The MAHA movement's fatal flaw
At the core of the 'Make America Healthy Again' movement is a fatal contradiction. On the surface, it purports to favor the prevention of diseases over the treatment of them. Some of its approaches seem to be common sense: Who could argue against cutting ultra-processed food and removing harmful pesticides?
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Medscape
34 minutes ago
- Medscape
Real Life Simulations: Mass Casualty Training in Med School
Anyone who watched television show The Pitt on Max knows how overwhelming a mass casualty event can be for a hospital. Preparation is key, and accredited hospitals are required to hold training exercises. But these incidents don't only affect physicians in the Emergency Department. The random nature of mass shootings, natural disasters, multi-car pileups, building collapses, and the like means an all-hands-on-deck situation could happen at any time. An increasing number of medical schools see the value in preparing their students early. 'Unfortunately this is where the world is going. We need to rely on ourselves because help may not be coming,' said Jeffrey Pearl, MD, associate dean of professional health education at the University of Texas (UT) at Tyler School of Medicine. 'In the end, the first line is going to be one of us picking someone out of the rubble from a tornado and putting a tourniquet on.' Unfortunately this is where the world is going. We need to rely on ourselves because help may not be coming. More than 20 years ago, the Associations of American Medical Colleges and the CDC issued a joint report recommending disaster-related training for medical students. It's still a relatively rare offering — by 2021, only seven allopathic medical schools in the US mentioned disaster response training in their course catalogs. But just 2 years later, that number had more than doubled. Roughly 10% of allopathic medical schools now offer it, as do a number of osteopathic medical schools. 'I think the best part is, it gives you perspective as to what goes on out in the field,' said Joshua Goodman, a rising fourth-year medical student at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He's participated in the school's annual training day more than once. 'Even in non-MCI situations, you might wonder why the patient is being brought in in this condition. Why didn't they do this? Why didn't they do that? This gives you a better understanding of what it's really like out there, so you know what to expect and can act on it.' Different Approaches to the Same Concept In order to prepare their students for an unpredictable future, medical schools take a variety of tacks. At some schools, all students undergo this training. At others, it's voluntary. Scenarios include bus bombings, school shootings, landslides, and the like. Often, they're location-specific, like the New York City subway car used in Hofstra's training, done at the local fire training academy. 'They fill it with smoke, and have students come in to rescue patients,' said Thomas Kwiatkowski, MD, assistant dean for simulation and professor of emergency medicine and science education at Hofstra. 'Some victims speak a different language, which is typical for New York City. It really challenges the students.' The variations don't stop there: At both UT Tyler and Hofstra, all first-year medical students complete a full emergency medical technician course. It concludes with a mass casualty simulation, which provides the chance to really practice the skills they've just learned. 'We didn't just want them to ride along in an ambulance,' Kwiatkowski said. 'That's not going to provide anything more than observation. I wanted a true clinical experience.' A presentation on FEMA's National Incident Management System kicks off the day at Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio. Students then move on to training with emergency equipment like cervical collars and backboards. But the bulk of the day is spent at the local fire department's training center for a hands-on simulation. Training at Perelman School of Medicine, University of Pennsylvania, Philadelphia, is part of a popular 2-week elective in wilderness and disaster medicine. Medical students learn to handle scenarios including avalanches, dirty bombs, and chemical weapons. At Idaho College of Osteopathic Medicine, Meridian, Idaho, training has included a simulated music festival gone awry as well as a multi-vehicle accident. College of Osteopathic Medicine, University of New England, Portland, Maine, has held four annual mock events. Last year's program focused on the lessons learned in the 2023 mass shooting in nearby Lewiston. Investing in Realism Limited research has been done to show exactly how realistic simulations should be, but there is some that suggests the more accurately a scenario reflects real life, the more students can benefit from it. Depending on a medical school's budget, things can get quite realistic, indeed. For many, it includes going off-site to a training ground, where students must triage realistic victims even as they experience the chaos of an actual event. 