Perfect timing, Maggie! A long and excellent piece on the huge variations in care in the US. States are ranked in terms of their health care quality.

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Oh, to be alive in the ’70s. Apparently this video is from 1971 by Robert Alan Weiss for the Department of Chemistry of Stanford University, and shows some totally free loving hippies acting out protein synthesis as interpretive dance. I personally like the synth organ / bongo drums theme of mRNA binding to the 30s subunit about about 4:36 into the video. Hilarious.

[via kitsune noir ]

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Several comments and critiques as I watched Eric Schmidt, Google’s CEO, talk about Google Health:

• Please stop calling patients consumers. Patients are people with illnesses or injuries who need medical care; consumers are people who purchase goods or services and are informed about what they’re purchasing. (Most patients are not actively dictating what health care resources they’re consuming.) Note: there are certainly consumers of health information, but a person who comes to me seeking medical attention is not a consumer. He or she is a patient.
• The medical record is not the patient’s property. I believe the model we need to use for the medical record is “shared control,” that is, the patient controls who sees the information in their medical record, but the patient’s physician controls the actual information . A patient with HIV or a history of anaphylactic shock to penicillin should not be able to delete this from their medical record.
• Wow, it would be amazingly cool to have all XRays and CT scans from everyone in the country online. I would love that.
• Dr. Schmidt talks about young people, and how we already see the future of what will happen with society, what changes will occur and how quickly and says that the older people like him need to be ready to change and adapt. But I’d guess no one on their Health Advisory Board , with the exception of Matthew Zachary , is under 40 or 50; few if any likely have a Youtube account or Facebook profile. If young people are so in the know, get our opinions!

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Investigating a bit further into the Stewart Medical School craziness , there’s a Youtube account for someone claiming to be a med student there , and the videos the person favorited are craaaaazy lectures by this naturopath. (Medblogging gold, GOLD I say!) Like, seriously, seriously crazy, and you feel bad and worry for the students in the audience, ’cause there’s no way anyone could answer the questions in lecture, ’cause they make no sense:

“Tongues shaped like a hammer are the tongues of nymphomaniacs, as well as kidney problems.”

“If you get a patient who gets the flu, and a week later gets the flu again, what do you do? You have them throw away their toothbrush.” Also, if you have a high change in your morning cortisol levels, it’s “some kind of parasitic infection, some type of growth, some type of infection in the intestines.” A student asks him to explain these changes, and he says, “Oh, 15 years of gastroenterologists running correlations.”

A woman’s testosterone level is high because she is scared:

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So I come across this link for Stewart Uniersity: New Scotland International School of Medicine , which is apparently a “new medical school” and is somehow just down the road from Stanford. Funny, I’ve never heard of it. So I delve a little deeper, and my “sketchy”-dar (similar to gaydar) starts to go off. As I delve a bit deeper, I’m even more concerned for students and potential applicants (has scamming moved to medical schools now?). Let’s investigate the general info first:

• Right off the bat, the school claims to be “the #1 leader in US medical education.” Them’s some big balls you got there, Stewart.
• “Stewart University is the first medical school to open west of the Mississippi in the past 45 years.SM” Okay, fine, got me there — we need more doctors!

• Stewart University is an International School of Medicine. Our curriculum is the standard allopathic (MD) degree discipline. The accelerated 16 month MD degree curriculum completes the basic science courses in first four semesters.

  The World Health Organization (WHO) requires recognized MD degree granting programs to be at least 30 months in length. The Stewart University MD program is 34 months in length for a student with normal degree progress.

  So they’re somehow an “International Medical School,” operating in the US. While the WHO may recognize an MD program as one with 30 months of teaching, I’m pretty sure the AAMC and other licensing bodies require a 4-year medical school, no?

Next, Admissions :

• 2 years and ten months total program length
  3 starting classes per year: January, May, September
  No MCAT – NOT required for MD licensure
  No Bachelor’s Degree – NOT required for MD licensure
  No Minimum Undergrad Credit Hrs -NOT required for MD licensure
  No AMCAS Application, Apply Directly via School Website
  No Age Limit
  Provisional Admittance – for those without prerequisites
  Equal Admissions Process for All Applicants
  Immediate Admissions Application Review

  Okay, it is freaking awesome that you wouldn’t have to take the MCAT. But really–you don’t even need to go to college? No Bachelor’s Degree ?

