The landscape of modern medicine has always evolved with science, technology, and social change. But in 2025, the most aggressive force reshaping healthcare delivery has been political. This year, physicians worldwide have felt a tightening grip of political authority around their clinical autonomy. From reproductive care to mental health access, from Vaccine distribution to gender-related treatment policies, medicine is increasingly at the mercy of lawmakers. These aren't peripheral issues-they're core matters of patient care, ethics, and scientific integrity. The medical community is now reckoning with a difficult truth: politics is no longer outside the clinic; it's in the room with the patient.

In the United States, legislative battles around abortion have reached new levels of complexity. Since the fall of Roe v. Wade, over a dozen states have passed or expanded laws that criminalize doctors for performing or even recommending certain reproductive procedures, even in medically urgent situations. In 2025, several high-profile cases have shown physicians facing prosecution for providing standard miscarriage management or ectopic pregnancy care. The legal environment is now so precarious that hospitals in restrictive states often delay critical care while waiting for legal teams to weigh in. This creates moral distress for physicians, many of whom now practice in constant fear of lawsuits or even arrest-just for doing what they were trained to do.

Outside the U.S., similar trends are unfolding. In parts of Latin America and Eastern Europe, governments have tightened control over what is considered "acceptable" reproductive care, often under the guise of protecting national values or traditional family structures. Physicians in countries like Hungary and El Salvador report mounting pressure to withhold information or restrict access to contraception and abortion, even when it goes against clinical guidelines. Meanwhile, international NGOs trying to provide comprehensive reproductive health services are being blocked or defunded. These constraints have created a two-tiered healthcare system-one for those with means to travel and another for those left behind.

One of the most heated and politically charged areas in 2025 has been gender-affirming care. Several countries have enacted legislation banning or severely limiting this type of care for minors, while others are placing restrictions on adult services as well. As doctors, we're taught to respect patients and evidence-but this issue has become increasingly fraught. Some physicians, myself included, have genuine concerns about the long-term impacts of hormone therapy and surgical interventions in adolescents. We've seen cases where patients later regret transitioning or feel they were rushed into decisions without adequate psychological assessment. These concerns are not rooted in hatred, but in caution, ethics, and a responsibility to "do no harm." Yet raising such concerns today often leads to accusations of bias or professional misconduct. Political and institutional forces seem determined to silence even respectful debate within the medical field, leaving many physicians to navigate these dilemmas quietly, without guidance or support.

The politicization of public health has also disrupted our ability to respond effectively to infectious disease outbreaks. In several countries, Vaccine programs have stalled due to partisan interference. In India, for instance, regional governments have delayed the rollout of a new dengue Vaccine due to internal power struggles, despite surging infection rates. In the U.S., routine childhood vaccination rates continue to decline, fueled by political figures who cast doubt on their safety or necessity. Physicians are once again in the position of defending settled science in the face of misinformation, while battling mistrust from patients who view every public health recommendation as a political statement.

Another major impact of politics this year has been on mental health funding and policy. In the wake of post-COVID burnout, economic strain, and social polarization, demand for mental health services has skyrocketed. Yet several governments-particularly in the UK, Italy, and Australia-have cut funding for public mental health programs as part of broader austerity agendas. In practice, this has left general practitioners, emergency room physicians, and pediatricians scrambling to manage complex psychiatric cases without adequate support. Waiting lists have ballooned. Suicide rates have risen in several countries. And physicians are increasingly asked to take on roles they are not fully trained for, simply because the systems meant to support them are collapsing under political pressure.

Even international medical collaboration has suffered. Geopolitical tensions, especially among NATO, BRICS, and non-aligned states, have made global health data harder to access. Projects on infectious disease surveillance, antibiotic resistance, and climate-related health threats have stalled due to nationalism and protectionism. Several governments are now blocking cross-border data sharing unless certain political conditions are met. This slows response time during outbreaks, stifles innovation, and undermines trust among health professionals who once relied on international cooperation to advance their work.