'When they walk into a burn tower knowing that there's been an explosion, and they hear people screaming out and they can't see much, it's an environment that probably causes their heart rate to go up a little bit, perhaps their respiratory rate to go up a little bit,' said William Burke, DO, dean of Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio. 'I think those types of situations help you better understand, as an individual, how you might respond in real life.' William Burke, DO For the simulations' victims, most schools use a combination of mannequins and volunteers — either locals or other medical students. Often, moulage artists are brought in to apply special-effects makeup. At UT Tyler, a relatively new school, Pearl had a sizable budget to design the mass casualty training program. Faculty works with campus and local law enforcement, fire department and emergency medical services, and even the Federal Bureau of Investigation to make the event feel as real as possible for students. High-tech wound simulation includes three-dimensional printed shrapnel mounted on silicone patches that are easily applied to volunteers' bodies; bleeding systems that pump fake blood; two cut suits of repairable skin with organs that bleed — which can be operated on while actors wear them; and several mannequins with realistic injuries. A significant amount of effort goes into creating thoughtful, plausible scenarios. A school shooting is part of the simulation at Hofstra. 'The way they set it up is hyper realistic, in that you have real police officers acting, there's a lot of yelling, it's dark, there's a lot of banging on doors. It's frankly a little bit scary,' Goodman, the medical student, said. 'You really do feel like you're in a school and you have to hide but you also have to triage: Who can we get out? How are we going to get them out? Is it safe to open the door?' Decisions Under Pressure Whatever the scenario, the goal in all these simulations is the same: To help medical students learn to make life-or-death decisions quickly, under extreme circumstances. 'The first minute or two, they're a little shell shocked. After that, it's like watching your children grow up,' Pearl said. 'These are first- and second-year med students, and they're rocking and rolling.' Thomas Kwiatkowski, MD During the exercises, they must triage victims into color-coded categories. Yes, just like in The Pitt : Green goes to the walking wounded, those who need minimal help. Yellow indicates a more serious injury, but not immediately life-threatening. Red means a victim has severe injuries, but with a high potential for survival. Victims designated with a black mark are either deceased or have injuries incompatible with life. 'It's very difficult when you have to make that decision,' Kwiatkowski said. 'There are a couple of maneuvers that people do before they can decide to make someone black, but sometimes you can have someone who's talking to you, and you know that you can't save them. That's an important experience for students.' Other ethical considerations also play out. During some simulations, for instance, a school shooter is still active. Students must decide how to help children while staying safe themselves, or if and when it's worth it to risk their own lives. At Ohio University, one situation involves a bombing. Unbeknownst to the students, the bomber is among the victims. 'Students are turning victims over and see the person playing the bomber has another bomb underneath them,' Burke said. 'It helps them understand the ethics of the situation: Do you treat them the same? The answer is yes, you take care of everybody. When you ask those questions, students are thinking about things in ways they've never had to before.'
Yahoo
an hour ago
- Yahoo
LQpay Expands Compliant Surcharging Solution, Optimizing Payment Strategy for Healthcare Practices
End-to-End Compliant Credit Surcharging with Custom Integration Now Available PLANTATION, Fla., June 11, 2025 (GLOBE NEWSWIRE) -- LQpay, a leading provider of innovative patient payments and automation technology, announced the expansion of its end-to-end compliant credit card surcharging solution, empowering healthcare practices to optimize their payment strategy and more seamlessly defray operational costs without sacrificing efficiencies or the patient experience. The latest enhancements enable medical and dental organizations to pass along credit card processing fees and serve up the necessary disclosures to patients across all eligible channels, encompassing both in-office and remote payment types, such as recurring billing plans, text- and email-to-pay, card on file, etc. In addition, by leveraging its proprietary RPA (Robotics Processing Automation) technology, LQpay has the unique capability to customize the integration of these payment types into any underlying EMR/practice management system. This custom integration capability allows practices to tailor the posting and reporting of surcharged transactions according to their unique workflows, business requirements, and practice management systems. By automatically calculating and applying compliant surcharges to eligible credit card transactions and facilitating accurate record-keeping of patient accounts, healthcare practices can reduce operational expenses without increasing administrative burden. As payment processing costs continue to rise, healthcare providers face continuous pressure on operating margins. LQpay's enhanced surcharging platform offers a powerful, compliant way for practices to offset these expenses without disrupting workflows or compromising the patient experience. 