Muchikamu chino chePrioritizing Equity series, dzidza nezve nhoroondo uye kusaenzana kwazvino mudzidzo yekurapa, basa, uye mikana yehutungamiriri.
Iyo Prioritizing Equity vhidhiyo yakatevedzana inoongorora kuti kuenzana mukutarisira hutano kuri kuumba sei kutarisirwa panguva yeCOVID-19 denda.
Chiyero chekuchengetedza hachitariswe nemafambisirwo azvinoitwa, saka masevhisi enharembozha anofanirwa kubatwa kune mamwe mazinga sekuchengeta mu-munhu.
Pa2023 ChangeMedEd®️ Musangano, Brian George, MD, MS, akagamuchira 2023 Inokurumidza Shanduko muMedical Education Award.Kuti udzidze zvakawanda.
Kuunza sainzi yezvehutano muzvikoro zvekurapa kunoreva kutanga kuitsvagira imba.Dzidza zvakawanda kubva kuvadzidzisi vezvokurapa vakazviita.
AMA inogadziridza inovhara akati wandei ehutano misoro inobata hupenyu hwevanachiremba nevarwere.Tsvaga kuti ungawana sei chakavanzika chepurogiramu yekugara yakabudirira.
AMA inogadziridza inovhara akati wandei ehutano misoro inobata hupenyu hwevanachiremba nevarwere.Tsvaga kuti ungawana sei chakavanzika chepurogiramu yekugara yakabudirira.
Kumbomira pakubhadhara chikwereti chemudzidzi kwapera.Tsvaga kuti izvi zvinorevei kune vanachiremba uye kuti ndezvipi zvingasarudzwa zvavanazvo.
Mudzidzi wezvekurapa kana mugari angagadzira sei yakanaka poster mharidzo?Aya mazano mana mavambo akanaka.
AMA kuCMS: Tora danho rekukasika kuona kuti varapi havagamuchire MIPS muripo wekugadzirisa muna 2024 zvichibva pa2022 MIPS performance uye imwe data yakaonekwa mune ichangoburwa update inotsigira Medicare kubhadhara kwekuchinja.
Dzidza kuti CCB inokurudzira sei shanduko kune AMA Bumbiro neMitemo uye inobatsira kudzokorora mitemo, mirau uye maitiro ezvikamu zvakasiyana zveAMA.
Tsvaga ruzivo uye ruzivo rwekunyoresa kweVechidiki Vanachiremba Chikamu (YPS) misangano nezviitiko.
Tsvaga iyo ajenda, zvinyorwa uye rumwe ruzivo rwe2023 YPS Midterm Meeting musi waNovember 10 paGaylord National Resort uye Convention Center muNational Harbor, Maryland.
Iyo 2024 American Medical Association Medical Student Advocacy Conference (MAC) ichaitwa Kurume 7-8, 2024.
Essential Elements of Sepsis: Yekupedzisira webinar muCenters for Disease Control and Prevention (CDC) webinar series inokurukura kukanganisa kwedzidzo ye sepsis mukuhaya vashandi vehutano.Register.
AMA inogadziridza inovhara akati wandei ehutano misoro inobata hupenyu hwevanachiremba, vagari, vadzidzi vekurapa uye varwere.Inzwa kubva kunyanzvi dzezvokurapa, kubva kune vega vega uye vatungamiriri vehutano system kusvika kune vesainzi nevakuru vehutano hweveruzhinji, paCCIDID-19, dzidzo yezvokurapa, kumiririra, kupererwa, majekiseni uye nezvimwe.
Mune yanhasi AMA Nhau, aimbova Mutungamiriri weAMA Gerald Harmon, MD, anojoinha nhaurirano yekushomeka kwevashandi vekurapa uye kukosha kwevarapi vakura.Dr. Harmon anogovera pfungwa dzake pamusoro pebasa rake idzva semutungamiriri wenguva pfupi weYunivhesiti yeSouth Carolina Chikoro cheMishonga muColumbia, basa rake semutevedzeri wemutungamiri wezvehutano paTidelands Health muPawleys Island, South Carolina, uye zvinotora nzvimbo yezvokurapa.munda sachiremba.Mazano ekuti ugare uchishanda.Vanachiremba vanopfuura makore makumi matanhatu nemashanu.Host: AMA Mukuru Experience Officer Todd Unger.
