Obtaining Career Certification in Medicine

This is a Guest Post by Jim Kelly

As mentioned by The American Registry of Radiologic Technologists, (AART), “Certification is the initial recognition of an individual who satisfies certain standards within a profession.” Without the proper certifications and training, a medical professional would simply be a highly educated person with a wealth of knowledge about medicine. You hear about nurses, physicians, and other healthcare providers taking the required state and national exams in order to certify themselves in the specific area of medicine in which they choose, but how does one go about becoming certified?

Each healthcare professional requires a certain certification. Nonetheless, becoming certified in any medical career is a rigorous process that requires attention to detail, intense focus, time, dedication, and a lot of studying. Let’s take a closer look at the certifications necessary to follow these medical career paths; physician, nurse, radiologist and pharmacists:

• Physician- There are certain educational and training requirements a physician must complete; however, board certification demonstrates “a physician’s exceptional expertise in a particular specialty and/or subspecialty of medical practice”, as stated by The American Board of Medical Specialty (ABMS). What this means is that, in the U.S., medical specialty certification in not required, but is actually voluntary. What certification can do is enhance your career and offer benefits not available to those otherwise. In other words, certification makes you a “qualified physician” in the eyes of the public.

The ABMS offers different specialties and subspecialties depending on the area of medicine you choose. So regardless of the field of medicine you choose, it’s possible to become a board certified physician.

• Nurses- We’ve all heard the term RN and LN when relating to nurses, but what makes a nurse a registered or licensed? In order to become a Registered Nurse or Licensed Nurse, one must obtain the proper certifications from the National Council of State Boards of Nursing (NCSBN). The National Council Licensure Examination-Registered Nurse (NCLEX-RN) is the exam one must pass to become an accredited nurse.

• Radiography Technician - As one of the 24 national medical specialty boards associated with the ABMS, The American Board of Radiology (ABR) represents physicians who become radiologists. There are also careers as radiography technicians, also known as radiologic technologists. Sanford Brown offers a radiography training program for future radiography technicians. Subspecialties in radiology recognized by the ABR include: Neuroradiology, Nuclear Radiology, Pediatric Radiology, Vascular and Interventional Radiology.

• Pharmacists- Also one of the 24 boards associated with the ABMS, The Board of Pharmacy Specialists offers the same type of certifications, but for those looking to pursue a career in pharmacology. To get an idea of what to expect from the examination process, the exam is split up into two parts. Each part consists of 100 multiple-choice questions and testers are only given a total of five hours to complete both. Once started, the entire exam must be completed that same day.

An important key to remember is, after you are certified in your desired medical professional, you must maintain the certification. Just as First Responders need to retake CPR and First-Aid courses, medical professionals must do the same as well. Some organizations do not require you to retake the examination that certified you, but it is highly recommended for advancements in your career.

Addiction and Your Recovery: What Are the Best Options for You?

The following is a guest post:

Whether it is alcoholism, drugs, or a behavioral addiction, addiction itself is an intricate and painful disease, both mentally and physically; it’s no wonder that finding the right rehab or treatment facility can seem just as difficult at times. Getting help for your addiction will ensure your success, but finding the right facility will truly determine the longevity of your success and sobriety. With the immense amount of options available to one seeking treatment, it’s extremely tempting to merely just pick any facility, which is a mistake some make. It is imperative to take time to research your options, finding a program that adequately fits with your personal situation, needs and preferences will significantly increase the likelihood that you will achieve recovery.

The Physician's Evolving Role in Healthcare: Lead or Be Led

This is a guest post by Wen Dombrowski, MD

During medical school and residency I realized that individual physicians can choose to Lead or Be Led. Each of us can try to design and manage the systems of care we would like to see (whether care models or technology that enables them), or physicians can be victims of what others decide we should do (such as administrators, sales reps, or well-intended developers without user experience insight).

I recall over a decade ago there were critics who lamented the rise of HMOs and Pay For Performance would end the Practice Of Medicine as we know it. Various medical organizations encouraged physicians to run away from these changes so they could continue business as usual. But while many physicians had their head in the sand and academic faculty were often shielded from practice management realities, the business world continued to evolve with new budgets, rules, and technology.