'Today's healthcare practices need more than a payment processor. They need a partner who can help them navigate complexity while protecting profitability,' said Shashi Kapur, CEO of LQpay. "Based on valuable feedback from our customers and partners, along with our dedication to innovation, we are proud to be a premier payments technology provider merging end-to-end compliant surcharging with robust Robotics Processing Automation (RPA). Our expanded surcharging capabilities provide healthcare organizations with a turnkey, compliant way to reduce costs and operate more efficiently.' Since its initial introduction, LQpay's compliant surcharging feature has provided practices with a valuable tool to offset the growing expense of payment processing fees. Recognizing the evolving needs of the healthcare industry and LQpay's commitment to continuous improvement, these enhancements truly set LQpay apart in the industry, ensuring practices experience greater efficiency and maximized financial benefit. Key Benefits of LQpay's Surcharging Enhancement: Optimized payment strategy ensuring credit card processing fees are consistently offset, regardless of how patients choose to pay. Custom integration with practice management systems (PMS). Unlike generic surcharge options, payments are automatically posted according to each practice's workflow and reporting requirements. Certified, compliant solution aligned with processor mandates, card network rules, and applicable state and regional regulations. Configurable patient communications and transparent fee disclosures to ensure patients are clearly informed about surcharges before payment and provided options for alternative, non-surcharge payment methods (e.g., ACH, debit, cash). Real-time reconciliation and reporting tools with detailed dashboard, making it easy to track surcharge revenue and monitor compliance without manual record-keeping. The surcharging capability is now available to both new and existing LQpay customers using approved payment gateways. Practices eager to enhance their financial performance and reduce processing expenses are encouraged to schedule a personalized demonstration. About LQpay Based in Plantation, FL, LQpay stands as a leading end-to-end patient payments platform, dedicated to serving the healthcare, dental, and veterinary practices. By integrating cutting-edge automation, AI-powered integrations, and modern payment functionalities such as text-to-pay and auto-posting, LQpay empowers practices to streamline operations, accelerate cash flow, and elevate the overall patient financial experience. For more information or to schedule a demo, please visit CONTACT: Press Contact: 954.909.5948 info@ in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
an hour ago
- Yahoo
The cheap fat jabs sending big pharma into a frenzy
For many Americans who tuned in to watch the Super Bowl earlier this year, it was a surprise to find themselves fat-shamed during the ad break. 'Obesity is America's deadliest epidemic,' a voiceover said, as images of wobbling bellies, greasy burgers and giant apple pies flashed across TV screens. The Super Bowl's 127m-strong audience, who were tucking into an estimated 1.5bn chicken wings during the event, were warned that 'obesity leads to half a million deaths each year'. But Hims and Hers, the US online medicines company behind the ad, said people should not blame themselves. Instead, its advert claimed that 'the system' was keeping them 'sick and stuck', adding that 'there are medications that work, but they're priced for profits, not patients'. To the relief of viewers, Hims and Hers offered a 'life-changing' solution. Rather than paying hundreds of dollars each month for well-known, branded weight-loss jabs such as Wegovy, households could instead try Hims and Hers' cheaper, replica versions. 'This is the future of healthcare,' it argued. 'Join us in the fight for a healthier America.' However, for the likes of Danish obesity drug maker Novo Nordisk and US pharma rival Eli Lilly, which have claimed the rise of copycat jabs poses potential health risks, such claims have become a serious headache. Over the past few decades, both businesses have poured billions of dollars into obesity drug research – recently yielding blockbuster drugs Wegovy and Mounjaro. The rapid uptake of such drugs has prompted a surge in revenues for big pharma. But bosses are now increasingly worried that demand among American patients has been dented by a cluster of smaller, copycat companies. According to industry estimates from November, around a quarter of the 8m Americans on weight-loss drugs were taking knock-off replica versions. These medicines, known as 'compound' drugs, were priced at around $200 ($148) a month, compared to over $1,300 for some branded