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Endocrinology

Hypothalamic inflammation and obesity, study suggests a pathological mechanism – News-Medical.Net

In a recent review published in the European Journal of Endocrinology, researchers discussed current research on the relationship between human obesity and inflammation of the hypothalamus.

Study: Is human obesity an inflammatory disease of the hypothalamus? Image Credit:SciePro/ Shutterstock

In 2022, the World Health Organization (WHO) declared that obesity was a pandemic in Europe, with 60% of the adult population being obese or overweight. Obesity directly reduces longevity and also increases the risk of various other diseases such as cardiovascular diseases, type 2 diabetes, hyperlipidemia, hypertension, gout, and various types of cancers.

Metabolic inflammation and its association with obesity is an area of research that has recently gained attention. Metabolic inflammation involves low-grade chronic inflammation in peripheral tissues such as adipose tissue, the liver, and the hypothalamus. The hypothalamus is thought to be the brain center that regulates appetite and body weight. While hypothalamic inflammation has been studied in animal models and humans, recent research is examining whether hypothalamic inflammation might not be a consequence of obesity but a cause.

The arcuate nucleus in the mediobasal hypothalamus integrates various peripheral endocrine factors and regulates appetite and the feeling of satiety. Two groups of functionally antagonistic neurons are located in the arcuate nucleus. The neuropeptide Y and orexigenic agouti-related peptide neurons form one group, and the anorexigenic proopiomelanocortin and the cocaine and amphetamine-regulated transcript form the other, and all four of these first-order neurons are involved in regulating satiety and appetite. These neurons also express insulin and leptin receptors, which are directly linked to nutrition and energy storage in the body.

Other gastrointestinal tract hormones such as glucagon-like peptide-1, ghrelin, and cholecystokinin can also stimulate the neurons in the arcuate nucleus, mediating appetite and feelings of satiety.

Metabolic inflammation is the moderate but persistent overexpression of pro-inflammatory signals, which has been observed in adipose tissue, the pancreas, the liver, and the hypothalamus. Studies indicate that hypothalamic inflammation is initiated due to different types of metabolic triggers but not body weight. Furthermore, cells such as perivascular macrophages, astrocytes, microglia, and neurons are also involved in the initiation of chronic hypothalamic inflammation. The crosstalk between glia and astrocytes is thought to play a role in the health of the central nervous system (CNS) and various CNS-related diseases.

Some chemokines involved in the feedback between glia and astrocytes have been linked to obesity-associated inflammation. In response to triggers, microglia are thought to secrete pro-inflammatory signals that activate astrocytes. Since astrocytes express leptin and insulin receptors, the sustained activation and feedback between astrocytes and glial cells impact energy homeostasis.

Studies on mice models have found that a hyperlipidemic diet has been linked to impaired insulin signaling and expression of inflammatory response proteins and cytokines in the hypothalamus. Other studies have also associated chronic high-fat diets with increased pro-inflammatory signaling. Saturated fatty acids such as stearic, arachidic, and behenic acids are thought to significantly increase the secretion of pro-inflammatory mediators.

Diets that have a high carbohydrate content have also been linked to the activation of microglia and hypothalamic inflammation. While astrogliosis is linked mainly to lipid metabolism and diets high in sucrose, have resulted in hypothalamic inflammation in mice without astrogliosis, a fructose-rich diet was shown to induce astrogliosis and increase the production of cytokines. Western diets are thought to contain large amounts of saturated fatty acids and monosaccharides commonly, and studies have found links between metabolic inflammation and Western diets and lifestyle. Additionally, factors such as imbalances in the gut microbiome, age-related changes, and neuronal overactivity could be other triggers of hypothalamic inflammation.

High-fat diets are thought to trigger hypothalamic inflammation through various signaling pathways, including toll-like receptor 4, c-Jun N-terminal kinases, protein kinase C, and ceramide pathways, and the induction of endoplasmic reticulum stress.

A method involving T2-relaxation time-weighted magnetic resonance imaging (MRI) had been used to detect hypothalamic inflammation and gliosis in obese individuals. Post-mortem biopsies have also linked gliosis in the hypothalamus to higher body mass index values.

Overall, the findings suggested that hypothalamic inflammation could be a cause and not merely a consequence of obesity. This is supported by the observation that hypothalamic inflammation occurred even before weight gain after the ingestion of high-fat diets. In addition, research on animal models and recent translational human studies have established a link between hypothalamic inflammation and obesity. The development of MRI techniques to detect hypothalamic inflammation could potentially identify targets for pharmaceutical interventions to treat or manage obesity.

