“Wherever the art of Medicine is loved, there is also a love of Humanity." - Hippocrates
CVMS has recently partnered with EdLogics, a company founded by Tom Chamberlain, dedicated to improving health literacy for the public in our area. Health literacy means the more patients know about their health, the healthier they are. Healthier 757 is the online program produced by EdLogics to accomplish this. It is presented as a game platform that is a fun way to learn about better health and at the same time offers real monetary rewards for answering questions correctly. Physicians can now offer this program to their patients for free due to multiple funding sources. Doctors can write specific prescriptions on what topics their patients should review, or just let them know about the program in general so they can browse through it.
This program is nothing less than revolutionary in educating the public about health-related matters. Take a look at Healthier 757 here...
Biomarkers have been identified in patients with Long COVID (Post-acute-COVID-19 syndrome) suggesting its presence as a real disease entity according to a study published recently in Nature. High Fibrinogen and and high D-Dimer levels along with low CRP levels during acute COVID infection have been found to be associated with the development of long COVID, specifically the subjective cognitive deficits and occupational outcomes.
Most patients with acute appendicitis can be successfully treated with antibiotics rather than surgery, even though some may require surgery up to 20 years later.
Price Transparency is required by Federal Law, but only one in five hospitals make this information available.
Virginia Total Care is a subsidiary of Centene, a health management company for Medicare and Medicaid, similar to Humana only much better. They have partnered with our neighbor, the Medical Society of Northern Virginia and will be in our area soon. CVMS has already been in discussions with them. We are looking forward to their presence in our community as a benefit to our patients and our physicians.
Jodi Helsel, a local representative of the Committee to Protect Healthcare, has reached out to CVMS with an opportunity to participate in a press conference regarding Site Neutral Payments. We are excited to get the word out about this since many people still have no idea about the large price discrepancies for procedures when done in the hospital versus when done in physicians' offices and outpatient facilities.
[Excerpt from Dr. Harry Gewanter's article on the MSV General Community Page.]
NCPA September 27, 2023
ALEXANDRIA, Va. (Sept. 27, 2023) – "The National Community Pharmacists Association loudly applauded a class action lawsuit filed against vertically consolidated CVS Health, Caremark, and Aetna that aims to recoup for independent pharmacies millions of dollars in what the lawyers say are wrongful back-end penalties for Medicare Part D prescriptions, otherwise known as pharmacy direct and indirect remuneration fees.
"It's payback time," said NCPA CEO B. Douglas Hoey. "Finally, community pharmacies have a chance to recover DIR fees that were unfairly taken. PBMs have been gaming the system for a long time, and it's time to turn the tables."
The lawsuit, announced today by the law firms Berger Montague PC and Cohen & Gresser LLP, claims that Caremark – the largest pharmacy benefit manager in the country and a subsidiary of Fortune 6 corporation CVS Health – has been assessing pharmacy DIR fees in violation of federal antitrust laws and state laws governing contracts. The lawsuit also challenges Caremark's agreements to arbitrate claims as being unfair and unenforceable."
As Covid cases are rapidly creeping up, and new variants are emerging with as many as 30 new mutations what do you do when your patient has completed Paxlovid only to test positive five to ten days later again?
According to the Centers for Disease Control and Prevention Paxlovid therapy was designed for people at high risk for severe disease yet with demand has expanded to a broader area. Now this category includes people with mood disorders, like depression, current and former smokers, those with obesity, the autoimmune, and an effective tool to keep people out of the hospital. But, now it's getting bad press from high-profile instances of "Paxlovid Rebound, " or testing positive days after recovering from the virus, " said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California San Francisco.
Although Paxlovid rebound is well charted in the literature, it's also possible to get rebound without ever having taken the drug. A representative of Pfizer wrote in an email to The New York Times, that "rebound is uncommon and not uniquely associated with any specific treatment."
So rebound is tricky stuff. You can look at it in two ways, says NYTs Dani Blum, looking at whether someone tested positive again a few days after testing negative, or by looking at whether symptoms have returned after someone seemingly recovered, or whether a new symptom appears as a secondary illness." Jay Pandit, the Director of Digital Medicine at Scripps Translational Institute believes it's hard to quantify how often rebound occurs.
In a clinical trial, Pfizer researchers estimated that 2.3 percent of people who took Paxlovid and 1.7 percent of the control group experienced rebound. Yet, estimates are 14 percent who took drug, and 9 percent for those who did not. As with everything Covid it's difficult to get real world data and those who experience rebound are unlikely to tell their doctors.
"The numbers are definitely higher than what has been reported, " said Dr. Michael Mina, a former Harvard epidemiologist, who is now chief science officer for eMed, a telehealth company, and who has studied rebound. "The theory behind Paxlovid rebound is that the treatment is so effective it's like allowing the medication to take the steering wheel from your immune system. Your immune system was going to take a back seat for a while, then you're asking it to kick back up after five days after you complete the treatment. Then the virus can replicate in your nose with a vengeance.
It's also not clear how contagious people are when they rebound. But according to the CDC if your patients test positive again on a rapid test, assume they are contagious, take precautions, isolate from other people, and if you go out in public, wear a mask. Rebound can last from two to ten days before testing negative again. Drink fluids. Report breathing poblems.
Excerpts from "What To Do When Covid Rebounds," by Dani Blum. New York Times, Oct. 2, 2023. Under WELL. Dr. Alexandria Peck Berger, Director of Public Health. CVMS.
Artificial Intelligence (AI) is revolutionizing healthcare in numerous ways, improving patient outcomes, reducing costs, and enhancing overall efficiency. Here are some key applications of AI in healthcare:
Overall, AI is helping healthcare providers deliver more accurate diagnoses, individualized treatment plans, and improved patient care while reducing costs and administrative burdens. However, it is essential to ensure privacy, security, and ethical considerations when implementing AI in healthcare.
Stay up to date on issues and news you need to know. The CVMS Bulletin is published monthly and will list concerns that local physicians have expressed about healthcare in Coastal Virginia and how we can make it better. We will provide potential solutions and let you know what is happening behind the scenes to help solve these problems.