News
WWAMI Seeks Admission Committee Members
The Idaho WWAMI Medical Education Program is seeking two board-certified Idaho physicians to join the Idaho Admissions Committee beginning with the January 2013 interview season. This committee is comprised of four Idaho physician members who interview the Idaho applicants to the University of Washington School of Medicine. Admissions Committee members are appointed by the Idaho State Board of Education for a three-year term with the option of serving a second three-year term. If you would like to learn more about the position or request an application please contact the Idaho WWAMI offices via e-mail idwwami@uw.edu or phone (208) 364-4544. Deadline for application and supporting documents is due October 28, 2011
Just Say No!
The American Medical Association's Council on Ethical and Judicial Affairs sent a recommendation to the AMA House of Delegates in June recommending "When possible CME should be provided without support or participation of individuals who have financial interests in the educational subject matter." The recommendation passed.For most of us using CME the issue is moot. Industry funding of CME is all but extinct. This ruling however aims to safeguard the delivery of unbiased education that promotes evidence based medicine by defining for physicians that taking industry support is in some sense inappropriate or unethical or wrong.
While there are those with earnest disagreement with the recommendations the approval is one more indication that industry support of physician education is going away.
CME Still Works
A recent study of 1500 physicians on preferences for CME conducted by Penton Media indicates 93% of physicians feel indicated CME activities were effective in meeting their educational needs. The average number of hours respondents received annually was 46 hours. Ninety-three percent indicated licensure and board certification requirements were the primary reason for participating in CME activities. Seventy-two percent indicated one of the main reasons was to obtain the latest clinical data on patient management and 71% indicated they use CME to validate their current patient management strategies. Thirty-one percent value the networking aspect of live CME to network with their peers. Seventy-six percent of all respondents received some credit from online point-of-care CME such as Up-to-Date.The study continues to show a reduction of preference for out of town meetings with 33% reporting they received CME at an out of town venue.
Wednesday, 8:00 a.m. - Anderson Center
Wednesday, 12:15 p.m. - Winter Room
Friday, 8:00 a.m. - McCleary Auditorium
Other Regularly Scheduled Conferences
St Luke's RMC
Tumor Board - Tuesday, 12:00 noonMercy Medical Center
Breast Tumor Board - Thursday, 7 a.m.
MSTI Pediatric Tumor Board - 2nd & 4th Wednesday, 12 noon
Meridian Tumor Board - 1st & 3rd Thursday, 12 noon
CHEERS (Children's Hospital Education Enrichment Review) - 1stThursday, 8 am
Anderson Center - Ada -2; MATCH 2nd Thursday, 8 am
Tumor Board- Tuesday, 12 noonWest Valley Medical Center
Tumor Board - Monday, 12:30 pmSaint Alphonsus RMC
Tumor Board - Thursday, 12 noon
Breast Care Panel, Tuesday, 7:00 am
MEMBERSHIP:
New members this month include: Andrew Holtz, D.O.; Kari Peterson, M.D.; Arden Mahaffey, D.O.; Jennifer Southard, M.D.
UPCOMING EVENTS:
October 28, 2011 ACMS Annual Meeting and new Physician dinner, Grove Hotel
November 17, 2011 ACMS Legislative Night, Red Lion Downtowner
PARAPOSDOKIANS A paraposdokian is a figure of speech in which the latter part of a sentence or phrase is surprising or unexpected; often used to a humorous effect.
- "Where there's a will, I want to be in it."
- Light travels faster than sound. This is why some people appear bright until you hear them speak.
- If I agreed with you, we'd both be wrong.
- War does not determine who is right - only who is left.
- Knowledge is knowing a tomato is a fruit. Wisdom is knowing not to put it in a fruit salad.
- To steal ideas from one person is plagiarism. To steal from many is research.
- Whenever I fill out an application, in the part that says, "In case of emergency, notify:" I put Doctor.
- You don't need a parachute to skydive. You only need a parachute to skydive more than once.
- Money can't buy happiness, but it sure makes misery easier to live with.
- I used to be indecisive. Now I'm not so sure.
- A diplomat is someone who tells you to go to hell in such a way that you look forward to the trip.