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Chinta Sidharthan is a writer based in Bangalore, India. Her academic background is in evolutionary biology and genetics, and she has extensive experience in scientific research, teaching, science writing, and herpetology. Chinta holds a Ph.D. in evolutionary biology from the Indian Institute of Science and is passionate about science education, writing, animals, wildlife, and conservation. For her doctoral research, she explored the origins and diversification of blindsnakes in India, as a part of which she did extensive fieldwork in the jungles of southern India. She has received the Canadian Governor Generals bronze medal and Bangalore University gold medal for academic excellence and published her research in high-impact journals.

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Endocrinology

Lee Health has several big projects in the works in Cape Coral – Naples Daily News

Surfside Medical expansion getting under way in next month or two; service growth at Cape Coral Hospital in the works

Lee Health has numerous projects in the works to address health care needs in fast-growing Cape Coral.

They range from adding physician offices so more specialty services are closer to home for residents, including pediatric care, to expansions at Cape Coral Hospital, according to Dave Kistel, vice president and chief facilities executive.

The board for the publicly-operated hospital system recently approved a contract amendment to expand the Surfside Medical Facility at Veterans Parkway and Surfside Boulevard. The total project cost is $10.4 million and is targeted for completion in January 2024.

The phase-two project involves adding 15,000 square feet of space to the two-story outpatient complex.

Specialists employed by Lee Physician Group in orthopedics, endocrinology, rheumatology, and rehabilitation medicine will go into the new space.

Lee Physician Group currently does not have specialists in orthopedics or endocrinology in Cape Coral so that will become a first in both fields, Kistel said. Rheumatologists have been part time and will become available full time, he said. Outpatient-based rehabilitation medicine has been available at Cape Coral Hospital but is maxed out so the expansion at Surfside will offer a second location.

Overall the expansion of Surfside will mean some patients wont need to commute to Fort Myers for specialty care with Lee Physician Group and wait times to see other specialists will improve, Kistel said.

Cape Coral and its geographic area of 120 square miles has faced steady population growth and is now the eighth largest city in Florida with 204,510 residents, upfrom 154,305 residents in 2010. City leaders in 2021 projected 50-year growth to 430,000 residents.

Forbes Magazine last year ranked Cape Coral as the fourth best place to live in Florida, ahead of Orlando at fifth place and Miami as the sixth best place to live. The first three are Tampa, Jacksonville, and Gainesville.

Forbes pegged median income of Cape residents at around $62,000 and the median home price at $479,000.

Therese Everly, Lee Health board member whose district includes Cape Coral, said the hospital system is committed to expanding services and access to health care throughout the region as Southwest Florida continues to grow.

This is a very exciting time in Cape Coral as we have several new projects underway," she said. "Cape Coral Hospital is the foundation of healthcare in the community, and were proud to be investing in innovative projects in the Cape, such as Bimini Basin, which is community-based."

There's been positive impact bringing internal medicine residency program through Florida State University College of Medicine to Cape Coral, she said.

"Through this residency program and clinic, Lee Health is developing well-educated, highly trained physicians, creating greater accessibility to needed care in the community," Everly said.

The 291-bed Cape hospital is getting some add-ons to keep up with both inpatient and outpatient demand.

Lee Health is planning to lease 47,000 square feet of building space in the future $100 million Bimini Basin project that is in the works by a developer in south Cape Coral.

The Cape Coral City Council approved rezoning and the master concept in February for the mixed-use development with apartments, a waterfront restaurant and shops on three sites south of Cape Coral Parkway.

The plan in the leased space is to offer laboratory services, radiology, womens breast and health care and adult cardiology. The space also will be used for pediatric services in primary care, rehabilitation medicine and behavioral health.

Its a pretty substantial complement of physicians at that site, Kistel said.

When Lee Health will gain access to the leased space depends on the developers time line for construction, he said.