Ultimately, what 2025 has taught us is that medicine cannot remain insulated from politics. Whether we like it or not, our clinical decisions, patient relationships, and professional obligations are now being shaped by external forces-sometimes subtly, sometimes overtly. Physicians must adapt to this new reality. We must stay informed, protect our ethical ground, and advocate where needed. And we must find ways to voice dissent, even within a system that increasingly prefers compliance. The health of our patients-and the integrity of our profession-depends on it.

Few moments in medicine are as morally charged as the decision to allocate scarce resources. Whether in an intensive care unit overwhelmed by pandemic patients, on a battlefield with limited medics, or in a rural clinic with a single ventilator, doctors are sometimes forced to decide who receives life-sustaining care - and who does not. In these moments, life itself becomes, unavoidably, a number. The tension between the sanctity of the individual and the needs of the many has long been the subject of moral philosophy, from Aristotle's virtue ethics to John Stuart Mill's utilitarian calculus, and it is one that medicine cannot escape.

Triage, from the French trier, meaning "to sort," was formalized by Dominique Jean Larrey, Napoleon's chief surgeon, who prioritized treatment for those most likely to survive, regardless of rank or status. His approach was revolutionary - rejecting the aristocratic idea that a general's life was inherently worth more than a soldier's - yet it also set the precedent for using survival probability as a moral metric. In modern disaster medicine, frameworks like the Crisis Standards of Care developed by the Institute of Medicine extend Larrey's principle, favoring patients who will benefit most from limited interventions. On paper, this maximizes lives saved; in practice, it demands that physicians act as both healers and moral mathematicians.

The utilitarian logic is compelling in its efficiency, but it carries a hidden moral cost. To reduce a patient's worth to statistical likelihoods risks dehumanizing them. The philosopher Immanuel Kant warned against treating people merely as means to an end, no matter how noble that end might be. For example, an elderly patient with advanced comorbidities may be passed over for a younger, healthier patient in a triage scenario. While this may seem rational from a resource-allocation standpoint, it also raises painful questions about ageism, ableism, and the societal value of experience, relationships, and dignity.

Real-world crises show the complexity of applying theory to practice. During the height of COVID-19 in Lombardy, Italy, some hospitals resorted to age-based cutoffs for intensive care admission, sparking fierce ethical debate. In the U.S., ventilator allocation guidelines often combined the Sequential Organ Failure Assessment (SOFA) score with "tie-breaker" criteria, such as younger age or healthcare worker status, arguing that saving those who could in turn save others was a multiplier of good. Critics countered that such criteria risked reinforcing systemic inequalities - those already disadvantaged by social determinants of health might also be the ones more likely to be deprioritized.

Even within medicine, cultural perspectives vary. In certain Indigenous frameworks, value is placed on community continuity rather than individual survival probability, leading to allocation decisions that prioritize elders as cultural knowledge keepers. In contrast, Western bioethics often emphasizes impartial numerical fairness. These differences reflect broader philosophical divides: whether justice is best served by maximizing aggregate benefit or by protecting the intrinsic worth of each life, regardless of outcome.

The emotional toll on clinicians in such scenarios is profound. Moral injury - the distress from perpetrating, failing to prevent, or witnessing acts that transgress one's moral beliefs - is a common consequence of triage decisions. Studies from emergency medicine and military healthcare show that even when clinicians believe they made the "right" choice by guidelines, the human cost of knowing someone was left untreated can linger for years. As Paul Farmer once wrote, "The idea that some lives matter less is the root of all that is wrong with the world." Doctors may know, intellectually, that they acted justly in the aggregate, yet still grieve for the individual lost.

Both the World Health Organization and Eli Lilly warned Thursday that consumers should avoid fake versions of weight-loss drugs that are circulating in numerous countries.

The WHO warning said that the international health agency has fielded several reports of fake semaglutide -- the active ingredient in Novo Nordisk’s Wegovy and Ozempic -- in all geographic regions of the world since 2022.

“WHO advises healthcare professionals, regulatory authorities and the public be aware of these falsified batches of medicines,” Dr. Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products, said in the warning. “We call on stakeholders to stop any usage of suspicious medicines and report to relevant authorities.”

