US News & World Report - Health 3 days ago
If you’re looking to lose a lot of weight, you may be considering a commercial weight loss plan. One option in that area is Medi-Weightloss, a program founded in 2005 by entrepreneur Edward Kaloust. He spent 40 years in the financial services industry before establishing Medi-Weightloss as a franchise company with the assistance of physicians, dietitians and fitness experts.
Medi-Weightloss is a commercial weight management program with 97 franchise locations in 27 states and several more locations opening soon. Collectively, the company says it has helped 300,000 people lose more than 7.9 million pounds since its founding.
Candace Pumper, a staff dietitian with the Ohio State University Wexner Medical Center in Columbus, notes that when you start the Medi-Weightloss program, you’ll first go through a consultation that includes a complete medical test and a body composition analysis, which determines your fat to lean mass ratio.
Clients are then provided a personalized nutrition plan and exercise education that can help you lose up to 20 pounds per month. (It's worth noting that many dietitians and health care providers recommend losing less than half that amount per month – about 1 to 2 pounds per week – as being a safer and more sustainable pace of weight loss.)
There are three phases to the Medi-Weightloss approach:
In the “Acute Phase,” patients follow an individualized, low-calorie and low-carbohydrate diet. The diet features lean protein, vegetables and healthy fats that support weight loss and induce ketosis, Pumper says. Ketosis is a metabolic state when the body shifts to burning fat because there aren’t enough carbs – the body’s preferred fuel – available. A keto diet can also induce ketosis.
While the plan is low-carb, with between 5% and 20% of your caloric intake coming from carbohydrates, “Medi-Weightloss does not specifically count calories or discuss carbohydrates consumed,” Pumper says. Nevertheless, when patients follow the plan as directed, “the program would typically generate a caloric deficit on the order of 500 to 1,000 calories per day.”
How long a patient stays in that lower-calorie state is individually driven based on a range of factors, including how much weight you have to lose.
Once you’re on the plan, you’ll have weekly consultations with a physician. Medications that can support weight loss may also be part of the program for some people who are medically eligible.
As you approach your target weight, you’ll transition to the “Short-Term Maintenance Phase" of the program.
“In this phase, patients gradually increase daily calorie and carbohydrate intake and are provided the tools necessary to achieve sustainable lifestyle and behavioral change to support long-term weight maintenance of lost weight,” Pumper says. You’ll continue receiving weekly consultations and individualized guidance.
During the final “Wellness Phase,” which occurs after you’ve hit your goal weight, you’ll move to monthly consultations that have a “strong focus on continued accountability, support, education and guidance to achieve overall health and wellness,” Pumper says.
During this phase, you’ll also have the opportunity to undergo advanced testing and metabolic analysis, and your body composition will be remeasured. During this phase, you’ll adopt a 40:30:30 eating plan. Also sometimes referred to as the Zone diet, this approach means 40% of your calories will come from carbohydrates, 30% will come from protein and 30% will come from fat. The total overall number of calories is tailored to each individual based on height, weight, age, activity level and other factors.
In addition to supervised weight loss support and nutritional education, Medi-Weightloss franchises offer pre-packaged meals and supplements for an additional charge. The company also offers vitamin injections as an additional service.
Throughout the program, patients are encouraged to exercise. The American College of Sports Medicine recommends getting at least 150 minutes of moderate-intensity aerobic exercise per week.
While on the Medi-Weightloss program, you’ll be able to shop and cook for yourself. Because the approach is low-calorie and low-carb, you’ll be focusing on eating:
You should limit your intake of several foods (because of their calorie or carb content), including:
“Avoiding foods that are processed or ultra-processed is central to the Medi-Weightloss diet plan,” Pumper says. Instead, select minimally processed or unprocessed, whole foods.
Specific foods to avoid include:
When considering whether Medi-Weightloss might be right for you, it’s wise to review the other commercial weight-loss programs available that involve one-to-one counseling and education, such as the Profile Plan diet, Optifast and Health Management Resources, or the HMR program.
The key difference, Pumper says, is that Optifast and HMR are shorter-term commitment programs, while Medi-Weightloss aims to support patients over the long term.
Medi-Weightloss caters to patients with obesity as well as those who have less weight to lose. By contrast, to participate in Optifast, a patient’s body mass index must be at or above 30, or at or above 27 with weight-related medical conditions such as heart disease, diabetes or hypertension. HMR does not have specific criteria for who should enroll.
“While individual results vary, Medi-Weightloss claims to provide greater weight loss when compared to Optifast and HMR, presumably because it provides resources for individualized counseling in a medically supervised environment and because the gradual, phased, low-carbohydrate dietary approach may promote greater satiety due to higher protein and fat intake,” Pumper explains. This increase in satiety reduces hunger and overall food intake and creates a calorie deficit.
Medi-Weightloss reports that, on average, patients can lose up to 20 pounds in four weeks. By contrast, Optifast’s average reported loss is 50 pounds in 26 weeks, while HMR’s at-home program reports an average weight loss of 23 pounds in 12 weeks. HMR’s in-clinic program reports losses of between 28 and 43 pounds in 12 weeks. A page listing research findings on the Medi-Weightloss website notes that in the company’s “most comprehensive study,” they found that patients lost 14% of their body weight in the first 13 weeks of the program and 21% by week 39.
Pumper says that registered dietitians do not appear to be part of the Medi-Weightloss program. “The website is vague on this detail, but it does indicate that all their physicians are members of the American Board of Bariatric Physicians and are trained in bariatric medicine, general medicine, endocrinology, family medicine, general surgery and obstetrics and gynecology.”
Medi-Weightloss did not respond to interview requests.
Program fees vary from location to location and depend on which services you’re selecting. The cost of the initial consultation, which includes taking baseline weight measurements and drawing up an initial plan, typically ranges between $275 and $300.
Each weekly session typically costs between $75 and $100. During those weekly follow-up sessions, your provider will check your weight, other health metrics such as blood pressure and administer any supplements or prescriptions you may get as part of the program. If any adjustments to your individualized plan are needed, they can be made during these meetings.
“Treatments may be covered by most health insurance plans,” Pumper says, but be sure to check with your insurance provider to understand what’s covered. For example, vitamin injections may be a covered benefit if they’re deemed medically necessary, but food and dietary supplements are rarely covered.
Pumper notes that she has some concerns about the Medi-Weightloss program, specifically related to:
The long-range nature of the program and the high price of each visit can add up quickly. If the program is not covered by your health insurance plan, that may make the program financially inaccessible.
“Hypocaloric, low-carbohydrate diets and specifically ketogenic approaches have shown to be effective in producing rapid initial weight loss,” Pumper says. “However, these dietary patterns are not an effective solution for long-term weight management.”
In other words, you may lose a lot of weight using Medi-Weightloss, and you may be able to maintain that weight loss as long as you’re in the program. But it’s common for people to regain lost weight if they deviate from the plan, as most people eventually do because it’s very difficult to stay on a restrictive diet long term.
“The strictest diet is not always the best diet,” says Shaun Carrillo, lead wellness coach for Providence St. Joseph Hospital in Orange, California. He also notes that “what works for one person may not work well for another.”
Medi-Weightloss does take this into account with its individualized, one-on-one counseling. However, all patients in this program are put into a low-calorie, low-carbohydrate plan, which may not be sustainable for everyone.
