Latest / Morning Medical with Dr. Chow / Alberta's PA Education, AI Diagnosing Bell's Palsy, and NHS Waiting Time Challenges

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Alberta's PA Education, AI Diagnosing Bell's Palsy, and NHS Waiting Time Challenges · Morning Medical with Dr. Chow

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  Good morning, everyone, and welcome to another episode of Morning Medical with Dr.
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  Chow.
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  I'm your host, Dr.
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  Chi-Ming Chow.
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  Today, we're diving into some of the most intriguing and impactful stories in the world
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  of medicine and health.
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  Let's kick off with some exciting news from Alberta.
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  Alberta's first cohort of students studying to become physician assistants have started their
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  journey at the University of Calgary.
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  This comes at a time when the health-care system is under significant strain, making the
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  demand for this program exceptionally high.
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  Physician assistants, also known as PAs, work under the supervision of doctors and can
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  examine, diagnose, and treat patients.
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  The University of Calgary's new, two-year master of physician assistant studies program
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  began training its inaugural class just a few weeks ago.
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  It's hoped that this program will help address the shortage of health-care providers in the
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  province.
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  Demand for the program far exceeded its capacity, with 200 applicants vying for just 20
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  provincially funded spots.
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  'It's a very popular program like all physician assistant programs across the country,' said
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  Dr.
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  Rahim Kachra, the program's medical director.
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  'We've been really excited to see the interest.'
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  Dr.
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  Kachra believes one of the program's key advantages is its ability to produce highly
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  skilled clinicians in just two years.
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  'This accelerated training allows us to quickly bolster the health-care workforce and improve
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  access to care, particularly in areas facing critical shortages,' he said.
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  According to Dr.
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  Kachra, 65 percent of the current crop of students comes from Alberta.
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  'We're really excited about having a cohort that really does represent the communities in
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  which they will live and serve,' he added.
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  Once they've graduated, these physician assistants will have opportunities in a variety
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  of environments, including inpatient and outpatient care in both rural communities and
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  large urban centers.
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  'I get emails on a regular basis from zone medical leads across the province, from
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  sub-specialists, from family medicine clinics,' Dr.
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  Kachra said.
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  'I think everyone's quickly recognizing the advantages of having a physician assistant join
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  their team-based care models.'
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  In addition to the requirement of a four-year undergraduate degree, physician assistant
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  students must also have previous health care experience.
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  The first cohort includes EMS workers, nurses, respiratory therapists, as well as occupational
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  and physical therapists.
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  'I love that aspect of being part of something new,' said Mozac Samson, a paramedic who is one
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  of the 20 students in the inaugural class.
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  'Being with the Cumming School of Medicine, the things that are available …
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  from a learning perspective is amazing, and every day I feel myself going 'Wow, we get to
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  learn that?
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  That's amazing.''
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  Mozac Samson appreciates the insights provided by other students from different health care
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  backgrounds and expects he and his colleagues will be able to help address health-care worker
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  shortages.
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  'We are physician extenders.
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  We're not replacements of physicians.…
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  We are here to do things to free up physicians to do the cases that require their
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  specialties.'
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  Kirsten Luomala, president of the Canadian Association of Physician Assistants, emphasized
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  the huge demand for physician assistants.
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  'We can increase the patient roster that a physician carries.
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  So if they're carrying 1,500 patients, on average, a physician assistant can easily bring
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  in another 500 patients ...
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  so that's increased access for Albertans and for Canadians,' she said.
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  According to Luomala, this is the fifth physician assistant training program to launch
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  in Canada, and others are expanding capacity.
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  Adding these health care providers will help a struggling health system, she said.
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  'It'll decrease the amount of people who are going to go to emergency departments when they
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  should be going to their family doctors.
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  It's going to decrease the end health-care complications that people are seeing because
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  they don't have access to family medicine,' said Luomala.
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  'This is going to be a ripple effect across the system as we have more physician assistants
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  trained across the country.'
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  In all, Luomala said there were over 2,500 applicants for 183 spots in Canada's five
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  programs this year.
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  She mentioned that the Canadian Association of Physician Assistants is working to have
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  training spots increased across the country and has met with Alberta government officials to
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  advocate for funding to expand the number of spots at the University of Calgary.
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  Luomala also believes there is enough demand to support a second training program in the
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  Edmonton region.
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  The Alberta government has spent tens of millions of dollars to expand health care
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  education through its targeted enrolment expansion initiative, which began in 2022.
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  Part of that money includes 6.8 million dollars for the creation of 40 new seats for the
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  University of Calgary program, including 20 this year and 20 for a fresh group of students
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  to enroll next year.
