything that has to do with nature, I have just loved ever since I was a kid,” Lores recalls with a smile. — AFP