“At present, there is limited data on the long-term efficacy of the Medi-Weightloss program,” Pumper says. A recent study reported an average weight loss of 21% at 39 weeks in adults with overweight and obesity who were enrolled in the Medi-Weightloss program. There were also demonstrated benefits in metabolic markers, such as increases in HDL (good cholesterol) and lowering blood pressure.
However, the study has some limitations, including a low retention rate among participants over a period of one year and some missing data that may have skewed the results somewhat, the authors noted. The study was also funded by Medi-Weightloss, which could influence results. More investigation is needed to confirm the findings.
For a sustainable alternative, consider intuitive eating, says Jessie Fragoso, a registered dietitian at CalOptima, a community-based health plan that serves vulnerable residents in Orange County, California. Intuitive eating means “eating when you’re hungry and stopping when (you) begin to feel full.”
Making sure most of what you put on your plate is whole, fresh veggies, whole grains and lean proteins can help support overall health goals.
“In the short-term, this diet is not inherently harmful, but the long-term continuation imposes increased risk of nutrient deficiency,” Pumper says. “Low-carbohydrate diets may displace other nutrients, including dietary fiber (and) B vitamins,” which may “contribute to an increased prevalence of gut diseases such as inflammatory bowel disease or contribute to subsequent bone breakdown and increased risk of metabolic bone disease and fractures.”
During the final phase, which is intended to be a lifelong maintenance phase, consumption of carbs from whole, unprocessed fruits and nonstarchy vegetables is encouraged, but dairy, grains, legumes and starchy vegetables are “demonized,” Pumper says. By eliminating dairy, some dieters may become at risk for calcium and vitamin D deficiencies.
Pumper notes that Medi-Weightloss is not appropriate for people with an eating disorder or those who are at risk of developing an eating disorder. “The rigid diet may lead to a dichotomous or ‘all-or-nothing’ approach to eating, dieting and weight. Keeping a food journal may also encourage this thinking as well as trigger negative eating disorder behaviors and worsen one’s relationship with food.”
Pumper adds: “I’m a proponent of making your eating strategy fit your life, not the other way around. No dietary pattern is worth following if it disrupts your peace of mind.”
Athletes and women who are pregnant or breastfeeding should also avoid this plan. “A healthy, varied diet providing sufficient calories remains the preferred means of meeting nutritional requirements in pregnancy, while breastfeeding and in athletes. These individuals are discouraged from participating in this program because it does not support them in meeting their increased nutritional demands,” Pumper says.
Another note of caution: The program claims an average weight loss of 20 pounds per month, or 5 pounds per week. That’s significantly higher than “most national health organizations recommend,” Pumper notes. One to 2 pounds per week is considered safe and sustainable weight loss.
What’s more, losing upward of 20 pounds per month while following a low-carb diet can increase the risk of developing gallstones. Rapid weight loss can throw off the balance of bile acids, cholesterol and lecithin in the digestive system and can make it more difficult for the gallbladder to empty normally, leading to the development of gallstones.
Pumper adds that some of the ingredients in the dietary supplements offered for sale by the company could cause adverse effects or interact negatively with medications. Be sure to check with your primary care provider before starting any new dietary supplement. The same goes for starting the Medi-Weightloss plan: Talk with your primary care provider first to discuss risks and benefits of this diet plan.
Copyright 2022 U.S. News & World Report
Affording dental work can be tough if you’re an older American on Medicare.
That’s because Original Medicare — which covers a majority of beneficiaries — doesn’t include routine dental care.
The Centers for Medicare & Medicaid Services announced plans to begin covering limited dental services starting January 2023. But the scope is narrow: Dental work must be linked to a covered medical procedure, such as before an organ transplant, to qualify for coverage.
For now, older adults are mostly on the hook when it comes to paying for their own oral health care.
Here are seven ways to get free or reduced dental care. We’ll also explain what limited dental benefits Medicare coverage provides, along with other options like private insurers and Medicaid.
Medicare beneficiaries who use dental services spent an average of $874 a year out-of-pocket, according to an analysis by the Kaiser Family Foundation.
That’s a lot of money, especially if you’re on a fixed income.
Here are a few tips and tricks to get free dental work and save big on oral health.
This program by the American Dental Association offers free, comprehensive dental treatment to specific groups, including people ages 65 and older.
You can use this tool on the Dental Lifeline Network website to learn about the specific program details in your state.
Heads up: Due to long wait lists, several states and counties are no longer accepting new applications for the Dental Lifeline Network program. When we did a quick search, Nevada and Wisconsin weren’t accepting new applications.
Federally funded community health clinics provide reduced-cost or free dental care services to people with low incomes.
Many operate on a sliding scale system while others offer flexible payment plans.
Wait lists can be long, so it’s important to reach out to your local clinic early.
Follow this link to find the nearest community health clinic near you.
Some dental schools offer low-cost cleanings and other routine care to members of the community.
Most of these teaching facilities have clinics that provide dentists-in-training an opportunity to practice their skills while providing low-cost dental care to the public.
You can search for dental schools and programs in your area by visiting the American Dental Association website.
There’s no ensure that a dental program in your area currently offers free or reduced dental care. You’ll need to contact each program individually to see what’s available.
When you call, make sure to ask about any fees up front.
This website offers a comprehensive list of dental offices with sliding scale payment options, community health center locations and dental school clinics.
It does a great job breaking down requirements and eligibility (if any) for services in your area, and provides contact information for each service.
Just enter your zip code into this search tool to get started.
It might be difficult to ask for help, but being honest with your dentist about your financial situation can help.
Your dentist may be able to offer a less expensive treatment, help you set up a payment plan or provide a sliding scale payment option.
Ask if you can receive a discount for referring a friend. Or, see if it’s possible to knock off a few bucks in exchange for a positive online review of the dentist office.
Dental savings plans aren’t dental insurance, but they may still be able to save you money.
Here’s how it works.
With a dental savings plan, you pay an annual fee, then get a 10% to 60% discount on most dental services such as exams, cleanings, fillings, root canals and crowns.
The plan contracts with dentists who agree to reduce their fees, then you pay the participating dentist directly using your discount.
You’ll still pay out of pocket for those services, but the idea is that you won’t pay as much as you would without the plan.
But let’s be clear: Dental discount plans aren’t free. The average cost for plans in Orlando, Florida, for example, ranged between $135 to $170 a year.
You can visit DentalPlans to find a plan in your area.
Dentists can charge widely different prices for the same exact procedure.
When it’s coming out of your pocket, it pays to shop around.
You can find average prices in your area by using FAIR Health, a national nonprofit organization. The site lets you search by specific procedures, so you get the average cost for a root canal or teeth cleanings in your area.
Armed with knowledge, call around to different dentist offices for quotes. Ask about senior discounts.
You can also look for discounted dental care on sites like Groupon.
A quick search on Groupon for dental services in Houston, Texas, showed numerous X-ray, test and cleaning packages for $25 to $50. One office even offered $700 toward dental implants for just $50!
If you reside in a high cost-of-living area, driving to a less expensive area is another smart way to find low-cost dental care.
Yes and no.
Original Medicare doesn’t provide coverage for routine dental, vision or hearing benefits.
Original Medicare will only cover dental work if it’s deemed medically necessary, i.e. you were hospitalized after a traumatic injury that also affected your jaw, teeth or mouth.
