Published in the July 2011 American Hospital Association Hospitals & Health Networks
By Whitney L.J. Howell
Teleradiology is growing, but experts caution about potential pitfalls
Hospitals never close, but that doesn’t mean someone from every specialty is always on call. A growing number of facilities aren’t scheduling radiologists for overnight and weekend shifts, and others no longer have them on staff. Instead, they rely on teleradiology companies to fulfill their imaging needs.
Also known as nighthawking, teleradiology steadily has grown in popularity in recent years. A 2009 study by VHA Inc., a nationwide network of community-owned health systems, reported 56 percent of U.S. hospitals use it. Many hail the service for its convenience and instant subspecialty coverage.
“Teleradiology is essential for small, rural practices that want to deliver high-end care, but don’t have enough volume to offer fellowships for subspecialty providers or that can’t afford to hire more staff to cover nights,” says William Bradley Jr., M.D., University of California–San Diego’s radiology chair. “Diagnosis quality also goes up because radiologists’ reading scans are already awake and alert. Someone who’s been awakened in the middle of the night is likely to miss finer details.”
Contracting with a teleradiology company also can help hospitals attract and retain talented radiologists, says Michael Modic, M.D., chairman of the Cleveland Clinic’s Neurological Institute. “Some radiologists are willing to forgo the additional reimbursement—sometimes as much as 10 to 15 percent of business—if they can avoid the night shift,” Modic says. “They want more work-life balance, and hospitals use teleradiology to retain them.”
But not everyone agrees teleradiology is financially sound or safe. Relinquishing additional reimbursement could have long-lasting effects, says David Levin, M.D., chairman emeritus of the department of radiology at Jefferson Medical College of Thomas Jefferson University. Having outside companies read scans could cause a permanent dip.
“It’s possible that reimbursement could start to drop because teleradiology companies bill less for reading scans,” he says. “If they’re billing $40 for reading an MRI, but hospitals bill $80, insurance companies will start wondering why they’re reimbursing at higher levels.”
Hospitals without in-house radiologists also lose an advantage when shopping for new imaging equipment, Levin says. Knowledgeable in-house radiologists can be intermediaries who negotiate with vendors for significant cost concessions on updated imaging equipment.
Levin disagrees that teleradiology improves diagnosis quality. Teleradiologists not only lack access to all patient records with potentially pertinent information that could alter a diagnosis, but neither can they consult with other providers if they have questions.
To read the article on the original Website: http://hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/07JUL2011/0711HHN_Inbox_telehealth&domain=HHNMAG
Published in April 28, 2011, DiverseEducation.com
By Whitney L.J. Howell
DURHAM, N.C. – Inclusivity was the buzzword on Wednesday at the annual Diversity in Higher Education Conference at Duke University in Durham, N.C. It permeated conversations of modifying higher education to more readily accept non-mainstream cultures, changing what people consider to be the color of the race problem, and making online education and technology more effective for diverse students. The challenge: making it all happen.
“Everyone seems to be onboard with diversity and inclusion, but the struggle is how to operationalize it,” said Dr. Benjamin D. Reese Jr., vice president of the Office for Institutional Equity at both Duke University and the Duke University Health System.
Duke University and the Duke University Health System collaborated with the New York-based Conference Board organization in staging the two-day conference, which concludes today.
According to Dr. Louis Mendoza, associate vice provost for equity and diversity at the University of Minnesota, higher education needs to give minority groups a venue to reclaim their cultural and ethnic identity and respect those characteristics. It isn’t enough to open the door to minority groups, expecting them to conform completely to the entrenched institutional philosophy.
“Diversity must move to the center of educational excellence,” Mendoza said. “It can’t be a case of telling a minority student or faculty ‘you can come in and play, but then what are we going to do with you?’ These individuals deserve a seat at the table as a social, intellectual and economic asset.”
Honoring diversity in community research and including populations in those endeavors are also important, he said. Many
groups resent being studied if they are denied the opportunity to offer their own insights and perspectives.
But reaching the point where minority individuals or groups feel true equity can be difficult, Mendoza said. Some schools view themselves as post-diverse—institutions with enough minority and international students—and others don’t want to upset the comfortable status quo.
The ideas sparked by the discussions about creating and improving inclusion are why many participants attended the conference. Terri Lockwood, director of programs for Appalachian University’s academic affairs department, said she came, hoping to take inspiration or nuggets of information back to her institution. She was pleased, she said, to hear a different perspective on how to handle discussions of equity between members of dominant and minority races.
“Appalachian has a commitment to diversity that we’ve woven into our strategic plan, and I came here looking for new methods of improving inclusivity at the school,” said Terri Lockwood, director of programs for Appalachian’s academic affairs department. “It’s clear that, as we work within our own parameters in society, it’s important that we try to work together to find a balance for the needs of all groups. No one needs to get offended or defensive in the process—it’s just a fact of life.”
According to Dr. Robert Jensen, journalism professor at the University of Texas at Austin, race continues to be a problematic topic in the United States because the country is, as he dubs it, a “White supremacy society.” Not a society in which Whites actively work to subjugate African Americans or other minority groups, but one in which Whites receive the most privileges and have little desire to change that situation.
For this reality to modify, the response must be radical, he said. Schools and employers can no longer pay lip service to diversity. The sentiment that multi-cultural inclusivity is essential must be authentic—institutions must not only think it and say it, they must do it, he added.
