| Anatomy
Medical school anatomy hours and instructors have been cut, and dissection
has become virtual, notes Abigail Zuger in the New York Times. Some argue
there is no substitute for the real thing; others point out that cellular and
molecular medicine, which are fast becoming mainstream medicine, don’t need it,
and that there are few new discoveries to be expected from anatomy. Perhaps at
best, it is useful for implant and prosthetic design.
Simulated patients in the form of high-tech mannequins, evolutionary
successors to the Resusci-Annie dolls used to teach CPR, are already in
use in some Oregon schools, notes Robin Moody in the Business Journal of
Portland. They breathe, speak, have virtual heart attacks, can accept
injections and urinary catheters, and report back in detail on how well the
student performed from their perspective.
A new Statewide Simulation Alliance aims to build a network of up to 40
simulation centers throughout Oregon, to meet the demand for training more
nurses, medical technicians and other in-demand health workers. The simulation
equipment for each site is expected to cost about US$40,000. The centers will
have broadband Internet connections for distance learning and to link the
facilities themselves.
In 2001, Moody writes, “the introduction of competition and other factors
forced down the price of the revolutionary mannequins from about $150,000 to
about $30,000 for a single model, making them accessible for educational
purposes.” Mannequin heads, filled with real and plastic teeth, are also
available to dental students.
We would only add that it should be obvious to regular Digest readers
that the mannequins will inevitably become increasingly life-like,
“socially-engineered” humanoids, and will become as indistinguishable from real
humans inside as out.
Reference: Zuger, Abigail (2004). “Anatomy Lessons, a
Vanishing Rite for Young Doctors.” New York Times, March 23.
Reference: Moody, Robin J. (2004). “New
models for medical learning: Simulated patients help teach students an array of
clinical tasks.” Business Journal of Portland, March 19.
Fast Care
A Kentucky startup called FastCare has opened kiosks in two Kroger
superstores to provide on-the-fly healthcare for shoppers. For about US$38 and
with a minimum of waiting and paperwork, they can buy treatment for common
illnesses like colds, strep throat, rashes, and ear and sinus infections. The
nurse practitioners who staff the kiosks are authorized to perform physical
exams, prescribe medications, and perform medical screenings. The kiosks are
open seven days a week and until 8 p.m. on weekdays.
So far, the kiosks have only attracted “about 10 patients a day,” writes
Patrick Howington in the Louisville Courier-Journal. The company hopes to
raise that to “about 25 or 30,” and has reluctantly begun accepting Medicare and
may also start accepting some private health insurance. The fees were designed
in part to be not much more than the co-payments people would pay under an
insurance plan, and the service was originally targeted at customers who either
don’t have private health insurance or don’t mind paying out-of-pocket in return
for convenience. But older customers asked to use their Medicare benefits.
FastCare’s pioneering competitor and model, MinuteClinic, now has clinics in
seven groceries, three Target stores, and two corporate offices, using nurse
practitioners and physician assistants who provide care for about $41. The
companies claim patients see them as “a great alternative” to, and more
convenient and affordable than, an emergency room visit or a long wait in an
immediate care center, not to mention a long delay for an appointment with a
family physician.
FastCare has arrangements with local physicians who can be contacted by the
nurse practitioners if patients show up with complex or dangerous conditions, or
they may direct them to an emergency room.
Reference: Howington, Patrick (2004). “Quick-care
kiosks open in 2 Krogers: Local start-up offers low-cost treatment by nurse
practitioners.” Louisville Courier-Journal, March 12.
Cancer Risk Assessment Tool
The IBIS risk evaluator, a software program, processes information
about a woman’s family history of breast cancer, age, height, weight, use of
hormone replacement therapy, whether she has had children, and other factors to
assess her risk of developing the disease.
Though not the first computer
program to evaluate the risk of breast cancer, “it models more carefully what
scientists know about the disease and includes more risk factors,” reports
Reuters’ Patricia Reaney. IBIS is being used in hospitals in Britain, the
United States, and Australia. It is currently available only to doctors, but its
developers envision making it publicly available eventually. They may also
modify it to evaluate the risk of heart disease, cancers, other illnesses.Reference: Reaney, Patricia (2004). “Computer
Program Evaluates Breast Cancer Risk.” Reuters via Yahoo News, March 22.
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