The Vanishing Mind
War on Dementia
Articles in this series are examining the worldwide struggle to find answers about Alzheimer’s disease.
Friday, September 28, 2012
Cheap Disposable Medical Supplies: China
http://www.ecvv.com/product/2343990.html
http://www.ecvv.com/company/changzhoudequn/products-map.html
Business License
http://www.ecvv.com/company/changzhoudequn/products-map.html
| Company Name: | Changzhou Dequn Medical Treatment Apparatus Co., Ltd. | |
| Legal Representative: | Yao Dequn | |
| Address: | Jiangsu Changzhou Sanhekou , Wujin | |
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| Telephone: | 86-1337-6256695 | |
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| Year Established: | 2003-10-9 |
Wednesday, September 26, 2012
Brain Stroke - having one on Live TV -what it looks like
This TV Reporter had a brain stroke on live TV. She had a brain clot, ischemic stroke.
Her words get scrambled because her brain is dying without oxygen inside her head.
Live Stroke on TV: Serne Branson
http://www.youtube.com/watch?feature=endscreen&NR=1&v=XvkC4t2d9Ok
After stroke surgery interview about the stroke:
http://www.youtube.com/watch?v=4-QTS739cQw&feature=related
Her words get scrambled because her brain is dying without oxygen inside her head.
Live Stroke on TV: Serne Branson
http://www.youtube.com/watch?feature=endscreen&NR=1&v=XvkC4t2d9Ok
After stroke surgery interview about the stroke:
http://www.youtube.com/watch?v=4-QTS739cQw&feature=related
Brain Stroke Surgery - Clot busting suction technique
Brain clot removal technique and devices explained (animation):
Solitaire - Guided Cather System
http://www.youtube.com/watch?v=0DQPD5TTS5Y&feature=related
Merci 6 - Guided Cather System
http://www.youtube.com/watch?v=P2TNz-TniIA
Solitaire - Guided Cather System
http://www.youtube.com/watch?v=0DQPD5TTS5Y&feature=related
Merci 6 - Guided Cather System
http://www.youtube.com/watch?v=P2TNz-TniIA
Stopping Alzheimers
http://www.nytimes.com/2012/05/16/health/research/prevention-is-goal-of-alzheimers-drug-trial.html?pagewanted=all&_moc.semityn.www
The Science Times Podcast
New Drug Trial Seeks to Stop Alzheimer’s Before It Starts
Todd Heisler/The New York Times
Brain scans of a member of a Colombian family who has Alzheimer’s, which leads to dementia.
By PAM BELLUCK
Published: May 15, 2012 151 Comments
In a clinical trial that could lead to treatments that preventAlzheimer’s, people who are genetically guaranteed to develop the disease — but who do not yet have any symptoms — will for the first time be given a drug intended to stop it, federal officials announced Tuesday.
Multimedia
This Week: Scientists behaving badly; a new front in the war on Alzheimer’s; and the tale of the manta ray and the coconut palm.
The Science Times PodcastRelated
Hoping to Crack Alzheimer’s, Together as a Family (October 4, 2011)
Readers’ Comments
Readers shared their thoughts on this article.
Experts say the study will be one of the few ever conducted to test prevention treatments for any genetically predestined disease. For Alzheimer’s, the trial is unprecedented, “the first to focus on people who are cognitively normal but at very high risk for Alzheimer’s disease,” said Dr. Francis S. Collins, director of the National Institutes of Health.
Most participants will come from the world’s largest family to experience Alzheimer’s, an extended clan of 5,000 people who live in MedellÃn, Colombia, and remote mountain villages outside that city. Family members with a specific genetic mutation begin showing cognitive impairment around age 45, and full dementia around age 51, debilitated in their prime working years as their memories fade and the disease quickly assaults their ability to move, eat, speak and communicate.
Three hundred family members will participate in the initial trial. Those with the mutation will be years away from symptoms, some as young as 30.
“Because of this study, we do not feel as alone,” said Gladys Betancur, 39, a family member. Her mother died of Alzheimer’s, three of her siblings already have symptoms, and she had a hysterectomy because of her fears that she has the mutation and would pass it on to her children. “Sometimes we think that life is ending, but now we feel that people are trying to help us.”