There are parallels to then and now : physicians are facing unprecedented changes -- some embrace or at least reluctantly accept change as inevitable, but many physicians have told me "I don't understand what any of that ACA/ACO/PCMH/MU/ABCDEFG is about, so I'm just going to ignore it and just be a doctor." Then they are surprised when their hospital, state, and federal policies don’t reflect what they would want.

Hospitals Slow to Go Paperless Despite Benefits

Guest Post: Hospitals Slow to Go Paperless Despite Benefits

If you are walking into an ER, you better have a reliable memory of your last doctor's visit, the medications you have taken, and any x-rays you've had in the last year. Unless you are walking into one of the very few hospitals in the United States that has gone paperless, your wait could be very long. This is because hospitals are still using an outdated method of managing information: paper.

Healthcare is far behind other industries when it comes to information technology and document management. Hospitals and patients could greatly benefit from the conveniences an upgraded IT system could provide. This isn’t wishful thinking or guesswork. The benefits for hospitals and patients have been proven.

In 2009, Johns Hopkins released a now famous statewide study that demonstrated the benefits of hospitals using paperless technologies. The study included over 40 hospitals and 160,000 patients and found a correlation between computerizing records and overall hospital safety and effectiveness.

The hospitals with the top paperless technologies in the state showed a 15% decrease in the odds of patients dying while hospitalized. Imagine if we could see this kind of decrease throughout the rest of the healthcare industry. Assuming this decrease would hold true for all US hospitals, going paperless across the country could save more than 100,000 lives every year.

Tomotherapy treatment

This is a guest post by William Blackhurst, MD

Have you ever heard of Tomotherapy treatment?  This is a treatment designed for radiation therapy of various cancers.  Its name comes from the Greek root for slice.  Basically it combines a CT or other type of scan with radiation therapy in such a way that the radiation dose can be altered to match the thickness of the tumor in a given image slice.

Tomotherapy is both intensity modulated and image guided.  Intensity modulated radiotherapy or IMRT uses devices called collimators to adjust the amount of radiation delivered in a single dose.  Image guided radiotherapy or IGRT, on the other hand, uses a scan (from a CT or another imaging modality) to adjust the dose base on the tumors size and shape.

While tomotherapy may or may not be the best treatment option in a given case, it is good to know that it is an option.  It has now been a way to treat cancers for more than 10 years and there are over 300 sites across the US, Canada, Europe and Asia that offer this new kind of cancer treatment.

About the author:

William Blackhurst, MD, after graduating from The Ohio State University College of Medicine, converted from clinical work to medical communications. 

Pineal Tumor

The following is a guest post:

Pineal tumors are associated with the pineal gland, which is located near mid-brain. The pineal gland is part of the body’s endocrine system and produces a hormone called melatonin, which affects your awake and sleep patterns and how the body adjusts to changes in seasonal climate. The endocrine system consists of organs, which help, in regulation of various functions such as metabolism, growth, and development. Pineal tumors disrupt the production of the hormones this gland produces with the expected results. Sleep patterns are disturbed which can then multiply into other physical problems beyond what the tumor itself causes. The location of this gland tucked deeply between the hemispheres of the brain make it a sensitive and delicate area to reach and remove tumors. These tumors are not common in adults (less than 1% of all pineal tumors) and much more prevalent in children just entering their teen years making this problem more of a childhood disease.

Diabetes and your feet

The following is a guest post:

If you or anyone you know suffers from diabetes, you are well aware of the damage the body endures. When there is too much glucose in the bloodstream for a long period of time, diabetes problems are sure to arise. The high blood glucose (blood sugar) will damage many and often times multiple parts of the body; heart, blood vessels, eyes, kidneys, and even feet.

There are two main problems that are caused from too much glucose in your blood to focus on which will cause harm to your feet; nerve damage and poor blood flow. With damaged nerves in your legs and feet, one may not be able to feel pain, heat, or even cold in the leg and feet region. Diabetic neuropathy, which is basically the lack of feeling caused by nerve damage, may cause one to have cuts or sores on the feet which may get worse and infected because its presence isn’t known. Secondly, another common foot concern occurs when not enough blood actually flows to the legs and feet. Slow/poor blood flow makes it extremely difficult for a sore to heal, which can eventually and sometimes rapidly, lead to a severe infection. PVD (peripheral vascular disease) is the general term that is used to describe this problem. In short, it is extremely important to pay attention to your feet, especially if you are suffering from diabetes.