Mushure mekurwira vanachiremba panguva yedenda, American Medical Association iri kutora dambudziko rayo rinotevera risingawanzoitiki: kusimbisa kuzvipira kwenyika kuvanachiremba.
Unger: Mhoro uye unogamuchirwa kune yakagadziridzwa AMA vhidhiyo uye podcast.Nhasi tiri kutaura nezvekushomeka kwevashandi pamwe nekukosha kwevana chiremba vakwegura mukugadzirisa dambudziko iri.Iyi nhau inokurukurwa pano naDr. Gerald Harmon, mutungamiriri wenguva pfupi weUniversity of South Carolina School of Medicine muColumbia, South Carolina, uye aichimbova purezidhendi weAMA, kana kuti mumashoko ake amene, “purezidhendi weAMA akadzorerwa.Ini ndiri Todd Unger, Chief Experience Officer weAMA Chicago.Dr. Harmon, ndafara kukuzivai.Uri kuzviita sei?
Dr. Harmon: Todd, iwoyo mubvunzo unonakidza.Pamusoro pebasa rangu seAMA Recovery Chair, ndawana basa idzva.Mwedzi uno chete, ndakatanga basa idzva mubasa rangu seChief Health System Scientist uye Interim Dean weChikoro cheMishonga paYunivhesiti yeSouth Carolina muColumbia, South Carolina.
Dr. Harmon: Zvakanaka, iyo inhau huru.Yakanga iri shanduko yebasa yandaisatarisira kwandiri.Mumwe munhu akandibata nezve qualification dzavo uye zvavanotarisira.Ndinonzwa sekuti kwandiri uyu mutambo wakaitwa kudenga, kana usiri mutambo wakaitwa kudenga saka pakati penyeredzi.
Unger: Zvakanaka, ndine chokwadi pavakatarisa kuenderera kwako, vakafadzwa nezvimwe zvawakaita.Wanga uri chiremba wemhuri anodzidzira kwemakore makumi matatu nemashanu, Mubatsiri Mukuru weSurgeon weUnited States Air Force, Surgeon General weNational Guard, uye, zvechokwadi, nguva pfupi yapfuura, Mutungamiri weAMA.Haisi kana hafu yehondo.Chokwadi wawana kodzero yekuenda pamudyandigere, asi wave kutanga chitsauko chitsva chose.Chii chinokonzera izvi?
Dr. Harmon: Ndinofunga kuti ndakanga ndiri kuona kuti ndichine mukana wokugoverana zvakaitika muupenyu hwangu nevamwe.Shoko rokuti “chiremba” rinobva muchiLatin uye rinoreva “kutakura kana kudzidzisa.”Ndinonzwa zvechokwadi kuti ndichiri kugona kudzidzisa, kugovera zvakaitika muupenyu hwangu, uye kupa dzidzo nenhungamiro (kana kusiri nhungamiro) kuchizvarwa chavanachiremba vari mukurovedza uye kunyange kuva vanachiremba vanoshanda.Saka zvaive zvanyanya kunaka kuve chokwadi kutora basa remubatsiri wekutsvagisa ndichichengetedza kugona kwangu kudzidzisa kwekiriniki.Saka handina kukwanisa kuramba mukana uyu.
Dr. Harmon: Zvakanaka, basa rekuita provost chimwe chinhu chandisati ndamboona.Ndakanga ndiri purofesa wepakoreji uye ndakadzidzisa makirasi (chaiwo anodzidziswa) mumunhu pane kupa mamakisi uye yakanyorwa ongororo kuvadzidzi, vagari, uye dzimwe nyanzvi dzehutano (vanamukoti, radiologists, sonographers, vabatsiri vechiremba).Kweakawanda emakore angu 35-40 ekudzidzira, ndakanga ndiri mudzidzisi, mudzidzisi anoshanda.Saka basa iri harizi mweni.
Kukwirira kweacademia hakugone kurerutswa.Ndiri kudzidza - ndiri kushandisa fananidzo iyi kwete nehosi yemoto, asi nemabhaketi brigades.Ndinokumbira vanhu kuti vandidzidzise ruzivo rumwe chete panguva.Saka rimwe dhipatimendi rinounza bhaketi ravo, rimwe dhipatimendi rinounza bhaketi ravo, maneja anounza bucket ravo.Ndakabva ndatora bhaketi pane kuti ndifukidzwe nepombi yemoto ndikanyura.Saka ini ndinogona kudzora mapoinzi data zvishoma.Tichaedza rimwe bucket svondo rinouya.
