Some US cities may also start to measure a decline in available nurses, thanks to a Virgin Islands health system which on March 1 began a “massive 100-day recruitment effort targeting RNs in Detroit, Pittsburgh and Cincinnati“ to come work “in paradise.” This can hardly help the nursing shortage in the US, although the US (and other wealthy countries) has not been reluctant to recruit nurses from all over the world. One might speculate whether this hospital is next planning to invite medical tourists, once it has a built a world-class clinical team.

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Without a patent to provide a monopoly and resulting ability to charge high prices, drug companies are ignoring non-patentable cancer compounds shown to be beneficial, according to a newspaper op-ed writer.

So patients, ignoring the obvious dangers of taking untested drugs, are taking matters into their own hands. Case in point: Some 200 presumably desperate people have bought dichloroacetate, a compound shown to have shrunk tumors in rats, over the Internet.

This is probably an unstoppable trend, and rather than just whine about the dangers should we not look for a way to recruit self-medicators into some form of rough-and-ready clinical trial?

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Baylor joins health systems waking up to the opportunities for referrals from the growing number of retail clinics in supermarkets.

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Solo practitioners and small practices can now get an EMR system for free, in return for accepting ads from pharmaceutical and other companies on their screens. The idea leaves privacy advocates feeling queasy, but one 500-member practice has embraced the service.

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The US has fallen from top to seventh in the World Economic Forum’s Networked Readiness Index, a measure of technological innovation in nations, as a result of a “deterioration of the political and regulatory environment in the US.”

The top 10 rankings for 2006, with 2005 ranking in parentheses, were:

1: Denmark (3)

2: Sweden (8)

3: Singapore (2)

4: Finland (5)

5: Switzerland (9)

6: Netherlands (12)

7: US (1)

8: Iceland (4)

9: UK (10)

10: Norway (13)

“Denmark, in particular, has benefited from the very effective government e-leadership, reflected in early liberalisation of the telecommunications sector, a first-rate regulatory environment and large availability of e-government services,” a WEF official told the BBC News .

Globalization: Nurse Poaching

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Attention, nurses: Why not work in paradise?

ST. THOMAS, U.S.V.I. (Feb. 17, 2007) – Registered nurses in all specialties – including medical-surgical, critical care, nursing educators, case management and certified nurse-midwives – are being sought by Schneider Regional Medical Center (SRMC), a modern family of facilities providing comprehensive and specialty care in the gorgeous tropical setting of the English-speaking U.S. Virgin Islands.

A massive 100-day recruitment effort targeting RNs in Detroit, Pittsburgh and Cincinnati begins March 1 for Schneider Regional Medical Center, consisting of the Roy Lester Schneider Hospital and Charlotte Kimelman Cancer Institute (opened 2006), both on the island of St. Thomas, and the Myrah Keating Smith Community Health Center on nearby St. Johns.

Exciting professional challenges in these up-to-date facilities are just as attractive to nurses as the spectacular living conditions in the English-speaking, dollar-based U.S. Virgin Islands, says SRMC’s Chief Nursing Officer Angela Rennalls-Atkinson.

“This is paradise,” says Rennalls-Atkinson, under whose watch the 100 Days recruitment seeks to bring topnotch nurses to the JCAHO-accredited SRMC.

“I have worked on the mainland myself,” explains Rennalls-Atkinson. “Spent most of my time in New York. And one of the things that pushed me here was snow storms and temperatures below 30 degrees. Anything below 30 degrees is too cold!”

Instead of shivering and shoveling snow, she and her nurses enjoy excellent benefits including 19 paid holidays in tropical beauty that’s a winter-whipped Northerner’s fantasy. Here, a more leisurely pace of life creates dramatically different, more humane and pleasant days. Here, Rennalls-Atkinson says, life simply becomes easier and better.

Delphine Olivacce. from Detroit, Michigan agrees. “I first came as a travel nurse, and I immediately fell in love with the people and the beauty of the island,” says Olivacce, who weighed job offers in Michigan, New York, California, Connecticut, and Ohio before committing to the islands.

“Once I found out it was a U.S. territory, I was more relaxed,” says Olivacce, now the clinical nurse educator for critical care and medical-surgical. “I actually worked here for a little while, then left and came back. I worked as a staff nurse, in intensive care, then moved into supervision.”

