SuzanaKM

@AAHPM’s call for nominees for humanities award. http://www.aahpm.org/news/default/call-for-award-nominations-now-open.html Martensen deserves it with all the work he has done in history of medicine, end-of-life care, and his amazing, provocative book Life Worth Living: A doctor’s reflections on Illness in a High-Tech Era. book link

Are we entering into the post-antibiotic era when what used to be simple infections once again could become life-threatening?  Currently, mortality rates for patients infected by drug-resistent bacteria (i.e. MRSA) is 50%, and the incidence of these infections is rising.

Unless the meat and poultry industries follow the model taken up in Denmark - where prophylactic antibiotics are banned (and actually livestock and poultry production increased) - this could be an unfortunate increased role/demand for hospice & palliative care clinicians.  

I for one hope that it is one we can avoid.  As a hospice & palliative care physician, I believe that our societies deserve a system of care from prevention to treatment that holds back avoidable death and suffering.  If curtailing unneeded use of antibiotics can do this - as was shown in Denmark - then it is a move we should adopt behavior to do the same.  We need to ask our Congressmen & Women, our Senators, Governors and Presidents of our respectful countries to pass laws to restrict the use of antibiotics for our cattle and poultry - avoiding antibiotic use as “growth-promotors” and use them only as they were originally designed (to treat illness.)

While this issue has been hotly debated in the US, 

The Animal Veterinary Medical Association (AVMA) notes that “evidence is accumulating to support the hypothesis that antimicrobial resistance in animals can result in the transfer of resistant bacteria … or genetic determinants to humans through the food supply by direct animal-to-human contact or indirectly through the environment.”9 In May 2003, AVMA issued a position statement reading, in part, “The AVMA supports a national, coordinated, and appropriate response to the issue of antimicrobial resistance in bacteria that includes an open or public FDA approval process that is rigorous and that includes an assessment of food safety to approve animal health products for use in animals.” AVMA, the Animal Health Institute (AHI) and other groups are now developing guidelines for the prudent use of antibiotics in farm animals.

 We should also continue to put pressure on agribusinesses to promote healthy practices.  MacDonalds Corp gave a year to its growers to stop using antibiotics as growth promotors in 2003, despite the meat it refused to use was FDA approved for sale.  

This is likely to increase the cost of our meat and poultry - as Denmark has shown that the ban of antibiotics for growth-enhancement has increased cost of meat production by 1%.  (A small price to pay for a society, given the dramatic cost of treating drug-resistent infections, I might add.)

For more information:

PBS - 2001

Medline Plus - Jan 2012: FDA Curbs Use of Certain Antibiotics in Livestock, Poultry

Low-level Use of Antibiotics in Livestock and Poultry

What happens to people with cognitive issues living in NH during the last 3 months of life? This article reviews the care received by 474,829 NH decedents between 2000-2007.

This monster forces a boy to confront his despair over his mother’s terminal illness.

This section is rich this month:

HPM Pass counts towards ABIM maintenance of certification! Imagine that.  How absolutely cool.  OK - now I get to do it.

Announcements about the annual assembly - including for physicians in training, mentorship, scholarships.

Oh… and they announce the Medical Directors group on LinkedIn - while I announce a group on Lois Green.

Abraham Verghese speaks- charismatic as always

Useful guide when considering a brand