NCDHHS Places Important Focus on Sickle Cell Disease with Federal Partnership

With approximately 6,800 people in North Carolina suffering with sickle cell disease, the North Carolina Department of Health and Human Services (NCDHHS) intends to increase access to new therapies through the Cell and Gene Therapy (CGT) Access Model.
The Cell and Gene Therapy (CGT) Access Model aims to improve the lives of people with Medicaid living with rare and severe diseases by increasing access to potentially transformative treatments.
Cell and gene therapies have high upfront costs but have the potential to reduce health care spending over time by addressing the underlying causes of disease, reducing the severity of illness, and reducing health care utilization.
Initially, the model will focus on access to gene therapy treatments for people living with sickle cell disease, a genetic blood disorder that disproportionately affects Black Americans.
NCDHHS has updated a white paper it issued in December when the U.S. Food and Drug Administration approved the historic therapies named Casgevy and Lyfgenia, which are now available on the market. In clinical trials, both therapies were found to reduce or completely eliminate the extreme pain crises experienced by people living with sickle cell disease.
For additional information on the Cell and Gene Therapy Access Model, see the fact sheet and CGT model page.
Related Reading:
U.S. Set to Approve First Gene-editing Treatment for Sickle Cell Patients
FDA Approves Amivantamab as First-Line Lung Cancer Treatment

The Food and Drug Administration (FDA) has approved amivantamab-vmjw (Rybrevant, Janssen Biotech, Inc.) with carboplatin and pemetrexed for the first-line treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 20 insertion mutations, as detected by an FDA-approved test.
The FDA also granted traditional approval to amivantamab-vmjw for adult patients with locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutations, as detected by an FDA-approved test, whose disease has progressed on or after platinum-based chemotherapy. FDA previously granted accelerated approval for this indication.
Read the full article here.
New NC Food Program Will Feed Children Over the Summer

Expected to provide food for nearly a million school children this summer
Food and nutrition security means having reliable access to enough high-quality food to avoid hunger and stay healthy. Improving access to nutritious food supports overall health, reduces chronic diseases, and helps people avoid unnecessary health care. That’s why food and nutrition security is one of the key social determinants of health, according to the Centers for Disease Control. A new program in North Carolina is expected to provide food for nearly a million school children this summer.
The North Carolina Department of Health and Human Services (NCDHHS), in partnership with the North Carolina Department of Public Instruction, has announced its intent to administer the U.S. Department of Agriculture's new Summer Electronic Benefits Transfer (S-EBT) Program known as "SUN Bucks."
"Food is foundational to health," said NC Health and Human Services Secretary Kody H. Kinsley. "The SUN Bucks program will help relieve kids' hunger, support their health and promote the ability for them to learn."
Get all the details on this beneficial program here.
Free Community Wellness Event in Greensboro This Saturday

J. Douglas Galyon Depot
234 East Washington Street
Downtown Greensboro
Saturday, March 9
10:00 a.m. to 2:00 p.m.
Cone Health is partnering with Downtown Greensboro, Inc. to provide a free community health screening event on Saturday, March 9, from 10:00 a.m. to 2:00 p.m. at the J. Douglas Galyon Depot located at 234 East Washington Street.
Free blood pressure and blood sugar screenings will be offered at the event. There will also be team members on hand to provide patient education and health resources, including information about where to receive care in the community.
Super Tuesday Results and What They Mean for NCMS

Super Tuesday Results Are In.
What Does That Mean For You?
The North Carolina Medical Society has several member candidates for both state and federal office. Over the past several months, many of them have answered questions important to NCMS members. So what happened?
On Friday, The NCMS Vice President of Advocacy, John Thompson, will have an analysis of the results and the impact they have on the next several months.
Look for his report in Friday's edition of Morning Rounds.
AMA Center for Health Equity: Applicants for Medical Justice in Advocacy Fellowship Needed

