Latest / Morning Medical with Dr. Chow / Knee Osteoarthritis Insights, Physician Salary Trends, and Paris 2024 Health Concerns

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Knee Osteoarthritis Insights, Physician Salary Trends, and Paris 2024 Health Concerns · Morning Medical with Dr. Chow

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  Welcome to Morning Medical with Dr.
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  Chow, your daily update on the latest in medical and health news from around the world,
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  powered by artificial intelligence.
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  I am Dr.
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  Chi-Ming Chow, a family physician, general internist, and cardiologist.
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  Today, we will delve into some fascinating new findings on how strong leg muscles could help
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  combat arthritis in the knee.
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  Chances are you know someone who has had a total knee replacement.
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  The surgery is fairly common, with about seven hundred ninety thousand of these procedures
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  done annually in the United States.
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  Most people undergo a knee replacement due to osteoarthritis in the joint, which can cause
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  pain, swelling, and less knee mobility.
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  In fact, knee osteoarthritis is considered to have a high rate of morbidity and disability,
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  according to a study published in August two thousand twenty-three in the journal
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  Experimental and Therapeutic Medicine.
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  Those most at risk of developing this painful condition include older adults, women, those
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  who are overweight, and people who have participated in certain sports, such as soccer,
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  tennis, and long-distance running.
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  Your genes and previous knee injuries can also play a role.
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  But new research has found you may be able to slow the progression of knee osteoarthritis or
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  possibly eliminate its development by strengthening your leg muscles.
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  This is according to a study published in April in the journal JAMA Network Open.
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  After performing a meta-analysis on data obtained from five thousand and three patients
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  in the Netherlands, researchers found no link between a person’s total physical activity and
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  an increased risk for knee osteoarthritis.
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  Researchers then divided the patients into two groups—those whose physical activity came
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  through non-weight-bearing activities such as swimming and cycling, and those whose physical
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  activity came via weight-bearing sports such as walking and running.
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  Here, the team discovered people engaged in weight-bearing recreational physical activity
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  were at an increased risk for developing knee osteoarthritis if they had low levels of
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  lower-limb muscle mass.
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  Dr.
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  Joyce van Meurs, a professor in population genomics in musculoskeletal diseases at Erasmus
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  Medical Center in Rotterdam, Netherlands, noted, 'After seeing that only weight-bearing
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  sports gave people an increased risk of knee osteoarthritis, we looked into whether its
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  development was dependent on how much muscle you have surrounding the joint.'
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  Since larger muscle mass can protect and cushion the knee from mechanical forces inside
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  the knee joint, the researchers expected those with stronger muscles would fare better than
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  those with weaker ones.
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  'And that’s exactly what we saw,' van Meurs said.
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  'When people had a higher muscle mass, then the increased risk of developing osteoarthritis
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  from weight-bearing sports was not there.'
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  Prioritize leg strength training before easing into weight-bearing exercise such as running to
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  protect knee joints and prevent injury, said van Meurs.
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  Dr.
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  Kathryn Miller, an associate professor of internal medicine at the University of
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  Wisconsin School of Medicine and Public Health in Madison, echoed this sentiment.
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  'We’ve always had this idea that muscle mass matters and helps protect joints,' said Miller,
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  who was not involved with the study.
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  'Now here is one study that starts to build on the idea that muscle mass is important to
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  function and also to possibly decrease the risk of developing osteoarthritis.'
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  While the study’s findings are important, there is still more to learn, van Meurs said.
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  For example, scientists know weight is the biggest risk factor for developing knee
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  osteoarthritis.
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  The data that van Meurs and her colleagues studied came from people with an average body
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  mass index of twenty-six.
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  A body mass index of twenty-six is slightly above a healthy level but lower than the
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  average body mass index for people in the United States.
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  Can the study’s findings be extrapolated to those who are considered overweight or have
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  obesity?
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  'We are not completely sure,' van Meurs said.
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  '(A high) body mass index is a major risk factor in developing knee osteoarthritis.
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  If it’s so dominant, maybe the rest of the association is not the same.'
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  Miller agreed.
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  'The higher your body mass index, the higher stress you’re putting on your joints,
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  especially when engaged in weight-bearing activities,' Miller said.
