Internal Medicine

Is mineral water good for you? Benefits and disadvantages explained. – USA TODAY

Delaney Nothaft| Special to USA TODAY

Minerals are essential for our bodies to operate smoothly. Dr. Pedro R. Rodriguez Guggiari, an internal medicine specialist and Chief of Staff at Banner Del E. Webb Medical Center in Sun City West, Arizona, says, Minerals help in a variety of ways: like iodine for thyroid (energy and stamina); calcium fluoride for bone and tooth health; iron for blood cell formation and to prevent anemia; magnesium and potassium for muscular function and structural tissues.

Are the minerals found in mineral water also good for you? Whats the best way to get minerals? We spoke with the experts to find out.

Dr. David Nazarian, a board-certified internal medicine specialist and founder of VitaminMD.net, says, Mineral water comes from springs and underground reservoirs and the mineral content can vary depending on the source and geographic location. In general, it can be a source for essential trace minerals such as calcium, magnesium and potassium.

But, mineral water alone, he says, is not enough. Nazarian adds, While mineral water does have higher mineral content than purified or filtered water, it does not contain all the minerals and should not be the sole source for these nutrients.

Elise Heeney, a clinical dietitian at Banner Del E. Webb Medical Center says, The best way to obtain all the vitamins and minerals our bodies need is by eating a diet that includes a variety of fruits, vegetables, whole grains, beans, nuts and seeds, lean proteins and low-fat dairy products. Aim for a well-balanced plate at each meal.

There are also certain foods you can eat that target specific minerals. For example, to get more calcium in your diet, you can try:

Or, if you are trying to get more potassium into your diet, you can try foods like:

There's no question that the vitamins found in vitamin water are important to one's health. What's more,electrolyte-infused drinks are proven to improve physical performance during exercise and can help hydration.

At the same time, the Centers for Disease Control and Preventionwarns againstconsuming food and drinks with too many "added sugars"because they are known to contribute to obesity, type 2 diabetes and heart disease.

Is vitamin water actually good for you? It's complicated, experts say.

What do minerals do for the body? Calcium, magnesium, iron, zinc and what to know.

More: Zinc is an important nutrient, but get it from food, not supplements, experts say

Many people take daily vitamins. What they should know first.

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Is mineral water good for you? Benefits and disadvantages explained. - USA TODAY

Internal Medicine

From Boston to Ann Arbor and back: Doctor-to-be, Graduation … – Michigan Medicine Headlines

Holly Roberts journey to become a doctor has come full circle during her time as a medical student at U-M by distance and also by how she learned the art and practice of medicine.

Roberts, a native of Hudson, New Hampshire, soon will return home to begin a residency in pediatrics at Boston Childrens Hospital, which she hopes to follow with a fellowship in pediatric hematology/oncology. She earned her undergraduate degree from Boston University, and her hometown is a mere 45 minutes north of the city.

When she leaves Michigan soon after Commencement activities on Friday, May 12, Roberts will do so as a member of the Class of 2023 that overcame so much during its four years together. This group was just getting started at U-M in 2020 when the COVID-19 pandemic hit. It still affects them as they prepare to graduate.

Our entire world, and especially the world of medicine, was instantly shaken. However, through flexibility, innovation and dedication to patients, health care professionals worked tirelessly to meet the evolving needs of our community, said Roberts, who added that her extracurricular focus shifted to supporting the local community, from assembling hand sanitizer kits for those experiencing houselessness to assisting patients with telehealth visits. Overall, this has taught me to be flexible in order to support the ever-changing needs of my patients and community.

Ironically, the pandemic has affected Roberts personally as she completes her medical degree. She and her husband, Dylan, both contracted COVID-19 in March and had to stay home instead of attending the annual Match Day festivities. Both are feeling much better these days and she is looking forward to being among 162 Michigan graduates.

The medical school community is invited to attend the Commencement ceremony at 3 p.m. in Hill Auditorium. It also will be livestreamed at: https://youtu.be/fLbGpMJOsDg.

Roberts is among the Class of 2023s most-honored graduates. She is recipient of the Deans Commendation for Excellence in Clinical Skills and the Art of Medicine, and the Andrew J. Zweifler Award for Excellence in Clinical Skills. She also is graduating with distinction (top 10% of students based on grade-point average) and distinction in medical education. Further, she is recipient of an Academic Recognition Award and a Glasgow-Rubin Citation for Academic Achievement.

Roberts said Michigans emphasis on clinical education and compassionate patient-centered care has paved the path for her to become the type of physician, educator and researcher she wants to be. In medical education, she has had opportunities to teach from high school to medical students and create an elective course for senior medical students about hospice and palliative care.

UMMS has also provided me with exceptional mentorship, opportunities and training in clinical research related to pediatric neuro-oncology, she said. I hope to continue my work in this field to improve care and outcomes for children with aggressive brain tumors, and I am endlessly grateful to my mentors for setting the stage for this aspect of my career.

As she completes her educational circle this week, Roberts looks forward to developing meaningful relationships with patients and families, supporting them through challenges and celebrating their victories.

The field of pediatrics, and specifically pediatric oncology, provides a unique opportunity to support patients and their families through some of lifes greatest challenges, while also celebrating the everyday joys of childhood, she said.

Below is a full list of student, departmental and faculty awards:

Student Awards

Deans Award for Research Excellence

This award is given by the faculty to those students who have made outstanding research contributions during their medical school career.

Deans Commendation for Excellence in Clinical Skills and the Art of Medicine

This award is given to ten percent of senior students, based on top Comprehensive Clinical Assessment (CCA) scores and clinical grades from the required junior clerkships, for outstanding skills in verbal communication with patients, interviewing, counseling, and physical diagnosis.

Puneet Ashu Ailawadi Memorial Award

This award honors Dr. Puneet Ashu Ailawadi, a 2000 graduate of the Medical School who was completing a residency in the Department of Psychiatry at the University of Michigan Health System at the time of his death. Dr. Ailawadis family, friends, and colleagues have established a memorial fund to honor him. In keeping with Dr. Ailawadis dedication to helping underserved communities, this award is presented annually to a senior medical student who has demonstrated a commitment to serving underprivileged and underserved populations.

George R. DeMuth Medical Scientist Award for Excellence

This award honors Dr. George R. DeMuth, the founding Director of the University of Michigan Medical Scientist Training Program. The award is given to a graduating senior in the University of Michigan Medical Scientist Training Program who has demonstrated outstanding accomplishments in research and who exhibits the personal and professional qualities desired in the complete physician.

Paul DeWolf Award

In memory of Paul DeWolf, a member of the Class of 2014, this award was created by the Student Council to honor the most unique and extraordinary qualities that he possessed. Paul was an includer, someone who used his enthusiasm for life to rally everyone around himself and help people contribute their voice on equal ground. He was also tireless in his dedication to patient-centered care, going the extra mile to connect on a much deeper level with each and every one of his patients. And he had an indefatigable joie-de-vivre with an infectious attitude of play hard and work hard. Most of all, he strove to improve himself for the purpose of bettering the condition of others. This award is presented every year to a senior who best exemplifies these attributes.