There are many preventatives that can be made to help reduce the chances of affecting ones health in concern with the feet; washing feet with warm water every day, file calluses gently, cut toe nails straight across, rub lotion on your feet but never in between toes, look at your feet every day to check for cuts, sores, etc., always wear slippers/shoes to protect feet from injuries, always wear socks to avoid blisters, and always wear proper shoes. That may look like a lot of steps to take, but your feet and your health will thank you. If you need to get the proper shoes or inserts to help prevent and future health problems, a great site to check out some really comfy shoes and foot accessories is http://drcomfort.com.

ADHD: What exactly is it?

The following is a guest post:

Everyone has heard the term, whether it was on a TV commercial, in a magazine headline or the topic of a local news health update. Some people might even use the term to describe themselves in moments of frustration of not remembering a phone number or being unable to concentrate on a friend’s meandering story telling.

But just because someone might have occasional moments of forgetfulness or inattention, doesn’t mean he or she is clinically ADHD. Attention Deficit Hyperactivity Disorder (commonly known as ADHD) has an early onset, typically appearing in childhood or adolescence. It is estimated that anywhere from 5% to 10% of children are affected by the disorder, some suffering into adulthood. It is marked by three main categories of symptoms.

Six Misperceptions about the Telemedicine Market

The following is by Jonathan D. Linkous, CEO of the American Telemedicine Association:

Six Misperceptions about the Telemedicine Market

Healthcare is a $2.5 trillion market in the United States and growing. Companies, institutions and individuals from everywhere are looking to see how to get a piece of the healthcare market. It’s the gold rush of the 21st century and health technology is where a lot of companies are staking a claim.

And now the excitement is turning to telemedicine. The variety of new entrants is vast: vendors selling devices or software; health systems using telemedicine to expand their market share and new providers of remote health services. ATA’s annual meeting is one of the fastest growing meetings and trade shows in the country. The opportunities are large but so are the dangers. So, based on the feedback from hundreds of entrepreneurs coming through the ATA offices over the past 20 years I wanted to share six of the biggest misperceptions about the telemedicine market.

1. It’s not the technology, it’s the service. Dial up phones were a great invention. So was the VCR. They are both gone but telecommunications services and watching movies are bigger than ever. New and amazing devices and applications are coming on the market every day. But devices are TOOLS that allow services to be provided at a distance. In healthcare, the focus, the purpose and the finances are on the service.
2. Despite what you hear, Medicare reimbursement is not the Holy Grail for telemedicine. It’s important, but… Medicare fee-for-service covers about 36 million Americans, 12 percent of the total U.S. population. 88 percent of Americans are covered elsewhere and 81 percent of healthcare spending comes from other sources. There are no federal restrictions on using telemedicine for billions of health dollars spent on managed care, bundled services and on alternative plans by private payers.
3. Healthcare institutions, physicians and industry are partners not enemies. “Transforming” does not require “replacing.” So many new entrepreneurs in telemedicine start out with a negative, competitive attitude to traditional healthcare. We have not reached the point when someone with heart disease is going to trust their care to a computer alone. The roles of hospitals and health providers are changing but they will continue to be the backbone of medicine.
4. Device regulation is not bad – it’s good. In fact it could rapidly accelerate adoption. FDA rules for wired and mobile telemedicine devices and their certification by an official government agency is a stamp of approval, providing reassurance for cautious buyers.
5. A great idea is born every minute but few of them are successful. I have heard of hundreds of stories about how a new technology, application or remote health service results in lower rates of hospitalization, improves compliance, etc. only to see it disappear a year later. A positive study nis nice but marketing, partnerships, revenue pathways and knowledge of healthcare business practices are essential, for starters.
6. Consumers don’t buy healthcare themselves. For fifty years the percent of out-of-pocket spending on healthcare by consumers has dropped (not counting insurance or co-pays). It is now less than ten percent of healthcare costs. Consumers are getting much more knowledgeable and engaged in selecting among available procedures and treatments but they rarely pay directly for a healthcare product and service.