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Lee Health has several big projects in the works in Cape Coral - Naples Daily News

Endocrinology

Pediatric Investigation review takes stock of history and current … – EurekAlert

image:The growth hormone somatotropin is directly involved in regulating growth in children, and continues to play a role in adulthood. Long-acting growth hormone is now available in most global markets and will positively impact growth hormone therapies by reducing the treatment burden on the patient. view more

Credit: Pediatric Investigation

In 1957, Maurice Raben successfully isolated and purified the growth hormone (GH) from the pituitary gland, opening up a potential avenue of GH therapies. Children who were born with a deficiency of this hormone could now receive medical intervention in the form of daily injections to substitute the product into their body, thus avoiding the ill-effects of GH deficiency. However, given that it was a product that had to be meticulously extracted from the pituitary of dead bodies, and was time-consuming as well as labor- and resource-intensive process, it remained available only in limited quantities, wherein only a few patients could be treated.

A few years later, in 1985, recombinant-DNA generated GH became available that could be produced in laboratories and in much larger quantities. As a result, it became more easily available and accessible for treating children with GH deficiency. However, one drawback these therapies suffered from was the need to take daily injections of the hormone to ensure that it was available in appropriate concentrations in the blood.

A recent review article published in Pediatric Investigation on 03 January 2023 has now taken stock of the clinical development in GH therapy since its isolation, outlining how far we have come and where we are headed with the use of GH therapy. The physiological regulation of GH involves a complex mechanism that depends on several age-related and metabolic factors. This regulatory mechanism releases GH doses into the bloodstream every three hours. While this mechanism remained a theoretical interest from clinical perspectives, researchers tried to synthesize a recombinant GH that could integrate itself seamlessly into the mechanism, explains corresponding author Dr. Paul Saenger, who is a professor at NYU Long Island School of Medicine. The goal was to produce a pharmaceutical product that would remain active in the body and mimic this pulsatile release of the hormone such that a daily dose would not be necessary.

A prototype of such a long-acting growth hormone (LAGH) was developed by LG Life Sciences in 2014 and the research data were made publicly available. Over the next few years, multiple research labs and pharmaceutical companies have fine-tuned this original prototype, developing many LAGH products.

The review begins with a discussion on the clinical evolution of GH therapy from a historical perspective, followed by a deep dive into the hormonal rationale for GH therapies, development phases and mechanisms involved in these different LAGH products. It then goes on to highlight the considerations patients and their families must keep in mind when planning a LAGH therapy, and its overall role in improving GH therapies.

The mechanisms underlying novel LAGH action involve either a formulation that forms a subcutaneous deposit to allow the release of native/modified GH hormone in a pulsatile manner similar to the actual GH release patterns in the body, or injecting it as a substance that can be easily absorbed in the bloodstream but is removed slowly such that the same pulsatile release can be maintained.

With these developments, LAGH therapies now only require a weekly or monthly dose instead of a daily intake, greatly reducing the burden of injection on the patient. This, in turn, is likely to improve patient compliance. LAGH-based products like Jintrolong and Lonapegsomatropin have already cleared phase 3 trials and are being marketed in China and USA respectively, while Somatrogon has been approved in Europe and Canada.

The clinical use of GH is an exciting success story. We are now entering a new era of LAGH therapy with new formulations of GH, which will predictably be the preferred form of therapy for years to come. Additionally, the availability of new safety data will further establish its use in clinical medicine, comments Dr. Saenger.

While further research on dosage regulation and timing is still underway for other forms of LAGH, their availability in international markets certainly paints a bright picture.

***

Reference

Authors: Margaret Steiner, Jacklyn Frank, and Paul Saenger

DOI: https://doi.org/10.1002/ped4.12358

Affiliations:

NYU Langone Health-Long Island, 101 Mineola Boulevard, Mineola, New York, USA

About Dr. Paul Saenger

Dr. Paul Saenger is a Professor of Pediatrics Emeritus,Albert Einstein College of Medicine, Professor of Pediatrics at NYU Langone HospitalLong Island, Visiting Professor of Munich University, Visiting Professor of Beijing Children's Hospital. He received his training at the New York Hospital/Cornell Medical Center in Pediatric Endocrinology. He treats patients with growth disorders, diabetes mellitus, and disorders of puberty and the thyroid. Taking care of both children and their families, he helps them formulate realistic expectations and cope with their diagnoses. With more than 40 years of experience in the field, he has trained more than 45 fellows who currently work in pediatric endocrinology.