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  'Our government is committed to ensuring that Alberta students have every opportunity to
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  succeed and contribute to Alberta's health care system, and we will continue to consider future
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  investments in the expansion of health care related programs,' said Advanced Education
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  Minister Rajan Sawhney.
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  The Chatbot Will See You Now
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  Susan Sheridan had heard of ChatGPT but had never used it, so the first question she asked
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  the artificial intelligence chatbot was a bit garbled: 'Facial droop, facial pain and dental
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  work.' She had turned to ChatGPT in a moment of desperation.
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  The right side of her face was sagging, she tripped over words as she spoke and her head
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  hurt so much that she could not rest her head on the pillow.
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  A day earlier, when her husband first noticed the drooping, the couple drove three hours to
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  an emergency room, only for the doctor to send her home after labeling her symptoms as benign.
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  ChatGPT disagreed.
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  One potential explanation for her symptoms, the chatbot told her, was Bell’s palsy, which
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  needed urgent treatment to avoid lasting damage.
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  She made another trip to the emergency room, where a doctor confirmed the chatbot’s
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  suspicions and gave her steroids and antivirals.
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  As a result, she was mostly cured.
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  'I do not want to replace doctors — I believe in the doctor-patient relationship, I believe
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  in the health care system,' said Ms.
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  Sheridan, sixty-four, co-founder of a patient safety advocacy organization.
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  This case highlights a growing trend: people are turning to artificial intelligence chatbots
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  for medical advice, sometimes with remarkable results.
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  But it's not just patients who are taking advantage of this technology.
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  Medical professionals are also beginning to use artificial intelligence to assist in
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  diagnostics and treatment plans.
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  Dr.
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  John Brown, a general internist, said, 'I have found that artificial intelligence can be an
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  invaluable tool for cross-referencing symptoms and potential conditions.
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  It is like having an incredibly comprehensive medical database at your fingertips.'
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  However, there are significant caveats.
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  Artificial intelligence is not infallible and can make errors.
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  Dr.
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  Brown emphasizes the importance of human oversight.
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  'Artificial intelligence should be used as a supplementary tool, not as a replacement for
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  professional medical judgment,' he said.
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  Privacy is another concern.
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  The sensitive nature of health information means that data security is paramount.
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  Chatbots and artificial intelligence systems must adhere to stringent privacy regulations to
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  protect patient data.
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  Despite these challenges, the integration of artificial intelligence into healthcare
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  continues to expand.
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  Many see its potential to improve diagnostic accuracy, reduce wait times, and make
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  healthcare more accessible.
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  For example, artificial intelligence chatbots can provide preliminary consultations, triage
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  patients based on the severity of their symptoms, and even remind patients to take
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  their medications.
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  These functionalities can free up healthcare professionals to focus on more complex cases.
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  Dr.
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  Brown noted, 'In remote or underserved areas, artificial intelligence could be a
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  game-changer.
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  It allows for quicker consultations and can help in managing limited medical resources more
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  efficiently.'
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  However, it's crucial to maintain a balanced perspective.
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  While artificial intelligence can offer valuable support, it is not a panacea.
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  The human touch in healthcare is irreplaceable.
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  In summary, the use of artificial intelligence in healthcare is a double-edged sword.
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  It has the potential to revolutionize the field but must be integrated thoughtfully and
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  ethically to ensure it complements rather than compromises patient care.
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  Ballooning National Health Service (NHS) England waiting times and delays in getting
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  emergency treatment are costing lives, according to a critical government-commissioned
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  report on the service.
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  People have 'every right to be angry,' the Prime Minister says, adding that the health
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  service must 'reform or die.'
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  Health Secretary Wes Streeting has warned that the NHS could 'go bust' if the government does
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  not reform it to account for an aging society, more sick people, and rising costs.
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  He pledged to spend a greater proportion of the NHS budget on general practitioners, social
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  care, and 'community services' rather than hospitals, which he said would help alleviate
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  pressure on the service overall.
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  But the Conservatives said the government needed to turn 'rhetoric to action' after
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  scrapping its plans to reform social care and build new hospitals.
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  The report was the result of a nine-week review by the independent peer and NHS surgeon Lord
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  Darzi.
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  He was asked by Labour, shortly after the election, to identify the failings in the
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  health service, but his remit did not stretch to coming up with solutions.
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  His findings present a stark picture of a service which he says is in a 'critical
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  condition' and 'serious trouble.'
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  In response, Sir Keir Starmer is promising 'the biggest reimagining of the NHS' since it was
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  formed, with a new 10-year plan for the health service to be published in the coming months.
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  He proposes three key areas of reform: the transition to a digital NHS, moving more care
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  from hospitals to communities, and focusing efforts on prevention over sickness.