Starting Jan. 1, Medicare will begin covering the following dental procedures:
Here are the other dental services covered by Medicare Part B:
So if you’re looking for standard dental care like teeth cleaning, X-rays, fillings, extractions, dentures and more — the cost comes out of your pocket.
Medicare Advantage plans are administered by private insurance companies. They must provide the same basic coverage as Original Medicare, but plans may offer additional benefits, such as dental.
About 94% of private Medicare Advantage plans provide some dental coverage, but the amount of coverage varies by plan.
Nearly all Medicare Advantage plans that include dental offer coverage for oral exams, cleanings and X-rays, according to the Kaiser Family Foundation.
But benefits for more advanced dental work like root canals, implants and dentures can carry substantial copays, depending on the plan.
Medicare Advantage plans almost always impose restrictions, including annual dollar caps and how often you can get certain benefits, such as dental implants.
The average annual limit on dental benefits among Medicare Advantage plans that offer more extensive benefits was about $1,300 in 2021, according to KFF.
If you’re enrolled in a Medicare Advantage plan, it’s important to check the plan’s summary of benefits or evidence of coverage to see exactly what dental work is covered. It can vary widely from plan to plan.
About half of all Medicare beneficiaries — 47% — did not have any form of dental coverage in 2019, according to the Kaiser Family Foundation.
Besides Medicare Advantage plans, other sources of dental coverage for seniors include Medicaid and private plans, such as employer-sponsored retiree plans and individually purchased dental plans.
A standalone dental policy for people 65 and older is typically $20 to $50 a month, according to AARP. You can expect an annual deductible of $50 to $100 with these policies.
Dental insurance plans usually cover checkups and cleanings 100% but you will probably owe 20% to 50% for other services, such as tooth extractions or dentures.
The devil is in the details with private dental plans: It’s important to shop around and carefully compare benefits to make sure you’re getting the best deal.
Here are a few other things to keep in mind about private dental insurance plans:
About one in five Medicare beneficiaries is also enrolled in Medicaid, sometimes referred to as being “dual enrolled.”
Medicare usually pays as your primary insurance when you’re dual enrolled. But if you need dental work done or even a yearly cleaning, consulting your Medicaid handbook is a smart move.
If you meet Medicaid low-income requirements in your state, you may be able to receive free or low-cost dental care for certain procedures and services.
But it’s not a guarantee. While most states provide at least some emergency dental services, only 39 states and Washington, D.C. offer limited or comprehensive dental benefits for adults, according to the National Academy of State Health Policy.
Even if your state Medicaid program includes dental, it may not pay out much. Of the 39 states with routine dental care coverage, only 25 states offer an annual expenditure cap of $1,000 or more.
Adult Medicaid recipients in Arkansas, for example, only receive annually up to $500 of dental services, and that excludes dentures and tooth extractions. So if you need a $3,000 root canal and you’re dual enrolled with Original Medicare, you can expect to pay $2,500 out of pocket in that state.
According to Medicaid’s national website, “States have flexibility to determine what dental benefits are provided…There are no minimum requirements for adult dental coverage.”
To find the Medicaid office contact information for your state, click here.
Rachel Christian is a Certified Educator in Personal Finance and a senior writer for The Penny Hoarder.
This was originally published on The Penny Hoarder, a personal finance website that empowers millions of readers nationwide to make smart decisions with their money through actionable and inspirational advice, and resources about how to make, save and manage money.
Millions of people are affected by humanitarian crises in daily life. These crises include natural calamities, conflicts, and disease outbreaks. The emergency response aims at mitigating such situations to avoid loss of lives and minimize injuries.
On the other hand, first aid refers to the immediate attention or care given to a person in case of an accident, injury, or illness before more advanced medical care is provided or the person recovers. First aid training prepares individuals with the necessary skills to support victims before help arrives. They can preserve life, prevent the situation from worsening, and promote stamina. For better preparedness, it’d help to have a medical device in your first aid kits like a junctional tourniquet, trauma pads, bandages, gauze pads, cold compresses, tweezers, and examination gloves, among others.
Notably, first aid can heighten risks associated with the crisis if the correct procedures aren’t followed. Thus, it helps to incorporate technology to help marshal resources more effectively and make it easier for persons to reach out for assistance. Below are the significant trends and innovations in first aid and management response:
With the advancing technology, driverless ambulances have turned cars into points of care. This innovation has made transportation barriers to healthcare a thing of the past. Driverless ambulances facilitate patients’ fast and safe arrival at the hospital for treatment.
Drones are majorly in use as transport media. They have a tremendous potential to provide drugs and other medical aids faster, especially in remote areas where vehicles take a long time. For this reason, healthcare facilities use drones to send serums, drugs, and vaccines quickly, especially in remote areas.
Additionally, drones can provide instructions to the emergency response team or first responders who do not know how to administer first aid to victims during an emergency.
Portable Point-Of-Care Diagnostic Services
Pocket-friendly diagnostic devices allow first aid respondents to offer medical care to patients regardless of where they are. Portable devices ensure easy and fast treatment of patients on the spot as they can detect bacteria, nucleic acid, and other biomarkers that impact a person’s health. In addition to that, medical care practitioners can carry diagnostic and first aid tools in an emergency kit or suitcase.
Apps Streamlining Emergency Care
Healthcare apps enable first respondents to reach medical attendants easily. They can track patients’ steps, heart rates, and other biometric data. This way, specialists at the nearest hospital can liaise with those administering first aid and advise on the most feasible course of action to get the victim out of trouble.
Disaster management teams and first responders use Artificial Intelligence (AI) imaging for the response. These tools help in disaster forecasting, generating risk models, and giving early warnings, yielding disaster-resilient populations. AI tools are also used for responsive management and disaster surveys to assess the damage. They also aid in evacuation plans and survivor identity verification.
Robots, automated guided vehicles (AGV), and autonomous robots (AMR) are essential in disaster management and control. They’re used to ensure the safety of humans from high-risk areas where first aiders can’t walk into. For instance, a flooded area or the scene of a collapsed building may be too risky for people to get in. However, with the use of robots, trapped victims can be rescued.
Some robots use machine vision sensors for wading through difficult-to-reach areas. Thus, they help in disaster surveillance and monitoring to remotely assess the true extent of the damage and take the necessary steps.
Another example is in-pipe robots, which provide a detailed report on the condition of water pipelines in case of widespread contamination of water supplies. Knowing the specific problem area can help reduce containment costs.
Emergency Communication Systems
The widespread use of smartphones facilitates the spreading of information to the public. Enhanced wireless, satellite, and fifth-generation (5G) network connectivity ensures timely information delivery to high-risk areas.
Additionally, authorities can provide disaster-related warnings, necessary awareness, and field information to help people with situational preparedness matters. Field information is shared by taking photos and videos and sharing them on social media platforms and blogging sites to promote disaster awareness among populations.
On the other hand, anyone with a smartphone can install apps that connect them with the nearest emergency response and management units for faster assistance. Apps have also been developed to sense danger. Remember, in times of disaster, the victim may not always have the time and strength to reach out for help. Smart apps sense you’re in danger and send alerts to the nearest emergency response units. But despite the technological advancements, it still helps to master the traditional 911 emergency response hotline. It’s a necessity for all households, including children, to master the 911 code for safety purposes at all times.
