Did You Know? Delaware's Population is Aging Faster than the National Average
Delawarecitizens with chronic conditions like Sickle Cell Anemia, Diabetes, Obesity & Heart Disease are key drivers of both spending & poor health outcomes. Delaware’s population is older & aging faster than the national average. It will be the 10th oldest state by 2025.
William Hicks Anderson Community Center community longs for economic development and resources for an upgrade. The Neighborhood Medical Home aims to improve the community’s health by improved access to social and
vocational services in the center. My vision is to get this once thriving community, now blighted and sick, back on its feet. Real estate development is happening all around the city which includes a $45 million investment in a
bike trail on the Riverfront, a $100 million Governor Printz development project, a $10 million project to re-locate the Rodney Square transit hub, a $20 million new Baynard Stadium, and a State $65 million bond for real estate developers. As an alumnae, I even watched in awe as the
University of Delaware allocated $180 million to build a biotechnology center. Though the university was not interested in investing resources to support access to quality primary specialty care in a ‘One Stop Shop,’ which was something that I advocated for. Delaware citizens are sicker than most average states, with higher rates of chronic disease (obesity, heart disease and diabetes) in part driven by poverty, food scarcity, homelessness, underemployment and violence. Our state is
consistently ranked among the states that spend the most on health care, yet have poor outcomes. Independent Primary Care Practices once a mainstay to help reduce healthcare costs are at risk of closing up as administrative costs become unbearable. Without changes and investment in primary preventative care, it is estimated that Delaware’s total health care spending will more than double from $9.5 billion in 2014 to $21.5 billion in 2025. Transferring $3 million dollars to this project would pay for the new building construction and would create three full-time city employee jobs who would have health insurance, a pension, sick and vacation time and union representation. As the legendary music icon and activist James Brown sang, Get Up, Get Into It and Get Involved. We can do this! Signing out for 2018. To find out more information about the Beatty Place project go to www.tovacommunityhealth.org or call the mayor’s office.
The hustle and bustle of the holidays are upon us. Between shopping for loved ones and preparing for guests, emotional and physical demands can be high and the stress that they cause can have negative effects on your well-being. In fact, the time between Thanksgiving and New Years is associated with an increase in depression and heart related death.One contributingfactor is thought to be stress. Concentrate on filling your hearts with the things that mean the most to you. Take extra steps to prevent stress from creeping in and taking over that joy. Here are a few tips to take the stress out of yourholidays. Shop Early, Limit Alcohol, take 10 minutes every day to meditate, get our sleep on, limit time on the Internet, get moving and stick to a budget. As always, take time for yourself and value the things that matter the most. Your Health is your Wealth. For more information from this Penn Medicine re-blog, go to tovacares.blogspot.com. Enjoy a Stress Free Holiday Season (UPenn re-blog)
Opioid misuse and the overdose epidemic have occurred amongst patients with chronic pain. Every day, more than 115 people in the United States die as a result of opioidmisuse.More than 2.1 million people have anopioid use disorder and 1,756 teens will abuse a prescription drug for the first time every day (CDC). This may be due both to the lack of education amongst patients and providers, and to obtaining overlappingprescriptions from multipleproviders or pharmacies.
According to Dr. Alford education has the potential to both reduce overprescribing and to ensure that patients in need retain access to opioids.Many patients and healthcare providers set unrealistic goals of treatment for their chronic pain condition. They also tend to have unrealisticexpectations regarding the potential benefits of opioids and not to fully appreciate the degree of risk conferred byescalating their own doses in a desperate attempt to obtain pain relief.The patient and provider must have arelationship thatinvolves trust and communication with one another when the opioids seem not to work, or onebecomes dependent on the drug.In this way, the provider can declare failure and move to morealternative modalities of dealing with chronic pain.