Pediatric Investigation

Literature review

Not applicable

Long-acting growth hormone in 2022

3-Jan-2023

The authors declare that they have no conflict of interest

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Pediatric Investigation review takes stock of history and current ... - EurekAlert

Endocrinology

Progyny Enhances Male Fertility Offering with the Expansion of its … – GlobeNewswire

NEW YORK, March 14, 2023 (GLOBE NEWSWIRE) -- Progyny, Inc. (Nasdaq: PGNY) a leading benefits management company specializing in fertility and family building benefits solutions, today announced the expansion of its provider network to include reproductive urologists (RU). Patients with Progynys comprehensive and equitable solution will now have convenient access to high-quality urological care, in addition to the existing Progyny network made up of more than 650 clinics and over 950 leading fertility specialists.

Currently, about one third of infertility cases are due to one partner being unable to create and ejaculate healthy sperm, often referred to as male-factor infertility. While Progyny has already been covering several treatments for sperm-related infertility through its reproductive endocrinology and infertility (REI) network, there are those who need further evaluation from a RU, a doctor who specializes in reproductive health for people who produce sperm. Progyny is proud to now offer coverage and access to a curated network of accredited RUs for those individuals.

Infertility impacts millions of people and sperm related infertility accounts for a sizable portion, yet most of the conversation and responsibility falls to the female population, said Pete Anevski, Progynys CEO. At Progyny, we work to address all areas of infertility to provide the best services and treatments possible to ensure everyones dreams of parenthood are realized. Expanding our male fertility offering to include a RU network of best-in-class physicians is a vital step to furthering this mission.

To expand Progynys provider network, the company worked closely with its well-respected REI partners to distinguish RUs that provide best-in-class urological care. Each RU has been vetted to meet Progynys network standards and will work collaboratively with the REIs to ensure a streamlined and cohesive patient experience.

I am very excited to be involved in the roll-out of Progynys extended coverage for male-factor infertility. This is a great opportunity for patients to have expanded coverage to optimize their chances of achieving their family building goals, said Dr. Shane Russell, a reproductive urologist in Progynys network. The Progyny team has been great to work with and I look forward to a long and productive partnership with them.

To find a reproductive urologist in Progynys network, please visit: https://providersearch.progyny.com/.

About Progyny

Progyny (Nasdaq: PGNY) is a leading fertility benefits management company. We are redefining fertility and family building benefits, proving that a comprehensive and inclusive solution can simultaneously benefit employers, patients, and physicians.

Our benefits solution empowers patients with education and guidance from a dedicated Patient Care Advocate (PCA), provides access to a premier network of fertility specialists using the latest science and technologies, reduces healthcare costs for the nations leading employers, and drives optimal clinical outcomes. We envision a world where anyone who wants to have a child can do so.

Headquartered in New York City, Progyny has been recognized for its leadership and growth by CNBC Disruptor 50, Modern Healthcares Best Places to Work in Healthcare, Financial Times, INC. 5000, and Crains Fast 50 for NYC. For more information, visit http://www.progyny.com.

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Progyny Enhances Male Fertility Offering with the Expansion of its ... - GlobeNewswire

Family Medicine

Family doctor: NC politicians making health care landscape toxic – The Fayetteville Observer

Dr. Rebecca Kasper| The Fayetteville Observer

As a family medicine resident physician in the Triangle area, I originally came to train in North Carolina because the state has some of the best family medicine programs in the country. For five years now I have called this state home.

I am involved in my local faith community, I volunteer with my neighborhood association, and I am falling in love with the varied landscapes across this beautiful state. I had planned on staying and raising my family here.

However, the increasingly toxic healthcare landscape is making me seriously reconsider this plan.

As a family doctor, my job is to comprehensively care for my patients across a wide variety of health problems. Living in a state that seeks to further restrict abortion access, criminalizes exploration of gender identity and still hasnt expanded Medicaid for over 10 years after the Affordable Care Act became law threatens my professional ethos.

I am also increasingly fearful for my personal safety as I just try to do my job. My patients, all patients everywhere, deserve the best, most up-to-date medical care. North Carolina is moving in directions that propagate bad medicine and limit my ability as a physician to do the right thing.

Abortion is an essential option in pregnancy care, and is often life saving. Living a life aligned with your gender identity is also often life saving 40% of transgender youth attempt suicide each year.

Having access to health insurance to be able to afford to care for yourself and your family is lifesaving. The list of ways the North Carolina legislature has stepped in to limit my ability to care for my patients goes on and on. The Speaker of the Houses announcement recently of further proposed restrictions on abortion adds moral injury to what is already a long list of ways that the state interferes with my ability to care for my patients.