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  'Maybe people with higher body mass indexes will need even more lower-limb muscle mass than
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  those with lower body mass indexes.' Another large study going on through Erasmus Medical
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  Center is trying to determine whether physicians can personalize their advice for
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  patients based on a patient’s muscle mass, weight, and joint movement.
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  'We’re studying how much people can load their joint, based on these factors,' van Meurs said,
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  noting many patients with knee pain ask their physicians whether it’s safe to continue
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  participating in their favorite activities.
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  Currently, there is no definitive answer.
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  Despite these uncertainties, the study offers some valuable takeaways.
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  'Before engaging in a lot of weight-bearing activity, do some training in the gym to
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  strengthen your leg muscles,' van Meurs said.
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  And if you’re going to take up a weight-bearing activity such as running, start slowly.
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  'It’s not only your muscles but your tendons that have to get used to these new stresses, or
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  you’ll get injured right away,' she said.
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  Miller said she counsels her patients to have a healthy body weight and keep exercising.
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  'And if you learn you have osteoarthritis, don’t stop your activities,' she said.
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  'People who are sedentary have lower joint health and muscle mass and are at big risk for
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  developing symptomatic osteoarthritis.' So take a walk, do some wall sits, or sit in a chair
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  and stand up ten times without using your arms to push yourself up, Miller said.
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  Just keep moving.
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  'Our rule for osteoarthritis patients is that if you have mild discomfort with an activity,
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  but it goes away quickly, that’s fine,' Miller said.
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  'But if an activity gives you higher pain and it’s not better the next day, it may be too
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  much for your joint right now.'
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  Orthopedic surgeons have the highest average starting salary among all specialties, starting
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  at six hundred eighty-six thousand dollars per year, according to a new report from AMN
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  Healthcare.
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  Other specialties with the highest average starting salary included gastroenterologists at
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  five hundred thirty-one thousand dollars, urologists at four hundred ninety-six thousand
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  dollars, radiologists at four hundred ninety-five thousand dollars, and
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  dermatologists at four hundred eighty-six thousand dollars.
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  On the other end of the spectrum, pediatricians had the lowest average starting salary at two
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  hundred forty-four thousand dollars, followed by family medicine and internal medicine
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  physicians, both at two hundred seventy-one thousand dollars.
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  "Current physician payment models favor specialists," Leah Grant, president of AMN
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  Healthcare Physician Solution, said in a press release.
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  "They perform the high revenue generating procedures on which many hospitals and medical
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  groups depend." Average starting salaries increased year-over-year in thirteen of the
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  twenty tracked specialties, according to the report.
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  Family medicine physicians actually saw a six point two seven percent increase from the
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  previous year's two hundred fifty-five thousand dollar starting salary, which was likely due to
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  ongoing high demand for that specialty.
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  It was the most requested hiring search among hospitals and medical groups for the eighteenth
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  year in a row, according to the report.
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  Starting salaries for obstetricians and gynecologists averaged three hundred
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  eighty-nine thousand dollars, up six percent year-over-year and twenty-two percent from five
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  years ago; this was also one of the most "in demand" specialties, according to the report.
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  The increased demand could be related to the relative lack of obstetricians and
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  gynecologists around the country, as half of all United States counties do not have one,
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  according to the report.
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  In addition, more than two point two million women of childbearing age live in maternity
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  care deserts with no hospitals offering obstetric care, obstetric providers, or
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  birthing centers.
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  Advanced practice providers such as nurse practitioners, physician assistants, and
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  certified registered nurse anesthetists, also enjoyed strong salary growth.
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  Nurse practitioners experienced an eight point six one percent year-over-year increase in
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  average starting salary to one hundred sixty-four thousand dollars, representing a
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  thirty-two percent increase from five years ago.
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  Meanwhile, certified registered nurse anesthetist average starting salaries were up
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  more than thirty percent year-over-year to two hundred seventy-nine thousand dollars,
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  according to the report.
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  "Nurse practitioners are in rapidly growing demand as physician shortages persist," Grant
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  said in the press release.
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  "Without them, access to healthcare would be even more problematic, particularly in rural
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  and other underserved areas."