Ralph M. Gibson Award

This award honors Dr. Ralph Gibson, a distinguished African American faculty member in the Department of Pediatrics who also served as an assistant dean for student affairs in the Medical School. Dr. Gibson consistently emphasized the pursuit of academic excellence and demonstrated a concern for all students, their health, welfare, and career development. The award is presented to the senior student(s) who has best demonstrated these same qualities and who has had a dedication to addressing the health disparities experienced by minority and disadvantaged populations in the United States.

Patrick John Niland Award

This award is presented in memory of Patrick John Niland, a member of the Class of 1986, who died in an automobile accident. This award was established by the Class of 1986 to recognize the important attributes that Pat possessed: a cheerful, friendly demeanor and a patient, honest, and compassionate approach to medicine. It is given annually to a senior student who, in the eyes of the graduating class, best exemplifies these traits.

Sujal Parikh Award

This award is presented in memory of Sujal Parikh, a member of the Class of 2011, who died as a result of an accident while serving as a Fogarty Fellow in Uganda. This award was established by Student Council and the Class of 2011 to recognize the spirit and passion that Sujal dedicated to issues of social justice, global health, and collegiality. It is given annually to a senior who, in the eyes of the graduating class, best exemplifies these traits.

Dr. Jane Skillen Award

This award honors Dr. Jane Skillen, a 1928 graduate of the Medical School. Dr. Skillen was an Irish immigrant who came to the United States at age 16 and worked diligently to support herself and eventually earn her undergraduate and medical degrees at the University of Michigan. Dr. Skillen had a highly accomplished career as a thoracic surgeon in California. Her achievements stemmed from strength of character and a love of medicine, and her children honored her by establishing this award.

Andrew J. Zweifler Award for Excellence in Clinical Skills

This award is given to a graduating senior who has consistently demonstrated outstanding care and competence in verbal communication with patients in terms of interviewing and counseling, as well as excellence in physical diagnosis.

Leonard Tow Humanism in Medicine Award presented by The Arnold P. Gold Foundation

This award honors one graduating medical student who best demonstrates the ideals of outstanding compassion in the delivery of care and respect for patients, their families, and health care colleagues, as well as demonstrated clinical excellence.

Gold Humanism Honor Society (GHHS)

The GHHS recognizes students who practice patient-centered care by modeling the qualities of integrity, excellence, compassion, altruism, respect and empathy. Members are nominated by their peers for being a person they would like by their side in a medical emergency, who personifies good patient care, shows exceptional interest in community service, and a classmate they would want as the doctor of their loved ones.

Graduation with Distinction

The Graduation with Distinction honor is awarded to the top 10% of students based primarily on grade-point average.

Graduation with Distinction in Medical Education

The Graduation with Distinction in Medical Education honor is awarded to 10% of the class based on the students commitment to medical education research and evaluation, involvement with innovation in education and academic program development, and exceptional teaching skills in clinical and non-clinical settings.

Graduation with Distinction in Research

The Graduation with Distinction in Research honor is awarded to 10% of the class based on the students research training experiences, publications, presentations, and letters of support from faculty. Standard and MSTP students were considered separately.

Graduation with Distinction in Service

The Graduation with Distinction in Service honor is awarded to 10% of the class based on the students service to the community and the Medical School, drawn from the students curriculum vitae and letters of support.

Academic Achievement Award

The Academic Achievement Award, on the recommendation of the faculty of the Medical School, is given to the graduating senior who has achieved the highest academic standing in his or her class.

Academic Recognition Awards

Academic Recognition Awards are presented to the top five graduates who have demonstrated academic excellence throughout the four years of their medical education.

Alpha Omega Alpha (AOA)

AOA is the only national honor medical society. Its mission is to recognize and enhance professionalism, academic excellence, service, and leadership within the profession. The societys motto is Worthy to serve the suffering and membership is based upon scholarship and character.

Glasgow-Rubin Certificate of Commendation for Academic Achievement

This award is given to a woman medical student, graduating with academic distinction, should she graduate first in her class.

Glasgow-Rubin Citations for Academic Achievement

These awards are presented by the American Medical Womens Association to those women who graduate with academic distinction from medical schools throughout the country.

United States Public Health System 2023 Excellence in Public Health Award

The USPHS awards program recognizes medical students across the United States who advance public health and those who exemplify the USPHS mission to protect, promote, and advance the health and safety of our nation.

Departmental Awards

American Academy of Neurology (AAN) Medical Student Prize for Excellence in Neurology

This award is given to a graduating medical student who exemplifies outstanding scientific achievement and clinical acumen in neurology or neuroscience, outstanding personal qualities of integrity, compassion, and leadership.

Roger A. Berg Prize in Radiology

This award is given each year to a fourth-year medical student or students for outstanding performance in radiology. The award is made possible through a gift from Dr. Roger A. Berg, a University of Michigan Medical School alumnus.

C. Gardner Child 3rd Award

The career and dedication of Dr. Child, former chair of surgery, are honored in this award to a graduating senior or seniors for outstanding performance in the junior clerkship, senior electives, and research in surgery.

Terence C. Davies, M.D. Award

This award, in honor of the founding chair of the Department of Family Medicine, is presented to a graduating senior or seniors for clinical and scholarly excellence in family medicine. These students exemplify the qualities of the outstanding family physician: dedication to patient needs, intellectual curiosity, personal integrity, community service, and leadership.

Henry Fitzbutler Award for Excellence in Hospital Medicine

This award is conferred upon the fourth-year medical student who best displayed clinical and scholarly excellence in the field of hospital medicine. The award honors the life and accomplishments of Dr. Henry Fitzbutler who was the first African American to graduate from the Medical School in 1872. He then went on to establish both a hospital and medical school in Kentucky.

Albert C. Furstenberg Award

This award is given to a medical student for outstanding performance in otolaryngology. scholastic achievement, clinical work, and research efforts are considered in addition to interest in otolaryngology.

Robert I. Goldsmith, M.D. Award

This award is given by the Department of Ophthalmology and Visual Sciences to a senior medical student who has demonstrated outstanding scientific achievement or clinical prowess in ophthalmology and visual sciences. This student exhibits a high level of integrity, compassion, and intellectual curiosity towards optimizing vision and preventing and curing eye disease. The award is in honor of Dr. Robert I. Goldsmith, a distinguished alumnus and loyal friend of the W. K. Kellogg Eye Center.

Timothy R. B. Johnson Global Womens Health Award

The Timothy R. B. Johnson Global Womens Health Award is presented to a graduating medical student recognizing their authentic global engagement and anticipating their future contributions embodying Dr. Johnsons vision of global academic partnerships and his commitment to safe motherhood and global womens health.

Edgar A. Kahn Award

This award is given each year in memory of Dr. Kahn, former chief of neurosurgery, to a senior medical student(s) for outstanding performance in clinical or laboratory work in neurosurgery.

William Dodd Robinson Award

This award is given by the faculty of the Department of Internal Medicine to a graduating senior or seniors for outstanding performance in the junior medicine clerkship and senior electives in Internal Medicine. The award honors Dr. William Robinson, chair of the Department of Internal Medicine from 1958-75.

Eli G. Rochelson Memorial Award

This award is given for the most outstanding performance in pulmonary and critical care medicine by a graduating medical student. It honors Dr. Rochelson, a pulmonary physician and father of an alumnus of our school.