Meanwhile, Lilly said in an open letter that it was “deeply concerned” about phony or compounded versions of tirzepatide, the active ingredient in the Lilly weight-loss drugs Mounjaro and Zepbound.

"These [fake] products are often advertised and sold online, through social media or at certain med-spas," Lilly said in its letter. "They may contain no medicine, the wrong medicine, incorrect dosages or multiple medicines mixed together, which could result in serious harm. They are never safe to use."

Novo Nordisk has issued similar warnings in the past about its medications.

The WHO said patients can protect themselves by using prescriptions from licensed physicians to buy the medications. Consumers should also avoid buying the drugs from unfamiliar sources, the agency added.

For its part, Lilly noted any products marketed as tirzepatide and not Mounjaro or Zepbound were not made by the drugmaker and are not approved for use by the U.S. Food and Drug Administration.

More information

The Obesity Medicine Association has more on weight-loss drugs.

SOURCES: Eli Lilly, news release, June 2024; World Health Organization, news release, June 20, 2024

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Daily multidisciplinary rounds conducted by a board-certified intensivist through telemedicine do not reduce intensive care unit (ICU) length of stay (LOS) in critically ill adult patients, according to a study published online Oct. 9 in the Journal of the American Medical Association to coincide with the annual congress of the European Society of Intensive Care Medicine, held from Oct. 5 to 9 in Barcelona, Spain.

Adriano J. Pereira, M.D., Ph.D., from the Hospital Israelita Albert Einstein in São Paulo, Brazil, and colleagues assessed whether an intervention involving daily multidisciplinary rounds and monthly audit and feedback meetings performed by a remote board-certified intensivist reduces ICU LOS versus usual care. The analysis included patients treated in 30 general ICUs in Brazil in which daily multidisciplinary rounds performed by board-certified intensivists were not routinely available (1,794 patients in the baseline period and 15,230 in the intervention period).

The researchers found that mean ICU LOS, adjusted for baseline assessment, did not differ significantly between the tele-critical care and usual care groups (8.1 versus 7.1 days). In sensitivity analyses and prespecified subgroups, results persisted. There were no statistically significant differences seen in any other secondary or exploratory outcomes, including ICU efficiency, in-hospital mortality, incidence of central line-associated bloodstream infections, ventilator-associated events, catheter-associated urinary tract infections, ventilator-free days at 28 days, patient-days receiving oral or enteral feeding, patient-days under light sedation, and rate of patients with oxygen saturation values under that of normoxemia.

"This highlights the need but also the challenge of how to tailor telemedicine delivery models while guaranteeing a minimal adequate structure and qualifications at local sites," the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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The physician-patient relationship has always been built on trust, expertise, and communication, but in recent years, doctors are increasingly encountering a new kind of patient one who is more informed, more skeptical, and more demanding than ever before. With instant access to medical information, direct-to-consumer advertising, and the rise of patient-centered care, many physicians feel that expectations have shifted dramatically, often creating challenges in clinical practice. One of the biggest drivers of this shift is the internet. Patients now come to appointments armed with Google searches, social media advice, and self-diagnosed conditions, sometimes challenging the doctor s expertise. While greater patient involvement is generally positive, misinformation has complicated medical decision-making, leading to longer consultations, more second opinions, and even conflicts over treatment recommendations. A growing concern is that patients increasingly request tests, medications, or procedures that may not be necessary, expecting their doctor to comply. Physicians often find themselves caught between evidence-based medicine and patient expectations, knowing that refusing a request could damage the doctor-patient relationship or lead to dissatisfaction, poor reviews, or even complaints. The rise of "healthcare consumerism" where patients view medical care as a service rather than a professional consultation has further altered expectations. Many patients see themselves as customers rather than just patients, demanding faster access, personalized treatment, and even alternative therapies that may lack clinical support. For doctors, this creates a dilemma: Should they focus on meeting patient demands, even when they may not be medically necessary, or risk upsetting patients by sticking strictly to guidelines? Some physicians report feeling pressured to overprescribe medications, order unnecessary imaging, or agree to treatments they don t fully support just to avoid conflict. This shift has led to increased stress, longer working hours, and even physician burnout. Many doctors now feel that patient satisfaction scores and online reviews are influencing medical decisions more than clinical judgment. Others struggle with the balance between providing thorough, evidence-based care while keeping up with increasing demands for availability, responsiveness, and personalized medicine. What are your thoughts?

