The Most Exciting Medical Technologies of 2017 - The Medical Futurist

2016 proved to be an exciting year for providers as well as patients.

2016 was a rich year for medical technology. Virtual Reality. Augmented Reality. Smart algorithms analysing wearable data. Amazing technologies arrived in our lives and on the market almost every day. And it will not stop in the coming year.

The top technologies with the biggest promise for 2017

1) A new era in diabetes care

2) Precision medicine in oncology

3) Narrow artificial intelligence in US clinics

4) Driverless trucks or cars will include health sensors

5) New service in nutrigenomics

6) SpaceX and NASA will realize they need a digital health masterplan to reach Mars

7) The genome editing method CRISPR in clinical trials

8) A big tech company will step into health

9) An insurance company launches a wearable sensor package

10) The surgical robot by Google and Johnson&Johnson will compete with daVinci

11) Vocal biomarkers: the future of diagnostic medicine

12) Pharma will start using massive AI in clinical trials and drug research

13) A company will make the 3D printed cast a real choice

These are all some amazing predictions.  Whether they prove to be successful or not will depend upon market demand, health care financing, and government approval. These medical technologies are in early development and implementation may be five years or more.

Don't plan on seeing these on your CVS or Rite Aid shelf soon.

The Most Exciting Medical Technologies of 2017 - The Medical Futurist

Hearing Tests Could Be Vital Concussion Indicator

A test that measures the brain’s response to speech could provide a new way to diagnose concussions and track patients’ progress toward recovery, a small study suggests.

Developed by researchers at Northwestern University, the test is meant to detect neural activity when patients are exposed to auditory stimuli. Since one of the common side effects of concussion is a compromised ability to make sense of sound, researchers believe a blow to the head temporarily disrupts the way the brain processes and hears speech.

Led by Nina Kraus, a professor and director of Northwestern’s Auditory Neuroscience Laboratory, scientists built a test using electrodes to measure the electrical signals generated in the brain. The team placed three electrodes on children’s scalps while the subjects listened to several minutes of various spoken sounds designed to assess their ability to understand speech and distinguish between certain sounds.

Researchers observed differences in neural response among children who suffered concussions in the past five to 56 days compared to children without concussions. Children with concussions had reduced reactions to the pitch of the recorded sounds than the control group. The test was able to correctly identify 18 out of 20 study participants with a concussion and 19 out of 20 healthy controls. As the children recovered from their head injuries, their ability to process pitch improved, the researchers reported.

One limitation of the study was that it did not measure participants’ baseline sound processing before a concussion, says Marc Nuwer, a clinical neurophysiologist and professor of neurology at UCLA School of Medicine. That would have helped determine whether the patterns in a subject’s auditory processing were different than normal. Nuwer says injuries other than concussions, medications, and fatigue can also affect the brain’s ability to process sound.

While the initial results are interesting, such a test may not be practical in a doctor’s office or in the field. The equipment needed to conduct the test—an electroencephalogram machine—is expensive, and the analysis of results is complicated.

Kraus says her team will be recruiting more study participants to try the test in a bigger population.

Traumatic brain injuries account for more than two million emergency room visits in the United States each year and contribute to the deaths of more than 50,000 Americans, according to the U.S. Centers for Disease Control and Prevention. A significant percentage of these injuries are considered to be mild ones, which include concussion. Currently, doctors rely on symptoms to diagnose concussions. Computerized tomography scans can rule out more serious brain injuries, but they can’t detect concussion.

Hearing Tests Could Be Vital Concussion Indicator

A letter to her physician husband

Dear Husband, MD

I see you. I hear you cough all night, knowing your flu vaccine has failed and you have it. I hear you wheeze with your post-flu pneumonia. I feel you shiver in the bed beside me while you sleep for 5 hours before you get back up and start getting ready for the next “shift.”

I put quotations around “shift” because we both know you will not work 8 admin or 12 clinical, but instead you will do your own personal gauntlet of a 16+ hour combo before heading home for a typical late evening and early morning of multiple texts and phone calls while you attempt to shove a cold supper down or dry off from a quick shower. Because they never leave you alone. Even on vacation, they still call.

I see you give up your dreams and desires to keep the ever growing census list seen, to continue to manipulate the schedule thru physician shortages, random locums, NP and PA providers who are all tired of picking up extra shifts to cover the empty spots. I see the management company that you were sold to like meat, keep asking for more and more with less and less, the hospital administrators asking what your plan is, as if you have any say.

I see you losing your soul. Your joy and wit replaced by bitterness and sarcasm. You race against the clock. You rage against quality and quantity and charts and graphs and core measures and planning meetings and follow-up meetings and why-can’t-you-just-do-it-all meetings.