The AMA Center for Health Equity seeks applicants for the Medical Justice in Advocacy Fellowship program’s 2024-2025 cohort. The program is administered through a partnership between the AMA and the Morehouse School of Medicine’s Satcher Health Leadership Institute.
Using an anti-racist, equity-centered learning framework, fellows engage with equity experts and trailblazers. The fellowship equips and empowers fellows to be part of the next generation of advocacy leaders, driving meaningful policy and structural changes that produce equity and justice in the communities they serve.
Application deadline is April 1, 2024.
Duke, UNC Hospitals Ranked in Top 100 in Nation

Newsweek Ranks Duke, UNC Hospitals Top in Nation
DURHAM, N.C. (WNCN) — Duke University Hospital in Durham has been recognized as one of the top medical centers in the country in 2024.
Newsweek magazine, in partnership with Statista, has released its annual rankings of the world’s best hospitals, with an overall global list as well as ones divided by country.
Duke University Hospital comes in at No. 16 on the list of the best hospitals in the United States, the highest ranking of any hospital in North Carolina. The medical center is also on the list of top 250 hospitals worldwide, ranking at No. 68 globally.
While Duke University Hospital is the only one in North Carolina that ranked globally, several others from around the Triangle made the list of best in the country.
Two UNC-system hospitals ranked in the top 100 — UNC Rex Hospital in Raleigh at No. 71, and UNC Medical Center in Chapel Hill at No. 79.
Another Durham facility, Duke Regional Hospital, comes in at No. 143. Also ranking in the top 200 is FirstHealth Moore Regional Hospital in Pinehurst at No. 171.
Newsweek lists two more Triangle hospitals among its list of the 412 best in the U.S. — UNC Health Johnston in Smithfield (No. 333) and Duke Health Raleigh (No. 408).
The rankings were put together using data from online recommendation surveys taken by medical professionals as well as patient satisfaction surveys, hospital quality metrics and patient-reported outcome measures, or PROMs. [source]
NC Hospital to Host Colorectal Health Lunch and Learn

Harris Regional Hospital in Sylva will host a special “Lunch and Learn” opportunity focused on colorectal health on Thursday, March 21st from noon – 1:00 p.m.
The event, which will be held in the Easton Board Room on the first floor of the hospital, will be led by general surgeon Gilberto Robles, MD, who will share his expertise on the importance of maintaining colorectal health, including prevention, screenings, warning signs, and more.
The event is open to the public and individuals who have questions about colorectal health are encouraged to attend. Lunch will be served at the event and dietary preferences can be accommodated.
For questions or to register for the event call 828.631.7429.
NC Medicaid will now cover imported benzathine benzylpenicillin for syphilis
A message from Elizabeth Cuervo Tilson, MD, MPH, State Health Director and Chief Medical Officer of NC Department of Health and Human Services:
Dear Colleagues:
NC Medicaid will now cover imported benzathine benzylpenicillin (Extencilline) for use in outpatient medical drug claims. This new coverage is being added to address the ongoing national shortages of Bicillin® L-A (penicillin G benzathine injectable suspension).
While we have not heard of major shortages in North Carolina, we wanted to ensure that providers had access to every tool that may be available.
The statement on the policy change is available at https://www.ncdhhs.gov/news/press-releases/2024/03/04/ncdhhs-releases-statement-state-health-director-dr-elizabeth-cuervo-tilson-increasing-access
Provider guidance on extencilline is available at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5a026d0c-6f91-4ee3-b193-b2186a37e7ca
More detailed information on Medicaid billing is available at NC Medicaid to Cover Imported Benzathine Benzylpenicillin (Extencilline): Billing Guidelines | NC Medicaid (ncdhhs.gov)
Register Now! NC Allergy, Asthma, and Immunology Society Annual Meeting is May 18-19

| Download the meeting agenda.
Accommodations: Be sure to reserve your room at the Crabtree Valley Marriott before Thursday, April 25 to get our discounted rate of $159. Use this link to book today! Exhibiting Opportunities: Help ensure a successful meeting by sharing the exhibitor prospectus with the product and service representatives who call on your practice. Questions? Contact Megan Eberle at [email protected] or call 919-833-3836. |
Want To Go To Medical School for Free? Here Is A Billion Ways It Is Now Possible

