Massachusetts Medical Society's Physician Focus


Prescription Drug Abuse: The Physician’s Perspective
Abuse of opioids and prescription drugs has become a national public health problem in the United States. Many efforts – legislation, regulations, restrictions, prescription monitoring programs – have been undertaken by government officials, law enforcement, and health providers at all levels to reduce the problem – with varying results. At the same time, many patients are experiencing chronic pain, and patients and providers alike are concerned that overreaction will deprive patients of needed medications. What is the physician’s perspective of prescription drug abuse? What do those who treat the patients and write the prescriptions think should be done to reduce the problem? What are the responsibilities of physicians when prescribing and patients when using opioids?

Chronic Kidney Disease
The Centers for Disease Control estimates that more than 20 million Americans – about 10 percent of the adult population – have chronic kidney disease. Adults with diabetes and high blood pressure, two of the most prevalent medical conditions in the country, are at higher risk for developing CKD than others. The chances of having CKD also increase with age, and as the population ages, the incidence of CKD is likely to increase. What causes this condition? How is it detected? What implications does it have for overall health? Can it be prevented? And what are the treatments available for it?


Food and Your Health
The food one eats has an enormous effect on one’s health, yet many consumers, bombarded with study after study about what’s good and what’s bad to eat, are confused. In some cases, the studies offer conflicting information. This program will look at such questions as: What IS the impact of food on our health? What constitutes healthy food? Is organic food really better? Is food from Genetically Modified Organisms (GMO) safe? How can consumers become more aware and more knowledgeable about the foods they buy and eat?

Managing Your Chronic Disease
Chronic diseases, long-lasting conditions such as heart disease, diabetes, HIV, asthma that can be controlled but not cured, are a leading cause of death and disability in the U.S. and in total affect some 90 million Americans. Traditional care has focused on the physician’s role in caregiving, but a new model of care is emerging: patient self-management, where patients become their own principal caregivers. What are the principles behind this new model? Will patients embrace it? And what advantages does it bring - to the patient, to the provider, to the health care system?

HPV: Human Papillomavirus
Human Papillomavirus is the most commonly sexually transmitted disease, currently infecting about 79 million Americans, with 14 million becoming newly infected each year. HPV can lead to certain cancers, including cervical cancers and head and neck cancers. This program will look at such questions as: Why is this condition so widespread? Who is most at risk for this disease? How is the disease detected? How can the number of infections be reduced? And what treatments are available for those who get the disease?

Is Marijuana Medicine?
Despite Federal law prohibiting the drug and lack of approval by the Food and Drug Administration, the use of marijuana as medicine is now permitted in Massachusetts as well as several other states. Yet the debate continues on many topics: What are the health risks associated with its use? What is the drug’s effectiveness as a therapy for medical conditions? This program will look at those questions and others, including what the available science says about the drug, and what patients should know if they are considering using it for medicinal purposes.

End-of-Life Care: Advance Care Planning
Physicians are trained to promote wellness, cure illness, and preserve and protect life. Yet, death is inevitable, and health care providers are now paying more attention to end-of-life issues. One of the most important aspects of end-of-life issues is preparing advance directives. These include such items as a living will, health care proxy, durable power of attorney. Why should people prepare advance directives? What do they signify? How difficult are they to prepare? And how do they benefit the patient, family members, and health care providers?

Boards of Health: Public Health at the Local Level
They’re invisible to many citizens, but the work of the local boards of health in communities across the state is critical to our collective well-being and safety. This edition of Physician Focus will take an in-depth look at public health efforts at the local level by examining how local boards of health operate. What are the responsibilities of these boards? What kinds of power do they have? How, exactly, do they operate? Who are the people who watch out for our health and safety? And how do they interact with state public health officials?

Common and Emerging Infectious Diseases
The familiar ones are with us each year – West Nile virus, Easter Equine Encephalitis, Lyme disease. But outside of the U.S., unfamiliar infectious diseases like Chagus disease, dengue, Ebola, and Chikungunya virus – continue to affect millions around the world. And some are getting closer to the United States. How dangerous are these diseases? What are the biggest threats of infectious disease facing the U.S.? And how are public health officials acting to safeguard against them?

Oral Health
The U.S. Surgeon General’s first-ever report on oral health in America, issued in 2000, declared that oral diseases remain prevalent across the country, and that, for some populations, the lack of oral health was a “silent epidemic.” Evidence has shown that oral health and physical health are linked, and that oral complications are associated with respiratory disease, cardiovascular disease, and diabetes. How far have we progressed since the Surgeon General’s report? What are the factors contributing to a lack of oral health? How do we improve people’s oral health? And how can physicians and dentists work together on behalf of the patient?

Unequal Treatment: Disparities in Health Care
A dozen years ago, the Institute of Medicine issued its report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, pointing out that racial and ethnic minorities receive poorer quality care than white patients. What’s causing this unequal treatment? What can physicians and patients do to improve their care? And how much progress have we made since the IOM’s landmark report?

In 1981, the Centers for Disease Control described a rare, then-unidentified lung disease affecting the immune system. It was the first official reporting of what would come to be known as human immunodeficiency virus, or HIV that leads to AIDS. Today, about 50,000 people in the U.S. get infected each year with HIV, and many do not know they are infected, and some 15,000 people die each year from AIDS. Worldwide, the figures are even higher. How far have we come in more than thirty years in our fight against HIV and AIDS?