I see you come home exhausted, attempt to do dishes or a load of laundry because, honestly, I’m losing hope too. I fear we will never get to finish this build onto the house, see our children happy and content in a stress-free home. I’ve lost hope that you will move away from this path that destroys you. There are no more interviews, no more recruiters calling, you have sent them all away to live in your comfortable misery because everywhere is the same and that this is what health care has become. And I know that you are right.

You never meant for this to happen. It just did. You wanted to help people, treat them, see them walk out of the hospital and go home to their families. Or, ease their transition into the next adventure, because you know we are all mortal. Yet here you are. Documentation and EHRs, and intake registry and profit margins and Facebook posts from former patients trashing your hospital and your team’s care because they have no idea how hard a tick-born/auto-immune/mental illness is to diagnose and they just want to feel better, while you stand before them with pneumonia, taking care of them.

They don’t see you researching and reading late into the night, worrying yourself and not sleeping, pouring over medical records of 20 other patients and keeping up with them all just to start over with 20 different ones the next day. They don’t see you code the elderly patient over and over that just needs to die with peace and dignity like any mortal soul should, and they don’t see you deal daily with the ones that abuse their bodies yet still demand miracles from you. They didn’t see you dedicate 23 years of your life and hundreds of thousands of dollars to educating yourself to where you are.

I see you. And I love you.

Charity Williams is a physician’s wife.

This is dedicated to the unseen, under appreciated and unrecognized partners in our lives as physicians

A letter to her physician husband

Trump’s Health Secretary Pick Leaves Nation’s Doctors Divided - The New York Times

When President-elect Donald J. Trump chose Representative Tom Price of Georgia to be his health and human services secretary, the American Medical Association swiftly endorsed the selection of one of its own, an orthopedic surgeon who has championed the role of physicians throughout his legislative career.

Then the larger world of doctors and nurses weighed in on the beliefs and record of Mr. Price, a suburban Atlanta Republican — and the split among caregivers, especially doctors, quickly grew sharp.

The controversy began soon after Mr. Trump announced on Nov. 29 that he had chosen Mr. Price to head the Department of Health and Human Services, which controls Medicare, Medicaid, the Affordable Care Act’s federal health insurance exchange, the National Institutes of Health, the Food and Drug Administration and the Centers for Disease Control and Prevention.

Within hours, the A.M.A. — the nation’s largest medical advocacy group, which has nearly 235,000 members and calls itself “the voice of the medical profession” — issued a statement saying it “strongly supports” the selection.

It noted Mr. Price’s experience as a doctor, a state legislator and a member of Congress. It praised, in particular, his support for “patient choice and market-based solutions” and his efforts to reduce “excessive regulatory burdens” on doctors.

The enthusiasm was understandable at one level: Mr. Price has been a member of the A.M.A. house of delegates since 2005 and was an alternate delegate for a decade before that, according to the A.M.A. and the Medical Association of Georgia.

“For those who are attacking Dr. Price, I have to ask whom you would rather have at the helm of H.H.S. — a career bureaucrat? A former governor who views doctors as a cost center to be controlled?” said Dr. Robert E. Hertzka of San Diego, an anesthesiologist and former president of the California Medical Association. “Tom Price may turn out to be the best friend that physicians and patients have ever had in that role.”

Many doctors are not willing to take that chance. More than 750 people who identify themselves as members of the A.M.A. signed a letter to the association’s board objecting to the endorsement.

Nurse Bytes # 10: Upcoming Doctor Shortage

Disturbing news.

The secret to happiness in America. A paradoxical realization

When she used to see an elderly woman on the street, hunched over, taking tentative little steps, Ashton Applewhite would say to anyone who'd listen, "put me out my misery if I ever get like that."

Today, that makes Applewhite, 63, cringe.

"I'm ashamed of thinking that now. Why assume she's miserable? My guess is that she's happy to be alive and out and about. Maybe she's going to meet her boyfriend. It's presumptuous to assume her quality of life sucks because her body has changed," said Applewhite, a writer and self-described "apprehensive boomer turned pro-aging radical."

Applewhite, whose book "This Chair Rocks: A Manifesto Against Ageism" was published March 15, is part of a growing national movement to redefine what it means to age in America.

Leaders in this field include Dr. Dilip Jeste, the director of UC San Diego's Center for Healthy Aging, and AARP Chief Executive Jo Ann Jenkins, whose new book "Disrupt Aging" - which challenges people to not only accept their age but embrace it - came out of a 2014 speech she gave to 10,000 AARP members in San Diego.

On Friday, Dr. Bill Thomas, a Harvard Medical School-educated geriatrician, will bring his so-called Age of Disruption Tour to San Diego's Joan B. Kroc Theatre, where he'll put on a presentation that's part concert, part lecture, part call to arms to revolutionize aging.