SAEM Excellence in Emergency Medicine Award

The members of the Department of Emergency Medicine honor a graduating senior for outstanding performance in the specialty of emergency medicine. This award is sponsored by the Society for Academic Emergency Medicine.

Robert B. Sweet Award

This award is given to a senior medical student who has shown the highest achievement and the greatest potential in the field of anesthesiology. The award is in honor of Dr. Robert B. Sweet, founding chair of the Department of Anesthesiology.

William B. Taylor Dermatology Clinical Science Award

The faculty of the Department of Dermatology honors a graduating senior medical student(s) for outstanding performance in dermatology clinical science. The award honors Dr. William B. Taylor, a faculty member of the department from 1950-92 and recipient of the National Dermatology Teacher Award.

Harry A. Towsley Award

This award is given by the faculty of the Department of Pediatrics to senior students for outstanding performance in the junior pediatrics clerkship and senior pediatrics elective. The award is named in honor of Dr. Harry A. Towsley, a distinguished member of the Department of Pediatrics from 1935-72.

Raymond W. Waggoner Award

This award is given by the faculty of the Department of Psychiatry to a graduating senior for distinguished performance in psychiatry. This award honors Dr. Raymond W. Waggoner, chair of the Department of Psychiatry from 1937-69.

Warner/Goldberg Womens Health Program Award for Excellence and Commitment to Womens Health

This award is given to a graduating senior(s) for their outstanding academic achievement and commitment to the ideals of its sponsor, the University of Michigan Center of Excellence in Womens Health. It is named for Patricia Warner, former associate hospital director, UMHS, and Dr. Edward Goldberg, founding chief of the Division of Womens Health, in recognition of their vital roles in the initiation and success of the Womens Health Program.

Wiegenstein Leadership in Emergency Medicine Award

This award is presented to the graduating medical student who best demonstrates the potential for leadership in emergency medicine, as exemplified by Dr. John Wiegenstein, Medical School Class of 1960, a pioneer in the field of emergency medicine.

J. Robert Willson Award for Outstanding Achievement in Obstetrics and Gynecology

The J. Robert Willson Award, in honor of the former chair of the Department of Obstetrics and Gynecology, is given to a senior student(s) for outstanding performance in obstetrics and gynecology. A Medical School professorship is established in his name.

Faculty Awards

Senior Year Award

This award is given each year to the faculty member below the rank of associate professor who, in the opinion of the graduating class, has best upheld the ideals of medical education.

The American Medical Womens Association Gender Equity Award

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From Boston to Ann Arbor and back: Doctor-to-be, Graduation ... - Michigan Medicine Headlines

Internal Medicine

LEADING PHYSICIAN-SCIENTIST DR. BRADLEY A. MARON APPOINTED SENIOR ASSOCIATE DEAN FOR PRECISION MEDICINE AT UMSOM AND CO-DIRECTOR OF NEW UNIVERSITY OF…

Dr. Maron also Named Director of Scientific Operations for UM-IHC

Baltimore, May 8, 2023 /PRNewswire/ -- University of Maryland School of Medicine (UMSOM) Dean Mark T. Gladwin, MD, announced today that Bradley A. Maron, MD, Associate Professor of Medicine at Brigham & Women's Hospital (BWH) and Harvard Medical School (HMS), and Co-Director of the Pulmonary Vascular Disease Center at the VA Boston Healthcare System, has been appointed Co-Director of the UMB's new Institute for Health Computing (UM-IHC), Director of Scientific Operations for the UM-IHC at UMSOM, as well as Senior Associate Dean for Precision Medicine at the UMSOM, effective May 1, 2023.

In his new role as Co-Director of the UM-IHC, Dr. Maron will work with University of Maryland, College Park (UMCP) and University of Maryland Medical System (UMMS) partners in establishing the new Institute as an international leader in the interdependent fields of clinical analytics and computational biology, using advanced data science technologies. He also will lead efforts to build centers within the Institute that focus on therapeutic target discovery, population health, pragmatic clinical trials, and an educational core curriculum that emphasizes scientific entrepreneurship.

Launched in November, 2022, UM-IHC seeks to leverage recent advances in network medicine, artificial intelligence (AI), and machine learning to create a premier learning healthcare system that evaluates both de-identified and secure digitized medical health data to improve outcomes for patients across the state of Maryland.

As Senior Associate Dean for Precision Medicine, Dr. Maron will oversee initiatives that build UMSOM's capacity to pursue research that advances the school's leadership in precision medicine, a new area of medicine that uses information captured from a patient's own biological and clinical profile to prevent, diagnose, or treat disease. These initiatives will include acquiring funds for operational advances, building new partnerships with key federal health agencies such as the NIH and FDA, identifying appropriate faculty recruits, and advocating for precision medicine approaches to clinical care. In collaboration with the Senior Associate Dean for Undergraduate Medical Education, Dr. Maron also will ensure that precision medicine is represented in the medical school curriculum and that UMSOM is preparing students to lead clinical and research initiatives in this emerging area.

Story continues

Dr. Maron is a recognized physician-scientist in the rapidly growing fields of precision medicine, network medicine, and computational data analysis. Currently, he is engaged as the Co-Principal Investigator in an ongoing study entitled, "Network Medicine and Systems Pharmacology to Advance Precision Medicine in Combined Pulmonary Hypertension," and a second, as the Principal Investigator, entitled, "Personalized protein-protein interactomes and precision medicine in pulmonary arterial hypertension." He is also the co-author of numerous papers published in flagship journals for the American Heart Association, American Thoracic Society and Nature family discussing how multi-omics technologies can contribute to precision medicine

"Dr. Maron is a highly-effective and strategic leader who is ideally suited to move this new Institute forward," said Dean Gladwin, who also is Vice President for Medical Affairs, University of Maryland, Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor. "His experience and entrepreneurial management skills are perfectly aligned with our new vision to utilize disruptive technology and embrace and harness the power of clinical analytics and precision medicine to enhance patient care and provide populations health services."

In 2021, he was inducted into the American Society of Clinical Investigation, one of the oldest and most prestigious medical societies in the United States. At BWH, he was Vice-chair of the Cardiovascular Life Sciences Section in the Division of CV Medicine and Medical Director of the Cardiopulmonary Exercise Center. Additionally, he is the recipient of the Excellence in Tutoring Award, Eleanor and Miles Shore Scholar in Medicine fellowship, Chair's Research Award, and Distinguished Master Clinician Award and Master Clinician Award from BWH and Harvard Medical School.

Dr. Maron is a widely-published and NIH-funded investigator, with co-authorship on more than 200 peer-reviewed articles and book chapters. His research focuses on understanding novel molecular mechanisms involved in the pathobiology of cardiovascular disease. He is currently the principal investigator on three major NIH Project Grants, totaling over $1.6 million per year in funding. The American Heart Association, National Scleroderma Foundation, Pulmonary Vascular Research Institute and National Institutes of Health have supported his research.