The A(H5N1) virus generally causes mild illness of short duration, mainly among U.S. adults exposed to infected animals, according to a study published online Dec. 31 in the New England Journal of Medicine.

Shikha Garg, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed data from persons with laboratory-confirmed A(H5N1) virus infection to describe the characteristics of cases identified from March through October 2024 in the United States.

The researchers found that 20, 25, and one of the case patients were exposed to infected poultry, exposed to infected or presumably infected dairy cows, and had no identified exposure, respectively. All 45 cases with animal exposure had mild A(H5N1) illness; none were hospitalized and none died. Overall, 93, 49, and 36 percent of patients had conjunctivitis, fever, and respiratory symptoms, respectively; 33 percent of patients had conjunctivitis only. Among the 16 patients with available data, the median duration of illness was four days. Eighty-seven percent of the patients received oseltamivir, which was started a median of two days after onset of symptoms. Among the 97 household contacts of case patients with animal exposure, there were no additional cases identified. Workers exposed to infected animals most often used gloves, eye protection, and face masks (71, 60, and 47 percent, respectively).

"Public health efforts should continue to focus on protecting workers exposed to infected animals through implementation of prevention measures on farms, including personal protective equipment use, and ongoing monitoring, early testing, and prompt antiviral treatment," the authors write.

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Copyright © 2020 HealthDay. All rights reserved.

The physician-patient relationship has always been built on trust, expertise, and communication, but in recent years, doctors are increasingly encountering a new kind of patient one who is more informed, more skeptical, and more demanding than ever before. With instant access to medical information, direct-to-consumer advertising, and the rise of patient-centered care, many physicians feel that expectations have shifted dramatically, often creating challenges in clinical practice. One of the biggest drivers of this shift is the internet. Patients now come to appointments armed with Google searches, social media advice, and self-diagnosed conditions, sometimes challenging the doctor s expertise. While greater patient involvement is generally positive, misinformation has complicated medical decision-making, leading to longer consultations, more second opinions, and even conflicts over treatment recommendations. A growing concern is that patients increasingly request tests, medications, or procedures that may not be necessary, expecting their doctor to comply. Physicians often find themselves caught between evidence-based medicine and patient expectations, knowing that refusing a request could damage the doctor-patient relationship or lead to dissatisfaction, poor reviews, or even complaints. The rise of "healthcare consumerism" where patients view medical care as a service rather than a professional consultation has further altered expectations. Many patients see themselves as customers rather than just patients, demanding faster access, personalized treatment, and even alternative therapies that may lack clinical support. For doctors, this creates a dilemma: Should they focus on meeting patient demands, even when they may not be medically necessary, or risk upsetting patients by sticking strictly to guidelines? Some physicians report feeling pressured to overprescribe medications, order unnecessary imaging, or agree to treatments they don t fully support just to avoid conflict. This shift has led to increased stress, longer working hours, and even physician burnout. Many doctors now feel that patient satisfaction scores and online reviews are influencing medical decisions more than clinical judgment. Others struggle with the balance between providing thorough, evidence-based care while keeping up with increasing demands for availability, responsiveness, and personalized medicine. What are your thoughts?

FRIDAY, March 3, 2023 (HealthDay News) -- Breast cancer risk estimates for individual women vary substantially depending on which risk assessment model is used, according to a study published online Feb. 7 in the Journal of General Internal Medicine.

Jeremy S. Paige, M.D., Ph.D., from the University of California in Los Angeles, and colleagues assessed the accuracy and disagreement between three commonly used risk models (Breast Cancer Risk Assessment Tool [BCRAT], Breast Cancer Surveillance Consortium [BCSC] model, and International Breast Intervention Study [IBIS] model) in categorizing individual women as average versus high risk for developing invasive breast cancer. The analysis included 31,115 women (40 to 74 years) presenting for screening mammography at a multisite health system between 2011 and 2015 with five-year follow-up.