The $100 million study will last five years, but sophisticated tests may indicate in two years whether the drug helps delay memory decline or brain changes, said Dr. Eric M. Reiman, executive director of the Banner Alzheimer’s Institute in Phoenix and a study leader.
Alzheimer’s experts not involved in the study said that though only a small percentage of people with Alzheimer’s have the genetic early-onset form that affects the Colombian family, the trial was expected to yield information that could apply to millions of people worldwide who will develop more conventional Alzheimer’s.
“It offers a tremendous opportunity for us to answer a large number of questions, while at the same time offering these people some significant clinical help that otherwise they never would have had,” said Dr. Steven T. DeKosky, an Alzheimer’s researcher who is vice president and dean of the University of Virginia School of Medicine. Dr. DeKosky was part of a large group consulted early on, but is not involved in the study.
Some 5.4 million Americans have Alzheimer’s, and the numbers are expected to swell as the baby boom generation ages. Dr. Reiman’s team is planning a similar trial for people in the United States considered at increased risk for conventional late-onset Alzheimer’s. The study announced Tuesday will include a small number of Americans with gene mutations guaranteed to cause early-onset Alzheimer’s.
The drug trial is part of the federal government’s first national plan to address Alzheimer’s, which was unveiled Tuesday by Kathleen Sebelius, the secretary for health and human services. The government took the unusual step of assigning $50 million from the current year’s N.I.H. budget to research considered too promising to wait, including the Colombia trial and a study on whether inhaled insulin can ease mild cognitive impairment, Dr. Collins said. Another $100 million is proposed for 2013, mostly for research, but also for education, caregiver support and data collection.
Success for the Colombia trial is, of course, no sure thing. Many trials fail, and Alzheimer’s research has so far found no treatment effective for more than several months. But experts say that trying drugs years before symptoms emerge could have greater potential because the brain would not yet be ravaged by the disease. The trial will be financed with $16 million from the National Institutes of Health, $15 million from private donors through the Banner Institute and about $65 million from Genentech, the drug’s American manufacturer.
The drug, Crenezumab, attacks amyloid plaques in the brain. If it can forestall memory or cognitive problems, scientists will know that prevention or delay is possible and appears to lie in targeting amyloid years before dementia develops. Many, but not all, Alzheimer’s researchers believe amyloid is an underlying cause of Alzheimer’s.
In 2010, The New York Times reported on the pervasiveness of dementia in this large Colombian family and scientists’ hopes of testing prevention drugs. But persuading pharmaceutical companies to invest took months. There are scientific and ethical issues involved with giving drugs to people who are healthy and people who live in a developing country, some of whom have little education, paltry incomes and longstanding superstitions about the disease they call La Bobera — the foolishness.
“The first thing I did was to ask myself the question, Are we taking advantage of these folks?” said Richard H. Scheller, Genentech’s executive vice president of research and early development. “The answer was clearly no.”
The risks, he said, are balanced by the fact that if nothing is done, “they’re going to get this terrible, terrible disease for sure.”
The few trials of prevention therapies — involving ginkgo biloba, women’s hormone replacement treatment and anti-inflammatory drugs — have involved people not guaranteed to get the disease. These therapies either failed or caused adverse side effects.
Testing drugs on that kind of population takes “too many healthy volunteers, too much money, and too many years,” Dr. Reiman said.
The Colombian population is ideal because it is large enough to provide solid results, and it is easy to identify whom the disease will strike and when.
Crenezumab was chosen for the Colombia trial partly because it appears to have no negative side effects, unlike other drugs designed to clear amyloid from the brain, said Dr. Francisco Lopera, a Colombian neurologist who has worked with the family for decades and is a leader of the study. Other anti-amyloid treatments have caused edema in the blood vessels, an imbalance of fluid that can have serious consequences.
Crenezumab is currently being given in two clinical trials to people with mild to moderate symptoms of dementia in the United States, Canada and Western Europe to see if it can help reduce cognitive decline or amyloid accumulation, according to Genentech.
In the Colombia study, expected to start early next year, 100 family members with the mutation will receive the drug every two weeks in an injection at a hospital. Another 100 carriers will receive a placebo. And because many people do not want to know if they have the mutation, researchers will include 100 noncarriers in the study; they will receive a placebo.