Albert Einstein College of Medicine to offer free tuition after billion-dollar gift
Dr. Ruth Gottesman, 93, who spent 55 years as the chair of the school’s board, made the historic donation in the name of her late husband, David “Sandy” Gottesman, who was an early investor of Berkshire Hathaway and a longtime friend of Berkshire’s famed CEO Warren Buffett.
Philip Ozuah, president and CEO of Montefiore Medicine, the school’s parent company, announced the “transformational gift” on Monday, saying that “this is the largest donation to any medical school in the country.”
Sandy Gottesman, who was the co-founder of New York-based investment firm First Manhattan Co., died in 2022.
The Gottesmans had long been involved in health care philanthropy. In 2010, their gift of $25 million to the Albert Einstein College of Medicine went towards creating the school’s Institute for Stem Cell Research and Regenerative Medicine. Sandy Gottesman also served on the board of New York’s Mount Sinai Hospital.
“I am very thankful to my late husband, Sandy, for leaving these funds in my care, and l feel blessed to be given the great privilege of making this gift to such a worthy cause,” said Dr. Ruth Gottesman in a news release.

Dr. Ruth Gottesman joined the medical school in 1968 and developed screening, evaluation and treatments for children with learning disabilities. In 1992, she founded the Adult Literacy Program at Einstein’s Children’s Evaluation and Rehabilitation Center, “the first of its kind.” She also served as the founding director of the school’s Emily Fisher Landau Center for the Treatment of Learning Disabilities, which opened in 1997.
Few educational donations rival the magnitude of Dr. Ruth Gottesman’s. In 2018, former New York mayor Michael Bloomberg donated $1.8 billion to his alma mater, Johns Hopkins University. And New York hospitals have long drawn the philanthropy of billionaires, with individual donations sometimes amounting to more than $100 million. Home Depot co-founder Ken Langone has heavily invested in New York University’s medical centers. In 2018, in part due to Langone’s donations, NYU’s School of Medicine became the first medical school in the country to offer free tuition to accepted students.
An October survey from the Association of American Medical Colleges found that 70% of medical students who graduated in 2023 have taken on some level of education debt. The average graduate left medical school owing more than $200,000, according to the AAMC.
“This donation radically revolutionizes our ability to continue attracting students who are committed to our mission, not just those who can afford it,” said Dr. Yaron Tomer, the dean at Albert Einstein. “We will be reminded of the legacy this historic gift represents each spring as we send another diverse class of physicians out across the Bronx and around the world to provide compassionate care and transform their communities.”
On Point: Alabama Supreme Court Ruling That Disrupts Healthcare For People Building Families is Unconscionable -- Dr. Amy Bryant
On Point submissions are individual member viewpoints and not North Carolina Medical Society policy.