Janelle Wanzor, DSU Psychology Senior/Dr. Nina Anderson
Being nominated for the 2018 NAACP Health Advocacy Award is quite an honor. So many people know my trials and tribulations as a grass roots organizer whose treaded stormy waters in Delaware to increase awareness of a Rare Disease sickle cell anemia that impacts so many. Just when it seems that my efforts to improve access to high quality care in a collaborative effort in Delaware have withered, I get this awesome nomination. For whomever pushed for my nomination, I truly say Thank You! For Delawareans living with Complex Chronic Diseases such as Sickle Cell we have made an impact. This will be a great day of celebration especially for all those who dedicate their lives fighting for social justice, economic inclusion, and health equity. As a black american visionary with progressive ideologies, I pray that the many of the seeds that I have been planted will one day grow into strong- tall trees. I say, the Future Looks Very Bright.
Marijuanamay cause memory loss for those who use it over long-periods of time starting in adolescent when the brain is still developing. Studies foundthat (THC) may alter areas of the brain called the hippocampusresponsible for memoryformation (NIH/NIDA).
Managing pain can be stressful and debilitating in itself.Multiple thingscan trigger pain.For example, dealing with stress and anxiety, lack of sleep, tension, circulatory issues and constipation, just to mention a few.As stressful events arise in our lives, we tend to hold on to that stress and tension in our bodiesthat cause our muscles to become sore and tighten up over time.The benefitin massage therapy for self-care is that it plays a large roll in a holisticapproach to your overall medical care.Massage therapy specifically works to lengthenmuscles that are stuck in a pattern of chronic shortening.If you're worried about the cost of regular massage sessions, consider how costlyprescription drugs, doctor visits and surgeries may be once that nagging muscle achebecomes a real functional problem.Massages help reduce some of the keycontributors that can cause pain crisis and eases chronic painful stimuli.Just the simple form of touch helps release toxic chemicals, tension and stress from the body that have built up over time.It aids in improving circulation that can assist in improving healing (from leg ulcers) due to poor blood flow andcirculation in persons with sickle cell anemia, lupus, diabetes etc.One whoexperiences painful crisis flare-ups, may want to consider this approach as a preventative measure that can assist in reducing frequent crisis and chronic pain.
The good news is that Massage Therapy has no adverse side effects unlike narcotic (opioid) drugs.Today, there are many options that allow one to have massages that are affordable in your budget.The larger massage chaincompanies have reduced rates that makes it more cost effective starting around $59.00 for one hour.Also, you can always get session deals on Grouponthat offer first time client massages as low as $29.00 for an hour.Massage is astaple thathelps heal ones mind, body and spirit.It allows thebody to relax and allows one to go into a meditation mode giving the body a flow of positive energy.In this case an ounce of prevention through massage is worth morethan a pound of cure and it may cost less!Schedule a Massage for your self-care in order to improve your overall health and wellness.Make yourself a priority.
Radio host, Tom Joyner founded a mass campaign called, ‘Take a Loved One to the Doctor’ many years ago which has helped many hesitate men get a check-up.The importance of preventative health maintenance is ever more important as the statistics show that the gender health gap has widenedbetween the sexes.According to the World Health Organization’s GlobalBurden of Disease study, women tend to have a longer life expectancy than men.Oftentimes, men do not like discussing their personal health issues with their loved ones and wait to seek care when the condition is in an advanced stage. There are many reasons and excuses given such as ‘they are always looking for something’to delay going.It is important to find a healthcare provider that your he feels comfortable talking with about his personal health concerns and is invested into helping him make strides towards living a healthy lifestyle. Once you have found a primary care provider, it is a good idea help facilitate scheduling the appointment and completing the necessary paperwork.
It is also important to advocate by attending (or a family member)theappointmentto help bring out questions that he may not ask.Before thevisit, get a copy of his medical summary which should include his current medicines.Write down one to three questions that need to be discussed.Ensure him that going to the doctor is just a step towards living a healthier lifestyle.Though it may be uncomfortable and invasive (like drawing blood), it can help prolong your man’s life.Frankly, ‘Taking your Man to the Doctor’ is just worth the investment.I declare, October as‘Take Your Man to the Doctor’ month.Let’s Get Started!