Because of technological advancements, emergency response is becoming more advanced, efficient, streamlined, and faster. From smartphone apps to cutting-edge medical devices, drones, and robots, first responders are now in a position to get disaster victims out of trouble in the shortest time possible. So, equip yourself with the requisite first aid basics and invest in the necessary equipment, as you never know when disaster will strike. The aim is to save lives and promote a speedy recovery.
Mary R. Dale
Mary R. Dale is a USA-based blogger with profound interest in disaster management. She takes pride in helping individuals and institutions stay safe from harm in the face of disasters. During her free time, you’ll always find her playing and bonding with her children.
KINGSTON, N.Y.--(BUSINESS WIRE)--HealthAlliance Hospital, a member of the Westchester Medical Center Health Network, and Royal Philips (NYSE: PHG, AEX: PHIA) a global leader in health technology, held a ceremonial signing today commemorating a partnership that is delivering advanced medical technologies to the new HealthAlliance Hospital and the communities the hospital serves in and around Kingston.
The Philips health technologies at HealthAlliance Hospital will help medical imaging technicians capture patient scans fast, with enhanced clarity for more accurate diagnoses of patient conditions, monitor patient vital signs with increased efficiency, and enable patient care collaboration between HealthAlliance Hospital clinicians and medical subspecialists around the WMCHealth Network.
Many of the Philips health technologies found in the new HealthAlliance Hospital are the same systems used at WMCHealth’s Westchester Medical Center, as well as other hospitals both nationally and globally that stand at the forefront of healthcare delivery. For example, HealthAlliance Hospital patients will benefit from Philips’ industry-leading Azurion system, which enables image-guided interventional therapies for conditions affecting the brain and heart.
Michael D. Israel, President and CEO, WMCHealth, and Vitor Rocha, Chief Market Leader for Philips North America, put pen to paper at today’s signing.
“The new HealthAlliance Hospital and the accompanying Philips partnership are part of WMCHealth’s ongoing efforts to equip our network with the newest medical systems and technologies to provide the best care possible,” said Israel. “We are bringing some of the world’s most advanced medical technologies to Ulster County so we can deliver the highest quality care right here. Thank you to Philips for this commitment and our long-standing partnership.”
“The WMCHealth Network and Philips share a common goal of wanting to Excellerate lives. To achieve that goal, we need to work together to understand the unique healthcare challenges of our communities and how we can work together to deliver the right solutions,” said Rocha. “By empowering staff with the right tools and technologies, we can allow them to deliver on the Quadruple Aim and focus on what is most important - providing the best quality care for patients.”
First Phase-Completion of Healthcare Advancement Plan on Horizon
The expansion and enhancement of HealthAlliance Hospital on Mary’s Avenue is a key component of a $134.9 million Ulster County healthcare advancement plan initiated by WMCHealth, in cooperation with New York State, to consolidate the operations of the two HealthAlliance Hospitals in Kingston. WMCHealth expects to open the new HealthAlliance Hospital for care later in 2022.
The new HealthAlliance Hospital will offer an expanded, modernized area for behavioral health diagnosis and treatment among other newly renovated treatment units and centers. In the next phase of this plan, WMCHealth will convert the HealthAlliance Hospital on Broadway into a walkable health village, where HealthAlliance workforce members will collaborate with community partners to deliver preventive and primary healthcare services as well as lifestyle counseling.
The Benefit of Long-Term Strategic Partnerships
Long-term strategic partnerships help hospitals and health systems better manage the cost and complexity of their technology investments, with the goal of improving patient outcomes.
In 2015, WMCHealth and Philips commenced a multi-year deal in which Philips agreed to supply WMCHealth with a comprehensive range of clinical and business consulting services, as well as advanced medical technologies. The collaboration also aimed to redefine how WMCHealth delivered quality care in all of its medical subspecialties. A similar agreement with Philips is in place at other WMCHealth community hospitals, including Bon Secours Community Hospital in Port Jervis, St. Anthony Community Hospital in Warwick and Good Samaritan Hospital in Suffern.
For the HealthAlliance Hospital partnership, Philips will provide the latest connected patient monitoring systems, as well as diagnostic imaging technologies such as CT that can help lower radiation dose, and innovations such as Compressed SENSE for MRI exams that enable patients to be scanned up to 50% faster.
Moreover, HealthAlliance Hospital will offer the Philips Ambient Experience in the new imaging center, designed to create a calm and engaging experience for patients, family and staff with dynamic lighting, video projection and sound, to provide positive distractions and provide patients more control of the imaging environment.
 Compared to Philips scans without Compressed SENSE
About Westchester Medical Center Health Network
The Westchester Medical Center Health Network (WMCHealth) is a 1,700-bed healthcare system headquartered in Valhalla, New York, with nine hospitals on seven campuses spanning 6,200 square miles of the Hudson Valley. WMCHealth employs more than 13,000 people and has nearly 3,000 attending physicians. The Network has Level I (adult and pediatric), Level II and Level III trauma centers, the region’s only acute care children’s hospital, an academic medical center, several community hospitals, dozens of specialized institutes and centers, Comprehensive and Primary Stroke Centers, skilled nursing, assisted living facilities, home-care services and one of the largest mental health systems in New York State. Today, WMCHealth is the pre-eminent provider of integrated health care in the Hudson Valley. For more information about WMCHealth, visit WMCHealth.org or follow WMCHealth on Facebook.com/WMCHealth or Instagram.com/WMCHealth.
Royal Philips (NYSE: PHG, AEX: PHIA) is a leading health technology company focused on improving people's health and well-being and enabling better outcomes across the health continuum – from healthy living and prevention, to diagnosis, treatment, and home care. Philips leverages advanced technology and deep clinical and consumer insights to deliver integrated solutions. Headquartered in the Netherlands, the company is a leader in diagnostic imaging, image-guided therapy, patient monitoring and health informatics, as well as in consumer health and home care. Philips generated 2021 sales of EUR 17.2 billion and employs approximately 79,000 employees with sales and services in more than 100 countries. News about Philips can be found at www.philips.com/newscenter.
By Kate Ruder, Kaiser Health News
GRAND JUNCTION — During her 12-hour overnight shift, Brianna Shelton helps residents at BeeHive Homes Assisted Living go to the bathroom. Many of them have dementia, and some can’t get out of bed on their own. Only a few can remember her name, but that doesn’t matter to her.
“They’re somebody’s mom, somebody’s grandma, somebody’s great-grandmother,” Shelton said. “I want to take care of them like I would take care of my family.”
Shelton trained to be a personal care aide through an apprenticeship program designed to meet the increasing need for health care workers in rural western Colorado. Here, far from Denver’s bustling urban corridor, worker shortages mount as baby boomers retire, young people move away from these older communities, and demand for health care in homes and facilities rises.
Rural areas often have larger shares of residents who are 65 or older than urban areas do. And the most rural regions have relatively fewer direct care workers, like personal care aides, to help people with disabilities than less-rural regions do, according to a exact study in the journal Health Affairs.
Besides increasing the number of direct care workers, the Colorado apprenticeship program offers opportunities for improving earning power to residents who live at or below the poverty line, who lost their jobs during the COVID-19 pandemic, or who are unemployed or underemployed. They train to become personal care aides, who help patients with daily tasks such as bathing or housekeeping, or certified nursing assistants, who can provide some direct health care, like checking blood pressure.