The researchers found that when using the ≥1.67 percent threshold, more than 21 percent of women were classified as high risk for developing breast cancer in the next five years by one model but were classified as average risk by another model. When using the ≥3.0 percent threshold, more than 5 percent of women had disagreements in risk severity between models. For the threshold of ≥1.67 percent, almost half of the women (46.6 percent) were classified as high risk by at least one of the three models versus 11.1 percent when using the ≥3.0 percent threshold. At the population level, all three models had similar accuracy.

"Women are likely receiving vastly different recommendations depending on which breast cancer risk model is used and which cutoff is used to define 'high risk,'" the authors write.

One author receives royalty payments from licenses for commercial use of the IBIS algorithm, through Cancer Research U.K.

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Inappropriate antibiotic prescribing is common with or without a plausible antibiotic indication, and inappropriate prescribing is also common in U.S. emergency department visits, according to a study published online April 26 in the Journal of General Internal Medicine and a second study published May 14 in Antimicrobial Stewardship and Healthcare Epidemiology.

Joseph B. Ladines-Lim, M.D., Ph.D., from the University of Michigan in Ann Arbor, and colleagues examined the differences in inappropriate prescribing with or without a plausible indication between safety-net and non-safety-net populations. The analyses included 67,065,108 and 122,731,809 weighted visits for children and adults, respectively. The researchers found that the prevalence of inappropriate antibiotic prescribing was 11.7 and 22.0 percent, respectively, with a plausible indication among children in the safety-net and non-safety-net populations and 11.8 and 8.6 percent, respectively, without a plausible indication. For adults, the corresponding prevalence was 12.1 and 14.3 percent and 48.2 and 32.3 percent.

In a second study, Ladines-Lim and colleagues used national emergency department visit data from 2016 to 2021 to estimate the proportion of visits with inappropriate antibiotic prescribing. There were 819,395,799 weighted emergency department visits; 18.6 percent of these visits had one or more antibiotic prescription. The researchers found that 27.6 percent of the visits with antibiotic prescriptions had inappropriate prescribing, with 14.9 and 12.7 percent, respectively, with and without a plausible antibiotic indication. Of visits with inappropriate antibiotic prescribing, 54.0 and 46.0 percent had and did not have a plausible antibiotic indication, respectively.

"Emergency department antibiotic stewardship initiatives should focus both on reducing antibiotic prescribing for infectious, antibiotic-inappropriate conditions and on improving coding quality for antibiotic prescriptions," write the authors of the second study.

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FRIDAY, Jan. 26, 2024 (HealthDay News) -- Coronary artery disease (CAD) testing within 90 days of hospitalization for heart failure is associated with a lower risk for heart failure readmission or all-cause mortality, according to a study published online Jan. 18 in the Journal of General Internal Medicine.

Cheng‑Wei Huang, M.D., from Kaiser Permanente Los Angeles Medical Center, and colleagues assessed whether widespread CAD testing in patients with new-onset heart failure leads to improved outcomes. The analysis included 2,729 adults with new-onset heart failure with reduced ejection fraction hospitalized within one of 15 Kaiser Permanente Southern California medical centers between 2016 and 2021.

The researchers found that 54.5 percent of patients received CAD testing, and after a median of 1.8 years, the testing group had a reduced risk for heart failure readmission or all-cause mortality (adjusted hazard ratio, 0.71; 95 percent confidence interval, 0.63 to 0.79). These results persisted across subgroups with a history of atrial fibrillation, diabetes, renal disease, myocardial infarction, or elevated troponin during hospitalization. Regardless of timing of CAD testing, findings were similar (early testing, or received testing before discharge, versus late testing, or up to 90 days after discharge: adjusted hazard ratio, 0.97; 95 percent confidence interval, 0.81 to 1.16).

"Further studies are necessary to examine factors associated with testing as well as testing completion to identify areas that may be more suitable for intervention to improve testing rates," the authors write.

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The U.S. Supreme Court announced Monday that it would hear a case on a Tennessee law that bans transgender minors from receiving certain medical treatments in that state.

