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Substance abuse among U.S. military declared a public health crisis

Rising rates of alcohol and prescription drug use among the nation’s armed forces have become a public health crisis that could negatively affect service members’ abilities to perform their duties, said an Institute of Medicine report issued Sept. 17. In 2008, 47% of active duty personnel reported binge drinking at least once in the previous month, up from 35% in 1998. Between 2002 and 2008, misuse of prescription medication in the past 30 days increased from 2% to 11% of active service members, the IOM report said. Contributing to the problem are outdated military policies on preventing and treating substance use disorders, according to the IOM. “Many of these policies had been drafted more than 10 years previously and had not been revised to reflect emerging knowledge,” the report said. Other challenges include patients avoiding care for substance-use disorders due, in part, to concerns about being penalized, and limited training in addiction and psychiatry among phy ...

Hospitalist project reports success in improving ED patient flow

Assigning a hospitalist and an allied health professional to patients admitted to a facility but waiting in the emergency department for a bed improved patient flow through the hospital and saved it more than a half-million dollars, according to a study in the September Journal of Hospital Medicine. “The emergency department is not something that I thought was my purview, but now I think there is a role for an internist-hospitalist,” said Smitha R. Chadaga, MD, the lead author, who launched a hospitalist program for the ED in 2009 at Denver Health, a 477-bed academic safety net hospital in Denver. “And it’s a great opportunity.” Patient boarding in the emergency department has been a longtime concern of several medical societies. The American Medical Association supports collaboration between organized medical staff and emergency department staff to address the issue. The American College of Emergency Physicians generally is behind initiatives that move admitted patient ...

Med students’ biggest challenges: educational costs, workload

The cost of medical education poses the biggest challenge for medical students, according to a national survey of students released Sept. 13. “They’re really seeing the bills piling up as the costs for medical school go up year after year,” said Erica Sniad Morgenstern, spokeswoman for the health information technology company Epocrates. The company surveyed 1,015 students in August who use its drug reference tool at more than 160 medical schools nationwide. Medical school costs have been an increasing challenge for students in the seven years the company has been conducting the survey, she said. The average student debt is $162,000 for allopathic students and $205,674 for osteopathic medicine students, according to the latest data from the Assn. of American Medical Colleges and the American Assn. of Colleges of Osteopathic Medicine. Eighty-six percent of allopathic medical school graduates and 91% of osteopathic medicine college graduates had educational debt in 2011. ...