• Letters of Recommendation are not required.
• Interviews are done over the phone. Fine by me!
• $950 non-refundable “seat reservation fee?” That has to be paid, via Paypal, within 48 hours of “initial acceptance?” Skeeeeetchy.
• Stewart University School of Medicine reserves the right to change or modify tuition rates at will. So I could enroll, and two days later the tuition could be $100,000 an hour?
• I love the handy Tuition Comparison Chart . Wow, if you go to Stewart University, you save a whole $9,000 a year over Stanford or USC. And you receive, according to the chart, a Curriculum with “Equivalent books and instruction as other Calif Med Schools**”. I had no idea.

Faculty/Administration:

• This has to be a joke, right? None of the administrators (most of which appear to have their most recent photo from World War II) have an MD, and there’s only 4 faculty, and only 3 with MDs?
• Two big red flags here: Student Recruiter job posting and one of the 4 staff positions is Marketing Illustrator (shown at left).
• On further inspection: It’s called Stewart University because most of the university is run by The Stewarts! William Bullock Stewart, Sr. is Provost Emeritus, his son, William Bullock Stewart, Jr. is Provost, and his son, William Bullock Stewart, III is Chancellor. The Board of Advisors, Ronald S. Steward, Rosemary E. O’Hara, and James T. Stewart are all of the Stewart clan as well, as well as the Marketing Illustrator.

Curriculum:

• Okay, good, they say they cover all the basic science stuff for preclinical work , and their textbook list is probably pretty similar to what I mostly studied from.
• “The Basic Science phase includes didactic instruction (and may have cable television instruction available also).” Where are they getting the bodies for anatomy? Are they even allowed to have bodies to dissect if they’re not accredited?

• The Clinical phase of the curriculum is intended to be conducted at various U.S. Veteran’s Administration hospitals around the United States and Caribbean Island locations. This affords great flexibility to the student, particularly those on active duty or mobilized, to perform clinical rotations in military treatment facilities and tertiary care military hospitals around the world.

  I guess this is how international medical students do it.

Accreditation:

• It would seriously worry me if my school had a whole section on Accreditation, and the first sentence of the page was, “It is not illegal to operate a school without possessing an accreditation.”
• And the kicker, buried in the text: “For-profit institutions almost always have to wait 2 years after starting operations before they are eligible to submit an application for accreditation.” Oh, well there we go. You’re a for-profit medical school. I was guessing I’d find that somewhere. So you can teach, and provide the same training as any other California medical school, and take a cut as profit? Color me skeptical.
• There’s also a blank but present page on Known Falsehoods , whatever that means.
• Finally, there’s a big long-winded explanation about how the school is somehow on “Federal land,” not “California State Land,” so if you call California, they’ll say the school is not recognized, but it doesn’t matter, ’cause it’s on Federal land.

  It all leaves me pretty darn puzzled, ’cause when you Google the school’s address, you end up with A Postal Annex Store in Los Gatos, California — no medical school listing — and I’m pretty sure the Postal Annex isn’t Federal Land.

Finally, Beware any medical school catalog whose first page is entitled “California Living.”

Sure, some of these features go along with some of the features of the Caribbean Medical Schools — but an accelerated curriculum, with almost no requirements for admission, and a campus that appears to be a mailbox in a Mailboxes Etc. store? Stay away, pre-meds, stay far, far away.

(I know my tone in places is snarky or sarcastic, but in all seriousness, I think there are reasons that American medical schools require things like the MCAT, admissions essays, and letters of recommendations. Mainly those being that as an MD you will be responsible for people’s lives , and it’s not something you should be able to just “sign up and do ’cause you feel like it,” which seems like the gist of the marketing campaign of Stewart University. I’ll admit I don’t know a whole lot about the Caribbean medical schools or licensure process in the US for IMGs, but these groups at least seem more interested in putting out good doctors than just somehow skirting around the requirements to get an MD through a loophole.)

Update: I just spoke to a man who answered the phone, who was very confrontational when I asked “Where is the school located?” He started rambling about how ValueMD and StudentDoctor have been harassing and stalking people from the school. He admitted the address on the website is a PO Box, and said the school does not release the address or location of the school until an applicant has been accepted. (“Fine by me,” I said, “But it seems a little weird that a medical school wouldn’t be visitable or even map-able.”) He then noted that “members of Al Queda have been in contact” with the school, and the school had to file a “400 page document with the FBI” because of this. Yowsers.