Fall is just around the corner and the summer always seems to go byquickly.A new chapter in your child’s life is beginning whether it is going off toKindergarten or College.A parent’s anxiety can be quite overwhelming. We all want to protect our children as much as we can and strive for them to achieve their best.Most challenging is when your child is moving out andgoing off to college.A psychologist would always say that, “Letting Go isLetting Grow.”As the cost of college increases and stakes are higher, we still must allow our children to find their place and know that we are still there for them.Be encouraged that the foundation you have set for the first 18 years will follow them throughout their lives.College is a time to explore new ideas and opportunities in life, mature and learn about themselves.Keep in mind that their journey may take different paths.Be supportive and keep the lines of communication open.
Radio host, Tom Joyner founded a mass campaign called, “Take a Loved One to the Doctor” years ago which has helped many hesitant men get acheck-up.The importance of preventative health maintenance is ever more
important as the statistics show that the gender health gap has widenedbetween the sexes.According to the World Health Organization’s GlobalBurden of Disease study, women tend to have a longer life expectancy than men.Oftentimes, men do not like discussing their personal health issues with their loved ones and wait to seek care when the condition is in an advanced stage. There are many reasons and excuses given such as ‘they are always looking for something’ to delay going.It is important to find a healthcare provider that he feels comfortable talking with about his personal healthconcerns and is invested into helping him make strides towards living a healthy lifestyle. Once you have found a primary care provider, it is a good idea to help facilitate scheduling the appointment and completing thenecessary paperwork.
It is also important to advocate by attending (or a family member)theappointmentto help bring out questions that he may not ask.Before thevisit, get a copy of his medical summary which should include his current medicines.Write down one to three questions that need to be discussed.Ensure him that going to the doctor is just a step towards living a healthier lifestyle.Though it may be uncomfortable and invasive (like drawing blood), it can help prolong your man’s life.Frankly, “Taking your Man to theDoctor” is just worth the investment.I declare, October as“Take Your Man to the Doctor Month.TM”Let’s Get Started!
TOVA Community Health
Primary Specialty Care www.tovacommunityhealth.org (302) 429-5870
I had the honor of serving on the Pfizer Council for Change committee with passionate healthcare providers, patients and advocates working tirelessly to set the bar high for increased awareness, research and care for persons living with sickle cell anemia. Our goal is to improve access to optimal care for persons in crisis, understand the landscape of specialty care across the country and identify where the gaps are. There is so much work to be done. I want to personally thank my colleagues, committee chair, Dr. Wally-Smith and the entire the Pfizer team for championing forward this vital effort.
Click below to review the, Sickle Cell Disease Council For CHANGE Report: Improving Vaso-occlusive Crisis Management (June, 2018)
Pfizer Rare Disease supports the mission of the Sickle Cell Disease Council For CHANGE and has provided financial support for their meetings and this report. Pfizer colleagues have contributed to the content in this report in partnership with the members of the Council For CHANGE, but Pfizer does not have editorial control over or responsibility for its final content.
The response was huge: So many distressed doctors (and medical students) wrote and phoned me. Soon I was running a de facto international suicide hotline from my home. To date, I’ve spoken to thousands of suicidal doctors; published a book of their suicide letters; attended more funerals; interviewed hundreds of surviving physicians, families and friends. I’ve spent nearly every waking moment over the past five years on a personal quest for the truth of “why.” Guilt, bullying, exhaustion are big factors. Here are some of the things I’ve discovered while compiling my list and talking to so many people:
High doctor suicide rates have been reported since 1858. Yet more than 150 years later, the root causes of these suicides remain unaddressed.
Physician suicide is a public health crisis. One million Americans lose their doctors to suicide each year.
Many doctors have lost a colleague to suicide. Some have lost up to eight during their career — with no opportunity to grieve.