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  Physicians and advanced practice providers also received other financial incentives, such as
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  signing bonuses, relocation allowances, and continuing medical education allowances.
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  Physicians had an average signing bonus of thirty-one thousand four hundred seventy-three
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  dollars, while nurse practitioners had an average signing bonus of eleven thousand
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  thirty-seven dollars, according to the report.
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  The average relocation allowance was eleven thousand two hundred eighty-four dollars for
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  physicians and seven thousand nine hundred ten dollars for nurse practitioners and physician
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  assistants, the report showed, and the average continuing medical education allowance was
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  three thousand nine hundred sixty-nine dollars for physicians and two thousand one hundred
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  ninety-five dollars for nurse practitioners and physician assistants.
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  The report is based on internal hiring data from a representative sample of two thousand
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  one hundred thirty-eight physicians and advanced practice providers from April first,
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  two thousand twenty-three, to March thirty-first, two thousand twenty-four.
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  In some unfortunate news from the Paris 2024 Olympics, several triathletes have fallen ill
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  after swimming in the River Seine.
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  Concerns about the river’s water quality have been a persistent issue leading up to and
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  during the Games.
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  Team Belgium had to withdraw from Monday’s mixed relay triathlon after one of its
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  athletes, who competed in the women’s individual triathlon last week, fell ill.
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  Switzerland also faced challenges, having to revise its mixed relay lineup twice due to
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  gastrointestinal infections affecting two of its athletes.
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  The Associated Press reported that a female triathlete from Sweden and a male triathlete
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  from Norway also became sick after their individual events in the Seine last week.
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  While it is not yet confirmed if these illnesses were directly caused by the water
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  quality in the Seine, the situation has raised significant concerns.
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  Paris 2024 organizers emphasized that the health and well-being of athletes is their top
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  priority.
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  They have been conducting daily water quality tests, and any decision to proceed with an
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  event is made in coordination with the International Federation and World Triathlon,
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  based on the test results and various health criteria.
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  Last week, high bacteria levels forced organizers to postpone the men’s triathlon by
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  one day.
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  On Tuesday, a test run for the marathon swimming course in the Seine was canceled due
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  to water quality concerns.
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  Despite these issues, more than one hundred triathletes competed in the men’s and women’s
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  individual races last week.
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  World Triathlon released data showing that fecal bacteria levels were within acceptable
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  limits during the mixed relay event on Monday.
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  The Belgian Olympic and Interfederal Committee stated that their triathlete Claire Michel had
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  to withdraw from the mixed relay competition due to illness after participating in the
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  women’s individual event on July thirty-first.
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  Similarly, Swiss officials announced that their athlete Adrien Briffod would not compete on
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  Monday because of a stomach infection, and his replacement, Simon Westermann, also had to
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  withdraw because of a gastrointestinal infection.
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  Other athletes affected include Norwegian triathlete Vetle Bergsvik Thorn, who
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  experienced a bad stomach illness, and Swedish triathlete Tilda Månsson, who became sick three
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  days after competing.
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  While the exact cause of their illnesses remains unclear, the pattern has led many to
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  suspect the Seine’s water quality.
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  Experts had previously warned about the health risks of swimming in polluted water.
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  Ted Steiner, an infectious disease physician at Vancouver General Hospital, noted that while E.
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  coli infection in water can occur, it is typically not the biggest concern.
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  E.
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  coli serves as a marker for other potentially more contagious parasites, bacteria, or
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  viruses.
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  Marc Habash, an associate professor at the University of Guelph’s school of environmental
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  sciences, explained that bacteria associated with fecal pollution could lead to
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  gastrointestinal infections, causing symptoms like upset stomach, vomiting, and diarrhea.
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  The situation remains fluid, with two more Olympic events scheduled to take place in the
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  Seine: the women’s marathon swim on Thursday and the men’s marathon swim on Friday.
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  As always, the health and safety of the athletes remain paramount, and we hope that the
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  organizers can address these concerns swiftly.
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  That wraps up today’s episode of Morning Medical with Dr.
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  Chow.
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  Thank you for joining me.
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  Stay healthy and stay informed.
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  Until next time, I am Dr.
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  Chi-Ming Chow.