Researchers have developed a sophisticated battery of five memory and cognitive tests that have been shown in other studies to detect subtle alterations in recall and thinking ability that usually go unnoticed. Dr. Pierre N. Tariot, director of the Banner Institute and a leader of the study, said the measurements would involve recalling words, naming objects, nonverbal reasoning, remembering time and place, and drawing tests involving copying complex figures.
Dr. Tariot said researchers would also assess changes in people’s emotional state, “irritability, sadness, crying, anxiety, impulsivity — these are cardinal features of the disease as it emerges.”
The scientists will take physiological measurements, including PET scans that measure amyloid and how glucose is metabolized in the brain, M.R.I. scans that measure whether the brain is shrinking, and cerebral spinal fluid tests that measure amyloid and tau, a protein in dying brain cells.
If any of these indicators are improved by the drug, Dr. Reiman said, scientists may then be able to treat one of these early physiological changes, just as high blood pressure andcholesterol are treated to prevent heart disease.
In MedellÃn, Marcela Agudelo, 17, has Alzheimer’s on both sides of her family because her parents are distant cousins. Marcela watched her maternal grandmother die, and her father, 55, once a vibrant livestock trader, has deteriorated so much that he can no longer walk, talk or laugh.
With the research, “we have more hope for a cure,” Marcela said, “or at least a better life.”
Monday, September 24, 2012
How to Stop Hospitals From Killing Us
http://online.wsj.com/article/SB10000872396390444620104578008263334441352.html?mod=WSJ_hp_mostpop_read
How to Stop Hospitals From Killing Us
Medical errors kill enough people to fill four jumbo jets a week. A surgeon with five simple ways to make health care safer.
MORE IN LIFE & CULTURE »
By MARTY MAKARY
When there is a plane crash in the U.S., even a minor one, it makes headlines. There is a thorough federal investigation, and the tragedy often yields important lessons for the aviation industry. Pilots and airlines thus learn how to do their jobs more safely.
The world of American medicine is far deadlier: Medical mistakes kill enough people each week to fill four jumbo jets. But these mistakes go largely unnoticed by the world at large, and the medical community rarely learns from them. The same preventable mistakes are made over and over again, and patients are left in the dark about which hospitals have significantly better (or worse) safety records than their peers.
WSJ's Gary Rosen talks to author and surgeon Marty Makary about his ideas for making American hospitals more transparent about their safety records and more accountable for the quality of their care.
As doctors, we swear to do no harm. But on the job we soon absorb another unspoken rule: to overlook the mistakes of our colleagues. The problem is vast. U.S. surgeons operate on the wrong body part as often as 40 times a week. Roughly a quarter of all hospitalized patients will be harmed by a medical error of some kind. If medical errors were a disease, they would be the sixth leading cause of death in America—just behind accidents and ahead of Alzheimer's. The human toll aside, medical errors cost the U.S. health-care system tens of billions a year. Some 20% to 30% of all medications, tests and procedures are unnecessary, according to research done by medical specialists, surveying their own fields. What other industry misses the mark this often?
It does not have to be this way. A new generation of doctors and patients is trying to achieve greater transparency in the health-care system, and new technology makes it more achievable than ever before.
I encountered the disturbing closed-door culture of American medicine on my very first day as a student at one of Harvard Medical School's prestigious affiliated teaching hospitals. Wearing a new white medical coat that was still creased from its packaging, I walked the halls marveling at the portraits of doctors past and present. On rounds that day, members of my resident team repeatedly referred to one well-known surgeon as "Dr. Hodad." I hadn't heard of a surgeon by that name. Finally, I inquired. "Hodad," it turned out, was a nickname. A fellow student whispered: "It stands for Hands of Death and Destruction."
Leonard Mccombe/Time Life Pictures/Getty Images; Photo Illustration/The Wall Street Journal
'Doctors absorb an unspoken rule: to overlook the mistakes of our colleagues.'
Stunned, I soon saw just how scary the works of his hands were. His operating skills were hasty and slipshod, and his patients frequently suffered complications. This was a man who simply should not have been allowed to touch patients. But his bedside manner was impeccable (in fact, I try to emulate it to this day). He was charming. Celebrities requested him for operations. His patients worshiped him. When faced with excessive surgery time and extended hospitalizations, they just chalked up their misfortunes to fate.