In 2020, he led an international research program resulting in a publication in Lancet Respiratory Medicine entitled, "The association between pulmonary vascular resistance and clinical outcomes in patients with pulmonary hypertension: A retrospective cohort study." This work contributed to a change in the definition of the disease pulmonary hypertension. His seminal paper on "NEDD9 targets COL3A1 to promote endothelial fibrosis and pulmonary arterial hypertension" that was published in Science Translational Medicine, a marque journal of the American Association for the Advancement of Science, established the foundation for a U.S. patent and implicated NEDD9 as an important mediator of pulmonary vascular fibrosis and thrombosis. He also is the lead Editor of the seminal text, Pulmonary Hypertension: Basic Science to Clinical Medicine (Springer, 2016).

"We are in a transformative period for healthcare in Maryland, in which building computational systems using individual patient-level information to tailor disease prevention and treatment strategies is a reality," said Dr Maron. "The key is building systems with the capacity to improve health, wellness and longevity for all of the people of Maryland---that is our mission. I am extremely excited and fortunate to work with the Co-Directors from the University of Maryland College Park and University of Maryland Medical System in this endeavor. "

Dr. Maron is a graduate of Williams College and received his M.D. degree from The Warren Alpert Medical School of Brown University before completing an internal medicine residency at Boston Medical Center. He then finished cardiovascular medicine research and clinical fellowship programs at Brigham and Women's Hospital (BWH). Dr. Maron is an American Board of Internal Medicine-certified in Cardiovascular Medicine.

About the University of Maryland School of Medicine

Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 46 academic departments, centers, institutes, and programs, and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.3 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic, and clinically based care for nearly 2 million patients each year. The School of Medicine has nearly $600 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 students, trainees, residents, and fellows. The combined School of Medicine and Medical System ("University of Maryland Medicine") has an annual budget of over $6 billion and an economic impact of nearly $20 billion on the state and local community. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity (according to the Association of American Medical Colleges profile) is an innovator in translational medicine, with 606 active patents and 52 start-up companies. In the latest U.S. News & World Report ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked #9 among the 92 public medical schools in the U.S., and in the top 15 percent (#27) of all 192 public and private U.S. medical schools. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

Provided by Newswise, online resource for knowledge-based news at http://www.newswise.com

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LEADING PHYSICIAN-SCIENTIST DR. BRADLEY A. MARON APPOINTED SENIOR ASSOCIATE DEAN FOR PRECISION MEDICINE AT UMSOM AND CO-DIRECTOR OF NEW UNIVERSITY OF...

Internal Medicine

PET TALK: Prioritizing Health And Comfort For Show Animals | FCT … – Freestonecountytimesonline

Throughout the year, youth across the country prepare and travel to various events, such as livestock shows, rodeos and fairs, to show their animals.

Because an animals performance at an event can be impacted if they are stressed or sick, Dr. Kevin Washburn, a professor of large animal internal medicine at the Texas A&M School of Veterinary Medicine and Biomedical Sciences, offers tips for keeping animals relaxed and healthy every step of the way.

First, owners should ensure that their animals are appropriately vaccinated so that they are healthy enough to travel.

The best prevention of any disease process is proper vaccinations when they are young and booster vaccines when necessary, Washburn said. Giving your animals booster vaccines about three weeks prior to the exhibition is a great practice for prevention.

Most importantly, show animals need to be vaccinated against respiratory disease before arriving at an exhibition.

Respiratory disease is the most common problem in exhibition animals due to the stress of travel, a new environment, and comingling with animals from many different locations and backgrounds, Washburn said. More specifically, cattle should be vaccinated against common respiratory pathogens before and at weaning.

Owners should also prepare trailers in a way that keeps show animals calm and comfortable, since traveling can be stressful for them.

Trailers should have adequate protection from extreme weather conditions and need to have a non-slip surface on them regardless of whether they are bedded or not, Washburn said. Non-slip surfaces prevent animals from slipping, losing balance, and falling in trailers, so it is less likely for animals to be injured.

Washburn explained that ensuring an animal is as comfortable as possible in their trailer will reduce stress, which is better for their immune system.

If cattle are tied, they should have enough length of rope to hold their heads in a natural position; for longer trips, cattle should be untied, the floor should be deeply bedded with mats or straw, and there should be enough room for them to lie down, Washburn said. For pigs and small ruminants like sheep and goats, there should be comfortable bedding so they can lie down during travel.

Once animals arrive at the show barn, they will need frequent access to fresh water to prevent dehydration and be fed their normal portion of food since dietary changes can cause digestive issues. Washburn also suggests owners provide fans or misters in warmer months and space heaters in colder months to improve animal comfort.

To maintain an animals health at an exhibition and decrease the risk of spreading diseases, especially when surrounded by other animals, Washburn encourages owners to be careful when walking from one animal stall to another.

Many diseases are spread through fecal-oral transmission, and contaminating bedding with fecal material from other farms can lead to animals picking up diseases, Washburn explained. So pens and tie stalls should only be entered by their owners to avoid bringing fecal material from one farm to another. If fecal material is picked up on boots and shoes from other places at the exhibition area, owners should wash them off prior to handling their own animals.

As another method of disease prevention, owners should avoid sharing with other animal caretakers their combs, brushes, clippers, feed tubs, water buckets, and tools used to clean bedding and stalls.

Lastly, Washburn pointed out that an animals health should continue to be a priority when they arrive back home.

Any exhibition animal should return to their normal environment and be allowed to rest from further training for at least the first five to seven days after returning home, Washburn said.

By practicing good health management before, during and after 4-H events, you can ensure that your show animals are healthy and comfortable every step of the way to the exhibition so that they have a successful performance.

Pet Talk is a service of the School of Veterinary Medicine & Biomedical Sciences, Texas A&M University. Stories can be viewed on the web at vetmed.tamu.edu/news/pet-talk. Suggestions for future topics may be directed to vmbs-editor@tamu.edu.

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PET TALK: Prioritizing Health And Comfort For Show Animals | FCT ... - Freestonecountytimesonline

Internal Medicine

Expert panel that sparked mammogram controversy now says tests … – Los Angeles Times

A new look at the science of preventing breast cancer deaths promises to reshape when, and how many, mammograms American women will get again.

An influential panel intends to recommend that U.S. women begin mammograms to screen for breast cancer at 40 and continue getting them once every two years until age 75. Doing so is expected to reduce the number of breast cancer deaths by 19% compared with following the mammography regimen it previously endorsed.

The new slate of draft recommendations from the U.S. Preventive Services Task Force marks a major shift from the controversial advice it promulgated in 2009 and largely reiterated in 2016 that most women could safely wait until 50 to begin having their breasts scanned for signs of potential malignancies. The panel also said women at average risk could be screened every other year instead of annually.

In calling for fewer mammograms over a womans lifetime, the task force cited the frequency with which breast cancers were overdiagnosed, leading to invasive yet unnecessary treatment, as well as the harms that come from needless biopsies and other work-ups done in response to false-positive test results. It also recognized that mammograms expose women to radiation, which in some cases could wind up causing cancer in otherwise healthy women.

Those recommendations touched off a firestorm and were denounced by womens health advocates, who have long argued that early detection gives the best chance of survival.

What prompted the task force to change its mind and advise that screening mammograms begin at 40? The members said they were strongly influenced by the experiences of Black women, who tend to develop aggressive breast cancers earlier than white women do, and to die of them more often. According to one study, Black women are 39% more likely to die of breast cancer than the population of women as a whole.

