Princess Health and More residency placements will be needed as medical school enrollments rise, perhaps by 30 percent through 2016.Princessiccia

Princess Health and More residency placements will be needed as medical school enrollments rise, perhaps by 30 percent through 2016.Princessiccia

doctors medical education medical school physicians

Gusty 06:20 Add Comment

Aimed at addressing expected physician shortages, enrollment at U.S. medical schools is on target to increase by 30 percent by 2016, the Medical School Enrollment Survey has found.

But even if enrollment rises through expansion of medical schools and construction of new ones, "This won't amount to a single new doctor in practice without an expansion of residency positions," said Dr. Darrell G. Kirch, president and CEO of the Association of American Medical Colleges.

First-year medical school enrollment is expected to reach 21,376 in 2016-17, a 29.6 percent increase over enrollment in 2002-03. Nearly 60 percent of the growth will happen in the 125 medical schools that were accredited in 2002; 25 percent will happen in schools accredited since then, and 17 percent will come from schools that are applicant or candidate schools.

The United States is facing a shortfall of more than 90,000 primary care and specialty doctors by 2020, the AAMC estimates. With medical schools stepping up, what's key is "an increase in federal funding to expand the number of residency training positions � which prepare new doctors for independent practice," research-reporting service Newswise reports.

"Otherwise it may become more difficult for medical students to complete their training and for patients to get the care they need � as our population continues to grow and age, more doctors retire, and 32 million Americans enter the health care system as a result of the Affordable Care Act," Kirch said. (Read more)

Princess Health and Local health care centers in Ky. get $16.5 million in federal grants.Princessiccia

Princess Health and Local health care centers in Ky. get $16.5 million in federal grants.Princessiccia

community health centers federal grants health care access health reform Patient Protection and Affordable Care Act primary care

Gusty 06:17 Add Comment

Kentucky recently received $16.5 million in grant for health care centers as part of the Affordable Care Act.

Recipients include Family Health Center Inc. in Louisville ($5 million); Cumberland Family Medical Center in Burkesville ($4.86 million); Grace Community Health Center Inc. in Knox County ($4.33 million); and Big Sandy Health Care Inc. in Prestonsburg ($977,375). The grants were made through a building-capacity program, reports Greg Kocher for the Lexington Herald-Leader.

Grants given under the "immediate facility improvement program" include $425,000 for Mountain Comprehensive Health Corp. in Whitesburg; $380,000 for Family Health Center Inc. in Louisville; $360,863 for Cumberland Family Medical Center in Burkesville; and $216,543 for Big Sandy Health Care in Prestonsburg.

The awards will help serve about 29,475 new patients, states a news release from the U.S. Department of Health and Human Services. Nationwide, $728 million was awarded for renovation and construction projects. (Read more)

Princess Health and Lessons in battling obesity can be learned from the anti-tobacco movement, but there are big differences.Princessiccia

Princess Health and Lessons in battling obesity can be learned from the anti-tobacco movement, but there are big differences.Princessiccia

food nutrition obesity smoking tobacco weight loss

Gusty 06:10 Add Comment

To make real headway in battling the obesity epidemic, lessons can be learned from the war on smoking � though the two public-health issues have certain unique challenges. Judith Graham, reporting for Kaiser Health News in collaboration with USA Today, delves into the similarities and differences.

Her piece deserves to be read in its entirety, which can be done by clicking here, but here's a summary of her analysis:

Children are central. The majority of people start using tobacco as teenagers, with one-third of kids who smoke daily set to die prematurely of tobacco-related illnesses. Likewise, overweight children are at a greater risk of a vast array of health problems, including diabetes, liver disease and obesity in adulthood.

Protecting children as at the heart of both the anti-tobacco and anti-obesity efforts. "First let's protect our children," said Dr. David Ludwig, a child-obesity expert at Harvard Medical School. 

Changing social norms is the goal. While smoking in a hospital or airplane has become inconceivable, the same shift in social norms is required to fight childhood obesity. "Our (eating and physical activity) tastes, our preferences and our behaviors are learned and can be changed," said Dr. Jeffrey Koplan, former head of the Centers for Disease Control and Prevention and vice president for global health at Emory University in Atlanta. It won't be easy, but at least "we're dealing with a population that would like to be thinner and that works in our favor."

We can't "just say no" to food. "Tobacco we can get rid of entirely," said Dr. David Katz, director of Yale University's Prevention Research Center. "But we have to eat to live and make terms with food as the enemy."