ATA’s 2013 Annual Meeting – May 5-7, 2013 in Austin, TX - One of the best ways to learn and participate in the brave new market of remote healthcare. - Focused exclusively on applications and services providing remote healthcare to patients and consumers. The meeting provides over 500 peer-reviewed presentations, over 300 exhibitors and 6,000 attendees. Register or exhibit at www.ata2013.org

Jonathan D. Linkous
CEO
American Telemedicine Association

A Stethoscope for the Superorganism

Author: Ethan Segal, MD

"You look like a supernerd, made out of many lesser nerds," -Triumph, the insult comic dog

In the medical field, we focus on the care of the individual, a product of genetics, environment, and physiology. Recently, a lot of interest is coming from sociological circles investigating the role social structures play in the health of individuals, the social determinants of health. Scientists are finding more clues about the role social networks play in effecting individual health. For example, Kristakis and Fowler have found that rises of obesity can occur in social networks and social networks can be used to predict the spread of influenza (1). Similarly, many societies that have the healthiest people with longevity also have the strongest social ties. These ties foster interdependence as opposed to individual welfare or survival of the fittest. They are often referred to as "a society of us" instead of "a society of me's." Many sociological studies point to the symbiotic relationships of fungi. Mycotic organisms often form "superorganisms," networks of many individuals that symbiotically help scavenge for food or warn when dangerous pathogens are in the area. If society plays a large role in the welfare of individuals, should the healthcare community treat a human superorganism? The problem is that the healthcare community never really had a tool to measure the health of the superorganism. Until just recently.

Long-awaited Cancer Drug Treatment Looks Promising

This is a guest post by Joseph Baker

Long-awaited Cancer Drug Treatment Looks Promising

Bayer HealthCare has created a promising new drug to aid patients of colorectal cancer and will seek FDA approval this year. The drug is called regorafenib and will act as a medication for people who have run through all existing treatments of advanced colorectal cancer, including chemotherapy and other medications. Colorectal cancer has gone without a treatment drug for over five years; this innovation will provide a better outlook for patients and is expected to extend lives.

Perspectives on Vaccines

Author: Joseph Baker

The practice of vaccinating against diseases is a divisive issue, especially when the conversation turns to childhood vaccines. There are no federal laws mandating vaccination, but all 50 states require vaccinations for children entering the public school system. Though all states offer medical exemptions and most offer religious exemptions, most parents accept the process as a normal part of life without questioning the necessity of vaccinations. However, a growing number of parents are beginning to question the safety and efficacy of these vaccines. Though you'd need a biology degree to understand the full nature of vaccines and their effects on the human body, there are some basic issues that can be addressed without an in-depth background on the workings of the human body and viruses. In the end, there's no completely right or wrong answer to the question of vaccinations. The issue is nebulous at best and it all boils down to a personal choice. Though both sides present their issues as concrete and inflexible, the fact that there are two opposing sides capable of making reasoned, logical arguments disproves the belief that either side's claims are absolute.

4 Ways That The Internet Has Changed Medicine

Author: Thomas Stone

The Internet has changed the way people interact with the world. The changes in the practices of medical patients provide a clear example of the profound effects of the increase in readily available information. Previously, patients had to rely solely on their doctors to provide them with any pertinent health information and had few options for obtaining second opinions or exploring alternate treatment options. Also, patients can now reach out to others across the world who have experienced similar illnesses, allowing them to form large support groups with people who understand their concerns and feelings.

Finding Doctors

The prevalence of the Internet makes it much easier for people to locate and connect with doctors specializing in their required area of care. Locating a doctor can be as easy as doing a Google search from an Internet-connected device, whether a laptop, desktop or smartphone. Though many doctors aren't currently connected to social networks, it is starting to become more popular and, if it picks up more momentum, will allow patients to develop stronger connections to their doctors and explore their physician's network. Further, finding doctors to provide a second opinion is much easier, even if that doctor is thousands of miles away. There are times where no travel will be necessary, as doctors can receive test results and provide an over-the-phone or email evaluation.

