Susan M. Whitely, MD

I am writing this in 2009, and my wish is that your Holiday was relaxing and joyous.

I am Susan Whitely, your 2010 Maricopa County Medical Society President.  First, I would like to thank Dr. Brian Riveland, as Past President, and Dr. Edward Donahue, who preceded Dr. Riveland.  They have both guided me and mentored me.  I would also like to sincerely thank the Society staff, especially Dan Mitten, for transitioning me into this servant role.

Many of you may know or know of me, but for those who do not, I will tell you a little about myself.  I was born in Cincinnati, Ohio, and raised in Dayton and Columbus , Ohio.  I come from a large Irish-German family and I'm one of 60 grandchildren on my Irish side.  I have been married to Ed for 18 years, and he is the reason I have been able to do what I do.  We are blessed with an amazing 15-year-old son, Benjamin.

The Arizona Board of Regents has endorsed a $187 million expansion plan for the University of Arizona College of Medicine - Phoenix in partnership with Arizona State University.

 At its recent meeting in Tucson, the Board approved the plan to build a Health Sciences Education Building and other improvements on the downtown Phoenix Biomedical Campus that will allow the College of Medicine - Phoenix to train more physicians and strengthen the presence of the UA College of Pharmacy and other health-related colleges at the campus.

 "This is an integral step toward creating the state's next great academic health center," said William M. Crist, MD, vice president for health affairs at the University of Arizona. "The construction would bring immediate, much-needed jobs to our state and high-paying positions later. We need to expand to meet the health-care needs of Arizona."

 Leading the push for interdisciplinary education, the building will house classrooms, a simulation center and more to help the College of Medicine - Phoenix expand its current class size of 48 students per year to at least 110. It also calls for space for College of Pharmacy students to begin four-year programs in Phoenix. Until now, UA pharmacy students have only been able to complete their third- and fourth-year studies in Phoenix. The education building also allows ASU to bring nearby College of Nursing and Health Innovation students to the Phoenix Biomedical Campus and opens the door for Northern Arizona University to offer allied health courses on the downtown campus, as planned.

 The Regents-endorsed plan calls for the construction of the education building and accompanying facilities, as well as improvements to the Arizona Biomedical Collaborative research building on campus.

 "This building will bring all manner of health education under one roof," said Stuart Flynn, MD, dean of the College of Medicine - Phoenix. "It puts Arizona at the forefront of training the next generation of health-care professionals."

 The expansion plan, which has been approved twice by the Arizona Legislature and signed by the governor, still must be reviewed by the Joint Committee on Capital Review before ground can be broken. The committee is scheduled to reconvene after the first of the year.

 The 268,000-square-foot building is part of the overall plan to create a major academic health center in downtown Phoenix that includes health education facilities, research, clinical areas and already features the Translational Genomics Research Institute (TGen).

The Senate approved the Patient Protection and Affordable Care Act by a party-line, 60-39 vote on Dec. 24, 2009, after nearly a month of debate and several procedural barriers that required 60 votes to overcome. Negotiators now must find a consensus between it and the Affordable Health Care for America Act, which the House passed 220-215 on Nov. 7, 2009.

The two bills both would extend health coverage to most Americans through a combination of individual and business mandates, health insurance reforms, and new government coverage subsidies. Democrats predicted they would be able to hammer out a compromise that would garner a majority of support in the House and the 60 votes needed to move to final consideration in the Senate.

Doctors, hospitals and payers need to adopt an updated version of the International Classification of Diseases code sets, ICD-10, by Oct. 1, 2013.

As a prerequisite to the ICD-10 move, entities by Jan. 1, 2012, need to adopt updated electronic transaction standards, known as 5010, under the Health Insurance Portability and Accountability Act. The original compliance dates were much sooner -- April 1, 2010, for HIPAA 5010 and Oct. 1, 2011, for ICD-10 -- but were moved back due to a regulation released last January by the Bush administration in its final days in office.

Despite having the additional time to get up to speed, the AMA is worried that physicians are still facing a costly and aggressive time line for implementing ICD-10.

"We believe that use of the A1c, because it doesn't require fasting, will encourage more people to get tested for type 2 diabetes and help further reduce the number of people who are undiagnosed but living with this chronic and potentially life-threatening disease," Richard M. Bergenstal, MD, ADA president-elect of medicine & science, said in a news release. "Additionally, early detection can make an enormous difference in a person's quality of life. Unlike many chronic diseases, type 2 diabetes actually can be prevented, as long as lifestyle changes are made while blood glucose levels are still in the pre-diabetes range."

The A1c test, which measures average blood glucose levels for a period of up to 3 months, was previously used only to evaluate diabetic control with time. An A1c level of approximately 5% indicates the absence of diabetes, and according to the revised evidence-based guidelines, an A1c score of 5.7% to 6.4% indicates prediabetes, and an A1c level of 6.5% or higher indicates the presence of diabetes.

The report, from the academy's Therapeutics and Technology Assessment Subcommittee, was published online December 30 in Neurology. Authors on the new document are Richard M. Dubinsky, MD, MPH, from Kansas University Medical Center in Kansas City, and Janis Miyasaki, MD, MEd, from Toronto Western Hospital, Ontario, Canada.

"In the highest-quality studies of chronic low back pain, there was no benefit of TENS compared to sham or placebo TENS, leaving us to conclude that it is of no benefit, and make a recommendation that it should not be used for chronic low back pain," Dr. Dubinsky told Medscape Neurology.

In diabetic polyneuropathy, some studies showed slight benefit, he added. "We concluded it should be considered in the treatment of diabetic polyneuropathy."

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"Approximately one in five U.S. adults smoke cigarettes, and certain subpopulations have disproportionately higher prevalences of smoking," write S. R. Dube, PhD, from the CDC Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, and colleagues. "Cigarette smoking continues to be the leading cause of preventable morbidity and mortality in the United States. Full implementation of population-based strategies and clinical interventions can educate adult smokers about the dangers of tobacco use and assist them in quitting."

An analysis of data from the 2008 National Health Interview Survey showed that the proportion of US adults who were current cigarette smokers decreased by 3.5% during 1998 to 2008, from 24.1% to 20.6%. However, there was no significant change in that proportion from 2007 (19.8%) to 2008 (20.6%).

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