North Carolinians deserve the best medicine has to offer. Our healthcare shouldnt be subject to the state we live in, or the opinions of politicians. I am not alone in reconsidering my decision to stay in this state after I graduate residency.

North Carolina spent five years making me an excellent physician. It would be a shame to see myself and others leave the state just as we are ready to launch on our own. Abortion bans, gender affirming care bans, lack of support for comprehensive health care reform, and other limitations will force us to leave.

This brain drain will continue unless politicians get out of our exam rooms. Please trust us, your doctors, for your medical care, rather than politicians.

RebeccaE.Kasper, MD, MPH is a Family Medicine Doctor, a Primary Care Doctor and a Resident who sees patients at Duke Family Medicine Center.

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Family doctor: NC politicians making health care landscape toxic - The Fayetteville Observer

Family Medicine

Massachusetts Family Doctor Had Hidden Cameras, Thousands of Child Sex Abuse Images, Feds Say – NBC Connecticut

A Massachusetts family doctor was arrested for allegedly recording and possessing child sex abuse images, including on a hidden camera designed to look like a bracelet, prosecutors said Tuesday.

Dr. Bradford Ferrick, 32, was arrested Tuesday morning on a charge of possessing child pornography and was due to appear virtually in federal court in Boston, according to the U.S. Attorney's Office for Massachusetts.

About 80 devices were seized from Ferrick's homes in Winchester and Amherst, including hidden camera systems, last month, and thousands of images and videos showing suspected sexual images of children, prosecutors said. Alleged victims appear to be between 6 and 11.

"I can think of no greater fear as a parent or guardian than potential harm coming to your child. Today we allege that this doctor, who held a position of trust with access to children, maintained child sexual abuse material," U.S. Attorney Rachael Rollins said in a statement, noting that the investigation is ongoing.

Ferrick is a family medicine resident at Baystate Franklin Family Medicine, according to prosecutors. A hospital website listed him as a current resident at the hospital system's Greenfield Family Medicine.

NBC10 Boston has reached out to Baystate Health for comment. It wasn't immediately clear if Ferrick had an attorney who could speak to his arrest.

In Massachusetts, Ferrick had rotations in Springfield, Deerfield and Greenfield, prosecutors said. Before joining the hospital system in July 2022, he worked attended State University of New York's Upstate Medical University in Syracuse.

Investigators have set up this FBI website for anyone with information or concerns about the case.

Police in Winchester first reviewed tips from a national clearinghouse for child sexual exploitation information in January, according to the complaint filed in federal court. Videos with suspected child pornography were uploaded to a Google Drive in November 2021 and March 2022, each done in an IP address traced to Syracuse.

Winchester and state police searched Ferrick's parents home in Winchester, where he lives as well, on Feb. 13, and seized 61 devices, including hidden camera systems, computers, cellphones and storage devices that, in total, were able to contain more than 100 terabytes of data, the complaint said. He was arrested on four counts of possessing child pornography and released two days later on $50,000 bail under conditions including house arrest.

Several more devices were seized from the house later that week, after Ferrick appeared to have remotely manipulated one of the phones that had already been taken, investigators said.

A review of the devices found graphic videos showing a man raping a child, including two instances where the child was unconscious, according to the complaint.

The day after the search of the Ferricks' home, Winchester police found a hidden camera in a bathroom at the home of relatives, where two young children live, the complaint said. A Winchester detective had gotten permission to conduct the search after visiting the house and informing them of the charges.

The next week, police searched a home in Amherst that Ferrick rented and found eight more devices, including the hidden camera that appeared designed as a bracelet, investigators said. Its memory card allegedly showed videos of Ferrick giving medical exams in August 2022 with another doctor, including a audio of Ferrick apparently examining a teenage boy's genitals while his mother was present.

"It does not appear the individuals in the room are aware they are being recorded during either exam," an FBI agent wrote in the complaint.

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Massachusetts Family Doctor Had Hidden Cameras, Thousands of Child Sex Abuse Images, Feds Say - NBC Connecticut

Family Medicine

Mercyhealth welcomes Dr. David Rebedew, board certified family … – Mercyhealth

Mercyhealth is pleased to welcome David Rebedew, MD, board certified family medicine doctor, to the physician staff of Mercyhealth East and Mercyhealth South, and the faculty of the Mercyhealth Family Medicine Residency Program.