versions. Barclays analyst Emily Field says the boom in copycat weight-loss drugs has been a 'unique phenomenon' in the US, sparking an inevitable surge in legal claims that has drawn the attention of regulators. So-called compound drugs are essentially custom-made medicines created by pharmacies using the same active ingredients of patented drugs. Historically, compounding pharmacies create custom versions of medicines if they need to personalise them for patients. For example, if someone is unable to take a standard oral medicine in pill form, or is allergic to an ingredient in an existing medicine. Compounding pharmacies are also typically blocked from mass-producing their drugs. For weight-loss drugs, though, it has been a different story. After the US Food and Drug Administration (FDA) put semaglutide – marketed as the blockbuster obesity drug Wegovy – and tirzepatide – the same for Eli Lilly's Mounjaro – on the shortage list in 2022, compounders were allowed to ramp up production. 'It was almost like these companies found a loophole where they were allowed to do this on a mass scale,' says Field. The impact has been significant. At the start of this year, Novo Nordisk estimated that the copycat drugs accounted for around a third of the entire weight-loss market. That is despite warnings from the FDA about the health risks posed by compounded medicines, which do not have to be approved by the regulator. Beth, from Washington, says she was tempted by online ads for the compound medicines, having struggled with her weight since the pandemic. For her, the drugs helped her at a time when it seemed impossible to lose weight or stick to a diet. She dropped 30lbs over a few months of taking a compound weight-loss medicine. Others say they had little choice but to opt for compound versions, given that the branded medicines were too expensive and not covered by their health insurance. However, the situation is rapidly changing. Last month, the FDA banned mass production of copycat weight-loss treatments that use semaglutide, the ingredient in Novo Nordisk's Wegovy. It also removed tirzepatide from its shortage list last October. Novo Nordisk said the law has now made things clearer. 'Moving forward, any compounder that mass produces or sells knock-off drugs is breaking the law and compromising patient safety,' a spokesman said. Eli Lilly says the products 'pose potentially life-threatening health risks', adding: 'Patients shouldn't be exposed to risky, unapproved products when regulator-approved medicines are available.' Online medicines firms, also known as telehealth businesses, are now racing to find a way to continue getting cheaper, personalised replica drugs out to patients. Noom, a rival to Hims and Hers, has suggested it will still be able to sell compounded weight-loss drugs to patients under an exception set aside for 'personalised' medicines. Hims and Hers, meanwhile, has already struck a new deal with Novo to offer its branded obesity drug to patients. The US firm also said this month it was exploring expansion in the UK, after acquiring European rival Zava. Andrew Dudum, the Hims and Hers chief, suggested there could be 'expansive options in obesity that include that type of personalisation, or similar types', telling the Financial Times that it could sell replica obesity medicines in the UK and Europe. David Meinertz, the boss of Zava, agrees that there are opportunities for the business to grow outside of America. 'There's clearly the experience and expertise that Hims and Hers have built up in the US,' he says. 'But then we have things like the regulatory knowledge here in Zava, and this is where we combine our experiences and spearhead this effort.' Still, the situation in the UK is very different to the US. Here, the compounding pharmacy market is much smaller, with pharmacies able to prepare personalised medicines for patients if it is prescribed by a doctor. Elizabeth Philp, the co-founder of compounding pharmacy Roseway Labs, says there could be a role for more personalisation of medicines. 'The NHS will say wasted medication is one of their top issues – people who try medication, put it in their bathroom cupboard and never use it again because it didn't suit them,' she says. 'We can really help with that.' However, drug insiders argue it would be a 'very bad idea' if the UK started to think about bringing in cheaper compound medicines for weight loss. 'The real drugs are getting very cheap at volumes,' says one senior drug leader. 'Supply is not an issue.' It will be a message that Novo and Eli Lilly will seek to drum home as they seek to prevent smaller rivals from selling cheaper weight-loss medicines to patients. Still, the effects of this debate are already being felt by many in the US battling to lose weight. 'I cannot afford the full price at this time,' says Beth. 'I think it's awful that people are losing access to this medication due to finances or compounded meds going away. 'These drugs are literally life-changing.' Broaden your horizons with award-winning British journalism. Try The Telegraph free for 1 month with unlimited access to our award-winning website, exclusive app, money-saving offers and more.