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  Speaking to BBC Breakfast, Streeting added that primary care and community services would be
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  'the first port of call' for new money, not hospitals.
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  'Rather than a country with an NHS, we're going to have an NHS with a country attached to it if
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  we're not careful, and more likely an NHS that goes bust,' the health secretary said.
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  Streeting also pledged to deliver 'schemes' from the previous government's New Hospitals
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  Programme, but said it may be over a longer timeframe.
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  The report from the peer, a surgeon who served as health minister in the last Labour
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  government, said the NHS was still struggling with the aftershocks of the pandemic and
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  falling well short of its key targets for cancer, Accident and Emergency, and hospital
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  treatment.
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  It said this was contributing to poor survival rates in cancer and heart disease, and falling
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  rates of satisfaction.
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  The report said the NHS had been left chronically weakened by the policy of austerity
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  of the 2010s and in particular a lack of investment in buildings and technology.
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  This has left it with crumbling hospitals, fewer scanners than many other developed
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  nations, and years behind the private sector in terms of digital innovation.
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  This has contributed to falling levels of productivity in hospitals, with rises in staff
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  not matched by increases in the numbers of patients being seen.
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  It has meant hospitals have been sucking up an ever-increasing amount of the budget, when more
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  care should be shifted into the community.
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  Lord Darzi was also critical of the 'disastrous' 2012 reforms introduced by the
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  coalition government, which led to a shake-up of management structure in the NHS and acted as
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  a distraction for the rest of the decade.
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  It said all this contributed to the NHS entering the pandemic in a depleted state,
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  leading to the cancellation of more hospital treatments than any comparable country and the
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  'ballooning' waiting list, which currently stands at 7.6 million.
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  Meanwhile, a surge in patients suffering from several long-term illnesses, such as diabetes,
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  high blood pressure, and respiratory illness, is threatening to overwhelm the NHS alongside
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  soaring levels of mental health problems among young people.
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  The report says Accident and Emergency is in an 'awful state' with long waits likely causing an
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  additional 14,000 more deaths a year, according to the Royal College of Emergency Medicine.
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  The state of the NHS is not entirely due to what has happened within the health service,
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  but also because the health of the nation has deteriorated, for example bringing a surge in
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  long-term mental health conditions.
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  Rising levels of illness are risking economic prosperity, with 2.8 million people unable to
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  work because of poor health.
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  The United Kingdom has higher cancer mortality rates than other countries.
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  Although hospital staff numbers have increased since the pandemic, the number of appointments
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  and procedures has not because 'patients no longer flow through hospitals as they should.'
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  The NHS has been starved of capital investment, meaning 'crumbling buildings,' mental health
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  patients in 'Victoria-era cells infested with vermin,' and 'parts of the NHS operating in
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  decrepit portacabins.'
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  Lord Darzi said, 'Although I have worked in the NHS for more than 30 years, I have been shocked
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  by what I have found during this investigation – not just in the health service, but in the
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  state of the nation’s health.'
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  Although the report focused on the NHS, Lord Darzi also warned of the 'dire' state of social
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  care, which he said was not 'valued or resourced sufficiently.' The growing gap
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  between people's needs and the availability of publicly-funded social care in England was
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  placing 'an increasingly large burden on families and on the NHS,' he said.
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  Sir Keir, meanwhile, says the 2010s were the 'lost decade' for the NHS, adding, 'People have
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  every right to be angry.
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  It left the NHS unable to be there for patients today, and totally unprepared for the
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  challenges and opportunities of tomorrow.'
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  'The NHS is at a fork in the road and we have a choice about how it should meet these rising
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  demands.
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  Raise taxes on working people or reform to secure its future.
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  We know working people can’t afford to pay more, so it is reform or die.'
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  He acknowledged that waiting times in Accident and Emergency are leading to avoidable deaths:
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  'People's loved ones who could have been saved.
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  Doctors and nurses whose whole vocation is to save them - hampered from doing so.
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  It's devastating.'
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  Shadow Health Secretary Victoria Atkins said the government had still yet to come up with
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  meaningful plans for reform.
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  'The Labour government will be judged on its actions.
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  It has stopped new hospitals from being built, scrapped our social care reforms and taken
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  money from pensioners to fund unsustainable pay rises with no gains in productivity.'
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  She also defended the Conservative government's record, saying the NHS budget had been
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  increased during the last Parliament.
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  Former Conservative Health Minister Lord Bethell, who served for 18 months during the
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  pandemic, said action was taken by the previous government, although 'maybe not enough.' He
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  told BBC Radio 4's The World Tonight that the reason money was not spent was not 'some kind
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  of conspiracy to wreck the NHS' but because 'it has been impossible to persuade the Treasury
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  that we will get a return on investment by investing in NHS capital.'