Using Google Docs to gather clinical information from patients

Author: Steven Zuckerman, M.D.

The purpose of this article is to describe how I have been able to use “cloud technology” to simplify the process of getting useful clinical information from my patients. Since I am a neurologist, I have more than a passing interest in the management of patients with Parkinson’s disease. The successful management of this condition is highly dependent on the patient-physician communication regarding how their disease state is responding to their Parkinson regimen. Too much medication causes involuntary movements while inadequate dopamine stimulation results in the inability to move. Since there are several different Parkinson’s medications, all of which have different half-lives and durations of actions, the resultant clinical effectiveness is highly variable. Therefore, correlating clinical status with timing of medication ingestion is the only reliable means to make appropriate medication adjustments. Ideally, a patient log or journal should be completed at half hour intervals to capture this information. An analogous condition in Primary Care would be regulating a Diabetic. Insulin type and dosage need to be correlated with blood glucose determinations obtained throughout the day in order to optimize the Insulin regimen.

Future Color X-ray technology illustrated

Author: Benoit Dupont

All patients know that X-ray is a black and white image, right? And what if it would be possible to extract color information out of the image? Not for the sake of the cosmetic aspect of the picture, of course, but what if it had some diagnosis value, for the clinician? Well, it turns out it does.

• Caeleste Background

Caeleste is a begian CMOS image sensor expert design house (www.caeleste.be ). we introduced a new way to realize X-ray imagers based on energy separation (also called “color X-ray”). We are working closely with radiologists and researchers on this topic to see if it really makes sense to have such color detectors. We published early results on the value of energy differentiated color X-ray for mammography in ref [ ] and recently, researchers have proven in a publication at ESR2011 in Vienna (ref [ ]) that color X-ray applied to mammography would lead to a better diagnosis of tumor stages and Multifocality of lesion.

• Is color X-ray imaging interesting or just a hype?

We are not doctors but physicists and working with photons. When it comes to X-ray photons, their absorption by a material depends on its atomic weight. Color X-ray imaging is a technique where spectral information (“color”) is generated based on X-photon absorption versus energy differentiation. The color component in these images contains extra information: the chemical nature of the absorbing tissue.
How does this work? Next graph is the atomic composition of various body tissues and fluids:

How the Internet has changed healthcare

Author: David Spader

There is no denying it, the internet has dramatically changed virtually every facet of our lives. From communication to entertainment, the web enables us to access a wide array of information with the simple point and click of a mouse. Along with all the common things we think of, the internet has also radically changed healthcare and the way it works in this country.
Information

Perhaps the most important healthcare related internet development is the availability of information. There was once a time when an individual, if they were feeling ill, would have to hold off and wait to act until after they saw a medical professional. However, now, thanks to the virtual libraries available in cyberspace, a individual who feels that something may be wrong doesn’t have to wait until they actually see a doctor. Instead they can take advantage of technology, log on, and do some research about their symptoms. While this in no way replaces a visit to a doctor, and the importance of not self-diagnosing one’s self cannot be overstated, this new ability to at least have an idea about what certain symptoms may be mean can provide some peace of mind to individuals waiting for an appointment with their physician.

Nanotechnology & Cancer: The Cure Rx Couldn't Find?

Author: Ashley Warner

Science fiction has intrigued humankind for centuries. However, the imaginations of science fiction writers pale in comparison to the transcendent reality of nanotechnology and its effect on cancer. By utilizing nanotechnology, scientists have been able to target specific cancer cells and destroy them without harming the surrounding healthy cells. This allows doctors to not only treat cancer cells, but also possibly prevent cancer before it begins. Clearly, you don’t need an online biology degree to see that nanotechnology treatment is efficacious without the harmful side effects of conventional cancer treatments.

As most nanotechnology tools are smaller than a human cell, they can be used to detect and treat cancer in its earliest stages, with few to no side effects and extremely high precision. Better yet, these tools will eventually enable physicians to treat cancer at the genetic and cellular level by designing a treatment plan based on an individual’s genetic code. In the not so distant future, not only will nanotechnology enable treatment of cancer, it will be used to determine substances in the body that are known precursors to cancer.