The banned treatments include puberty-blocking drugs or hormonal therapies.

It's the first time the court will hear arguments regarding transitional medical care for transgender youth.

The issue is whether the new law violates the Constitutional rights of those seeking such care, according to the Biden Administration, which has asked that the court take up the case, United States v. Skrmetti.

The administration asserts that a ban prohibiting treatment for gender dysphoria in youths “frames that prohibition in explicitly sex-based terms.”

According to a petition to the court from Solicitor General Elizabeth Prelogar, the Tennessee law bans transgender medical care but “leaves the same treatments entirely unrestricted if they are prescribed for any other purpose.”

The case has already moved through federal courts, which have rendered varying decisions.

Republican-led states around the nation have pushed for laws in recent years focused on restricting gender-transition care, and at least 20 states have passed measures that do so, the New York Times reported.

Earlier this spring, the Supreme Court justices temporarily allowed Idaho to curtail medical treatment for transgender youth, based on a state ban passed by the state's Republican-led legislature. The law makes it a felony for physicians to provide minors with transgender medical care such as hormonal therapies.

The nine Supreme Court justices passed that measure based on an emergency application, and votes appeared to split along ideological lines, the Times reported, with liberal judges dissenting.

The court is also being asked to consider a case in Kentucky, known as S.B. 150, which bans doctors from providing gender-transition surgery, puberty blockers or hormone therapy to people under 18, the Times reported.

The laws enacted in both Kentucky and Tennessee underwent a temporary hold last summer as federal judges in both states temporarily blocked the laws days before key sections were set to go into effect.

Later, a divided panel of the U.S. Court of Appeals for the Sixth Circuit overturned those decisions, and the treatment bans were reinstated in each state. The plaintiffs in each case have now brought their cases to the Supreme Court, the Times reported.

More information

Find out more about transgender health care at Johns Hopkins Medicine.

SOURCE: New York Times, June 24, 2024

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Most patients with intractable Meniere disease (MD) experience symptom relief over time, according to a study published online Oct. 23 in Frontiers in Neurology.

F.R. Gerritsen, from Haga Hospital in The Hague, Netherlands, and colleagues described the evolution of vertigo attacks among patients with intractable MD in whom surgery was considered in a retrospective cohort study. Patients with definite unilateral MD and persisting vertigo attacks despite intratympanic steroid injection treatment were included in the study. All patients had been wait-listed for participation in a trial examining nonablative surgery; they were wait-listed between June 2016 and June 2021. To assess the evolution of the vertigo attacks, their data were collected in September 2022.

The analysis included 35 patients; 25 (71 percent) declined surgery. The researchers found that 21 of the 33 patients (64 percent) with complete information on vertigo attacks were free of vertigo attacks on data collection after a median disease duration of 5.3 years. The duration of disease was longer for patients who did versus those who did not undergo surgery.

"The current population was thought to suffer intractable disease, and yet most patients experienced relieve of symptoms in just over one year," the authors write. "Knowledge of the generally benign evolution of MD may be of value for patients and clinicians when weighing treatment options."

One author was employed by The Novo Nordisk Foundation Center for Stem Cell Medicine.

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Fierce Healthcare

Nearly a quarter of physicians reported clinical depression in a new survey, while 9% admitted to suicidal thoughts, and 1% shared that they attempted to end their lives.9,100 physicians across 29 specialties were surveyed last year. While physicians often address the suicide crisis throughout the U.S., many are struggling with their own mental health. Two-thirds of doctors reported colloquial depression, according to the survey. Twenty-four percent of doctors reported clinical depression, and the survey also found that doctors are more likely to have suicidal thoughts compared to those in other professions.

Depression in the medical community has been a serious problem for about as long as it has been measured, Andrea Giedinghagen, M.D., assistant professor of psychiatry at the St. Louis Washington University School of Medicine, said in the report. “Physicians are also still coping with a pandemic—the trauma from COVID-19 didn’t disappear just because the full ICUs did—and with a fractured healthcare system that virtually guarantees moral distress,” Giedinghagen said. “This is beyond individual solutions for individual problems. Systemic change is necessary.”Younger physicians were more likely to say that a med school or healthcare organization should be responsible for a student or physician’s suicide. Of those aged 42 to 56 years, 57% were unsure whether institutions should bear any responsibility.