Apprentices take training classes at Western Colorado Area Health Education Center in Grand Junction, and the center pays for students who live in more rural areas to attend classes at Technical College of the Rockies in Delta County. The apprentices receive on-the-job training with one of 58 local employers — an assisted living facility, for example — and they are required to work there for one year. Each apprentice has an employer mentor. Staff members at Western Colorado AHEC also provide mentorship, plus the center has a life coach on hand.
“We really just want students to get into health care, get jobs, and retain those jobs,” said Georgia Hoaglund, executive director of Western Colorado AHEC, which has 210 active apprentices and was bolstered by a $2 million grant from the U.S. Labor Department in 2021.
Some apprentices are exact high school graduates. Others are single mothers or veterans. They often have educational or economic barriers to employment. Hoaglund and her staff of 10 buy the apprentices scrubs so they can start new jobs with the right uniforms; otherwise, they might not be able to afford them. Staff members pay for apprentices’ gas if they can’t afford to fill up their tanks to drive to work. They talk to apprentices on the phone monthly, sometimes weekly.
Even though the apprenticeship program gives these workers a solid start, the jobs can be stressful, and burnout and low pay are the norm. Career advancement is another obstacle, said Hoaglund, because of the logistics or cost of higher education. Hoaglund, who calls her staff family and some of the apprentices her kids, dreams of offering more advanced training — in nursing, for example — with scholarship money.
Apprenticeships are perhaps better known as a workforce training tool among electricians, plumbers, carpenters, and other tradespeople. But they are also viewed as a way of building a needed pipeline of direct care health workers, said Robyn Stone, senior vice president for research at LeadingAge, an association of nonprofit providers of aging services.
“Traditionally, health care employers have hired people after they finish a training program,” said Susan Chapman, a registered nurse and a professor in the school of nursing at the University of California-San Francisco. “Now, we’re asking the employer to take part in that training and pay the person while they’re training.”
The pandemic exacerbated shortages of direct care workers, which could encourage employers to invest in apprenticeships programs, both Chapman and Stone said. Federal investment could help, too, and a Biden administration initiative to Excellerate the quality of nursing homes includes $35 million in grants to address workforce shortages in rural areas.
Shelton had never worked in health care before moving to Fruita, a small town that is about 12 miles northwest of Grand Junction and is surrounded by red sandstone towers. She left Fresno, California, a year ago to take care of an uncle who has multiple sclerosis. She and her 16-year-old daughter live in a trailer home on her uncle’s property, where Blackie, her rescue Labrador retriever, roams with the chickens and cats.
Blackie also sometimes accompanies Shelton to BeeHive to visit with the residents. Shelton said that it is more than a job to her and that she is grateful to the apprenticeship program for helping her get there. “It opened a door for me,” Shelton said.
Shelton works three 12-hour shifts a week, in addition to taking care of her uncle and daughter. Yet, she said, she struggles to have enough money for gas, bills, and food and has taken out small loans to make ends meet.
She is not alone. Personal care aides are often underpaid and undervalued, said Chapman, who has found significantly higher poverty rates among these workers than among the general population.
Direct care workers nationwide, on average, make $13.56 an hour, according to a study by nonprofit policy group PHI, and these low wages make recruiting and retaining workers difficult, leading to further shortages and instability.
In an effort to keep workers in the state, Colorado raised the minimum wage for personal care aides and certified nursing assistants to $15 an hour this year with money from the American Rescue Plan Act. And the Colorado Department of Health Care Policy and Financing’s 2023-24 budget request includes a bump to $15.75. Similar efforts to raise wages are underway in 18 other states, including New York, Florida, and Texas, according to a exact paper from the National Governors Association.
Another way to keep apprentices in jobs, and encourage career and salary growth, is to provide opportunities for specialized training in dementia care, medication management, or behavioral health. “What apprenticeships offer are career mobility and advancement,” Stone said.
To practice in Colorado, new certified nursing assistants complete in-class training, do clinical rotations, and pass a certification test made up of a written test and a skills test. Hoaglund said the testing requirements can be stressful for students. Shelton, 43, has passed the written test but must retake the skills test to become licensed as a certified nursing assistant.
Hoaglund’s program started in 2019, but it really took off with the 2021 federal grant. Since then, 16 people have completed the program and have received pay increases or promotions. Twice as many people have left without finishing. The largest hospital in Grand Junction, Intermountain Healthcare-St. Mary’s Medical Center, recruits workers from the program.
Hoaglund said each person who enters the health care field is a win.
Brandon Henry, 23, was a student at Colorado Mesa University in Grand Junction and working at PetSmart before he joined the apprenticeship program in 2019. After enrolling, he trained and worked as a certified nursing assistant through the worst of the pandemic. As an apprentice, he said, he learned the importance of having grace while caring for patients.
He went back for more training at Western Colorado AHEC to earn a license that allows him to dispense medicine in accredited facilities, such as assisted living centers. He now works at Intermountain Healthcare-St. Mary’s Medical Center, where he took training classes in wound care and physical therapy hosted at the hospital. This winter, he’ll graduate from Colorado Mesa with a Bachelor of Science in nursing.
“At the hospital, I’ve found more opportunities for pay raises and job growth,” Henry said.
Kaiser Health News is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at the Kaiser Family Foundation. KFF is an endowed nonprofit organization providing information on health issues to the nation.
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Last year, Sal Gomez noticed he felt pain in his right testicle and lower back. The third-year medical student thought maybe he pulled a muscle while working or exercising. When the pain didn’t go away, he visited his doctor and learned the reason for his ache: He had testicular cancer.
“I was really thinking I hurt myself, and I was super busy with the surgical rotation. It’s like a 5 a.m. to 5 p.m. type of thing,” Gomez, 26, a medical student at The Ohio State College of Medicine, tells TODAY.com. “I was shocked being 25 years old and diagnosed with cancer.”
Gomez is sharing his story to raise awareness of testicular cancer, a rare cancer that impacts mostly teens and young adults.
“We should talk about it more because it’s the most common cancer, although rare, in young men,” he says. “You’re in the prime of your life.”
After 12-hour days in the hospital as a medical student in a surgical rotation and then studying all night, Gomez thought when he first felt the pain in his testicle and back that he had pulled a muscle.
“I wasn’t really sure why it was going on there. I never had anything like that before,” he recalls. “After two weeks, it wasn’t really going away or getting better.” Gomez performed a self-examination on his testicle and didn’t feel any “lumps or bumps,” but he still scheduled an appointment with his primary care physician. “He wasn’t super concerned about what was going on,” Gomez says. “He did order a bunch of labs and an ultrasound.”
Gomez started to feel better, and with his busy schedule, he put off his ultrasound. Based on what he'd learned in medical school, he didn’t think he had the classic signs of testicular cancer.
“When you learn about testicular cancer, you learn symptoms like a lump,” he says. “You really don’t think about cancer being painful. You usually think of a pea-sized lump (on) a testicle that’s not painful but maybe has some kind of enlargement.”
But the pain returned, and by January, he resigned himself to undergoing the ultrasound.
“Pain really shouldn’t be coming and going,” Gomez says. “I did another exam, and at the time, I didn’t feel a lot there.”
But the ultrasound found a mass.