“It’s great to have an advocate that is neither of color nor specifically in the diversity and inclusion field,” said Patrice Hall, vice president of global equality, diversity and inclusion for Mercer, a global human resources company. “So much of diversity and inclusion work is dominated by people of color, so Jensen’s points about society being dominated by Whites explain why the work we do is often viewed as ‘less than’ and parochial by the mainstream.”
Some academic leaders recommend tailoring online education programs and other technologies to enhance the chances of success for minority students. Although historically Black colleges and universities have been slow to embrace online education, the field is growing, and minority students are flocking to this method of earning an advanced degree, said John Ebersole, president of Excelsior College. Excelsior is currently working with many HBCUs to help them establish online programs in a relatively low-risk way.
Virtual curricula will only truly flourish in the HBCU environment, however, if the programs speak the students’ learning styles, said Dr. James Anderson, president of Fayetteville State University in North Carolina. High enrollment isn’t enough to make an online program worth keeping.
“Enrollment numbers mean nothing. I’m interested in seeing that we get these students through graduation,” Anderson said. “We need to train our faculty to properly teach courses online—you don’t get to do it just because you want to. It’s important that we present information online in ways that fit our students’ learning styles. We need to teach them to be analytical learners because that style is associated with success in college.”
To read the article online: http://diverseeducation.com/article/15410/
Published in the Feb. 14, 2011, Raleigh News & Observer and the Feb. 14, 2011, Charlotte Observer
BY WHITNEY L.J. HOWELL - CORRESPONDENT
“You don’t have to be rich to be my girl. You don’t have to be cool to rule my world. Ain’t no particular sign I’m more compatible with. I just want your extra time and your …Kiss.”
DURHAM — Hand it to Prince for capturing the allure of a kiss in those lyrics.
It’s something almost everyone intuitively understands: A kiss is more than a kiss, and in fact, a good lip lock can seal a relationship.
The mystery of what makes a smooch smolder and why we do it prompted Sheril Kirshenbaum, a former research associate at the Duke University Nicholas School of the Environment, to study the passionate pastime and write “The Science of Kissing” (Grand Central Publishing).
“I didn’t realize until I did this book how important the kiss is,” said Kirshenbaum, now a University of Texas at Austin marine biology researcher. Kirshenbaum was at the Regulator Bookstore in Durham last month.
It takes chemistry
It might not be test tubes and Bunsen burners, but there’s more real chemistry going on during a kiss
than you probably want to contemplate during an embrace.
That fluttery feeling you get when you’re kissing a new partner – the racing heart and spiking blood pressure – comes from dopamine. It revs your engine, but you can thank the love hormone, oxytocin, for bringing you back for more years after the novelty has worn away, Kirshenbaum said.
Science also suggests kisses can be our detectives. With each swirl of the tongue, our partner’s saliva gives us hormonal clues about whether he or she would be a good companion for parenthood.
If you pucker up and the kiss is lifeless, your body could be telling you something. So, kiss your partner early and often, Kirshenbaum said, to see if you feel a sizzle.
Consider it the body’s first line of defense against dating – or marrying – the wrong person, said University of Albany evolutionary psychologist Gordon Gallup Jr. It also gets us off the hook for trying to improve our kissing techniques.
“There’s evidence to suggest that modifying your kissing ability might not be in your biological best interest,” Gallup said. “If you push for a relationship after a lackluster kiss, that relationship could end poorly.”
And don’t discount the role your nose can play in bringing you in for a kiss. Scientists have evidence that while men might not be pigs, they certainly smell like them – and women, in fact, may like it.
It turns out that men have the same hormone – androstenone – in their sweat that male pigs have in their saliva.
Though smelling the hormone makes sows immediately receptive to mating, it doesn’t exactly work like a magic elixir for women. However, in some experiments, women have shown a preference for chairs sprayed with the hormone, and men have conspicuously avoided the same seats.
“There are a lot of reasons to think that, as humans, we’re picking up on something at an unconscious level,” Kirshenbaum said. “Any woman who’s ever lived in a college dorm with other women and ended up on the same menstrual cycle knows it’s possible.”
Can’t we just kiss and make up?
It turns out we can. Despite women’s protests that a peck or two at the end of an argument isn’t enough to get a man out of the dog house, scientific research disagrees. According to Gallup, studies show that kissing, and the oxytocin it pumps into the body, actually makes women more likely to dole out a reprieve.
It also shows that a kiss means something different to men and women.
“Research supports what we know about how men view kissing. They kiss as a means to an end,” Gallup said. “Either they want to gain sexual favors or they want forgiveness for misbehavior.”
It’s also a tool men can use to their advantage, said Helen Fisher, a Rutgers University anthropologist who has studied kissing.
Saliva is swimming with testosterone, Fisher said, giving men the chance to slip the women they kiss a little extra hormone to get them in the mood. This added benefit of kissing could also explain why men are far more interested in sloppy, wet kisses than women are, Kirshenbaum said.
For women, though, kissing is less about sex and more about whether the relationship is solid or whether it’s on the way down.
“We see a lot among committed couples that women view the amount of kissing as a barometer of the relationship’s status,” Gallup said. “In their minds, the more kissing there is, the more passionate it is, the more viable the relationship is.”
And once you find the right person, there’s only one way to keep the relationship simmering Kirshenbaum said. Just keep kissing.
To read the Raleigh News & Observer story online: http://www.newsobserver.com/2011/02/14/988253/got-chemistry-its-in-a-kiss.html
To read the Charlotte Observer story online: http://www.charlotteobserver.com/2011/02/13/2060496/got-chemistry-its-in-a-kiss.html