Screening women of color for breast cancer earlier is just the first of many steps that must be taken to close persistent gaps along ethnic lines. For Black, Hispanic, Latina, Asian, Native American and Alaska Native women, timely follow-up and effective treatment for breast cancer will be needed as well, the experts warned.

Also driving the changes in the draft recommendations is a growing recognition of the risks faced by women with dense breasts, which make malignancies both more common and harder to detect on mammographic images.

Almost half of all women have dense breasts, and the task force members said they had little research to guide them on whether to recommend additional screening or other kinds of imaging, such as MRI or ultrasound.

New and more inclusive science about breast cancer in people younger than 50 has enabled us to expand our prior recommendation and encourage all women to get screened every other year starting at age 40, said Dr. Carol Mangione, chief of internal medicine at UCLA and the chair of the group that wrote the task forces proposed recommendation. The new guidelines will help save lives and prevent more women from dying due to breast cancer, she added.

Dr. Patricia Ganz, a breast cancer expert at UCLA who has served on many cancer-screening panels, said that there is little new evidence driving the task forces shift. But she called the groups focus on addressing racial inequities in breast cancer very, very important. And she said the every-other-year mammography schedule is in line with practices in Canada and Europe.

I do think this is a very good recommendation: It leaves doctors and their patients a lot of flexibility to decide how aggressive or relaxed their breast cancer screening should be, Ganz said. The fact that they recommend starting at 40 means these women will have an opportunity early to engage in a process of calculating their personal risks.

In doing so, women find they are subject to a range of breast-cancer screening recommendations.

The American Cancer Society suggests women begin annual mammograms at 45, then consider switching to biennial tests at 55. Women who would prefer to begin annual screening at 40 can do so, and they should continue getting mammograms as long as they expect to live at least 10 more years, the ACS adds.

The American College of Radiology and Society of Breast Imaging recommend annual mammography screening for all women ages 40 and older who are at average risk of breast cancer.

Neither group suggests that 75 should be a hard upper limit for screening mammograms. But the American College of Radiology has recommended that all women have a risk assessment for breast cancer by the age of 25, and discuss with their doctor whether earlier screening with mammography and/or MRI is needed.

Dr. Debra L. Monticciolo, a radiologist at Massachusetts General Hospital, was highly critical of the task forces decision to recommend mammograms every other year considering that Black women and Jewish women die from breast cancer prior to age 50 or even 40 more often than white women as a whole. Thats just going to exacerbate the racial disparities, she warned.

Their own evidence shows that the most lives are saved with yearly screening, said Monticciolo, who led the drafting of the American College of Radiology/Society of Breast Imaging recommendations. With annual screening of women 40-to-79, you get a 42% mortality reduction. Limit that to every other year, and it drops the mortality reduction to 30%. These are womens lives that would be saved. I dont know what their thinking is here.

The task force noted other consequences of shifting from the least-intensive to the most-intensive screening schedule, however. The number of mammograms a typical woman received tripled, as did the number of false positive readings. The rate of overdiagnosis more than doubled, from 8% of cases to 17%.

Dr. Otis Brawley, a Johns Hopkins oncologist and cancer epidemiologist, said that while it seems counterintuitive that screening less often could save more lives, its a possibility that cries out for rigorous testing.

Even many experts cant come to grips with how many cancers are caused by mammogram screening and how many deaths are diverted by that screening, said Brawley. People who carry genes that predispose them to some cancers may be particularly vulnerable to radiation-induced mutations, he said. But thats not a trade-off thats been explored with strong research, he added.

The task force made clear that its new recommendations were not undergirded with rock-solid confidence. That women should begin getting mammograms at 40 had its most solid research backing. But the task force assigned far lower confidence values to its every-other-year schedule of mammography, and to the idea that breast-cancer detection after 75 may not be lifesaving.

There is very limited research on this age population, the groups report acknowledged.

The draft recommendation will be open for public comment until June 5. Comments can be submitted on the task forces website.

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Expert panel that sparked mammogram controversy now says tests ... - Los Angeles Times

Internal Medicine

Migrants line up at the border, awaiting the end of Title 42 – The Texas Tribune

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EL PASO As the clock ticked down to the end of a policy used to expel migrants from the U.S. nearly 3 million times over the past three years, the lines formed again on a patch of American soil between the Rio Grande and the border wall.

Hundreds of migrants men, women and children stood in ragged lines, waiting near a gate in the wall for their turn to pass through. They were watched by Border Patrol agents and National Guard members in fatigues. For the moment, no one moved.

A group of four Venezuelan men with a boy and a Colombian couple with their 2-year-old son waded across the shallow river and were turned back by National Guard. The migrants said the soldiers told them the border was closed and they should go to another area 5 miles east where agents may let them pass.

The public health emergency order known as Title 42 which has been largely used as an immigration enforcement policy to quickly expel migrants, including asylum-seekers, trying to enter the U.S. ended late Thursday night.

In preparation, federal, state and border officials across the roughly 2,000-mile U.S.-Mexico border have implemented a series of policies to prepare for what they fear will be a chaotic crisis as thousands of migrants who have been forced to wait in Mexican border cities make a crucial decision: Follow the Biden administrations new rules and make an appointment to request asylum, or try their luck crossing the border en masse.

In South Texas, video footage from journalists on Wednesday showed hundreds of immigrants gathering on the banks of the Rio Grande near Brownsville. In neighboring Hidalgo County, County Judge Richard Cortez issued a seven-day disaster declaration on Thursday.

I have received credible information from officials with Customs and Border Protection that large groups of migrants are probing our international border in search of crossing points, he said. I have decided to declare this emergency as a first step in securing all available state and federal resources to ensure the health and safety of our residents.

El Paso, Laredo and Brownsville had previously declared states of emergency. On Wednesday, El Paso city officials converted two vacant middle schools into migrant shelters using federal money.

After Thursday, immigration agents will seek to deport migrants who attempt to enter the country without first having set up an appointment to enter the U.S. through a port of entry, using a government cellphone app known as CBP One. Migrants also have the option of applying for asylum at one of the new processing centers in Guatemala or Colombia, which will give successful applicants the option to legally enter Canada, Spain or the U.S.

"Starting tonight, people who arrive at the border without using a lawful pathway will be presumed ineligible for asylum, Homeland Security Secretary Alejandro Mayorkas said in a statement late Thursday. The border is not open. People who do not use available lawful pathways to enter the U.S. now face tougher consequences, including a minimum five-year ban on re-entry and potential criminal prosecution."

A couple of hours before Title 42 was set to end, a federal judge in Florida blocked the Biden administration from carrying out a key part of its plan: paroling migrants into the country without a formal notice to appear in court. The temporary restraining order came in response to a lawsuit by Floridas attorney general. Border officials used parole during the Trump administration and under previous administrations.

When the deadline came at 9:59 p.m. local time in El Paso, hundreds of migrants were still in line at the border wall gate, waiting for Border Patrol agents to apprehend them. Men stood in one line, women and children in another.

Whenever agents took a small group of them through the gate, the migrants applauded and cheered.

Earlier Thursday at a migrant camp in Ciudad Jurez, across the river from El Paso, Venezuelan migrant Richard Arcia, 23, said hell continue trying to use the app until he can get an asylum appointment. If hes successful, he said he plans to go to New Jersey, where he has family.