“There are not really many benign tumors in the testicle, and mine looked particularly cancerous,” he says. “I was really surprised.”
Soon after, Gomez met with an oncologist to come up with a treatment plan. Because he had back pain as well, doctors thinking the cancer had spread.
“A couple of days later, I got a CT scan of my abdomen and my (pelvis) that revealed what the back pain was,” Gomez says. “I had these very enlarged lymph nodes in my lower back area, up around where my kidneys are.”
The size of his lymph nodes was a worrying discovery because testicular often moves into the kidneys, Gomez says. But fortunately additional scans revealed that it hadn't spread.
About a week later, he had his testicle removed and learned he had stage 2 testicular cancer. He would need chemotherapy.
“I did nine weeks of chemotherapy after having the primary tumor removed. It was pretty brutal,” Gomez says, adding that his treatment often induced nausea.
Follow-up scans revealed that his lymph nodes responded to the chemo somewhat, but they were still enlarged enough that Gomez's doctors believed there could still be cancer. So, they performed a lymph node dissection, an eight-hour procedure to remove them.
“At the end of June, the pathology came back as no viable cancer,” Gomez says.
Testicular cancer generally impacts younger people, according to the American Cancer Society.
“It is a top cancer for young men in their teenage years to perhaps their early 30s. So, it’s a big deal for young men,” Dr. J. Paul Monk, a medical oncologist at The Ohio State University Comprehensive Cancer Center, tells TODAY.com. “It’s not a top killer, thankfully, because it’s so well treated.”
People with testicular cancer normally undergo surgery to remove the testicle and then might receive chemotherapy.
“Surgery is the bedrock of testicular cancer treatment,” Monk says. “It really responds so well to chemotherapy in the advanced and early (stages).”
Monk says that if it’s discovered early, some patients do not need chemotherapy or radiation. Doctors remain unsure why it impacts younger people more than older. People who have an undescended testicle at birth might be at an increased risk of developing the testicular cancer, Monk says. The most noticeable symptom is a lump in the testicle, which is why doctors recommend that men become familiar with what’s normal for their bodies.
“We say do a self-testicular test once a month,” Monk says. “If you notice a mass or something’s wrong, let somebody know because ... earlier rather than later is always good.”
Surgical removal of a testicle affects fertility, and often doctors encourage their patients to preserve sperm in case they face fertility issues later. But there’s good news about testicular cancer.
“We are still very proud that even in the advanced setting, we are anticipating a cure,” Monk says. “It’s one of the brightest spots in oncology because (testicular cancer) went from a mostly deadly disease in advanced settings to a mostly curable disease.”
As a medical student, Gomez had access to medical journals, so he could've taken his research much deeper than the average patient. But he experienced enough anxiety that he tried not to delve too deep into the literature about his cancer and treatment.
“I was trying to limit myself,” he says. “You learn about it and then it’s happening to you. … It’s a really weird experience.”
Recovering from his lymph node surgery came with complications. He started retaining fluid in his abdomen, making it difficult for him to keep food down. They drained multiple liters from his abdomen.
Gomez initially felt better afterward, but two weeks later, he had to return to the hospital because of more fluid.
“I had five liters taken (out), which was a lot,” he says. “That was pretty tough because I wouldn’t really be able to sleep if I had all the fluid in me. I was super nauseous.”
Luckily, the fluid accumulation stopped, and he was slowly able to restart regular activities and even go to the gym. While he receives scans regularly to make sure the cancer doesn’t return, it has a low recurrence rate. He recently got engaged and looks forward to starting his fourth year of medical school, which he had to put off for his treatment.
Gomez says that testicular cancer comes with a stigma and he hopes people feel less ashamed to talk about it.
“I had to tell everybody that I’m going to lose my testicle, and on top of that I think the biggest thing is — and I’m an example of this — men don’t want to go to the doctor,” Gomez says. “If we don’t talk about it, how can we find these really dangerous things?”
This article was originally published on TODAY.com
The University of Pittsburgh Medical Center has expanded its services in the Hershey area with the opening of a new 20,000-square-foot outpatient center. The health system opened an urgent center at the center with other practices to open in the future.
An 88,000-square-foot facility that is under construction will include 75 personal care apartments and 20 memory care apartments.
And Inspired Physical Therapy is building a larger clinic in Silver Spring Township.
These are just a few of the many health care development projects underway in the midstate. Here’s our latest list of medical-related projects, openings and moves in the region.
PennLive publishes a list of medical-related projects in the midstate several times of year. The last list was published on Oct. 21.
UPMC Urgent Care
The University of Pittsburgh Medical Center has opened a new 20,000-square-foot outpatient center at 121 Towne Square Drive. The first practice to open at the facility was UPMC Urgent Care, which treats patients of all ages with minor illnesses and injuries, and provides vaccinations, school and work physicals, basic laboratory and imaging services, respiratory therapy, wound management and orthopedic evaluations.
UPMC - thrombectomy services
The University of Pittsburgh Medical Center is now offering thrombectomy services in a newly opened interventional suite at UPMC Harrisburg hospital. UPMC said that thrombectomy is a minimally invasive and highly effective procedure to remove clots from blood vessels. The health system said it is used to treat ischemic strokes and in improving patient outcomes and experience.
Mission Autism Clinics
Mission Autism Clinics Harrisburg will open on Dec. 9 at 2550 Interstate Drive. The clinic offers applied behavior analysis therapy. Information: www.missionautismclinics.com.
Central Penn College
Central Penn College will now be offering classes leading to a physical therapy assistant degree in the evenings for the first time ever on its Summerdale campus. Central Penn is now enrolling students. Classes begin Jan. 9. Information: www.centralpenn.edu.
UPMC, Central Penn College
UPMC, UPMC Pinnacle Foundation, and Central Penn College are working together to help area residents pursue careers as medical assistants. Under this partnership, medical assistant students who successfully complete the program and are hired by UPMC will receive payments equivalent to the full cost of the programs, in addition to their salary. As part of this initiative, Central Penn College will offer a new 12-month, 30-credit, Medical Assisting Diploma Program that requires students to attend full-time, in-person classes. Students must complete at least two years of the work requirement at UPMC in Central Pa. facilities. Central Penn College is making the CPC Housing Scholarship — valued at $5,800 a year — available to all qualifying medical assisting enrollees who attend full-time. Classes will begin on Jan. 9, and the deadline to apply is Dec. 23. Information: www.centralpenn.edu/UPMC.
Legend at Silver Creek
The personal care and memory care residence is expected to open in July at 425 Lambs Gap Road. Kansas-based Legend Senior Living has opened a welcome center for the new facility at 6375 Mercury Drive, Suite 103. The office is now accepting reservations for new residents. The 88,000-square-foot facility will include 75 personal care apartments and 20 memory care apartments, along with dining venues, recreation areas, a garden and specialized rooms for such activities as physical therapy and advanced memory care therapy and programming.
Penn State Health Obstetrics and Gynecology
The new clinic opened in suite 1076 at Penn State Health Hampden Medical Center at 2200 Good Hope Road.
Inspired Physical Therapy
Inspired Physical Therapy will move to 1 Legend Lane from its current location nearby at 21 Waterford Drive. The new 10,800-square-foot facility is a larger space for the clinic. The new facility is expected to be completed in the second quarter of 2023.