We lose way more men than women. For every female physician on my suicide registry, there are seven men. Suicide methods vary by region and gender. Women prefer to overdose and men choose firearms. Gunshot wounds prevail out West. Jumping is popular in New York City. In India, doctors have been found hanging from ceiling fans.
Male anesthesiologists are at highest risk. My registry also shows that most of these doctors kill themselves by overdose. Many have been found dead in hospital call rooms where they are supposed to be resting between cases.
2:23
A ‘relatively simple’ intervention that could save lives
National Institute of Mental Health director Joshua A. Gordon explains some of the latest research surrounding suicide rates in the U.S.(Monica Akhtar/The Washington Post)
Lots of doctors kill themselves in hospitals. They jump from hospital windows or rooftops. They shoot or stab themselves in hospital parking lots. They’re found hanging in hospital chapels. Physicians often choose to die in a place where they’ve been emotionally invested and wounded.
“Happy” doctors also die by suicide. Many doctors who die by suicide appear as the happiest, most well-adjusted people on the outside. Just back from Disneyland, just bought tickets for a family cruise, just gave a thumbs-up to the team after a successful surgery — to mention only a few cases from my list — and hours later they shoot themselves in the head. Doctors are masters of disguise. Even fun-loving docs who crack jokes and make patients smile all day may be suffering in silence.
Family members of doctors who have killed themselves are also at high risk of suicide. Sometimes even by the same method. A year after a depressed Kaitlyn Elkins, a star third-year medical student, chose suicide by helium inhalation, her mother, Rhonda, died by the same method. At the mother’s funeral, her husband told me, “Medical school has killed half my family.”
Suicidal doctors are rarely homicidal. On the list of suicides I’ve compiled, only 2 percent (15) also involved homicide. Seven of those homicides were by male physicians who killed a female spouse/girlfriend (all in health care — four nurses, a nursing student, a pharmacy tech and a dentist) before killing themselves.
Three male physicians murdered their young children before taking their own lives. Another strangled his disabled adult daughter before killing himself. Less than 1 percent of all doctor suicides involve homicide of their children.
Of the three cases involving young children, all the suicide victims were having relationship problems with the mother. One also killed the mother.
Patient deaths hurt doctors. A lot. Even when there’s no medical error, doctors may never forgive themselves for losing a patient. Suicide is the ultimate self-punishment. In several cases, the death of a patient seemed to be the key factor in pushing them over the edge.
Malpractice suits can be devastating. Humans make mistakes. Yet when doctors make mistakes, they’re publicly shamed in court, on TV and in newspapers (that live online forever). Many continue to suffer the agony of harming someone else — unintentionally — for the rest of our lives.
Academic distress kills medical students’ dreams. Failing medical-board exams and not getting a post-medical-school assignment in a specialty of choice has led to suicides. Doctors can be shattered if they fail to gain a residency: Before his suicide, Robert Chu, unmatched to residency, wrote a letter to medical officials and government leaders calling out a system that he said ruined his career.
Assembly-line medicine kills doctors. Brilliant, compassionate people can’t care for complex patients in 15-minute slots. When punished or fired by administrators for “inefficiency” or “low productivity,” doctors may become suicidal. Pressure from insurance companies and government mandates crush these talented people who just want to help patients. Many doctors cite inhumane working conditions in their suicide notes.
Bullying, hazing and sleep deprivation increase suicide risk. Medical training is rampant with deplorable conditions — such as working nonstop for 24 hours or more — that are not permitted in other industries. Physicians report hallucinations, life-threatening seizures, depression and suicide due to sleep deprivation. Fatigued doctors have felt responsible for harming patients. Resident physicians are now “capped” at 28-hour shifts and 80-hour workweeks. If they “violate” work hours (by caring for patients), they can be forced to lie on their time cards or be written up as “inefficient” and sent to a psychiatrist for stimulant medications. Some doctors kill themselves for fear of harming a patient as a result of their extreme sleep deprivation.