Arcia said hes spent the past two months in Jurez after leaving Peru, where he lived for five years after his home countrys economy began to collapse amid political instability. He worked for a brewery, distributing beer to businesses, until criminal organizations in Peru began extorting Venezuelan immigrants.

He would pay $54, or two days pay, each time. He said one of his friends was killed after refusing to pay.

Whats better, to live in Venezuela going hungry, or try to cross to find a better life? he said. I dont need the American government to give me anything. I have a support system [in New Jersey], and Ill get to work as soon as I can.

Another Venezuelan migrant, 32-year-old Jhonan Polo, arrived at the camp Wednesday with his brother, two nephews and two cousins. The family hopes to get to Boston, where they have a cousin who has lived there for two years.

The camp, outside of a detention center that caught fire in March, killing 40 migrants, has shrunk from an estimated 100 people on Monday to about 60 Thursday evening. Some at the camp said others have left, hoping to sneak into the U.S. or surrender to Border Patrol before Title 42 ends.

Polo said hell look for construction work in Jurez until he can get an appointment through the app.

We want to do it the legal way, God willing, he said. I dont think its a secret why we left, or the conditions of my country: bad economy and bad salaries.

Were relieved because were one step away from a better life, he added. We just want to get to work and provide a life to our family that we couldnt provide in Venezuela.

Thousands of migrants have crossed the border into El Paso in the days leading up to the change, many of them immediately surrendering to Border Patrol agents. Some have avoided detection and entered the country illegally, sleeping in the streets of the citys downtown as they try to find transportation to the nations interior.

Earlier this week, immigration agents handed out Spanish-language flyers to migrants asking those without permission to be in the U.S. to turn themselves in. On Tuesday, hundreds of migrants who had been camping outside of El Pasos Sacred Heart Church did so; agents gave them a notice to appear at a later date at immigration offices across the country.

Since March 2020, when the Trump administration invoked Title 42 for the first time, immigration agents have used it about 2.7 million times at the southern border amid a dramatic increase in migration: In fiscal year 2022, which ended in September, agents apprehended immigrants a record-breaking 2.3 million times at the southern border.

Apprehensions have hit 1.2 million on the southern border during the first six months of the current fiscal year.

On Tuesday, border agents apprehended more than 11,000 people who crossed the border illegally nearly double the number in a typical day, The New York Times reported. After Title 42 lifts, U.S. officials are expecting up to 13,000 migrants to cross the southern border every day.

Ruben Garcia, director of the network of migrant shelters called Annunciation House based in El Paso, said that as of Thursday afternoon, Border Patrol agents already had released 400 migrants to his organizations shelters a number he said is higher than normal but manageable.

But that could change after Title 42 ends, Garcia said.

Your guess is as good as mine, he said when asked what tomorrow could look like.

On Wednesday, Border Patrol chief Raul Ortiz told reporters in El Paso that he does not expect an increase in illegal crossings after Thursday night.

The increases that weve seen in the last five to six days, I think were really the surge, he said, according to news outlets. I think that what we see now is a continued effort by some to message incorrectly that once Title 42 goes away, its going to be a free-for-all along the border.

Among the latest changes in immigration policy, the Biden administration finalized a rule that went into effect Thursday that will deny asylum to migrants who passed through a third country where they could have sought asylum instead.

U.S. Customs and Border Protection acting Commissioner Troy Miller on Thursday said that Mexico will continue to accept 30,000 migrants monthly from Venezuela, Cuba, Haiti and Nicaragua if they try to enter the U.S. illegally and are deported.

Migrants who enter the United States unlawfully by crossing the southwest border, and not via a lawful pathway, will be returned to Mexico and may be transported away from Mexicos northern border to locations in southern Mexico, Miller said. As we have said many times, the border is not open to irregular migration.

Immigrant rights advocates have criticized the Biden administration for the third-country asylum policy, which is similar to what the Trump administration had proposed.

Michele Heisler, the medical director for Physicians for Human Rights and professor of internal medicine and public health at the University of Michigan, said she welcomes the end of Title 42, which she said had no public health benefit, but criticized the Biden administrations new asylum policy as cruel.

This new rule is likely to cause significant harm to a population that is already highly vulnerable due to the factors that made them seek protection in the first place, compounded by the conditions faced on their journey to the border, including extortion, kidnapping, rape and other forms of physical and psychological violence, she said.

Shortly before Title 42 ended Thursday night, a group of about 15 migrants crossed the river seeking to join the line at the border wall, but the National Guard refused to let them past the concertina wire between the river and the wall. They waited for about an hour until they gave up and walked away.

Sindy, 34, a Colombian migrant in the group who declined to give her last name, said she had been waiting all day on the U.S. bank of the river with a group of Venezuelan migrants. They decided to cross the river after spending two months in Jurez unsuccessfully trying to get an appointment through the app, she said.

All this sacrifice for nothing, she said.

Sindy said she left her two daughters back in Colombia with her mother and was robbed by criminals during the long journey north. She still hopes to get to Houston where her sister lives.

Rebuffed by the soldiers, she and the rest of her group left looking for a place to sleep for the night. They said they had no money.

Jayme Lozano Carver contributed to this story.

Disclosure: The New York Times has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribunes journalism. Find a complete list of them here.

Tickets are on sale now for the 2023 Texas Tribune Festival, happening in downtown Austin on Sept. 21-23. Get your TribFest tickets by May 31 and save big!

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Migrants line up at the border, awaiting the end of Title 42 - The Texas Tribune

Family Medicine

From foster care to military family medicine residency – uoflnews.com

John Bowlings childhood was a struggle.

At age nine, he was placed in a childrens home due to difficulties his mother experienced from cerebral palsy. He lived there until his junior year of high school when he relocated with foster parents, staying with them through high school graduation. Supported by his foster family and his biological mother and sister, he attended Lee University and graduated in 2013 with a degree in broadcast journalism.

Im living proof that there are lots of kids out there who have so much potential but due to circumstances out of their control, are unable to realize it, he said.

Unsure of his next step, Bowling accepted a position through Teach for America as a high school biology and chemistry special education teacher in Hawaii. During his time there, he was inspired to pursue medicine. As much as he loved teaching, Bowling felt a call elsewhere after spending time with a physician mentor who encouraged him to consider medicine.

Going from teacher to doctor

When he made the difficult decision to move back to the mainland and pursue medicine, Bowling searched for programs that would help him obtain his pre-requisite courses for medical school and found the University of Louisville School of Medicine. He enrolled in the Post Baccalaureate Pre-Med program which provides individuals with a bachelors degree looking for a career change to participate in a two-year preparation program to gain pre-med science coursework and offers assured admission to the UofL School of Medicine.

Bowling has been an active student leader during his time at the School of Medicine, serving as historian and using his technical skills in digital media, as well as his interest in social media to help document and promote the activities of his classmates. In addition, he was elected president of the Medical Student Council. During his time as president, Bowling led a complete renovation of the medical student lounge, spearheaded initiatives to support and uplift diversity groups, and contributed to several social events that brought all four classes together despite the COVID pandemic.

As a former teacher, Bowling brings a unique perspective to his medical practice that will undoubtedly benefit his patients. His advice for students pursuing medicine emphasizes the importance of following ones passions.

