Demystifying Medicine One Month at a Time

Tag: radio (Page 1 of 2)

Truckers Against Trafficking

Kylla Lanier

A loyal reader has noticed the paucity of recent posts and suggested offering links to my radio interviews as a means of facilitating ease of listening.

Recently I interviewed Kylla Lanier, co-founder and deputy director of a non-profit called Truckers Against Trafficking. TAT is devoted to educating more than 400,000 truckers and owners and employees of truck stops about signs of human trafficking–which occurs to an estimated hundreds of thousands of Americans, both native and foreign born.

Trafficking has victims in both the sex industry and in general labor — including hospitality, food service and agriculture. Anyone forced to work against their will and paid for their labor is considered trafficked.

Click on over and you can stream the interview at your leisure. I learned a lot.

Medical Mondays on KWGS Radio

kwgs-logo-lg2Thanks to the many of you that have inquired about the lack of recent posts. Fear not — you have not had your subscriptions cancelled.

GlassHospital has been on hiatus for some family-related events and the production of a new radio program that will air weekly on KWGS Radio, 89.5-FM, also known as Public Radio Tulsa.

It will run every Monday, broadcast in Tulsa at 11:30AM central and again at 7:30PM. Starting today!

This is the weekday slot occupied by Tulsa’s longstanding interview program “Studio Tulsa,” hosted for 23 years by Rich Fisher.

Rich has been gracious enough to allow me to host the program every Monday — the only difference is that it will be specifically covering health, medicine and wellness related topics.

Think of it as “StudioTulsa: Medical Mondays.” That’s what we’re going to call it.

If you can’t catch it live, you can always stream it at your convenience at studiotulsa.org.

Thanks for listening!

— John

Timing is Everything

IUDs & Implant

Quick: Which US state has the highest rate of unintended pregnancy?

I’ll reveal below, but I learned the answer and several other surprising facts in an interview with Mark Edwards, the co-founder of Upstream USA, a non-profit training organization that provides technical assistance to health enterprises (medical practices, clinics, public health departments) in the use of long-acting, reversible contraceptives (known in the trade as LARC).

LARC consists of two options: IUDs (intrauterine devices) and implants — which are small, match-sized, plastic rods that deliver a slow, steady dose of hormone to prevent pregnancy. They are planted in the upper arm of women to provide another form of hassle-free contraception.

Both of these methods can be discontinued at any time, at which point fertility returns — faster, I’m told, than in the case of oral contraceptives.

Here’s a fact that surprised me about oral contraceptives (aka “The Pill”): Though when taken reliably their ‘success rate’ as a means of preventing unwanted pregnancy is considered to be 99%, over a 10 year use period, due to the challenging nature of remembering to take a daily pill, it’s likely that 61% of those taking the pill exclusively for birth control will become pregnant. Most definitely not the intended outcome. (Source: here.)

Big picture: every year in the US, there are about 6.6 million pregnancies. Of those, 3.4 million, or slightly more than half, are accidental: either altogether unwanted or ‘significantly mistimed’ — what we in the health care business describe as a pregnancy occurring 2 or more years before desired. The vast majority of these accidental pregnancies occur in women in their 20s (though teen pregnancy is a concern, only 20% of unplanned pregnancies are in teens, and the vast majority of those are in women 18-19 years old. In fact, the teen pregnancy rate has fallen significantly in the last 25 years).

That’s why, regardless of your politics, offering LARC to any woman of childbearing age is crucial. At the very first visit. As a primary care doc myself, I know that ‘family planning’ often falls down the list of concerns for patients that I see because there are so many other issues people wish to bring up in our short office visits. Thus, opportunities to provide women with LARC often fall through the cracks.

Upstream USA’s methodology includes technical assistance: training staff up to ask every woman that comes in a simple question: “Do you intend to get pregnant in the next year?”

If ‘yes,’ let’s get her into preconception care (folic acid, multivitamins, etc.). If ‘no,’ offer LARC right then and there. And the provider (doctor, nurse practitioner, or physician assistant) is trained up to put in an IUD or implant on the spot. No waiting until next time.

Why is this so important? Women with unplanned pregnancies are at greater risk for staying or falling into poverty. Their opportunity to advance in their education is diminished. Children should be brought into the world wanted — with parents that are prepared — with the maturity and resources to succeed.

It’s a fundamental choice for a woman to decide if and when she wants to have children. Of course, fewer unplanned pregnancies also means less need for abortion.

So what Upstream USA is offering is win-win-win. It’s bipartisan — a rare area that people on all sides of the political spectrum can agree upon. Upstream USA’s first big success was in none other than Texas. The organization also has partnerships in a number of other Red and Blue states.

The state with the highest rate of unplanned pregnancy? Surprisingly, Delaware. Upstream USA is there, too. And going big — across the whole state.

Rural Hospitals Fewer and Farther Between

rural-hospital-photoUSA Today ran a great series on recent closures of rural hospitals, more than 40 of them in all, predominantly in the South.

In total, the closures add up to less than two thousand beds, which is not a big number. Medium and big urban hospitals are often licensed for hundreds of beds in a single facility.

But rural hospitals fill a vital niche — usually more than 35 miles or more from the nearest health care facility. Many of them are known as “critical access,” which means that they qualify for enhanced payments for services due to the rural demand they meet and their remoteness.

The thing is, it’s tough to compete with bigger, regional hospitals and medical centers. Economies of scale allow bigger places to purchase expensive technologies (think MRI machines and surgical robots) that further enhance their marketing power. And the whole hospital industry is undergoing massive consolidation as hospitals join networks of even larger holding companies or non-profit networks. Smaller and rural hospitals just don’t fit in this brave new world.

I was lucky to interview one the authors of the series, Laura Ungar, who is the national/regional health enterprise editor for USA Today, and the Gannett-owned [Louisville, KY] Courier-Journal.

If you’re interested, you can stream it here.

Radio as Public Health

micMany of you know of GlassHospital’s passion for radio. Recently, I blogged about a radio-doctor colleague named Anne Hallward, a psychiatrist from Maine whom I was fortunate to interview.

Hallward is the creator and host of “Safe Space Radio,” now in it’s seventh year, a show that’s a back-to-back winner of the Maine Association of Broadcasters’ Public Affairs Award.

She recently gave a TED talk at an event in Maine. It’s compelling viewing, deeply personal, and gives a window into how one caring and empathic doctor has taken her skills to a broader, community-wide, public health level.

It’s well worth a listen.

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