When it comes to specialty, the top five specialist types most likely to report suicidal thoughts were otolaryngology, psychiatry, family medicine, anesthesiology and OB-GYN. The five specialist types least likely were orthopedics, nephrology, oncology, rheumatology and pulmonary medicine...Read more

Who should be responsible for dealing with this issue?

John Nicolas, a Chicago resident, has become the first person to receive a kidney transplant while awake, according to his doctors at Northwestern Medicine in Chicago.

Instead of using the normal general anesthesia, doctors used a single spinal injection to anesthetize Nicolas while allowing him to remain alert.

"At one point during surgery, I recall asking, 'Should I be expecting the spinal anesthesia to kick in?'" Nicolas, 28, recalled in a news release. "They had already been doing a lot of work and I had been completely oblivious to that fact. Truly, no sensation whatsoever."

This new option could make transplantation available to patients whose health makes them a high risk for general anesthesia, doctors say. It also could substantially decrease the length of a transplant patient's hospital stay.

Nicolas walked out of the hospital the day after his successful surgery, which occurred on May 24. Typically, kidney transplant patients spend two to three days in the hospital, doctors said.

"Inside the operating room, it was an incredible experience being able to show a patient what their new kidney looked like before placing it inside the body," Satish Nadig, M.D., a transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center, said in a news release. "The other exciting element is that the patient was able to be discharged home in less than 24 hours, basically making this an outpatient procedure. Our hope is that awake kidney transplantation can decrease some of the risks of general anesthesia while also shortening a patient's hospital stay."

Nicolas's surgical team performed his kidney transplant in less than two hours. Nicolas did not have any health risks that would have prohibited general anesthesia, nor did he have any phobia about it. In fact, his age and limited risk factors made him an ideal candidate to participate in a medical first, and Nicolas leapt at the opportunity.

"He is an extremely compliant patient who was in tune with his body and willing to push the envelope," said Vinayak Rohan, M.D., a transplant surgeon at Northwestern Memorial Hospital. "He had the upmost faith in us, and we had the upmost faith in him."

Northwestern Medicine plans to make this sort of surgery available to patients who cannot have general anesthesia or might otherwise benefit from it.

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There are important differences between the personalities of doctors, their patients, and the general population, researchers in Australia have found.

In a paper published in BMJ Open researchers found that doctors were significantly more agreeable, conscientious, extroverted, and neurotic than the general population, but that patients were more open than doctors.

The researchers compared the outcomes of two surveys to find out if there were personality trait differences between doctors and other people. The first survey was the Household, Income, and Labour Dynamics in Australia survey of 25 358 members of the general public aged 20-85 which included 18 705 patients, 1261 highly educated people, and 5814 professional carers. The second was the Medicine in Australia: Balancing Employment and Life survey of medical practitioners in Australia...Read more

Does one need to be more of an extrovert to be a good physician?

As a bird flu outbreak escalates across the U.S., the Trump administration has paused the release of key public health studies, stalling research that could provide insight into how the virus spreads to animals and people.

The blocked studies were supposed to be published in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR), a respected journal that has reported on health threats since 1952.

One of the studies examines whether veterinarians working with cattle have unknowingly been infected, and another explores whether people may have passed the virus to pet cats, according to CNN.

These reports could help scientists track and prevent future infections.

But a new memo from the Department of Health and Human Services (HHS) has placed an “immediate pause” on communications. Approval is now required from a presidential appointee before publishing, according to the memo.

“This idea that science cannot continue until there’s a political lens over it is unprecedented,” Dr. Anne Schuchat, a former principal deputy director at the CDC, told CNN. “I hope it’s going to be very short-lived, but if it’s not short-lived, it’s censorship.”

Public health experts warn that delaying research on bird flu could put veterinarians, farmworkers and the public at greater risk.