That range of opportunities, she notes, is a major attraction for nurses who want to grow. “We are a small hospital – a 169-bed facility,” she says. “You have a very strong support structure here. This is a place where you see your chief nursing officer everyday, and you have access to senior leadership every day. And it is more family-oriented than most large institutions.”

“We are offering registered nurses the opportunity for a rich, fulfilling work life in a gorgeous place,” says Rennalls-Atkinson. “We are eager to share the rewarding lives we enjoy here, working with an ethnically, racially, economically diverse population that is united by our love for our home – the beautiful U.S. Virgin Islands.”

Paying for the Unpatentable

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In 2001, the estimated cost of bringing a new drug to market in the United States was US$802 million; today it is approximately $1 billion, according to New York Times op-ed writer Ralph W. Moss. The result, he says, is that “drug companies seek to formulate new drugs in a way that guarantees watertight patents. In the meantime, cancer patients miss out on treatments that may be highly effective and less expensive to boot.”

He cites the cases of an off-the-shelf compound called 3-bromopyruvate, developed at John Hopkins in 2004, that was shown to arrest the growth of liver cancer in rats; the readily available industrial chemical, dichloroacetate, found by University of Alberta researchers to shrink tumors in laboratory animals by up to 75 percent, and the inexpensive food supplement melatonin, which “has repeatedly been shown to slow the growth of various cancers when used in conjunction with conventional treatments.”

Despite the “dramatic” results for 3-bromopyruvate, “no major drug company has shown interest in developing this drug for human use.” Why? Because the estimated cost to treat patients would be around 70 cents per day. Dichloroacetate is not patentable, and despite “more than 100 articles . . . and . . . numerous clinical trials,” the pharmaceutical industry has shown a “total lack of interest” in melatonin.

Moss calls for an expansion of the US Food and Drug Administration’s “orphan drug” program to include “unpatentable agents that are scorned as unprofitable by pharmaceutical companies.”

Untested Cancer Drug Bought Online

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Some 200 terminally ill cancer patients around the world have bought the experimental drug DCA (dichloroacetate), which has been shown to shrink tumors in rats, over the Internet, because they may not have the time to wait for the results of clinical trials. DCA is a small molecule that blocks an enzyme in mitochondria, which generate energy in cells and also control cell suicide. Cancer cells turn off the suicide switch, and DCA turned it on again in rats, thereby shrinking tumors by around 75 percent within three weeks.

One expert opined that self-medication with experimental drugs is “destroying” kosher scientific research, and another “strongly advised” patients not to buy DCA because it “might not be helpful and, indeed, might be harmful.”

Hospital Supports Quick Clinics

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Baylor Health Care System will provide supervising physicians for a supermarket-based retail clinic chain, MedBasics (formerly MedXpress). The clinics’ nurse practitioners and physician assistants offer preventive healthcare such as physical exams, immunizations, and lab tests, and treatments for sore throats, bladder infections, rashes and other common illnesses. They charge US$49 for most services, and are open evenings and weekends. Baylor doctors will be available to consult with clinic employees by phone and review patient records. The clinics will steer to Baylor doctors those patients who need medical care beyond what the clinics can provide.

About 200 retail clinics are now in operation across the US, according to the Convenient Care Association.

Innovative Acceleration of EMRs

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Practice Fusion Inc. will provide a Web-based digital medical records system to US physicians and medical groups at no cost, in return for having ads from pharmaceutical, insurance, and other health-related companies appear on screen.

As described by San Francisco Chronicle staff writer Victoria Colliver: “When a doctor using the service calls up a patient’s health record, [Google’s] AdSense will recognize certain keywords — such as “diabetes” — and ads related to that condition will appear on the page. Advertising will be discreet — no pop-ups — and keywords are limited to a patient’s condition, diagnosis or treatment.”

Doctors can opt instead to buy the service for US$250 a month without advertisements.

Privacy advocates are troubled by the use of patient data for profit, reports Colliver, though Google will have no actual access to patient data. Practice Fusion will provide advertisers with demographic information about the physicians who view the ads — such as their city and specialty — but will not reveal names.