Be sure of yourself and your decision; it will require effort and commitment beyond what you could ever expect, Bowling said. Surround yourself with people who encourage you and build you up, but also those who will hold you accountable. Always take time for yourself and do the things that make you happy.

Upon graduation, Bowling will begin his residency training in family medicine with the Naval Medical Hospital in Jacksonville, Florida.

It is an honor to be able to serve in the U.S. military, and Im beyond excited to get started this summer, he said. I love traveling and adventure. My communications with the U.S. Navy confirmed my decision. Ive made some amazing friends through boot camp and cannot wait to go active duty.

UofL Commencement is May 13

The UofL May Commencement Exercises are May 13 at the KFC Yum! Center.

Morning exercises begin at 10 a.m. honoring graduates from the College of Arts & Sciences, Brandeis School of Law, Graduate School (Interdisciplinary Graduate Studies only), Kent School of Social Work & Family Science, School of Dentistry, School of Medicine, School of Nursing and School of Public Health and Information Sciences.

Afternoon exercises begin at 3 p.m. honoring the graduates of the College of Business, the College of Education & Human Development, the J.B. Speed School of Engineering and the School of Music.

For more information, visitlouisville.edu/commencement.

By Edison Pleasants

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From foster care to military family medicine residency - uoflnews.com

Family Medicine

National Conference Student Chair Is Ready to Help Her Peers – AAFP News

I chose medicine as a career when I really realized how much I love interacting with people and caring for people who are often forgotten or left on the side, said Driscoll, a fourth-year student at the University of Texas Health Science Center San Antonio who recently matched at North Colorado Family Medicine Residency. Physicians get to take care of everyone in their most vulnerable states. Thats what drew me to medicine.

Driscoll didnt have to look far for inspiration. She shadowed her own family physician, John Agaiby, M.D., as a high school student and later as an undergraduate student at Carroll University in Wisconsin.

Something that I learned from him was how you can really get to know your patients and their entire situation, she said. He always knew the patients whole family and would give me that context before wed walk in the exam room. He remembered and cared about their family. He did a lot of hard work to make sure that they were getting great care. He would round on patients when they were in the hospital.

Driscoll said her experiences with Agaiby had her primed for family medicine entering medical school, although she considered emergency medicine and obstetrics, too.

What really struck me about family medicine was the opportunity to really get involved in your community and meet the needs of every single patient who comes through your door, as well as all of the advocacy work that happens in family medicine, said Driscoll, who served as a student representative to the Texas AFPs Alamo chapter and was a regional coordinator for the AAFPs FMIG Network.

Driscoll interviewed at a dozen residencies, looking for a program that could provide broad-scope training to prepare her for rural practice. She found her match at North Colorado, which has five family medicine training programs under one umbrella organization. Driscoll will train in Evans, Colo., at one of 10 clinics in North Colorados Sunrise program, which is a federally qualified health center.

She spent the spring in Ecuador completing a Spanish immersion program that will help prepare her to serve the FQHCs large Spanish speaking population. Greeley, five miles north of Evans, is home to the states second-largest refugee settlement.

Ill be serving underserved patients, including some of Greeleys refugee and migrant worker populations, said Driscoll, who noted that the program has an advanced obstetrics track in the second and third years to equip residents for surgical obstetrics. I am excited to have the privilege of serving this community. Although Greeley is a city, we serve patients from the surrounding rural and agricultural areas, and the broad-spectrum training provided there will certainly equip me to be a rural family medicine doc. This program fits all of the needs I was looking for.

Driscoll hopes to play a role in helping other students find their paths in the specialty as the student chair of the National Conference of Family Medicine Residents and Medical Students, which will run July 27-29 in Kansas City, Mo.

If this is your first big exposure to family medicine, its really a place where medical students can feel at home and feel confident in the choice to pursue family medicine, because there are so many like-minded people, she said. There are so many great mentors in one place who can really encourage you to move forward.

National Conference features one of the nations largest residency fairs, with exhibitors from hundreds of family medicine programs.

Having opportunities to meet with residents and program directors in person was so valuable going into the application season, Driscoll said. I really got to know people and be exposed to programs that maybe I wouldnt have considered otherwise, so that was really beneficial.

As chair, Driscoll will lead the Student Congress.

It was really enlightening for me to spend so much time in the student Congress last year and see how the process works and how that can effect change at the AAFP, she said. I saw the work that students were doing to advocate for medical education and for their patients.

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National Conference Student Chair Is Ready to Help Her Peers - AAFP News

Family Medicine

How joy in practice drives Dr. Harmon in his senior years – American Medical Association

At 71, Gerald E. Harmon, MD, has earned the opportunity to retire from medicine. Besides having practiced for more than 35 years as a family physician in rural South Carolina, he has served as assistant surgeon general for the U.S. Air Force, chief physician for the National Guard Bureau, board chair and president of the South Carolina Medical Association, chair of the AMA Board of Trustees, secretary of the AMA and, most recently, AMA president, from 2021 to 2022.

But retiring isnt something hes comfortable doing just yet.

What would I retire from? What would I do? Dr. Harmon said during a recent interview. I already do plenty of fun things. I hunt and I fish. I spend time with my family. I go to my grandkids events. I have a full life.

Dr. Harmon is also a member of theAMA Senior Physicians Section, which gives voice to and advocates on issues that impact senior physicians, who may be working full time or part time or be retired. In honor of Older Americans Month, May also is marked each year by the occasion of AMA Senior Physicians Recognition Month.

I live in a retirement community in a small rural area thats a destination for many folks, he said. Sometimes I'll get up in the morning and see folks walking their dogs, and if I want to be walking my dog too, Ill ask myself what keeps me going at my age. I'm not trying to be self-aggrandizing, but I always think: Im going to be a doctor come heck or high water. Because I enjoy it and its important."

To illustrate this, he likes to quote Dr. Joseph Warren, a major general in the American Revolutionary War who famously urged his fellow revolutionaries: Act worthy of yourselves.

Dr. Harmon served as a major general too, in the U.S. Air Force.

What we're doing today affects the lives of millions of Americans to come, he said, paraphrasing Dr. Warren. I took an oath when I applied to medical school. Like every other doctor, I said: I want to serve humanity. I feel I have a gift.

For this Q&A, Dr. Harmon discussed in depth what motivates him to keep working and providing care after the age at which many of his peers have retired. At the top of that list: Patients still need him.

AMA: To achieve all that you have in your career, youve obviously put in a lot of time. How many hours a week do you work?

Dr. Harmon: I work a minimum of 65 hours per week, as I always have. But I also vacation and goof offIm pretty aggressive about doing that too. I hear folks saying you should live every day as if it's your last, but I'm not quite that pessimistic. In fact, I describe myself as a pathologic optimist. I'm not manic, but I enjoy every day.

AMA: The physician shortage stands to affect patients of all ages, but older Americans might end up being among the hardest hit. With your being in family medicine, it seems much of the work of caring for older patients will fall to you and your colleagues in that specialty. Does that add to your sense of calling in your senior years?