One study, slated to be published last week in the MMWR, looked at cases in Michigan where dairy workers may have transmitted bird flu to their pet cats.

Dr. Jennifer Morse, medical director at the Mid-Michigan District Health Department and a scientist on the pending study, told CNN she got a note from a colleague last week saying that “there are delays in our publication — outside of our control.”

And this isn't the first time the government has disrupted CDC reports.

During President Donald Trump's first term, CNN noted, White House officials interfered with scientific studies on COVID-19.

“What’s happening now is quite different than what we experienced in covid, because there wasn’t a stop in the MMWR and other scientific manuscripts,” Schuchat told CNN.

CDC insiders say the pause will last until at least Feb. 6, though it’s unclear if publishing will resume as scheduled.

The bird flu has infected at least 67 people in the U.S., and claimed the life of one person in Louisiana earlier this year.

It's affected more than 148 million birds and heightened concern about human transmission.

“Maintaining open lines of communication and continuing research with our federal partners is critical as we fight this outbreak.” Dr. Fred Gingrich, executive director of the American Association of Bovine Practitioners, a group for veterinarians specializing in cattle medicine, told CNN.

Schuchat hopes efforts to spin or influence scientific reports won’t happen again.

“The MMWR cannot become a political instrument,” she concluded in a report published by CNN.

More information

The U.S. Centers for Disease Control and Prevention has more on the current situation of bird flu.

SOURCE: CNN, media report, Jan. 30, 2025; U.S. Centers for Disease Control and Prevention

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Sir, Amanda Pritchard says that we need to train more doctors (report, Jan 14). Why, so that they can go to look after sick people in Australia? Until the NHS is transformed into the exciting and rewarding workplace that it used to be, churning out more doctors is as pointless as pouring water into a sieve in the hope that it will not drain away. After yet another round of crisis meetings called by ministers whose only motivation is the next general election, we desperately need wise and experienced people who can take a genuinely long view. Setting up a royal commission would be a good start and is now an urgent imperative.Gareth Williams, FRCP, Emeritus professor and former dean of medicine, Bristol University

Sir, Your report emphasises the growing need for the NHS to train more homegrown doctors because 50 per cent of new doctors come from overseas. The worry is that, once trained, many of these doctors will be tempted to work overseas, meaning that recipient countries get trained doctors free. One obvious solution is to offer training bursaries. The British Army offers medical bursaries of up to £75,000 for medical students who pass officer selection. The quid pro quo is that they are expected to serve as an army medic for at least four years. Problem solved.Jonathan Beard, Professor of surgical education, Sheffield

Sir, The chief executive of NHS England must surely know that if we had paid more attention to retaining the doctors trained here during the past 20 years there would not be a staff shortage. If we show doctors that they are valued, reward them, forget mandatory modules and solve the social care crisis, very few would leave for places such as Australia.Dr Gill Dean, GP appraiser, Abingdon, Oxon...Read more

What would your letter look like?  

Greater television viewing in young adulthood is associated with incident cardiovascular disease (CVD) later in life, according to a study published online Aug. 22 in the Journal of General Internal Medicine.

Jason M. Nagata, M.D., from the University of California, San Francisco, and colleagues examined the relationship between level and annualized changes in television viewing from young adulthood to middle age and the incidence of premature CVD events before age 60 years. The analysis included 4,318 Black and White men and women (ages 18 to 30 years at baseline) participating in the Coronary Artery Risk Development in Young Adults study.

Over 30 years, the researchers found that every one-hour increase in daily hours of television viewing at age 23 years was associated with higher odds of incident coronary heart disease (CHD; adjusted odds ratio [aOR], 1.26) and incident CVD events (aOR, 1.16) before age 60 years. Similarly, each increased hour of daily television viewing annually was associated with higher annual odds of CHD incidence (aOR, 1.55), stroke incidence (aOR, 1.58), and CVD incidence (aOR, 1.32). The association was modified by race and sex with associations at age 23 years and later for CHD, heart failure, and stroke, with White men most consistently having significant associations.

"Young adulthood represents an important window for early intervention and a time in which individuals establish television viewing behaviors for the rest of adulthood," the authors write.

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