The Week in Review provides an overview of the past week’s top health care content, including industry news and trends, Mayo Clinic and Mayo Medical Laboratories news, and upcoming events.
FDA Takes "Historic Action" on Youth e-Cigarette "Epidemic"
Concerned with an "epidemic" surge in teen use of e-cigarettes, the head of the U.S. Food and Drug Administration announced a "historic action" against more than 1,300 retailers and five major manufacturers for their roles in perpetuating youth access to the devices in the US. "I use the word epidemic with great care," said FDA Commissioner Dr. Scott Gottlieb. "E-cigs have become an almost ubiquitous—and dangerous—trend among teens. The disturbing and accelerating trajectory of use we're seeing in youth, and the resulting path to addiction, must end. It's simply not tolerable." Gottlieb announced the agency sent 1,100 warning letters to stores for the illegal sale of e-cigarettes to minors under the age of 18, and issued 131 fines to stores that continued to violate the restrictions on sales to minors. Gottlieb called the action the largest coordinated enforcement effort in the agency's history. Via CNN.
Although We’re Running Low on Doctors, the Solution May Not Be More Doctors
Less than 5% of OB-GYNs practicing in Sacramento, California, are under age 40. West Texas can’t recruit enough psychiatrists to meet the region’s needs. All but two of Alabama’s rural counties need more primary care physicians. For most Americans, the physician shortage feels familiar: months to get an appointment, hours in the waiting room, and a visit so quick you barely scratch the surface. But it’s only going to get worse. The Association of American Medical Colleges (AAMC) suggests that the country could see a shortage of up to 120,000 physicians by 2030. It’s already begun: The federal Health Resources and Services Administration calculated that 29 states already had shortages of primary care physicians in 2013. Some argue that there are plenty of doctors, but they are just poorly distributed throughout the country. Although this may be true, the end result is the same: reduced access to care. Rural areas will likely bear the brunt of reduced access. Rural populations tend to be sicker and in higher need of medical care. But that care is often unavailable because medical centers and health care providers are concentrated in urban areas. Fewer providers overall will only exacerbate the disparity. Via STAT.
Nearly 30% of All Opioid Prescriptions Lack Medical Explanation
How large a role do doctors play in the opioid crisis? Nearly 30% of all opioids prescribed in U.S. clinics or doctors' offices lack a documented reason—such as severe back pain—to justify a script for these addictive drugs, new research finds. In total, opioids were prescribed in almost 809 million outpatient visits over a 10-year period, with 66.4% of these prescriptions intended to treat non-cancer pain and 5.1% for cancer-related pain, according to a study published Monday in the journal Annals of Internal Medicine. However, for the remaining 28.5% of prescriptions—about 3 out of every 10 patients—there was no record of either pain symptoms or a pain-related condition, the Harvard Medical School and RAND Corp. researchers say. Via CNN.
Leading Hospital Suspends Complex Heart Surgery to Maintain Patient Safety
A leading London teaching hospital has suspended the most complex types of heart surgery to maintain patient safety. Jacqueline Totterdell, chief executive of St George’s University Hospitals NHS Foundation Trust, said that the decision had been taken “to protect the long term future of our cardiac surgery service.” A trust spokesperson said that the move was a result of “response to feedback from clinicians working in the service” and was “to allow the service to focus on making improvements.” The cardiac surgery unit performs around 90 operations a month, and the trust expects 5% to 10% of these cases to be moved to other heart centers, although the trust did not provide details of which patients would be affected. No date has been agreed for the return of complex heart surgery to the trust. The performance of the heart unit at St George’s has prompted concern for some years. The unit was issued with alerts over its higher than expected mortality rates in April 2017 and April 2018. Via BMJ.
Minnesotans’ Obesity Rate Lower Than Other Midwest States, CDC Says
Minnesota again has the lowest rate of obesity in the Upper Midwest, according to 2017 figures released by the U.S. Centers for Disease Control and Prevention. For the first time, it also has the lowest rate among 12 Midwestern states. The CDC survey found 28.4% of Minnesota adults self-reported they were obese, which makes Minnesota the only Midwestern state below 30%. Via Pioneer Press.
Mayo Clinic News
"Battle of the Badges" Blood Drive Kicks off in Olmsted County
The American Red Cross reports that every two seconds, someone in the U.S. is in need of blood. To get more people to donate, Mayo Clinic is taking a different approach. It is starting its first “Battle of the Badges” blood donation challenge. This involves first-responder groups in Olmsted County looking to get into the community to get people to donate blood. “We don't have a substitute for blood products, so we are completely dependent on our community here,” said Justin Kreuter, M.D., Medical Director of the Mayo Clinic Blood Donor Program in Rochester, Minnesota. Via KIMT.
Ken Burns Turns His Camera on Mayo Clinic for PBS Documentary
The saga of Mayo Clinic is the subject of the latest project from famed documentarian Ken Burns. The two-hour film, co-directed by Burns and Erik Ewers and Christopher Loren Ewers, premiers September 25 on PBS. “The Mayo Clinic: Faith-Hope-Science,” explores how the history of the health system informs the system's practices today. “One of the messages from Mayo's history is that you can be entrepreneurial and competitive and idealistic and put the patient first all at the same time,” medical historian Rosemary Stevens said. “That is the message now that leaders of these organizations all across the country are trying to tackle.” Via Modern Healthcare.
With CRISPR, Scientists Engineered Nearly 4,000 Mutations of a Breast-Cancer Gene
BRCA1 is one of the best-studied cancer genes in the world. Still, on occasion, doctors will test a patient and find a BRCA1 mutation no one has ever seen before. This creates a dilemma. The newly discovered “variant of unknown significance” (or VUS) could be harmful, making a woman’s risk of developing breast cancer as high as 72%. Or it could be nothing to worry about at all. “You hear these horror stories about people who have a VUS,” says Fergus Couch, Ph.D., a breast-cancer researcher at Mayo Clinic. “They have the surgery”—to preemptively remove their breasts—“because they’re convinced the VUS is actually pathogenic, but then, we find out later that it is neutral.” The invasive surgery was never necessary at all. The opposite can also be true: A variant that looks neutral could turn out to be pathogenic. Via The Atlantic.
What Is the "Microbiome," and How Does It Affect Your Weight?
Normally, you think of bacteria as something bad that you should avoid. But, turns out, most of the bacteria inside your gut play an important role in keeping you healthy. That group of gut bacteria is called your "microbiome." Purna Kashyap, M.B.B.S., a Mayo Clinic gastroenterologist who researchers the microbiome, says everyone's is unique to them based on factors like where they live, what they eat and how they live their life. Via Mayo Clinic News Network.
Infectious Diseases A–Z: Asian Longhorned Tick Finds Its Way to U.S.
Ticks discovered in New Jersey now have spread into neighboring states. "For the first time in 50 years, a new tick species has been identified in the U.S.," says Gregory Poland, M.D., Director of the Mayo Clinic Vaccine Research Group. "Haemaphysalis longicornus, or the Asian longhorned tick, is in eight states already in the Northeast region of the U.S., primarily affecting livestock." Via Mayo Clinic News Network.