Unger: Dr. Harmon, mazwi auri kuvhura chitsauko chitsva pano anonakidza.Panguva imwecheteyo, tinoziva kuti vanachiremba vazhinji vari kusarudza kuenda pamudyandigere nekukurumidza kana kumhanyisa nekuda kwedenda.Wakamboona kana kunzwa izvi zvichiitika pakati pevaunoshanda navo?
Dr. Harmon: Ndakazviona svondo rapfuura, Todd, hongu.Isu tine data yepakati-denda, pamwe iyo AMA's 2021-2022 data ongororo, inoratidza kuti makumi maviri muzana, kana mumwe muvarapi vashanu, vakati vaizoenda pamudyandigere.Vachasiya basa mukati memwedzi makumi maviri nemana inotevera.Izvi tinozviona pakati pevamwe vashandi vezvehutano, kunyanya vanamukoti.40% yevanamukoti (vaviri muvashanu) vakati ndaizosiya basa rangu roukoti rekiriniki mukati memakore maviri anotevera.
Saka hongu, sezvandakataura, ndakazviona svondo rapfuura.Ndaive nachiremba wepakati-mwero akazivisa kurega kwake.Ndiye chiremba wokuvhiya, ane makore 60 okukura.Akati: Ndiri kusiya kudzidzira.Denda iri rakandidzidzisa kutora zvinhu zvakanyanya kupfuura maitiro angu.Ndine chinzvimbo chakanaka chemari.Pamba, anofanira kupedza nguva yakawanda aine mhuri yake.Saka akasarudza kurega basa zvachose.
Ndine mumwe wandinoshanda naye akanaka mukurapa kwemhuri.Muchokwadi, mukadzi wake akauya kwandiri mwedzi mishoma yapfuura ndokuti, "Unoziva, denda iri ranyanya kushungurudza mhuri yedu."Ndakakumbira Dr. X, murume wake, uye mumwe wandaishanda naye mubasa rangu kuti vaderedze dosi.Nokuti anopedza nguva yakawanda ari muhofisi.Paakadzokera kumba akasvikogara pacomputer achiita zvese zvaainge asina nguva nazvo.Akanga ari mushishi kuona nhamba huru yevarwere.Saka anocheka shure.Akanga achimanikidzwa nemhuri yake.Ane vana vashanu.
Zvose izvi zvinokonzera kushushikana kukuru kune varapi vakawanda vakwegura, asi avo vari pakati pebasa, makore makumi mashanu uye kupfuura, vari pangozi yakakura yekushungurudzika, kungofanana nezvizvarwa zvedu zviduku.
Unger: Izvo zvinokanganisa mamiriro ekushomeka kwachiremba atiri kutoona.Asi izvo, ongororo yakaitwa neSangano reAmerican Medical Colleges inoronga kushomeka kwachiremba kusvika 124,000 panosvika 2034, izvo zvinosanganisira musanganiswa wezvinhu zvatichangobva kukurukura, huwandu hwevanhu vachembera uye vashandi vezvechiremba vachembera.
Semunhu aimbove chiremba wemishonga yemhuri achishandira vanhu vazhinji vekumaruwa, pfungwa dzako ndedzipi pane izvi?
Dr. Harmon: Todd, uri kutaura chokwadi.Kushomeka kwachiremba kuri kuramba kuchiwedzera, kana kuti logarithmically, kwete nekuwedzera nekubvisa.Vanachiremba vari kuchembera.Tiri kutaura nezvenyaya yekuti mumakore gumi anotevera, varwere muUS vachange vava nemakore makumi matanhatu nemashanu kana kupfuura, uye 34% yavo zvino ichada kurapwa.Mumakore gumi anotevera, 42% kusvika 45% yevanhu vachada kurapwa.Vanoda kutarisirwa zvakanyanya.Wataura kushomeka kwachiremba.Varwere vakura ava vanoda rubatsiro rwepamusoro, uye vazhinji vanogara kumaruwa asina vanhu vakawanda.