Dr. Rebedew is excited to share his philosophy of care with the residents he is teaching. My philosophy of care is to combine the latest evidence with shared decision making to find out what is most important to my patients while trying to use the least amount of medications, referrals and tests to make them as healthy and happy as possible, he said. I do this through use of injections for pain, performing ultrasound to aid with diagnosis, complementary and alternative medicine, as well as teaching residents.

After earning his medical degree at University of Wisconsin School of Medicine and Public Health, Madison, Dr. Rebedew served a family medicine residency at Waukesha Family Medicine Residency Program, Waukesha, WI. He is certified by the American Board of Family Medicine.

Dr. Rebedews special interests include:

To make an appointment with Dr. Rebedew at Mercyhealth South, call (608) 755-7960. To make an appointment with him at Mercyhealth East, call (608) 756-7100.

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Mercyhealth welcomes Dr. David Rebedew, board certified family ... - Mercyhealth

Family Medicine

Future physicians to begin their next chapter at Match Day Ceremony – University of Arizona

At this years Match Day ceremony, to be held Friday, March 17, on the west side of the Old Main Building on the University of Arizona campus, 110 medical students from the University of Arizona College of Medicine Tucson will learn where they will complete the next phase of their medical training.

Surrounded by loved ones and in coordination with fourth-year medical students attending similar events across the country, students in their final semester of medical school will simultaneously tear open envelopes at 9 a.m. The contents will reveal where they will begin their residency, a three-to-seven-year stage of graduate medical education where new doctors practice medicine in their chosen specialty under the supervision of a senior medical clinician. Match Day represents a culmination of four years of intense study, volunteering, research, clerkships, sub-internships and clinical rotations for UArizona College of Medicine Tucson students.

During their last year of medical school, students interview for residency slots at institutions where they hope to receive further training. Students later rank their residency location preferences, while institutions rank the students they would like to have as trainees. The match process is completed by the National Residency Matching Program, and medical students are obligated to serve where they matched.

Match Day is the most anticipated event for medical students and for COM-T administration and faculty as we all find out where our students will be pursuing their graduate medical education during the next phase in their journey to become an independently practicing physician, said Kevin Moynahan, MD, vice dean for education at the College of Medicine Tucson. This day is the cumulation of four or more years of hard work, resiliency and professional identity formation. The college is proud to send our well-trained graduates to prestigious graduate medical education programs around the country and to welcome a significant number into our own residency programs.

Registration and breakfast begin at 7:30 a.m., with programming starting at 8:15 a.m. At 9 a.m., students will individually gather with their supporters to open their Match Day envelopes, and at 9:30 a.m., they will announce their matches publicly. Closing remarks begin at 11 a.m.

Parking is available ($8 per car) at the Tyndall Garage, located on Tyndall Avenue south of University Boulevard. There is an accessible drop-off area for people with disabilities on University Boulevard at the flagpole west of Old Main.

Those wishing to attend the event virtually can view the livestream at satyrlivestream.com/stream/match-day-2023/. For more information and to RSVP, visit the College of Medicine Tucson Match Day website.

College of Medicine Tucson medical students participating in Match Day include:

Ike Royal Chinyere, PhD, received his bachelors degree from the College of Medicine Tucson before enrolling as a dual MD/PhD student. As a doctoral student, Dr. Chinyere performed preclinical studies of an engineered biomaterial that could be implanted onto the hearts surface to help restore its electrical stability after a heart attack. The experience solidified his interest in helping patients through entrepreneurship.

Entrepreneurship fits into how I approach my goals as a physician-scientist in training. Utilizing both degrees is my main goal, he said. I believe it is my calling to simultaneously employ all of these skillsets to make a difference in patients lives.

Dr. Chinyere has applied for a select number of residency programs that will further develop him as a physician-scientist, and will pursue a career in cardiac electrophysiology, focusing on the electrical properties of the heart. He is looking forward to celebrating Match Day with his wife and young son.

I enjoyed my time here and met a lot of amazing people, and there are a lot of good memories, he said. I feel very excited that medical school is coming to an end, and very motivated for the next chapter.

Gabrielle Milillo has applied to residency programs in pediatrics, fulfilling a lifelong dream to be a pediatrician.