Dr. Hodad's popularity was no aberration. As I rotated through other hospitals during my training, I learned that many hospitals have a "Dr. Hodad" somewhere on staff (sometimes more than one). In a business where reputation is everything, doctors who call out other doctors can be targeted. I've seen whistleblowing doctors suddenly assigned to more emergency calls, given fewer resources or simply badmouthed and discredited in retaliation. For me, I knew the ramifications if I sounded the alarm over Dr. Hodad: I'd be called into the hospital chairman's office, a dread scenario if I ever wanted a job. So, as a rookie, I kept my mouth shut. Like the other trainees, I just told myself that my 120-hour weeks were about surviving to become a surgeon one day, not about fixing medicine's culture.
Hospitals as a whole also tend to escape accountability, with excessive complication rates even at institutions that the public trusts as top-notch. Very few hospitals publish statistics on their performance, so how do patients pick one? As an informal exercise throughout my career, I've asked patients how they decided to come to the hospital where I was working (Georgetown, Johns Hopkins, D.C. General Hospital, Harvard and others). Among their answers: "Because you're close to home"; "You guys treated my dad when he died"; "I figured it must be good because you have a helicopter." You wouldn't believe the number of patients who have told me that the deciding factor for them was parking.
There is no reason for patients to remain in the dark like this. Change can start with five relatively simple—but crucial—reforms.
Online Dashboards
Every hospital should have an online informational "dashboard" that includes its rates for infection, readmission (what we call "bounce back"), surgical complications and "never event" errors (mistakes that should never occur, like leaving a surgical sponge inside a patient). The dashboard should also list the hospital's annual volume for each type of surgery that it performs (including the percentage done in a minimally invasive way) and patient satisfaction scores.
The Saturday Essay
- Why Can't We Sell Charity Like We Sell Perfume? (9/15/12)
- Geography Strikes Back (9/8/12)
- Are Entitlements Corrupting Us? Yes | No(9/1/12)
- Conventional Wisdom (8/25/12)
- The Panic Over Fukushima (8/18/12)
- Can Syria's Christians Survive? (8/11/12)
- Decoding the Science of Sleep (8/4/12)
A survey of New Yorkers found that approximately 60% look up a restaurant's "performance ratings" before going there. If you won't sit down for a meal before checking Zagat's or Yelp, why shouldn't you be able to do the same thing when your life is at stake?
Nothing makes hospitals shape up more quickly than this kind of public reporting. In 1989, the first year that New York's hospitals were required to report heart-surgery death rates, the death rate by hospital ranged from 1% to 18%—a huge gap. Consumers were finally armed with useful data. They could ask: "Why have a coronary artery bypass graft operation at a place where you have a 1-in-6 chance of dying compared with a hospital with a 1-in-100 chance of dying?"
Instantly, New York heart hospitals with high mortality rates scrambled to improve; death rates declined by 83% in six years. Management at these hospitals finally asked staff what they had to do to make care safer. At some hospitals, the surgeons said they needed anesthesiologists who specialized in heart surgery; at others, nurse practitioners were brought in. At one hospital, the staff reported that a particular surgeon simply wasn't fit to be operating. His mortality rate was so high that it was skewing the hospital's average. Administrators ordered him to stop doing heart surgery. Goodbye, Dr. Hodad.
Safety Culture Scores
Imagine that a surgeon is about to make an incision to remove fluid from a patient's right lung. Suddenly, a nurse breaks the silence. "Wait. Are we doing the right or the left chest? Because it says here left, but that looks like the right side." The surgery was, indeed, supposed to be on the left lung, but an intern had prepped the wrong side. I was that doctor, and that nurse saved us all from making a terrible error. It isn't every hospital where that nurse would have felt confident speaking up—but it's this sort of cultural factor that is so important to safety.