Saka nekuchembera kwavanachiremba, kuenda pamudyandigere hakusiyi shure mafashamu evanachiremba nevashandi vezveutano vanoda kuenda kumaruwa, vachida kuenda kunzvimbo dzinenge dzisina rubatsiro.Nokudaro, mamiriro ezvinhu mumaruwa achatowedzera kuipa.Zvinoita sekuti varwere vemunharaunda iyi vari kuchembera uye vanhu vekumaruwa havasi kukura.Hatisi kuonawo kuwedzera kwehuwandu hwevashandi vehutano vari kuenda kumaruwa aya.
Saka isu tinofanirwa kuuya nehunyanzvi hwekuita matekinoroji, mazano ekuvandudza, telemedicine, timu-yakavakirwa kutarisira kubatsira kuzadzisa zvinodiwa zvemumaruwa ekuAmerica asina kuchengetwa.
Unger: Huwandu hwevanhu huri kukura kana kuchembera, uye vanachiremba vari kuchemberawo.Izvi zvinogadzira mukaha wakakura.Unogona here kungotarisa kune yakaomeswa data kuti gap iro rinotaridzika sei?
Dr. Harmon: Ngatitii ikozvino chiremba nheyo inoshumira varwere ve280,000.Semakore ehuwandu hweUS, i34% ikozvino uye 42% kusvika 45% mumakore gumi, saka sezvawaona, ndinofunga kuti nhamba idzi dzinenge 400,000 vanhu.Saka iri mukaha mukuru.Pamusoro pekudiwa kwevamwe vanachiremba, iwe unozodawo vanachiremba vakawanda kuti vashumire vanhu vakwegura.
regai ndikuudzei.Kwete vanachiremba chete.Uyu ndiradiologist, uyu mukoti, tisingatauri kuti vanamukoti vanoenda sei pamudyandigere.Masisitimu edu ezvipatara mumaruwa eAmerica akaremerwa: hakuna ma sonograph akakwana, ma radiologist, uye nyanzvi dzemurabhoritari.Yese yehutano system muUnited States yakatotambanudzwa yakatetepa nekushomeka kwevashandi vehutano vemarudzi ese.
Unger: Kugadzirisa kana kugadzirisa dambudziko rekushaikwa kwechiremba ikozvino zvakajeka kunoda mhinduro yemarudzi akawanda.Asi ngatitaure zvakanyanya.Unofunga kuti varapi vakura vanopindirana sei nemhinduro iyi?Nei vakanyanya kukodzera kutarisira vanhu vakwegura?
Dr. Harmon: Zvinofadza.Ndinofunga kuti hapana mubvunzo kuti vachazonzwira tsitsi, kana vasinganzwiri tsitsi, nevarwere vanouya.Sezvatinotaura pamusoro pevaAmerica 65 uye vakuru vanoita 42% yevanhu, nhamba iyi inoratidzwawo muvashandi vechiremba: 42-45% yevanachiremba vane makore 65. Saka vachave nezviitiko zvehupenyu zvakafanana.Vachakwanisa kunzwisisa kana iri musculoskeletal joint limitation, kuderera kwekuziva kana kunzwa-cognitive, kana kunzwa nekuona muganho, kana zvichida kunyange comorbidity yatinowana patinenge takura, chirwere chemwoyo.chirwere cheshuga..
Takataura nezve podcast yandakaita yakaratidza kuti vangangoita 90 miriyoni vekuAmerica vane prediabetes, uye 85 kusvika 90 muzana yavo havatomboziva kuti vane chirwere cheshuga.Nekuda kweizvozvo, vanhu vekuAmerica vakwegura vanotakurawo mutoro wechirwere chisingaperi.Kana tapinda muzvinhanho zvevanachiremba, uchaona kuti vanonzwira tsitsi, asi ivo vane ruzivo rwehupenyu.Vane unyanzvi hwakagadzirirwa.Vanoziva maitiro ekuita chirwere.
Dzimwe nguva ndinofarira kufunga kuti vanachiremba vezera rangu neni tinokwanisa kufunga uye kunyange kuita madhigirii pasina mamwe matekinoroji.Hatifaniri kufunga pamusoro pekuti kana munhu uyu ane dambudziko duku neizvi kana kuti nhengo yehurongwa, ini handizoiti MRI kana PET scan kana chero ipi zvayo yekuongorora laboratory.Ndinogona kutaura kuti mapundu aya ishingles.Iyi haisi contact dermatitis.Asi imhaka yekuti ndave ndichiona varwere kwemakore 35 kana 40 kuti ndine indekisi yepfungwa inondibatsira kushandisa zvandinoti njere dzemunhu chaidzo, kwete njere dzekugadzira, kuti ndiongorore.