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  Matthew Taylor, the head of the NHS Confederation, which speaks on behalf of NHS
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  organizations and their 1.5 million employees, told the same program the report had identified
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  some of the problems facing the health service.
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  But he warned that waiting lists would probably get even longer this winter, as normally
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  happens.
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  'It will take at least a full term for Labour to get anywhere near the kinds of targets
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  they've got for waiting lists,' he said.
• 17:29
  Thea Stein, chief executive of the Nuffield Trust think tank, said while Lord Darzi's
• 17:34
  report was 'not surprising,' it was still 'deeply troubling.' 'The big question now is
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  what happens next.'
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  William Pett, of the patient watchdog Healthwatch England, said the problems needed
• 17:46
  to be addressed, describing services as in disarray and waiting times as excessive.
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  And he added, 'These challenges are not experienced equally, with poorer communities
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  hit hardest.'
• 17:58
  Is there a surgical shortcut to six-pack abs?
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  According to recent reports, high-definition liposuction, also known as liposculpture or "ab
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  etching," is gaining popularity, especially among men.
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  This procedure involves strategically removing fat from certain areas and re-injecting it into
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  others to create the illusion of muscle definition.
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  Dr.
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  Neil Tanna, a plastic surgeon and vice president of women's surgical services with the
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  Katz Women's Surgical Center at Northwell Health in Great Neck, New York, explains that
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  high-definition liposuction goes beyond traditional liposuction.
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  'You do liposuction in a way that accentuates the desirable contours of the body,' he said,
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  particularly highlighting the muscle contours of the abdomen.
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  For general liposuction, patients are first injected with tumescent fluid, which contains
• 18:53
  epinephrine, a vasoconstrictor, and lidocaine, a local anesthetic.
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  This helps reduce bleeding, bruising, and pain during the procedure.
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  After the fluid takes effect, a cannula, a thick metal rod with a hole on the end, is used
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  to harvest the fat.
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  High-definition liposuction is more selective about where the fat is removed from, carving
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  out cavities to create negative spaces between muscle pockets.
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  'You kind of create these negative spaces where you remove additional fat between pockets of
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  muscle so you can accentuate that area,' Dr.
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  Tanna said.
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  The procedure also involves fat grafting, where the harvested fat is re-injected into the
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  muscle pockets to make the muscles appear larger.
• 19:38
  This technique is similar to the Brazilian butt lift, which involves a diffused fat transfer to
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  the buttocks.
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  The entire process takes between one to three hours, and patients can expect to be fully
• 19:49
  recovered in a few days.
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  However, like any surgical procedure, high-definition liposuction comes with its
• 19:56
  risks.
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  One significant risk is that re-injected fat could enter the bloodstream, potentially
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  traveling to undesirable places like the heart or lungs.
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  Other risks include skin and fat necrosis and intestinal perforation, which can occur if the
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  cannula is inserted too deeply and punctures an internal organ, often the colon.
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  A 2019 study in Aesthetic Plastic Surgery assessed the outcomes and complications in 417
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  patients who underwent high-definition liposuction.
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  Although non-serious complications were frequent, most were local and safely treated
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  without affecting the surgical outcome.
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  According to the study, two-thirds of patients experienced hyperpigmentation, and about a
• 20:40
  quarter had seroma or nodular fibrosis.
• 20:44
  Other complications included unsatisfactory definition in superficial liposuction areas, an
• 20:50
  unnatural-looking body contour, burns related to the procedure, and Mondor's syndrome.
• 20:57
  Despite these issues, patients were overwhelmingly satisfied with their results.
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  Dr.
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  Tanna emphasized the importance of candidate selection for high-definition liposuction.
• 21:09
  The ideal candidate should be at their ideal weight and able to maintain it, as weight
• 21:13
  fluctuations can alter how fat appears on the body and affect the skin's movement.
• 21:18
  This could compromise the results, although this aspect is understudied.
• 21:23
  Dr.
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  Tanna also mentioned that any elective surgery is a major health decision.
• 21:29
  He noted that social media has contributed to the rise in this procedure, as people are more
• 21:34
  connected to information about cosmetic surgeries and are keen to present a certain
• 21:39
  image to the world.
• 21:41
  Ultimately, high-definition liposuction is not a miracle shortcut to six-pack abs, but it can
• 21:47
  give patients a final push toward their aesthetic goals.
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  That wraps up today’s episode of Morning Medical with Dr.
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  Chow.
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  Thanks for joining us.
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  Stay tuned for tomorrow's episode where we'll bring you more updates from the world of
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  medicine and health.
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  Have a great day!