If anyone knows whether a hospital is safe, it's the people who work there. So my colleagues and I at Johns Hopkins, led by J. Bryan Sexton, administered an anonymous survey of doctors, nurses, technicians and other employees at 60 U.S. hospitals. We found that at one-third of them, most employees believed the teamwork was bad. These aren't hospitals where you or I want to receive care or see our family members receive care. At other hospitals, by contrast, an impressive 99% of the staff reported good teamwork.
These results correlated strongly with infection rates and patient outcomes. Good teamwork meant safer care. The public needs to have access to such information for every hospital in America.
Cameras
It may come as a surprise to patients, but doctors aren't very good at complying with well-established best practices in their fields. One New England Journal of Medicine study found that only half of all care follows evidence-based guidelines when applicable. Fortunately, there is a technology that could work wonders to improve compliance: cameras.
Corbis
You wouldn't believe the number of patients who have told me their deciding factor in choosing a hospital was parking.
Cameras are already being used in health care, but usually no video is made. Reviewing tapes of cardiac catheterizations, arthroscopic surgery and other procedures could be used for peer-based quality improvement. Video would also serve as a more substantive record for future doctors. The notes in a patient's chart are often short, and they can't capture a procedure the way a video can.
Doug Rex of Indiana University—one of the most respected gastroenterologists in the world—decided to use video recording to check the thoroughness of colonoscopies being performed by doctors in his practice. A thorough colonoscopy requires meticulous scrutiny of every nook and cranny of the colon. Doctors tend to rush through them; as a result, many cancers and precancerous polyps are missed and manifest years later—at later stages.
Without telling his partners, Dr. Rex began reviewing videotapes of their procedures, measuring the time and assigning a quality score. After assessing 100 procedures, he announced to his partners that he would be timing and scoring the videos of their future procedures (even though he had already been doing this). Overnight, things changed radically. The average length of the procedures increased by 50%, and the quality scores by 30%. The doctors performed better when they knew someone was checking their work.
The same sort of intervention has been used for hand washing. A few years ago, Long Island's North Shore University Hospital had a dismal compliance rate with hand washing—under 10%. After installing cameras at hand-washing stations, compliance rose to over 90% and stayed there.
Following Dr. Rex's camera study, he did a follow-up, asking patients if they would like a copy of their procedure video. An overwhelming 81% said yes, and 64% were willing to pay for it. Patients are hungry for transparency.
Open Notes
Sue, a young accountant, came to my office complaining of abdominal pain. She wasn't sure what was causing it. She offered various theories: "Could this be from my Bikram yoga?" "Did my late-night ice cream cause the pain?" "Does having unprotected sex have anything to do with it?" Throughout her visit, I took notes. When we were done, she looked down at them suspiciously.
"What did you write about me?" she asked.
She was concerned that I thought she was either nuts or an ice-cream addict. In the course of our conversation, I also learned that she wasn't quite sure why I was recommending an ultrasound, though I thought I had told her.
I decided to start dictating my notes with the patient listening in at the end of his or her visit. "I also have high blood pressure," was a correction one older patient blurted out. Another said, "My prior surgery was actually on the right, not the left side." Another patient interrupted me and said, "No, I said I take 20 milligrams, not 25 milligrams, of Lipitor." Being able to review your doctor's notes in writing might be even better than my method, particularly if you could add your own comments, perhaps via the Web.
Harvard doctor-researchers Jan Walker and Tom Delbanco are using "open notes" at Harvard and Beth Israel Hospital in Boston, and my hometown hospital, Geisinger Medical Center in Pennsylvania, has begun giving patients online access to their doctors' notes. So far, both patients and doctors love it.
No More Gagging
Though there are many signs that health care is moving toward increased transparency, there is also some movement backward. Increasingly, patients checking in to see doctors are being asked to sign a gag order, promising never to say anything negative about their physician online or elsewhere. In addition, if you are the victim of a medical mistake, hospital lawyers will make never speaking publicly about your injury a condition of any settlement.
We need more open dialogue about medical mistakes, not less. It wouldn't be going too far to suggest that these types of gag orders should be banned by law. They are utterly contrary to a patient's right to know and to the concept of learning from our errors.
Political partisans can debate the role of government in fixing health care, but for either public or private approaches to work, transparency is the crucial prerequisite. To make transparency effective, government must play a role in making fair and accurate reports available to the public. In doing so, it will unleash the power of the free market as patients are better able to take charge of their own care. When hospitals have to compete on measures of safety, all of them will improve how they serve their patients.