Saka handifanire kuita miyedzo yese iyi.Ini ndinokwanisa kunyatso kufanoongorora, kurapa nekusimbisa vanhu vachembera.
Unger: Uku kutevera kukuru.Ndinoda kutaura newe zvakanyanya nezvenyaya iyi maererano nemichina.Iwe uri nhengo inoshingaira yeSenior Physician Division, uchitaura mafungiro uye uchiita mazano panyaya dzine chokuita navanachiremba vakuru.Chimwe chezvinhu zvinouya zvakanyanya nguva pfupi yadarika (chaizvoizvo, ndanga ndichitaura zvakawanda nezvehungwaru hwekugadzira mumavhiki mashoma apfuura) mubvunzo wekuti vanachiremba vakura vanozogadzirisa sei matekinoroji matsva.Ndeapi mazano aunawo maererano neizvi?AMA inogona kubatsira sei?
Dr. Harmon: Zvakanaka, makandiona kare - ndakataura pachena kune zvidzidzo uye mapaneru - tinofanira kumbundira iyi tekinoroji nyowani.Hazvizoendi.Zvatinoona muhungwaru hwekugadzira (iyo AMA inoshandisa izwi iri uye ini ndinobvumirana nayo zvakanyanya) inowedzerwa njere.Nekuti haizombofi yakatsiva iyi komputa pano.Isu tine humwe hunyanzvi hwekutonga uye hwekuita sarudzo husingakwanise kudzidza kunyangwe michina yepamusoro.
Asi isu tinofanirwa kugona tekinoroji iyi.Hatifaniri kunonotsa kufambira mberi kwake.Hatifanire kunonoka kuishandisa.Hatifaniri hedu kumisa mamwe marekodhi emagetsi atinotaura tichizvidza.Iyi ndiyo teknolojia itsva.Hazvizoendi.Izvi zvichavandudza kugoverwa kwemabasa ekuchengeta.Izvi zvichavandudza kuchengeteka, kuderedza zvikanganiso uye, ndinofunga, kuvandudza kuongororwa kwechokwadi.
Saka vanachiremba vanoda chaizvo kugamuchira izvi uye kuzviongorora.Icho chishandiso, kungofanana nezvimwe zvese.Zvakafanana nekushandisa stethoscope, kushandisa maziso ako, kubata uye kutarisa vanhu.Iko kusimudzira kuhunyanzvi hwako, kwete chipinganidzo.
Unger: Dr. Harmon, mubvunzo wekupedzisira.Ndedzipi dzimwe nzira dzingaitwa nanachiremba vanosarudza kuti havachakwanisa kutarisira varwere kuti varambe vachishanda mumabasa avo?Nei zvichibatsira kuti vanachiremba uye basa varambe vaine hukama hwakasimba kudaro?
Dr. Harmon: Todd, munhu wese anozvisarudzira ega mune zvakasikwa zvake achishandisa data rake.Saka, nepo chiremba angave aine mibvunzo nezve kugona kwake, kuchengetedzeka kwake, kungave kuri mukamuri yekuvhiyiwa kana munzvimbo yekunze kwaunenge uchangobva kuita kuongororwa, hausi hazvo kuita zvekushandisa kana kuvhiyiwa.Pane kumwe kushanduka-shanduka.Tose tinofanira kunetseka pamusoro peizvi.
Kutanga, kana uine hanya zvechokwadi, kana iwe uchikahadzika kugona kwako, kuziva kana kwemuviri, taura kune waunoshanda naye.Usanyara.Isu tine dambudziko rakafanana nehutano hwekuita.Kana ndichitaura nemapoka echiremba, ndinoziva kuti tinotaura nezvekuneta kwechiremba.Tinotaura nezvezvinetso zvebasa uye kuti takaora mwoyo sei.Yedu data inoratidza kuti vanopfuura makumi mana muzana evanachiremba vanga vachifunga nezvemabasa avo-ndinoreva, iyo nhamba inotyisa.
Nguva yekutumira: Oct-13-2023