UPMC Child Advocacy Center of Central Pa.
The new location opened at 49 Brookwood Ave., Suite 2. The UPMC Child Advocacy Center of Central Pa. was previously known as the Children’s Resource Center. UPMC says that the center is dedicated to reducing the trauma and the aftermath of abuse for children and their families, and provides care in a safe, child-friendly environment for children suspected of having been abused or neglected.
The Residence at Boyertown
A joint venture of IntegraCare and Weathervane Capital Partners has announced it is building a senior living community, The Residence at Boyertown. Pending conditional use approval by the township, construction on is scheduled to begin in March 2023, with a projected opening date set in May 2024. The three-story, approximately 124,000 square foot, 125-unit senior living community will include 55 independent living units, 50 assisted living units and 20 memory care units. As many as 100 jobs are expected to be created at the Boyertown senior living community. The Residence at Boyertown will be located at Montgomery Avenue and Swamp Creek Road in Colebrookdale Township. The Triple Crown Corporation is the general contractor.
HNL Lab Medicine
HNL Lab Medicine has relocated to the Maxatawny Marketplace shopping center at 15100 Kutztown Road, Unit #2, from 333 Normal Ave. The new facility’s hours are from 7 a.m. to 3 p.m. Monday through Friday from and 8 a.m. to noon Saturday.
The Residence at Village Greens
A joint venture of IntegraCare and Weathervane Capital Partners has announced it is building a senior living community, The Residence at Village Greens, which is expected to create approximately 100 jobs in the 131-unit senior living community. The projected opening date is set for December 2023. The three-story, approximately 130,000-square-foot senior living community will include 60 independent living units, 51 assisted living units and 20 memory care units. The site of the senior living community project is located on what previously had been the Village Greens Golf Course near the intersection of Broad Street, Reedy Road and Cacoosing Avenue in Sinking Spring. The Triple Crown Corporation is the general contractor.
Paragon Behavioral Health Services
Paragon Behavioral Health Services has moved to a 5,000-square-foot space at 925 Berkshire Blvd. The practice offers behavioral health services. Paragon offers a range of mental health services including traditional outpatient therapy, autism diagnostic evaluations, and autism individual and group community services.
Leg Up Farm
Leg Up Farm, a nonprofit therapeutic riding center in York County for children with disabilities, plans to build a similar center in Franklin County at 3575 Cascades Drive in Guilford Township near Fayetteville. Leg Up Farm is a pediatric facility in East Manchester Township that provides physical, occupational, speech and aquatic therapy, counseling services, therapeutic horseback riding, nutrition services and educational and recreational programming. Construction on the facility in Franklin County won’t begin until the funds are raised.
Penn State Health – Leader Heights
Penn State Health opened a new facility at 130 Leaders Heights Road in York Township and will offer reproductive endocrinology and fertility services as well as pediatric specialties. The 5,600-square-foot facility includes eight test rooms. Initially, there is 17 providers in addition to support staff. Pediatric services include congenital heart and cardiology, gastroenterology, pre- and post-surgical consultations, rheumatology and pulmonology.
©2022 Advance Local Media LLC. Visit pennlive.com. Distributed by Tribune Content Agency, LLC.
"Canada just approved the euthanasia of children with depression. @Tucker Carlson compares it to what the Nazis did in Germany in the 1940s - killing the weak," says an October 30, 2022 tweet.
Similar posts have been shared hundreds of times on Twitter and Facebook.
Some of them include an excerpt from an October 26, 2022 broadcast in which Carlson, a Fox News host, says: "By March, a new law in Canada is expected to allow children to be killled by doctors, by state doctors, without the approval of their parents ... because the kids are depressed."
The social media outrage comes as Canada reviews its MAID law, as is required every five years.
The federal government says the MAID program -- first passed in 2016 following a 2015 ruling by the Supreme Court of Canada -- is intended for people with a "grievous and irremediable condition." Mental illnesses are excluded, patients must be at least 18 years old and two independent health professionals have to approve the request after receiving informed consent.
Bill C-7, which received royal assent in March 2021, expanded access to MAID by repealing an eligibility provision that required "a person's natural death be reasonably foreseeable." This led to an influx of participants; the program's third annual report found "10,064 MAID provisions reported in Canada, accounting for 3.3 percent of all deaths in Canada" in 2021.
But Natalie Mohamed, a spokeswoman for Health Canada, told AFP in a November 4, 2022 email that "there is no section in the law that allows for minors to receive medical assistance in dying, with or without parental consent, as minors are not eligible to apply for MAID under current Canadian law."
She added: "The Government of Canada has no immediate plans to alter the minimum age requirement to access MAID, though it will consider the advice of the Special Joint Committee on the matter of Mature Minors."
The Canadian government says MAID recipients must have "a serious illness, disease or disability," be "in an advanced state of decline that cannot be reversed" and "experience unbearable physical or mental suffering" that cannot be relieved under conditions the patient considers acceptable.
People whose mental illness is the sole condition leading them to consider MAID are not eligible under the law unless they have other medical issues, according to Hélène Guay, a lawyer specializing in health law. But that exclusion only remains in effect until March 17, 2023.
Health Canada's Mohamed said that "as of March 18, 2023, MAID requests by persons with a mental disorder as their sole underlying medical condition will be permitted," adding that "such requests will still need be assessed against the criteria and enhanced safeguards in the legislation."
Minors were excluded from the 2016 legislation, and the exact decision to review potential eligibility has sparked heated debate.
"Given the issue was a contentious one requiring further examination, the Government of Canada commissioned a study by the Canadian Council of Academies on MAID for Minors," Mohamed said.
The Special Joint Committee on Medical Assistance in Dying was put in place to review issues relating to mature minors and the protection of Canadians with disabilities, among others.
"The Committee is expected to present its report to Parliament by February 17, 2023," Mohamed said.
Louis Roy, inspector with the Directory of Professional Inspection of the Collège des médecins du Québec (CMQ), spoke in support of expanding eligibility before the Special Joint Committee on October 7, 2022 in Ottawa.
The CMQ wants adolescents deemed "mature," aged 14-17, to be eligible for MAID under the same criteria as adults, provided they receive parental consent. The CMQ also wants to make MAID available to infants when "the prognosis is very bleak and the living conditions appalling in cases of severe malformations or severe polysymptomatic syndromes, annihilating any prospect of relief and survival."
Following Roy's speech, public broadcaster CBC reported that the federal minister of disability inclusion, Carla Qualtrough, found the idea "completely shocking and unacceptable."
"I would never support going down that road," Qualtrough said.
Krista Carr, executive vice president of Inclusion Canada, told the National Post: "Most families of children born with disabilities are told from the start that their child will, in one way or another, not have a good quality of life."
She said: "Canada cannot begin killing babies when doctors predict there is no hope for them. Predictions are far too often based on discriminatory assumptions about life with a disability."
Despite facing criticism, the CMQ re-stated its position on October 14. The CMQ also told AFP on October 31 that "it is not the intention of the College to provide this care to babies born with a severe disability, impairment or mental illness," but rather "children who are born with conditions incompatible with life."
The vast majority of Canadians who apply for MAID have serious underlying health conditions, according to the program's third annual report.
In 2021, cancer was the most commonly cited underlying medical condition, followed by cardiovascular, chronic respiratory and neurological conditions. The average MAID recipient was 76.3 years old.