Dr. Harmon: It does give me perspective, no question about it. We know from the Association of American Medical Colleges that there is an expected shortage of up to 124,000 physicians by 2034, along with a 42% increase in Americans 65 or older. We also know that 40% of doctorstwo out of fiveare going to be 65 or older within the next decade.

I think I'm optimally set up to be a provider for my temporal peers. The challenge is not only around the shortage of geriatricians, or folks who are specialized in medicine for older people, but around the shortage of family medicine and adult internal medicine specialists.

I am trained to be a geriatrician without an extra fellowship year, and having 40 years of practice means I'm experienced in delivering health care for those who are 65 or older. My challenge is to do it in a quality, predictable, scientifically evident mannerin other words, to maintain my skill set and to recognize when I don't have it.

AMA: So what do you do if you suspect that your skill set might no longer be where it ought to be?

Dr. Harmon: One of the reasons we aging physicians are somewhat driven to retire is we're concerned that we may not have the mental acuity that we once had. So first we have to be aware, but we have to also trust the folks were working withwhether it's nurses, technicians or other physiciansif they tell us were not listening or comprehending as well as we used to. In other words, the aging physician needs to be accountable to the workforce.

But there are also lots of resources out there to help keep us sharp. One of those is the AMA Ed Hub, which is a lifelong training initiative. We have an opportunity to go back and learn how to use EHRs, learn how to use augmented intelligence, or AI, learn coping mechanisms for when we have to deal with workforce limitations, and maybe even retrain ourselves so we can volunteer. These things can enhance and extend physicians career paths.

AMA: You mentioned AI. What are your thoughts on it in the clinical and teaching environments?

Dr. Harmon: The first pushback you might get from aging physicians, particularly, is that they don't want to learn these newfangled things. And yet, were already using AI in the electronic health record. And if you think about it, its largely the same as what weve gone through with other technologies. For example, we use cameras and videos now in many professionswe no longer use slide rules. We use computers and calculators. These are the tools we have to become proficient in if we're going to succeed as health care providers.

The same is true in other professions. For example, Ive been flying planes for 40 years, and I use an autopilot in my airplane all the time; I don't try to do everything by hand. It's a time-saving device and a reliability device. When I turn it on, my focus shifts. Im no longer overwhelmed by a multidisciplinary approach to flying an airplane. Autopilot is augmented intelligence too, and weve become very comfortable with it.

AMA: What about the health needs of older Americans? How can senior physicians not just help fill the gap in access due to the physician shortage but even improve the care of older patients?

Dr. Harmon: One of the things were working on at the AMA and other health care organizations is advancing health equity by addressing health disparities. We know that patients of color tend to have better results when their physicians are people of color. They have better communication and they tend to be given better care when the folks that are taking care of them look like them and have similar life experiences.

I would say the same thing for older Americans. When someone in their advanced years is cared for by someone who is of the same demographic, I think we can expect that they're going to have better shared decision-making, be more adherent to the recommendations and have better outcomes. Also, I think we've been able to show that weve given good advice. We have a track record of competence.

And I'll tell you, older Americans do present a more complex burden because of the prevalence of chronic diseases. We have this old saying in medical school that the average person gets about a disease a decade. So, by the time someone is 60 years old, they might have six chronic conditions, such as diabetes, hypertension, lung disease or gastroesophageal reflux disease.

All these things tend to have a burden of overlapping therapies and interventions, and older physicians like myself have the experience to know that we don't always have to order a CT scan or a PET scan. I can examine a patient and have a good predictive instrument going forward. And I might be a little bit more efficient in utilization, or whatever health care matrix I'm giving those older patients.

AMA: Do you think the COVID-19 pandemic affected you and other senior physicians differently from younger physicians? In particular, was there any feeling that your decades of hard work were being undone as the health care system came under siege and physicians and other health professionals started quitting under the workload?

Dr. Harmon: No, but what was disheartening was the pandemic of mistrust that was laid on top of the pandemic of the virus. You heard me talk about that in an AMA Moving Medicine podcast episode. It was a pandemic of lack of faith in the institution of medicine.

But it also gave me an opportunity to step up as a voice of reason. Most people trust their family doctor, often more than anybody elsemore than politicians, more than journalists and almost as much as the military, which has always been one of the most trusted institutions. So it was kind of a bipolar situation: first a little discouraged, but then, hey, that's why I'm here.

AMA: So any plans to retire?

Dr. Harmon: Kind of. I've set an artificial date of three to four years from now just to reassess my situation, because if I don't do it by then I might wish I had. But Ill keep going as long as it's fun and as long as I'm making an impact and I dont have a major physical or cognitive limitation. The good thing about being my age is I realize time is relative and value is everything.

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How joy in practice drives Dr. Harmon in his senior years - American Medical Association

Family Medicine

MU School of Medicine to Award 110 Degrees at Commencement … – University of Missouri School of Medicine

Honorary degree will also be conferred to renowned orthopaedic oncologist

The University of Missouri School of Medicine will celebrate the graduation of 110 students in the class of 2023 at 11 a.m. Saturday, May 13, in Jesse Auditorium, 205 Jesse Hall.

This years graduating class includes 18 graduates who trained at the schools Springfield Clinical Campus in southwest Missouri. The Springfield Clinical Campus is a public/private partnership with MU and CoxHealth and Mercy hospitals.

MU School of Medicine alumnus Benjamin Schmidt, MD, was selected by this years graduating class to serve as commencement speaker. Schmidt is a gastroenterology fellow at SSM Health Saint Louis University Hospital who is known for his popular social media videos that aim to educate and entertain.

The 2023 class of medical students from the MU School of Medicine was highly sought after: 97% of the class received a residency program match, meaning many hospitals and health systems chose graduating MU medical students as their top resident physician candidates.

After receiving their medical degrees on Saturday, these physicians will go on to receive additional training in their chosen specialties. Many of the physicians 31% of MU School of Medicines class of 2023 will remain on the MU campus for their residency training. 44% of the MU School of Medicine 2023 class will remain in Missouri, and 36% of this graduating class selected residency programs in internal medicine, family medicine and pediatrics. Of those graduating, 71 are from Missouri and the others represent 16 other states and three other countries.

Graduates of the MU School of Medicine consistently score higher than the national average on the United States Medical Licensing Examination (USMLE). MU School of Medicine graduates are trained, evaluated and expected to be competent in their ability to deliver patient-centered care, including their capability to communicate with the patient, family members and colleagues working as part of an interdisciplinary team.

The commencement ceremony will also feature a special honor. Kristy Weber, MD, the Abramson Family Professor in Sarcoma Care Excellence, Chief of Orthopaedic Oncology and Abramson Cancer Center Sarcoma Program Director at the University of Pennsylvania School of Medicine will be conferred with the honorary degree of Doctor of Science. Weber is a 1987 graduate of MU, receiving a Bachelor of Science degree after studying Animal Science at CAFNR. In her current role, she specializes in the treatment of children and adults with benign and malignant bone and soft tissue tumors as well as metastatic bone disease. She is the first female president of the American Academy of Orthopaedic Surgeons (AAOS), the worlds largest medical association of musculoskeletal specialists.

Watch a livestream of the ceremony

Friends and family of the graduates can visit the University of Missouricommencement pagefor more information.

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MU School of Medicine to Award 110 Degrees at Commencement ... - University of Missouri School of Medicine