Allegheny County Medical Society Blog

“From Pittsburgh to the World” is the message on a banner at the Global Links headquarters in Green Tree. Surrounding the banner is detailed pottery from Cuba, lucky ekekos from Bolivia and beautifully painted feathers from Nicaragua. Adjacent to these mementos of thanks from communities around the world is a window that sits eye-level with I-376 West and the rapid traffic and massive semi-trucks that come with it. The colorful art and the grey interstate form a striking dichotomy ... and a striking partnership. Those massive semi-trucks that pass by may just have left Global Links filled with medical surplus such as life-saving sutures, hospital beds, wheelchairs, breathing machines, blood pressure cuffs and oto-ophthalmoscopes. Medical surplus is bound for Nicaragua, for Bolivia, for Honduras   or for Pennsylvania safety net organizations such as Jeremiah’s Place, the Latino Community Center, or Allies for Health + Wellbeing. More than 300 tons of medical surplus is rescued every year by Global Links   primarily from the Pittsburgh area. Instead of piling up in a landfill, these materials will improve access to healthcare for a community in need.

Catherine A. Chappell, MD, MSc
Debra L. Bogen, MD, FAAP, FABM

This is the first installment of a four-part series.

Since former U.S. President Richard Nixon redeemed his legacy by defrosting and strengthening the relationship between the United States and China, China has rapidly advanced in terms of technology, economic power and manufacturing capability to become a superpower in its own right. Our recent news is filled with worries of U.S. debt to China, trade wars with China, industrial and perhaps political espionage perpetrated by China and the like. At the same time, it has become fashionable amongst Americans to visit China and take pictures along the Great Wall of China or before the famous Stone Soldiers to cross these off one’s bucket list.

Opinion

Editorial ................................161
The China paradox
Deval (Reshma) Paranjpe, MD, FACS

1. Email your VERTICAL jpg photos with a resolution of 300 dpi or higher to
   bulletin-contest@acms.org. Photos should be 8”W x 10”H.
2. You must be an ACMS member physician to submit photos.
3. Include the name of the photo (please keep file names short) as well as your name, specialty, address and phone number in the email.
4. You will receive verification that your photo has been received and is eligible to be entered in the contest.
5. a) Horizontal photos will not be considered.
6. b) Photos with low resolution will not be considered.
7. c) Panoramic shots or photos featuring specifically identifiable individuals/relatives will not be considered.
8. The deadline for submission is Friday, October 4, 2019. After this date, a group of individuals selected by the ACMS Board of Directors and ACMS Editorial Board will vote on the top 12 photos.
9. Winners will be announced on the ACMS website, in the Bulletin and via email. The 1^st-place winner’s photo will appear on the January 2020 cover; the remaining winning photos will appear on Bulletin covers throughout the year.
10. Please continue to check the ACMS website and future issues of the Bulletin for further updates and reminders.
11. If you have any questions, please call Bulletin Managing Editor Meagan Sable at (412) 321-5030, ext. 105, or email msable@acms.org.

Maintenance of Certification (MOC) programs are a source of irritation and controversy in medical communities today. The American Board of Medical Specialties (ABMS), representing 24 specialty member boards, notes that prior to the 1970s, board certification of a physician provided them with lifetime credentials. These written and sometimes oral exams were designed to test for basic competence in that particular specialty. (This was analogous to medical licensure based on an individual passing the three parts of the examinations given by the National Board of Medical Examiners [NBME]. In 1992, this exam was superseded by the U.S. Medical Licensing Examination [USMLE], sponsored by the Federation of State Medical Boards [FSMB] and the [NBME]). As recognition that the science and practice of medicine underwent substantial and sometimes rapid changes over time, efforts were begun to assure that diplomates of the various specialty boards were, in fact, still competent to practice their specialties. Initially, the individual state boards of medicine required 50 to 150 hours of continuing medical education (CME) for each cycle of license renewal. Attendees at CME courses were given a Certificate of Attendance by the program sponsors, which could be used to verify individual participation. I ran a CME program for 25 years and noted that many registrants would duly sign in each morning, and then shortly leave to play golf!

The alarming rise in measles cases has finally reached Pittsburgh, with four cases confirmed after exposure to an unvaccinated adult with measles. These people visited the airport, grocery stores, a thrift store, a car rental agency and untold other venues, exposing untold other people. This has fueled reactions in the general public from righteous anger (how dare these idiots remain unvaccinated and endanger my vulnerable loved ones with a preventable serious disease?) to outright fear (I can’t take my infant/immunocompromised relative out of the house now!).

Hepatitis Awareness Month is a campaign to raise awareness about hepatitis. National Hepatitis Awareness Month was first established by the Center of Disease Control (CDC) and Prevention in 2001.

Background. Cannabidiol (CBD), derived from cannabis (cannabis sativa L.), has been marketed for several years, but interest in CBD products – and the number of outlets selling such products – skyrocketed after Congress passed the Agriculture Improvement Act of 2018 (Farm Bill). The Farm Bill, among other things, established a new category of cannabis – hemp – defined as cannabis with 0.3 percent or less concentration of compound delta-9-tetrahydrocannabinol (THC). Products meeting the definition of hemp were removed from the purview of the federal Controlled Substances Act. Companies manufacturing CBD products interpreted this to mean that their CBD products were legal so long as they were derived from hemp. However, a statement from the federal Food and Drug Administration’s (FDA’s) recently departed commissioner Scott Gottlieb, MD, on April 2, 2019, emphasized that the Farm Bill “explicitly preserved the FDA’s current authority to regulate products containing cannabis or cannabis-derived compound under the Federal Food, Drug and Cosmetic Act (FD&C Act) and section 351 of the Public Health Service Act.”