Blaming doctors increases suicides. Words such as “burnout” are often employed by medical institutions to shift blame to doctors for their emotional distress while deflecting attention from unsafe working conditions. When doctors are punished with loss of residency positions or hospital privileges for occupationally-induced mental health conditions, they can become even more hopeless and desperate.
Doctors who need help don’t seek it because they fear mental health care won’t remain confidential. So they drive out of town, pay cash and use fake names to hide from state medical boards, hospitals and insurance plans out of fear that they will lose state licensure, hospital privileges and health plan participation. (Even if confidential care were available, physicians in training have little time to access care when working 80 to 100 or more hours per week.)
Some doctors develop on-the-job post-traumatic stress disorder. This is especially true in emergency medicine, my registry suggests. One day, they just snap — like this ER doctor who contacted me after he tried to kill himself:
“My wife once asked how we do it in the ER, to be there for everybody’s worst day and also for their best. My worst day was almost my last. Funny thing is, I was as happy as I had ever been in my personal life. My decision to end it all was 100 percent work-related.”
The doctor had treated a girl in the ER for flu and then released her. She ended up back in the ER 30 hours later in respiratory distress and eventually died. His job was in jeopardy. “When I got home in the early-morning hours, I was just sad. I cried for the girl and her family. I cried myself to sleep and woke up still sad. . . . There’s a saying we have in the emergency room when we witness trauma and death among the innocent: A little piece of my soul died. . . . We’re almost never offered counseling, and in the end you get the jaded emergency doctor who struggles to care. My psychologist says it wasn’t just the last girl. It was trauma after trauma after trauma.” He took a handful of pills but ended up surviving and is grateful for it. Still, he writes “Emergency medicine once defined me. I loved going to work every day. I think at one point I was a good doc who cared about his patients. Now I am just very anxious even thinking about going back to work.”
No time for our own pain
Like everyone else, doctors have personal problems. We get divorced, have custody battles, infidelity, disabled children, deaths in our families. Yet working 60 to 80 or more hours per week immersed in our patients’ pain means we often have no time to deal with our own. I’m always surprised by how often nonmedical people tell me they are shocked that doctors have the same mental-health issues and personal problems that everyone else has.
Some people in the medical profession believe the public doesn’t need to know that doctor suicide is a real problem, as if a healer being in pain is shameful and would frighten patients. (A few years ago, I was honored to be invited to a special event hosted by the American Medical Association. They were interested in previewing a TEDMed talk I was scheduled to give about doctor suicides. But shortly before the event, I was disinvited: People were “uncomfortable’’ with the topic, I was told.)
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After collecting so many stories over the past five years I believe that ignoring doctor suicides just leads to more doctor suicides. Suicide is preventable, but we have to stop with the secrecy and face up to what it is about being a doctor that can be so emotionally difficult. I am hopeful that the forthcoming documentary “Do No Harm,” by Emmy-winning filmmaker Robyn Symon will raise awareness on both points. In the meantime, medical institutions need to openly acknowledge the problem and make changes to support the mental health of doctors and medical students.
Healers, after all, also need healing.
Wible is a family physician born into a family of physicians. When not treating patients, she devotes herself to preventing suicides by medical students and physicians. Contact her at idealmedicalcare.org/blog/contact.
The hustle and bustle of the holidays are upon us. Between shopping for loved ones and preparing for guests, emotional and physical demands can be high and the stress that they cause can have negative effects on your well-being. In fact, the time between Thanksgiving and New Years is associated with an increase in depression and heart related death. One contributing factor is thought to be stress. Concentrate on filling your hearts with the things that mean the most to you. Take extra steps to prevent stress from creeping in and taking over that joy. Here are a few tips to take the stress out of your holidays. Shop Early, Limit Alcohol, take 10 minutes every day to meditate, get our sleep on, limit time on the Internet, get moving and stick to a budget. As always, take time for yourself and value the things that matter the most. Your Health is your Wealth. For more information from this Penn Medicine re-blog, go to tovacares.blogspot.com.