Transparency can also help to restore the public's trust. Many Americans feel that medicine has become an increasingly secretive, even arrogant, industry. With more transparency—and the accountability that it brings—we can address the cost crisis, deliver safer care and improve how we are seen by the communities we serve. To do no harm going forward, we must be able to learn from the harm we have already done.
—Dr. Makary, a surgeon at Johns Hopkins Hospital and a developer of the surgical checklists adopted by the World Health Organization, is the author of "Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care," published this month by Bloomsbury Press.
A version of this article appeared September 22, 2012, on page C1 in the U.S. edition of The Wall Street Journal, with the headline: How to StopHospitals From Killing Us.
Cambodia: Garbage People - gutt turning
Garbage Dump People of Phnom Penh, Cambodia
this is gutt turning. Imagine yourself being there and then feel grateful for what you have.
http://peterpham.photoshelter.com/gallery-slideshow/G0000MqdQvuvKUFQ/?start
this is gutt turning. Imagine yourself being there and then feel grateful for what you have.
http://peterpham.photoshelter.com/gallery-slideshow/G0000MqdQvuvKUFQ/?start
Sunday, September 23, 2012
Isotretinoin: for Severe Acne Treatment Medication
Works for some:.....can have severe side effects, research thoroughly before use:
http://www.webmd.com/skin-problems-and-treatments/acne/isotretinoin-for-acne-vulgaris
Wednesday, September 19, 2012
HPSP: GREAT EXACT ANALYSIS AND COMMENTS BY PROS THEMSELVES !! (Health Professional Scholarship - Military)
http://halfmd.wordpress.com/2007/03/23/financial-analysis-of-the-health-professions-scholarship-program/
Financial analysis of the Health Professions Scholarship Program
Each year, military recruiters descend upon medical schools and pre-med fairs with the intention of signing people up for either the Army, Navy, or Air Force. Their goal is to fill the military with physicians to care for the soldiers in battle. They will cite patriotism and throw out stories of hero doctors and tell you than you (yes YOU) can be a Hero, MD. The greatest incentive they have is the Health Professions Scholarship Program. HPSP will pay for all of your tuition, fees, books, and supplies. All you have to do in return is serve a commitment of one year in the military for each year you take the scholarship.
The Student Doctor Network has a forum dedicated to military medicine. Many current and former active duty physicians will attempt to dissuade candidates from joining using a variety of illustrative stories to show that the mil med is overly bureaucratic, promotes ineffective leaders, and punishers free thinkers and whistle blowers. Think Walter Reed, but on a nation-wide scale. While the posters of SDN have their own reasons for their dissatisfaction with the Defense Department, my goal is to provide a quick and dirty financial comparison of HPSP to the civilian route. In other words, is the scholarship worth it?
First, let’s see how much the military is paying. I’ll use my school as an example.
Tuition = $30,000
Health Insurance = $2,500
Books = $1,500
Supplies = $700
Laptop rental = $200
Health Insurance = $2,500
Books = $1,500
Supplies = $700
Laptop rental = $200
Rounding up, the military is paying about $35,000 directly for my schooling. I also get $17,000 a year for a stipend. Over the course of four years, the military will have paid $208,000 for me to go to medical school. Now let’s do a comparison of different specialties and see how they stack up to HPSP. For salaries of military doctors, I used the Navy’s Pay Calculator. For the salaries of civilian residents, I took a rough average of several hospitals’ pay tables for post-graduate medical education. For the salaries of civilian doctors, I used the information provided by Washington University’s Residency Web.
Let’s start with internal medicine. I’m going to make a few big assumptions:
- No deployments
- I used my zip code (a rather expensive area to live) for the Pay Calculator
- No inflation or changes in salary for either civilian doctors or military personnel.
- No interest rates on student loans.
- The military doctor has no prior experience and gets promoted to major after six years in service.
For the civilian doctor, let’s use a similar table. Since I’m going to account for the $208,000 in debt that this person has, I’ve added another column, Wealth after debt.
From these tables we see that at the 7 year mark—the point at which the HPSP commitment is over—the military doctor comes out ahead. In fact, even after the ten year mark the military physician has accumulated more wealth.