The Proper Storage of Medication

Author: Emma Martin

Most people don’t put too much thought into how their medications are stored. Whether they’re in the medicine cabinet, a drawer, or out on the counter for easy access, it doesn’t seem to make any real difference. But in fact, there is a proper way to store medication, especially if you live in a household with others. In most cases, it’s not the temperature or other environmental factors you have to worry about (as you would with food items, for example), but rather other people (or animals) that might accidentally (or purposefully) get into your stockpile of prescriptions. For this reason, you should be aware of how to properly store any harmful medications that others could get their hands on.

If you have children or pets, you likely have some sort of cabinet to keep your medication in (a standard medicine cabinet is generally out of reach for the smaller inhabitants of your home). However, it’s not a bad idea to keep prescriptions (or even potentially harmful OTC meds) in a locked cabinet. Kids are curious, as are some pets, and they display alarming ingenuity in getting into places where they think you might have something interesting. Have you ever fibbed and told a child that their medication was candy in order to get them to take it? You may not have thought this little white lie dangerous at the time, but when your child overdoses on your medication, you’ll regret not having kept it under lock and key. And if you think childproof caps will keep your kids out, just think about how easily those plastic containers could break if dropped on a hard surface or sat upon.

Make Way for the Robots – Automated Medical Care is a Reality

Author: Cathy Thomas

The terms “robotics” and “artificial intelligence” have been bandied about for quite some time now, and we’ve seen the advances that have been made in robotics technology and applied successfully in various industries. The world of medicine however, was lagging behind – when lives are at stake, perhaps human intuition was considered superior to robotic efficiency. However, all that is set to change in the coming decade, with research in medicinal robots advancing by leaps and bounds. In particular, robots are already being used or will soon be used in:


• Providing care for senior citizens: In a nation filled with baby boomers who don’t have caregivers and who live alone, these robots are definitely going to be a boon not just to the elderly, but also to the ailing healthcare system of this country. Charles Kemp, assistant biomedical engineering professor at the Georgia Institute of Technology and his team at the institute’s Healthcare Robotics Lab are working on robots that can safely and effectively help care for senior citizens. Ideally, the machines would be able to provide their charges with access to the Internet, remind them to take their medicines, open doors and drawers, and retrieve objects like pill bottles when guided by a laser pointer, radio signals or touch.

• Aiding surgical teams: This one’s already happening – a tiny robotic arm and workstation unit together called SpineAssist is helping surgeons map out a patient’s spinal anatomy in advance so that patients are spared of complications and pain during and after the surgery. SpineAssist helps surgeons avoid making deep incisions while repairing the spine. Over 2,000 spinal implant surgeries have been completed with a 98 percent success rate with no cases of nerve damage. The use of the robot reduced patients’ hospital stay by 33 percent and produced a 70 percent reduction in misplaced implants.

Proloquo2Go iPad App vs. Decicated AAC (speech assistance) Devices

This is a guest post by Britney Baker

Proloquo2Go iPad App vs. Decicated AAC (speech assistance) Devices

In today's smartphone era, apps exist for almost every purpose imaginable. Today, I decided to explore how well apps stack up to dedicated devices that serve the same purpose.

AAC Devices- Proloquo2Go

AAC or Augmentative and Alternative Communication devices are devices that help people with communication or speech impediments effectively communicate with others. Most modern devices are tablet or PDA shaped, so wouldn't the iPhone or iPad be an effective alternative?
Proloquo2Go, an app designed for Apple's iDevices, appears to fill that niche. Proloquo2Go offers the same features of any AAC device, but on a platform people are more familiar with. For a self-conscious impaired teenager or young adult, the iPad or iPhone choice might be appealing in that it isn't anything an ordinary person wouldn't carry. One potential problem is the fact that Proloquo2Go is relatively new and not supported by any numbers or results. Despite lack of scientific results, professionals have pointed out that the organization of Proloquo2Go's extensive vocabulary (over 7000 words) is innovative and intuitive compared to other assistive communication vocabularies.