Issue 10: Mad Deer Disease, CHIP, and more

Mad Deer Disease
Image from OutdoorHub. Not an actual zombie deer
In the 1980's contaminated bovine feed infected large portions of English commercial cows with the dreaded Mad Cow Disease. Hamburger and beef lovers consumed the infected beef, unaware of the consequences, and close to 200 humans developed the fatal prion infection known as Creutzfeldt-Jakob Disease (CJD). But now there's a new threat on the block called Chronic Wasting Disease (CWD) that scientists say can be potentially transmitted to humans from eating infected deer meat. To be clear "Mad Deer Disease" has been known to exist for decades, but there have never been any reported cases in humans. In June, however, a Canadian study came out that showed CWD could be transmitted to macaque monkeys through eating contaminated venison. If monkeys can get it so can we rationalize scientists. The problem with CWD is that deer that are infected can look totally healthy so it's important for hunters to test their meat before consumption. So far hunters seem reluctant to test the meat and are fine with taking their chances. Let's hope they don't develop any prion diseases.

CHIPS on their Shoulder
In the US we take for granted how "stable" our government is compared to other countries. Fortunately (or unfortunately) we have also become accustomed to government shutdowns and the implications they have. Yes, this most recent shutdown resolved within 3 days and nothing catastrophic happened, however, the silver lining with this episode of bureaucratic shenanigans was that CHIP's got refunded.

CHIP is back! 
Erik Estrada pictured on the left. 
No sadly this does not mean we will get a sequel to the 2017 movie CHIPS or that Erik Estrada is going to return to reboot the old TV show CHIPS but rather the Children's Health Insurance Program is back. The program aids with health insurance whose families make too much to qualify for Medicaid, the government assistance for healthcare for low-income families. The program varies from state to state but targets families who make up to 100-200% of the federal poverty level which would be around $25,000 to $50,000 for a family of four. A little bit of history here, CHIP started in 1997 and has been fairly effective in decreasing the amount of low-income uninsured children since then, with the number falling from 25% in 1997 to 13% in 2013. So for everything going on in the world of politics, there are positives, namely politicians on both sides can agree that it's a good thing to have children to have health insurance! More importantly, 1997 is also when Erik Estrada was in both the TV show Baywatch as well as Homeboys in Outer Space. Thanks CHIP(s)!

Apple making a huge push into electronic health records
Not to be outdone by Amazon’s or Google’s ambitions in the digital health space, Apple unveiled a new feature in their preexisting app “Health” which enables the transfer of health information from their physicians directly to their iPhone. Biggest hurdle in this deal was getting clinician buy in. Many prestigious institutions including Johns Hopkins and University of Pennsylvania have already agreed to participate. Furthermore, Apple is actively working with electronic health record vendors Epic, Cerner, and AthenaHealth to strengthen protocols for exchanging electronic health records. Beta testing of this feature is set to roll out on 1/25/2018. A key concern of privacy was addressed when Apple stated that the information is encrypted from health providers and only locally stored on their phone - in other words, Apple cannot sell this information. This is the first of many ambitions that Apple has in the works including recently announced Apple Heart Study with Stanford University. 

CDC sees 700% increase in ADHD in young women
The CDC recently filed a report citing that a LOT of women are now taking ADHD meds like adderall, ritalin and vyvanse. Between 2003 and 2015 there was a 700% increase in ADHD prescriptions among women aged 25 to 29 and a 560% increase among women aged 30 to 34. The report found that increases were greatest in the Southern and Western states. Interestingly many industry experts and psychiatrists believe that the increase is not a result of over-prescription but rather because women had previously been under-diagnosed with the condition.

Canadians Want to Improve Healthcare by Spending Less on It

Canada. Apart from just being America's hat, our neighbor to the North is also pioneering an innovative way to improve the healthcare system by ironically spending less money on it. Canadian scientists recently examined data over a span of 31 years from 1981 to 2011 in 9 out of 10 Canadian provinces to show that increasing healthcare spending doesn't really work that well. They instead discovered that spending more on social services such as affordable housing and education improved healthcare outcomes on a population level. Dr. Dutton from the University of Calgary says that "If governments spent one cent more on social services per dollar spent on health be rearranging money between the two portfolios, life expectancy could have experienced an additional 5% increase and potentially avoidable mortality could have experienced an additional 3% decrease in one year". For anyone who has spent time working in a hospital this makes sense given how many of our patients have complicating social issues. The results of the study have major implications for government policy that are currently being discussed.

US Public Doesn't Trust Doctors
The US public currently has a record low amount of trust in its healthcare system. in 1966, close to 75% of the public trusted doctors, fast forward to today and only 34% of people trust doctors while worse only 23% of Americans have confidence in the US healthcare system. Interestingly although Americans don't trust the system, they do report high individual patient satisfaction. Currently the US ranks 3rd in the world on individual patient satisfaction. The NEJM penned a piece back in 2014 explaining this somewhat contradictory fact. You can check out the article HERE.The article explains that part of the reason can be attributed to the perception that medical costs are astronomically high, which is DEFINITELY true. The NEJM is urging docs to be vocal proponents of lowering costs in order to recover their dear reputations.





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