Only 219 individuals, or 2.2 percent of all MAID cases, were people whose natural deaths were not reasonably foreseeable, according to the report. Almost half of them cited underlying neurological conditions.
AFP previously debunked claims that MAID is "used to kill poor people."
University of Iowa Health Care complex, which houses University of Iowa Hospitals and Clinics. (The Gazette)
IOWA CITY — Adding to the growing list of construction and renovation projects that University of Iowa Health Care is pursuing in and around its campus, UIHC now is asking a development team to design, plan and build a new primary care medical office building in Iowa City.
The goal of erecting a UIHC-operated location in the same town as its main sprawling campus of more than 1 million square feet is to “increase access to primary medical care for the local community as well as train physicians in a setting most similar to other Iowa primary care offices.”
“UIHC will be the long-term tenant of the facility following successful completion of the project,” according to a request for qualifications from prospective developers. “The building will consist of test rooms, diagnostic imaging, pathology lab, and associated spaces.”
The project comes as UIHC is building or pursuing a growing list of facility endeavors — like a $525.6 million hospital in North Liberty; a $95 million vertical expansion of its existing inpatient tower; a $24.6 million renovation of its emergency room; an $8 million conversion of its south wing into inpatient rooms; and an entirely new inpatient tower it expects to spend $620.9 million on in the next five years.
UIHC officials have cited soaring patient demand, full beds and tight quarters in making the case for its explosive growth. When arguing last year for state approval to build in North Liberty, UIHC emphasized its focus on advanced and acute care that only it — as Iowa’s single academic medical center — can provide to the state’s sickest patients.
“The kind of care UIHC delivers cannot be relocated to a community hospital,” UIHC officials in August 2021 told a state board considering approval of the North Liberty project — disputing assertions the university was veering out of its lane and threatening community hospitals.
“Expansion of tertiary care services at UIHC does not threaten community hospitals,” officials said then, using the “tertiary and quaternary” term defining specialized and advance-level care.
But administrators with those Eastern Iowa community hospitals that sounded alarms UIHC was threatening their patient and staffing pool — and thus their livelihood — told The Gazette that the university’s community care development endeavor illustrates their earlier warnings and opposition.
“UnityPoint Health continues to have concerns with UIHC increasing its presence in primary care rather than focusing on tertiary health care,” Michelle Niermann, UnityPoint Health-Cedar Rapids president and chief executive officer, said in an email.
In arguing against the need for UIHC expansion a year ago, Niermann cited there was “significant capacity” at existing hospitals across Eastern Iowa — including more than 40 percent of UnityPoint’s available space at the time, more than half of Mercy Medical Center-Cedar Rapids’ space and more than 70 percent at Mercy Hospital Iowa City.
“Given the role of our organization as a leader in primary care, market research has indicated our community is already well represented in primary and urgent care options,” Niermann said last week.
When asked how the UIHC community care expansion — which doesn’t require state approval — might affect UnityPoint Health, she said, “We remain concerned about developments that may draw care out of communities across the state and have the potential to weaken Iowa’s community and rural hospitals.
“During the State’s Certificate of Need Hearing for the North Liberty hospital, UIHC indicated their intent was not to duplicate services already offered by existing community hospitals,” Niermann said. “Since this hearing, UIHC has opened an urgent care in downtown Cedar Rapids, which is directly competing and duplicating existing options.”
Of UIHC’s 78 locations statewide, it already has 21 in the Iowa City area and another three in Cedar Rapids — most of which offer some form of “family medicine” or primary care. The state has at least 125 hospitals — including 83 in the smallest classification; four characterized as rehabilitation or long-term acute care hospitals; 15 rural or rural referral hospitals; and 23 urban hospitals.
That doesn’t include specialty clinics — like Steindler Orthopedics — and surgical centers.
“Again,” Niermann said, “research has indicated primary and urgent care needs are currently being met by community hospital options.”
A spokeswoman for Mercy Iowa City — founded nearly 150 years ago and sitting just 2 miles east of the main UIHC campus — agreed with Niermann that “the region is well served with the current number of primary care physicians, clinics, hospital beds and health care entities.”
“As Iowa City’s first and only community hospital, Mercy Iowa City is proud of its long-standing commitment to providing high quality patient care, whether it is for primary care or within our scope as a community hospital,” Lisa Steigledar, Mercy Hospital Foundation president and marketing and community relations director, told The Gazette.
Mercy Iowa City last year argued more UIHC development not only would increase competition for patients but for staff — with 12 hospitals and surgery centers in the Cedar Rapids-Iowa City corridor vying for health care workers.
That, UIHC officials said, is part of the reason it needs more primary care space.
“This outpatient clinic building would increase local access to primary medical care, as well as provide modernized clinic facilities in a community setting to support necessary training and education of future primary care physicians,” according to a UIHC statement provided to The Gazette. “Nearly half of physicians trained at UI Health Care go on to practice in Iowa.”
In arguing for expansion last year, the university cited population-based forecasts showing Iowa’s unmet demand for primary care physicians will increase from 145 today to 418 in 10 years.
“Iowa needs UIHC to train more doctors,” officials said at the time, noting UIHC educates half of Iowa’s physicians and a quarter of its nurses. “UIHC cannot train more doctors without growing.”
In U.S. News & World Report’s 2023 “best medical schools for primary care” rankings, the UI tied for No. 16, topped by Big Ten Conference peers University of Minnesota at No. 3, University of Nebraska at No. 7 and University of Maryland at No. 15. But it beat the universities of Michigan and Wisconsin, which tied for No. 20 in the category, along with Indiana University at No. 23.
And the Association of American Medical Colleges has projected the country will experience a shortage of between 37,800 and 124,000 physicians by 2034, according to a 2022 report on the “state of academic medical centers,” produced by JPMorgan Chase’s Morgan Health unit.
That report indicated UIHC is not alone in expanding to address — among other things — the worker shortages and increased labor costs that “gnaw at AMCs’ bottom lines.”
“In exact decades, the stand-alone teaching hospital on a single campus has transformed into metro-wide or even statewide networks of partnerships with community hospitals and medical office complexes,” according to the report. “By expanding, AMCs aim to provide primary- and secondary-level care closer to patients’ homes, ideally at a lower cost than the flagship facility.”
Although primary care physicians don’t generate quite as much average revenue as specialist physicians, according to a 2019 Merritt Hawkins physician revenue survey, they did bring in an average of $2.1 million apiece that year, just under the $2.4 million specialist average and 50 percent more than in 2016.
Given the university just issued the request for qualifications from developers two weeks ago and is pursuing a two-phase selection process involving a shortlist of finalists who’ll be asked to submit more detailed proposals, UIHC officials don’t yet have many details about their new Iowa City-based medical office building vision.
Although they project it will be about 65,000 square feet, “UIHC may consider other scenarios to new construction, such as a re-purposed existing facility, if a compelling business case can be structured.”
Prospective developers have submitted dozens of questions to the university about what they’re looking for, although UIHC answered most by reiterating more details will be shared in the second phase of the selection process.
They did affirm it would include only UIHC providers and the university would like to start using the new medical office building “as soon as practical.”
“We anticipate the building being available for occupancy in the second half of 2024,” according to a UIHC answer to a developer question.
Vanessa Miller covers higher education for The Gazette.
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