Age of Disruption Tour

Who: Dr. Bill Thomas, with musical guest Nate Silas Richardson

What: Afternoon workshop, "Disrupt Dementia," a session designed for people living with dementia and their caregivers; evening event, "Aging: Life's Most Dangerous Game," includes musical and theatrical performances

When: Friday, 2:30-4:30 p.m. and 7-8:30 p.m.

Where: Joan B. Kroc Theatre, 6611 University Ave., San Diego; (619) 269-1552

Tickets: $15 per session; drbillthomas.org/local/san-diego-ca/

It's no coincidence that these four aging advocates are members of the baby boom generation, a group that's rewritten the rules in its youth, middle age and now older years.

"The baby boom has changed every life stage they've been a part of," said Thomas, whose tour is making its way to 30 cities across the country.

"As this giant generation faces this life stage, they're going to say, ‘hey no, I don't like that.'"

Thomas divides boomers into three categories:

Those in denial who try to stay young forever with Botox injections, expensive creams and unproven "snake oil" hormones and remedies. "It's the current equivalent to ‘Hell no, we won't go!'"

The resigned, who munch on kale and flax seed while doing Sudoku puzzles. "They tell themselves, ‘It's going to be bad, but if I do these things it won't be so bad."

And the embracers. "I'm in a rare tribe who looks forward to it with enthusiasm. It's possible to look forward to something and know there are parts of the experience you'd like to avoid, that won't be pleasant. That's why I call (my talk) Aging: Life's Most Dangerous Game," he said.

Thomas likened how people approach old age to those who'd rather go on, say, a safe cruise versus climbing Machu Picchu.

"There are some who would say, ‘you know there could be rock slides,' and there's the adventure traveler who says, ‘yeah, but it's Machu Picchu!' They do it because they think the adventure is greater than the risk. Look, I'm not a silly person who says old age is great and nothing will happen. Something will happen. But people who have a great fear of aging are going against their own future self. They become a traitor by robbing themselves of future possibilities."

All of the experts interviewed for this story said society's view of old age - that it's solely a depressing period of physical and mental decline - isn't backed up by data, science and research.

"We internalize a lifetime of messages that the younger self is worth more than the older self," Applewhite said. "The older self is just different."

She began writing her book while in her 50s, when its original focus was on people in the workforce well into their 80s. Her reporting, as well as research on longevity, led her to "This Chair Rocks."

"What surprised me was how everything I thought I knew about aging was wrong," she said by phone from Brooklyn.

Applewhite cited statistics that show a minute portion of the elderly live in nursing homes, with about 95 percent of Americans living independently. And she noted that while memory will moderately falter for most, about 20 percent of older people experience no decline at all in memory.

"Things slow us down, but it doesn't keep the vast, vast majority of us from functioning just fine," she said. "The epidemic isn't dementia, it's the anxiety about dementia."

Applewhite and Thomas both referred to the U-Bend theory, which holds that people are happiest at the beginning of their lives and toward the end.

"Statistically, the happiest decade is the 70s," he said.

National movement seeks to redefine what it means to age in America - The San Diego Union-Tribune

Dissent roils the AMA, the nation's largest doctors group

As usual the media over-reacts to events. Such is the case regarding the AMAs ambivalent attitude toward the Affordable Care Act.  The AMA sees health care through it's own prism. There is no one in the organization, nor non members who do not support universal access to quality health care, but the devil in in the details.

‘Followers rather than leaders’

That kind of caution is characteristic of the AMA, which generally prefers to work behind the scenes and press its agenda at the negotiating table, rather than rally the public.

“They end up being followers rather than leaders because they want to be where the action is,” said Dr. Marcia Angell, a former editor of the New England Journal of Medicine and a senior lecturer in the department of global health and social medicine at Harvard Medical School.

More than 190 medical organizations with various agendas are represented through the AMA’s House of Delegates, forcing the organization to balance often-competing interests. On top of that, there’s growing political polarization among doctors, now split almost evenly between Republicans and Democrats. And clinicians are further divided by type of practice and employer.

Because the AMA’s tent is so large, “they have difficulty articulating strong policy positions,” said Berenson, the Urban Institute scholar.

           The affordable care act has been a giant step toward the goal. However it has many near fatal flaws written into a non-flexible law. Now is the time for all physicians to step up and encourage changes that will make it successful.

           The numbers of how many more people are insured is no measure of success.  The cart has been placed before the horse. Despite the built in bureaucratic mandates it is paper tiger unrelated to real quality care in provider's offices.  In fact it has reduced efficiency, increased cost and in no way has improved quality of care.  The only measure Health Train Express has seen is the reduction in admissions within 30 days of discharge from a hospital.  I am not certain how that equates to an improvement in QOC except it saves CMS (taxpayers) dollars.













Dissent roils the AMA, the nation's largest doctors group