That makes fighting childhood obesity much more difficult, since the message can't be "stop, don't do this." It has to instead be "make good choices, set boundaries," which is more difficult to convey and adhere to, Graham reports.

Our biology works against us. "While smoking is highly addictive, the biological responses attached to eating food are even more deeply rooted in human evolution," Graham reports. Evolutionarily speaking, humans are "built" to eat food when it's available and "we're very good at storing calories and defending calories once we've got them," said Dr. Stephen Daniels, chair of the department of pediatrics at the University of Colorado School of Medicine. 

Shame and denial are greater among the obese. A person's self-image is tightly tied to his or her body weight in a way that isn't true of smoking. That can provide a compelling reason to stop over-eating, but people don't tend to think of themselves as obese. "Obesity is seen as a pejorative term that people don't connect with," said Dr. William Dietz, director of the division of nutrition, physical activity and obesity at the CDC. "They think, 'I'm just 30 or 40 pounds overweight, but I'm not obese.'"

There are more food products available. "Tobacco is a single substance," Graham reports. "By contrast, the food and beverage industry is enormous and makes a huge array of goods that extend into every home, restaurant, convenience store, and grocery store in America."

There is no second-hand smoke equivalent. "The notion that my behavior as a smoker can have an effect on you and can make you sick was critically important in accelerating people's intolerance of smoking and their willingness to see the government take action," said Michael Eriksen, director of the Institute of Public Health at Georgia State University. "Your being obese does not affect me in the same direct way."

The role of the food industry is less clear. While Big Tobacco was able to be demonized, "with obesity (as compared to tobacco) there's a much more nuanced relationship with industry," said Dr. James S. Marks, director of the health group at the Robert Wood Johnson Foundation.

Princess Health and 4 of 5 Kentuckians think child obesity is a problem, and more than half favor a statewide smoking ban, poll finds.Princessiccia

Princess Health and 4 of 5 Kentuckians think child obesity is a problem, and more than half favor a statewide smoking ban, poll finds.Princessiccia

child obesity depression Foundation for a Healthy Kentucky health care access poll prescription drug abuse prescription drugs smoking ban tobacco

Gusty 04:34 Add Comment

More than four out of five Kentuckians think too many children are overweight, and more than half want a statewide smoking ban. These are two of key findings of the Kentucky Health Issues Poll, which also asked respondents about prescription drug abuse, depression and access to health care.

Poll findings are available by clicking here. Findings have been broken down by region: Western Kentucky, greater Louisville, greater Lexington area, Northern Kentucky and Eastern Kentucky.

Statewide, the poll found 54 percent of Kentuckians favor a statewide smoking ban, up from 53 percent the year before. In 2010, Kentuckians were split down the middle, 48 percent to 48 percent.

A whopping 84 percent of Kentuckians feel childhood obesity is a problem, which is timely since 33 percent of children, 60 percent of women and 80 percent of men in Kentucky are overweight or obese, "Shaping Kentucky's Future: A Community Guide to Reducing Obesity" reports.

The poll also found more than one in three Kentuckians know someone who has misused prescription drugs; 65 percent of adults dispose of their prescription drugs in an unsafe way; nearly half keep guns in their homes; and 1 in 2 Kentuckians have a family member or friend with a serious problem of depression. Nearly 90 percent of people asked favor providing access to affordable, quality health care for all Americans.

"The Kentucky Health Issues Poll provides an excellent snapshot of how various health related issues are viewed throughout the commonwealth," said Dr. Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, which helped fund the poll. "The survey's methodology lets us compare responses and learn about regional differences in Kentucky views about health."

The poll was also funded by The Health Foundation of Greater Cincinnati. It was conducted Sept. 27 to Oct. 27 by the Institute for Policy Research at the University of Cincinnati. A random sample of adults across Kentucky were interviewed, including 1,313 landline interviews and 308 cell-phone interviews.

Princess Health and Report looks at ways Kentucky communities are battling obesity.Princessiccia

Princess Health and Report looks at ways Kentucky communities are battling obesity.Princessiccia

child obesity obesity

Gusty 04:32 Add Comment

Winchester residents walk the Traveling Trail, a walking
path meant to encourage residents to exercise.

A new report takes a hard look at obesity in Kentucky and highlights what individual communities are doing to combat the problem.

"Shaping Kentucky's Future: A Community Guide to Reducing Obesity" could be useful to readers, officials and advocates interested in effecting change, with some efforts relatively easy � and cheap � to implement.

Statewide, 33 percent of children, 60 percent of women and 80 percent of men are overweight or obese, ranking Kentucky's third highest in the country for children and sixth highest for adults. Health care costs attributable to obesity in Kentucky are estimated to be $2.3 billion in 2013.