Crohn’s and Colitis Diseases
Crohn’s and colitis are chronic diseases of the intestines, each affecting as many as 700,000 people in the U.S. What are the causes of these conditions? Who is most affected? How does it affect health and quality of life? And what treatments are available for these diseases?

Smoking, Tobacco and Health
January 2014 marks the 50th anniversary of the first Surgeon General’s report on the dangers of smoking and tobacco. While much progress has been made in getting people to stop using tobacco, smoking remains the leading cause of preventable death in the U.S. As the nations’ physicians refocus on anti-tobacco efforts, it’s time to review the impact of tobacco is having on our health and what can be done to continue to reduce the rate of smoking among all ages.


Violence and Mental Illness
The killings in Aurora, Colorado and Newtown, Connecticut in 2012 and at the Washington Navy Yard in 2013 are the latest in a long list of mass shootings in the U.S. that have called attention to the link between mental illness and violence. In recent Gallup polls, nearly half of Americans – 48% - blame the mental health system “a great deal” for mass shootings. What exactly is the relationship between mental illness and violence? And what role, if any, might mental health professionals play in reducing violent acts?

Hepatitis is one of several diseases affecting the liver, the largest organ in the human body that aids in critical functions of the body. Nearly four and half million Americans are living with chronic hepatitis, and most are unaware they are affected. What causes this condition? What are its symptoms? How is it diagnosed and treated? Who may be susceptible? And if left untreated, what consequences may occur?

Inside the ER
The hospital emergency department has become a mainstay of American medical care. An estimated one of every five Americans visit the ER each year, for a total of nearly 130 million visits annually. With only 4 percent of the nation’s physicians, emergency departments manage more than 10 percent of outpatient hospital visits, handling a wide range of medical challenges, often under difficult circumstances. What are the decisions emergency physicians and nurses face when patients present themselves? What should patients consider when thinking about visiting an emergency department for medical care? What is the role of the emergency department in today’s health care system? And what challenges do they face?

The Physician-Patient Relationship
The physician-patient relationship is regarded as the foundation of good health care, but medicine is constantly evolving and changing, and so, too, does the physician-patient relationship. How has this relationship evolved over the years? What elements make up a good relationship today? Will the relationship change with the move to “medical homes” and accountable care organizations? What should patients think about when seeking a primary care provider?

Complicated Grief
The loss of a loved one affects each of us deeply and moves us to mourning and bereavement following their death. After a period, most people gain acceptance of their loss and move forward with their lives. Some, however, are affected by complicated grief, a clinically significant and potentially debilitating condition. What are the causes of this severe grief? Who is at risk? What are the symptoms? How can it affect one’s health? And what kind of help is available to those who experience this condition?

Weight-Loss Surgery: Myths and Realities
Weight loss surgery has been touted as one solution to the problem of obesity, and in some cases, it’s also been known to eliminate diabetes. It’s a complex undertaking, however, that involves a lifetime of commitment, discipline, and attention to detail. Who are the best candidates for these procedures? What steps does a patient need to take for success? What are the surgical options available and what are the differences between them? What results can a patient reasonably expect, and what are the risks?

Disaster Medicine
The bombing at the Boston Marathon is the latest example of the role medical professionals and first responders play in meeting unexpected events. Whether natural or man-made disasters, medical personnel seem always ready to react quickly, to save lives and care for those in harm’s way. What goes into preparing for such events? What kinds of training and resources are necessary? And what is the impact on physicians, nurses and other first responders?

Joint Replacements
The number of joint replacements is soaring in the U.S., as more than a million people year are getting total replacements, usually for their hip or knee. As baby boomers age with arthritis and other conditions but still wish to remain active, these operations are expected to continue to increase. Who are the best candidates for these replacements? How expensive are they and how long do they last? What should patients know, pre- and post-surgery, about these procedures? And how successful have they been?
Check-ups and Screenings
The value of regular medical check-ups and screenings has come into question, dividing the medical community and causing confusion among patients. Independent groups such as the U.S. Preventive Services Task Force and The Cochrane Library in Europe say there’s little evidence that check-ups and screenings reduce health risks and can even do harm. Some physicians disagree. What’s prompting this divide within the medical community? How should patients react to this information? And what advice should they follow?
Youth Violence and Child Abuse
From bullying by their peers to sexual abuse by adults to actions portrayed in multiple forms of media, our children are being exposed more and more to violence. What is causing this? What steps can parents take to protect their children? How does it affect the physical and mental health of our children? And what role can the physician play in addressing and reducing youth violence?
Understanding Depression
Depression is a chronic mental illness that affects one in ten adults in America and is a leading cause of disability for individuals 15 to 44. Though women are much more likely to experience depression, the illness can reach anyone, regardless of social, ethnic, or economic status. What causes this mental illness? How is depression diagnosed? Is there a link between depression and other diseases? And what are the treatments to address this condition?
Doctor’s Rx: Healthy Eating
The medical conditions associated with obesity, such as diabetes, heart disease, high blood pressure, and osteoarthritis, are too costly and too common, and are brought on in large measure by the lifestyles we lead. How active we are, our use of substances such as tobacco and alcohol, and particularly the foods we eat – are major causes of obesity and overweight.