Now let’s run the same course for a general surgeon:
After just three years in practice, the civilian route wins. If these two surgeons practice medicine for the same amount of time, the military doctor will never catch up.
Now let’s consider a radiologist:
Here, the civilian route wins out after just 2 years of practice.
Conclusions: the Health Professions Scholarship Program is not a good financial motivator for luring people into the military. Only primary care physicians will see a financial benefit for joining the program. While my assumptions place limitations on the overall accuracy of my calculations, I stand by my initial statement. Worth noting, however, is that the military has no malpractice insurance and that there are lots of benefits such as free healthcare, cheap shopping and entertainment on base, and a tax break of almost $10,000. Also, the federal government has authorized the military to raise the HPSP stipend from $17,000 to $30,000 a year—although no appropriations have been made. In some urban areas, military students are forced to take out loans to make up for the paltry stipend that we graduate students are receiving. By raising the stipend, students will be able to live comfortably without resorting to more loans—something HPSP was supposed to do away with.
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Howie said,
halfmd said,
Nope said,
- leverage
and – Student Doctor Network!
NavyDO said,
AF Doc said,
halfmd said,
jeff said,
Think said,
AF_Primarycare said,
For those whose life is motivate by money the AF would not be for you, but that is not why I get up in the morning.
Navymedstudent said,
SpouseofaResident said,
ENSNavymedstudent said,
The military is strained for doctors right now, and does try to entice people with bonuses and cash, but if that is all you are thinking about, I would strongly suggest that you do not accept the scholarship and leave the opportunity available for someone who is more concerned with service than necessarily money.
Cthulhu Dreams said,
College said,
student said,
halfmd said,
fizzlemed said,
Joe said,
Wes said,
silvanus said,
DecidingWhichPath said,
Mike said,
Jambony said,
Military Surgeon said,
1. If you want to serve your country, take the scholarship.
2. If you know you are going into primary care (e.g., family practice, pediatrics. internal medicine) and know that you do not want to complete a civilian residency – Take the scholarship.
3. If you know you want to be a surgeon – Don’t take the scholarship. Get into a civilian residency, make sure you don’t want to complete a fellowship, then look into the Military Financial Assistance Program (FAP). In fact, If you’ve attend a state medical school, you might actually be money ahead with the FAP route (vs. HPSP).
Michelle said,
Dean said,
Kevin said,
1. The Navy (I cannot say about other branches) will not force you into a residency you do not want. If you do not get the residency you want, you can do a GMO tour, flight surgery, transitional year, undersea medicine, or defer to civilian residency. As the Navy is getting rid of GMO tours, civilian deferments will be much more common.
2. As others pointed out, student loans rack up huge amounts of interest.
3. Investing the positive cash flow you have during medical school means you to EARN interest. Over 7 to 13 years, this can add up.
4. There is now a $20,000 signing bonus
5. Monthly stipend payments are $1981 as of July 2009
6. The tax benefits are about $6000 PER YEAR (Again, consider interest earned by investing this)
7. You can’t factor in any loans you may take out in addition to your stipend while on HPSP because you would be taking the same amount of money out in loans as a civilian.
8. Cost of living in the military is drastically lower than in the civilian world. You get discounts everywhere, all your purchases at exchanges and commissaries are tax free, these places usually have very good deals, free health insurance, and no malpractice.
AFHPSP said,
Manny said,
Jon said,
ICEMAN720 said,
Nontrad said,
FutureReliefDoc said,
2. I have no savings, and about 40kd of debt (undergraduate loans and a car loan). My dad is a trucker without a college education and my mom is a social worker so family contributions are not an option.
3. I am not going into medicine for the money. My ultimate goal is to work for an organization like Doctors Without Borders, or Partners in Health. Traveling to random places after I graduate isn’t deterrent for me. It’s a resume builder.
4. I might want to go into a “low paying” specialty like family or internal medicine.
5. Members of my family have served in the military, and although I don’t think I will want to make a career of Air Force, I don’t mind serving.
Lauren said,
isdh said,
JTAC WIFE said,
JW said,
Victor Johnson said,
Ameera said,
Future - Navy - Gal said,