November 2011
December 2011
(Wednesday, 8:00am/St. Luke's RMC; Wednesday, 12:15pm/Mercy Medical Center;
Friday, 8:00am/Saint Alphonsus RMC)
Simvastatin (Zocor) is one of the most widely prescribed drugs. The FDA has recently changed the labeling to reduce the risk of myopathy which is closely related to the dose of the drug. The 80mg dose should be limited to patients who have been taking it for over 12 months without evidence of myopathy. Since it is metabolized by CYP3A4 certain drugs are contraindicated with it. These include Clarithromycin and Erythromycin. Calcium channel blockers also have new dosing restrictions with either 10mg/day or 20mg/day maximum if they are used concomitantly. Rosuvastatin (Crestor) has a low risk of myopathy and is the most effective in lowering LDL-C and has now been shown to improve clinical outcomes. It however remains one of the more expensive statin drugs. (The Medical Letter Vol 53 Issue 1370: Aug; 61-64)
Some patients with diagnosed hypertension are not really hypertensive especially if the diagnosis is based on clinic blood pressure measurements. Treatment decisions generally are based on blood pressure measurements obtained in our offices. Two recent studies point out that clinic based blood pressure measurement is often inaccurate. A single blood pressure measurement clearly is inadequate and if there is any question about "white coat hypertension" ambulatory blood pressure measurement which is covered by Medicare should be done. (Ann Intern Med 2011 Jun 21; 154:781)
Rivaroxaban (Xarelto) an oral direct factor Xa inhibitor has been approved for prevention of deep vein thrombosis (DVT) in patients undergoing knee or hip replacement. The recommended dosage is 10mg taken orally for 35 days following hip replacement and for 12 days following knee replacement. It should be started 6-10 hours after surgery. It appears to be more effective than Enoxaparin (Lovenox). It did cause slightly more post-operative bleeding than Enoxaparin in a clinical trial and there is no specific antedote. Unlike Warfarin it does not require any monitoring. (The Medical Letter Vol 53 Issue 1371: Aug; 65-68)
Should you use D2 or D3. Many Vitamin D supplements are available over the counter has D3 (cholecalciferol) usually in 400-1000 IU doses. D2 available by prescription as ergocalciferol can be prescribed in 50,000 IU doses. Two recent trials compared the two supplements and found on average that oral D3 raises 25 hydroxy blood levels more than does D2. These articles clearly show that D3 is preferable for correcting Vitamin D deficiency. (J Clin Endocrinol Metab 2011 Apr; 96-981) (J Clin Endocrinol Metab 2011 Mar; 96:E447)
John J. Mohr, M.D.
Anderson Center, St. Luke’s RMC, Wednesday 8:00 a.m.
Winter Room, Mercy Medical Center, Wednesday 12:15 p.m.
AW Horsley, VA Medical Center, Thursday 8:00 a.m.
McCleary Auditorium, Saint Alphonsus RMC, Friday 8:00 a.m.
2 Update on Asthma, G. William Palmer, MD
9 Dermatologic Update for Primary Care, Kalynne Harris, MD
16 St. Luke's Children's Hospital, Grand Rounds, TBA
18 Defensible Rational Compassionate Pain Management, Howard Heit, MD
23 Elder Financial Misuse & Abuse, Barry Cusack, MD
25 No Conference
30 Concussion Injuries, Kurt Nilsson, MD
14 Pharmacological Management of Anticoagulation, Mark Filicetti, MD
23 NO CONFERENCE
28 NO CONFERENCE
30 NO CONFERENCE
5 Lactose Intolerance, Jeannette Keith, MD
12 Update on Breast Disease , James Wolf, MD
19 Hearing Screening of the Newborn, Jessica Stich-Hennen, Au.D
26 Management of Small Renal Mass, Jay Bishoff, MD
5 Lactose Intolerance, Jeannette Keith, MD
12 Off Pump Bypass, Stephen Jones, MD
19 Hip Replacement, Dennis McGee, MD
26 Management of Small Renal Mass, Jay Bishoff, MD
6 Management of Thyroid Nodules, Speaker TBA
13 Hepatitis C, Lauren Beste, MD
20 Challenges to Immunizations: The View from Idaho, Tom Rand, MD
27 Rheumatology Update, Desmond Anim-Appiah, MD
7 Hand Hygiene: Why do we not wash our hands? J. Robert Polk, MD
14 Impact of Healthcare on Malpractice, Kenneth Freeman, MD, JD
21 Aortic Stenosis: Indications for Intervention and Evidence of an Untreated Patient, David Bach, MD
28 Update on Asthma, G. William Palmer, MD
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