Update 2: A spammer for Stewart University was banned from ValueMD , and a little more searching finds that Stewart University was removed from Wikipedia for possible fraud. According to this poster , none of the MDs from Stewart University were licensed in the state of California.

Update 3:
It looks like the school took over the high school in Oxnard, CA , because let me tell you, these photos are definitely not from beaches in Northern California , and it was trying to buy the high school apparently.

Update 4:
On Stewart University’s News page almost none of the links lead to actual stories. The Stanford Daily has published no stories about it , The San Jose Mercury News has no stories on it , nor does The LA Times . Hmmm.

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Sad to hear that Patrick Swayze has pancreatic cancer , but glad to hear he’s being treated at Stanford. Apparently he had a “serious GI procedure” back in February at Stanford — that would have been his Whipple procedure where they take out part of the pancreas along with a bunch of other surrounding structures, a surgery lasting a good 8 hours — and now he’s receiving chemo.

His oncologist Dr. George Fisher says he’s responding well to the chemo.

Pancreatic cancer is one of our worst enemies in the cancer world: the fifth leading cause of cancer-related mortality in the United States. There is a 4% 5-year survival rate. The problems are two-fold: first, due to the location of the pancreas, patients often don’t have any symptoms until the cancer has grown and spread to other organs that would cause symptoms (classically this is “painless jaundice” and weight loss). The second problem is that we don’t have great chemotherapy for pancreatic cancer, either.

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You know Airborne, that product “invented by a school teacher” that’s supposed to make you feel all better from a cold? It claimed it had a study done to show its clinical efficacy; turns out they finally admitted the “research company” was just two dudes , none doctors, created just to do the study. The company agreed to a class-action lawsuit settlement. Submit your claim if you have one.

(If it’s too good to be true, it probably is!)

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Not any surprise here, but my friend and classmate Cheri Blauwet ( her previous wins noted ) picked up her fourth marathon win in LA . Congrats, Cheri! (She’s even more awesome in person.) Visit Cheri’s blog.

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Pretty typical scenario for this real-life, accurate Flash game called Amateur Surgeon : Pizza delivery guy hits a homeless guy with his car, performs surgery on him using his Pizza Delivery Guy Tools, and homeless guy then teaches him how to perform other surgeries, as it turns out he used to be a doctor.

(If only closing wounds was as easy as stapling them and then burning them closed with a lighter! Especially lung lacerations.)

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KevinMD highlights some good posts from two of my favorite New Yorker bloggers about a new campaign encouraging people to get CT scans to catch lung cancer early, before it spreads–even though there’s no evidence to support this. Which I totally agree with. He says:

A deplorable campaign. Currently, there is no data suggesting decreased mortality from lung cancer screening. Asking the public to “demand” a CT scan simply drives up health care costs without a demonstrable survival benefit.

I find it curious for Kevin to have taken this position, when he recently started promoting Family Cord Blood Services , since there’s currently no evidence that private cord blood banking will provide any benefit to children, and the American Association of Pediatrics actually recommends against private cord blood banking , except in the case “when there is knowledge of a full sibling in the family with a medical condition (malignant or genetic) that could potentially benefit from cord blood transplantation.”

The AAP does recommend public cord blood banking, however–since public cord blood is available to… the public. Something I just learned that I didn’t realize–if your child ends up having a childhood blood cancer and needs a stem cell transplant, cord blood may have a higher successful transplant rate, but your own child’s blood won’t be used , because it likely already had the cancer growing in it. Someone else’s child’s cord blood will be used for the transplant.

I have no problem with Kevin’s blog advertising, and sure, Kevin, he makes it clear that it’s a “Sponsored Post.” And perhaps someday there will be a use for cord blood (I guess the 99.9% of us who don’t have our own cord blood available are just SOL). But as compared to Kevin’s other sponsors, who are selling magazines, or promoting their websites or electronic medical records, the cord blood post really makes it seem like he endorses/supports/agrees with private cord blood banking. Which is fine if he does–except the evidence isn’t there for private cord blood therapies, or lung cancer screening CTs.

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