The report highlights community efforts in:
� Berea, for its effort to make the city more accessible to pedestrians.
� Winchester, for mowing a walking trail on land owned by the community hospital.
� Louisville, for supporting breast-feeding mothers; selling healthy food at urban markets
� Madisonville, for Hopkins County's wellness program for its 150 county employees.
� Lexington, for serving the Better Bites menu at several pools and city facilities, rather than unhealthy meals and snacks.
� Hopkinsville, for its farmers' market being one of the first to accept SNAP nutrition assistance benefits.
� Tyner, for building a commercial kitchen so residents can process local food and package it for sale.
� Buckhorn, Lexington and Shelbyville, for opening up schools for exercise venues.

The report, which was funded by the Kentucky Department for Public Health, the Shaping Kentucky's Future Collaborative and the Tides Foundation, also looks at success stories in schools, from an effort at Science Hill in Pulaski County to the Healthy Monday program in Covington, which includes walking the Monday Mile and eating the Monday Meatless Meal. (Read more)

Princess Health and 'Health for a Change' webinar training series starts May 16, with session on where to find and how to use health data.Princessiccia

Princess Health and 'Health for a Change' webinar training series starts May 16, with session on where to find and how to use health data.Princessiccia

health policy

Gusty 04:28 Add Comment

How to find county-specific health data and how to use it to make community changes will be the focus of an hour-long webinar May 16.

The free session is the first in the 2012 "Health for a Change" training series, meant to advance today's health issues in Kentucky. It is sponsored by the Foundation for a Healthy Kentucky. "We have procured excellent speakers to present best practices and proven models of these skills in a combination of electronic webinar format and in-person workshops," a foundation press release says.

The June 20 workshop will provide training on building and maintaining a local health coalition. Other webinars this summer will help identify differences between advocacy and lobbying, discuss evidence-based policies and programs, give instruction on budgeting and teach how apply for grant funding.

The May 16 webinar will be held from 3 to 4 p.m. To register for it or the entire "Health for a Change" series, click here.

Princess Health and Cabinet must 'wield the stick' to get managed care under control, state auditor says.Princessiccia

Princess Health and Cabinet must 'wield the stick' to get managed care under control, state auditor says.Princessiccia

health insurance hospitals managed care Medicaid state government

Gusty 06:44 Add Comment

Though the state has a solid contract "filled with all the mechanisms you need for enforcement, from the carrots to the sticks," the Cabinet for Health and Family Services has to be more aggressive in cracking down on the managed care organizations (MCOs) that run the state's $6 billion Medicaid system, state Auditor Adam Edelen says.

Edelen, who has been in office a little over four months, discussed managed care with Ryan Alessi, host of cn|2's "Pure Politics." Edelen is reviewing the new system and submitted 10 recommendations for improvement to the cabinet in February.

"The issues have been enormous � providers not being paid in a timely manner, a lack of communication between the cabinet and the MCOs and the providers, has created a system in which there is a lot of uncertainty and a lot of people are being squeezed out," Edelen said.

Couple that with the fact that Appalachian Regional Healthcare, which serves more than 25,000 Medicaid patients, sued two of the three MCOs in charge of the state, claiming they are owed $18 million for services that have been provided. Last week, ARH and MCO CoventryCares came to an agreement after being ordered by a federal judge to negotiate.

Edelen pointed out the broader ramifications of the situation. "If our largest Medicaid provider in the part of the state that needs it most for some reason is not able to operate within the system because they can't manage their relationship with Coventry or vice versa, that represents a structural threat to the system," he said. "We've got to figure out a way to make it work."

In order to do so, Edelen said "the cabinet has got to be willing to wield the stick" and is able to do under the terms of its contracts with the MCOs, which allow the cabinet to cancel contracts, "sanction and punish" the MCOs and make changes to the system. He said new cabinet Secretary Audrey Haynes has a tough job ahead and said "strong leadership" is critical.

When asked if his review looks into what work is being accomplished by the state's 200 employees who used to handle Medicaid � work that is now being managed by the MCOs � Edelen said it hasn't. (Read more)

Meanwhile, the Lexington Herald-Leader weighed in on the lawsuit between ARH and CoventryCares, saying in an April 24 editorial, "Coventry should keep working with Haynes and ARH on solutions. The editorial also stated, "Beshear, a former corporate lawyer, should bring the weight of the governor's office to bear and get busy making his Medicaid managed care contracts work." (Read more)