I really idolized my pediatrician. I valued the partnership she made with my family and her commitment to helping me grow as a person and as a patient at the same time, she said. What I love about pediatrics is the ability to work with patients at the most transformative moments of their life, being able to contribute to their development in a positive way.

Milillo is participating in the couples match to receive training in the same region as her partner, who is also completing his medical degree.

I met my partner at the beginning of medical school, she said. To end it all with the opening of the envelope and to continue our life together is incredible. I dont know what city well end up in, but Im excited to explore with him.

The couple will celebrate Match Day with their families.

Opening up that envelope at the same time, knowing that were all bonded in that moment, is really special, she said.

Kaloni Peleketi Philipp received her bachelors degree from the College of Medicine Tucson and was accepted to medical school through Pre-Medical Admissions Pathway, an intensive medical school preparation program for promising students who have faced considerable obstacles.

Initially interested in obstetrics and gynecology, Philipp pivoted to family medicine.

I loved OB, but I wanted to know about the other parts of their life. Its important to me to build long-term relationships, she said.

With those deeper connections, her goal is to improve care for underserved people: I want to explore ways to get them into doctors offices to prevent a lot of the chronic conditions and complications were seeing in that population.

As a medical student, Philipp developed leadership skills as co-chair of the Student Diversity Committee and the Asylum Clinic. She co-founded Polynesians in Medicine, a nationwide organization that supports Pacific Islander pre-med students as they work through the pipeline toward medical careers.

She will celebrate Match Day with her husband, along with family members from the Phoenix area.

Its the culmination of years and years of work, she said. Im excited to see where I end up.

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Future physicians to begin their next chapter at Match Day Ceremony - University of Arizona

Family Medicine

B.C. has added 160 family doctors since rollout of new payment model, ministry says – CBC.ca

British Columbia

Posted: March 09, 2023 Last Updated: March 09, 2023

The province says 160 more family doctors have been added in British Columbia in the five weeks since a new physician payment model was rolled out.

Around half of them switched from another area of medicine to family practice, B.C.'s Ministry of Health said.

According to Health Minister Adrian Dix, a total of2,041 doctors, including the new recruits,have now signed on to the longitudinal family physician (LFP) model.

That equates to almost half of all doctors working infull-service family practice, which is referred to as longitudinal care by medical professionals.

"It's about 46 per cent of those who were longitudinal family doctors last yearand billed under fee-for-service," Dix said."So it's an exceptional change."

The LFPpayment modelwas introduced as an option to the existing fee-for-service model, under which doctors are paid around $30 per patient visit,no matter whether the patient has a simple cold or complex condition.

LFP, on the other hand, compensatesdoctors for number ofpatients seen,the complexity of their condition, and for time spent on other necessary tasks like reviewing lab results, consulting with other medical professionals, updating patient lists and clinical administrative work.

Half of the 160 new physicians on theLFP modelbilled to the Medical Services Plan in 2021-22, which indicates they were under a non-longitudinal model and switched to providing full-service familycare, the Ministry of Health said.

The ministry also said as of Feb.25, 120 new contracts have been signed, along with seven additional expressions of interest,as part of its New to PracticeIncentives Program, which offers incentives tophysicians who have recently completed their family medicine residency program and wish to provide full-servicefamily care.

Of these 120, 38 are Canadian medical graduates and 82 are international medical graduates, the ministry said.

Dr. Josh Greggain, president of Doctors of B.C., said early reviews from physicians working under the new model have been overwhelmingly positive.

"This is a great start and the joy that's come back to family medicine ... is critically important," he said.

"The secret sauce of this model is that [doctors] get value and get compensatedfor the things [they] do, whether that be seeing a patient or managing all of the other things that go along with being a family physician."

Under the new framework, the average family physician in B.C. will see a pay raise from roughly $250,000 annually to around $385,000.

It's estimated thatclose to onemillion British Columbians, about one-fifth of the population, are without a family doctor.

Greggain said family physicians who have elected to stay in the fee-for-service model are doing so because it works well for them, or possibly because they're still evaluating whether to make the switch.

"Any time you make any monumental change, not 100 per cent of people are going to jump into that change right away," he said. "The fact that we have nearly 50 per cent is very encouraging."

Karin Larsen is a former Olympian and award winning sports broadcaster who covers news and sports for CBC Vancouver.

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B.C. has added 160 family doctors since rollout of new payment model, ministry says - CBC.ca