MSCR, At Large Member of the Executive Committee, NCOGS
Not even a week after the Alabama Supreme Court gave unprecedented and medically unnecessary protections to frozen embryos, several IVF clinics in the state had already halted services, afraid in this dangerous new setting to provide the healthcare they are trained to provide. This disruption to healthcare for people trying to build their families is unconscionable.
Rulings such as the one from the Alabama Supreme Court have an undeniably chilling effect on medical practice. Physicians are trained to provide evidence-based care, and care for patients at their most vulnerable moments. They did not train to understand the nuances of criminal law and precious few want to risk felony charges that could rob them of their ability to support their families and future patients, or even land them in prison.
This bodes poorly for the healthcare workforce in Alabama which already struggles to keep its physician workforce. Alabama also has one of the highest rates of maternal and infant mortality in the nation in the country, with outcomes worse for Black infants and mothers. Over 34% of its counties are “maternity deserts” without adequate access to obstetric care. Further restricting and intimidating physicians, who provide reproductive and primary care, and may also need reproductive services themselves, is counterproductive to improving health outcomes.
Why would people who purportedly care about life at all stages want to put so many people in harm’s way? What about the health and lives of those who need assisted reproductive technology to grow their families? Or those who need contraception or abortion to have a healthy family? It seems that protecting life is not in fact the actual goal. Relegating those who can get pregnant to mere vessels is not meant to protect life, it is a means of coercion and control.
The tactics at play in this case are sadly all too familiar. They are an extension of the tactics that place medically unnecessary restrictions on abortion. This ruling shows that anti-science politicians never intended to stop at abortion. This new type of interference in reproductive healthcare clearly exposes anti-abortion intentions to continue to restrict bodily autonomy, no matter the circumstances. Banning contraception is the next logical step, and even talked about openly in some state legislatures.
Anti-science politicians and judges-most often with no medical training- but with a clear, ideological agenda to control and coerce women, are a serious threat to the healthcare system. This is just not right in a multi-faceted, pluralistic, democratic society where many viewpoints and religious beliefs have the right to coexist.
The Alabama Supreme Court's ruling will fortunately not affect North Carolina. But this ruling should be deeply troubling to all of us, not only because of the devastating impact on people seeking to grow their families using assisted reproductive technology in Alabama. This ruling could embolden other states to pass similar legislation.
North Carolina physicians should take note. The fantasy world of full personhood for embryos that is embodied by rulings such as this does not bode well for our actual patients or healthcare system. Patients and physicians should be allowed to make decisions regarding their fertility based on their personal values and beliefs, not those imposed by the state. A state that sanctions these deeply unpopular intrusions into people’s lives, based on the religious views of a subset of its population, will find itself without the healthcare workforce it needs to have a thriving population.
Keto Flu, VO2 Max, Bed Rotting. Some New Words Are Being Added to the Dictionary!

There's A Word For That!
Girl dinner, skiplagging, range anxiety, sound bath, shacket! These are just a few of the new words introduced this year and many of them are from the medical field.
by Nick Norlen, Senior Editor, and Grant Barrett, Director of Lexicography
It’s 2024, and the pace of language change is as rapid as it has ever been. Our lexicographers are updating the dictionary more frequently than ever, doing the human-scale work of documenting words across the vast spectrum of the always-evolving English language. And wow, the variety is real.

This snapshot of our most recent additions showcases the breadth of terms that have emerged to name the nuances of modern life, including:
- Terms surfaced from the major topics of the day, including economics (greedflation), climate (climate breakdown), and social issues (intimate partner violence)
- Words for things you didn’t know there were words for (skiplagging, bed rotting, range anxiety)
- Science terms you’ll encounter in the news (stellar nursery, superfog)
- Newly prominent health and wellness words (VO2 max, prebiotic, keto flu).
- Fashion words, including terms for industry trends (slow fashion, circular fashion), aesthetics (Barbiecore), and names for types of garments (shacket, shortalls)
- And so many more words across an all-encompassing range of the English language (energy poverty, sound bath, boobne).
As usual, this update includes words that are new to the dictionary as well as entries that are newly revised (such as newly added senses of existing words like mid and squish). Keep in mind that words that are new to the dictionary are not always new to the language (or even remotely recent), but their addition often reflects a prominent place in the lexicon.
As always, all of our dictionary work is descriptive—we describe language as it is really used (not just how we or others may wish it would be used). Learn more about how new words get added to Dictionary.com—and how the dictionary works.
Of course, some of the terms in the list below have more than one definition. We’ll highlight just the meanings most relevant to this release.
girl dinner noun. an often attractively presented collection of snacks that involve little preparation, such as small quantities of cold cuts, cheese, fruit, cherry tomatoes, etc., deemed sufficient to constitute a meal for one.
Girl dinner went viral after TikTok user Olivia Maher used the term in a video in May 2023, possibly shortening an earlier version, hot girl dinner, that often included decadent or youth-maintaining food.
mid adjective. mediocre, unimpressive, or disappointing.
bussin’ adjective. great; wonderful; amazing. Popular among Gen Z, this term originates in African American culture and is likely based on various senses of bust meaning “to explode,” “to do well,” or “to enjoy.”
the ick noun. a sudden feeling of disgust or dislike, often in response to the actions of another person. This phrase, popular in dating culture and on TikTok, is thought to trace back to the late 1990s TV show Ally McBeal. The ick is also used as an informal term for an illness, especially a cold or flu.
cheat code noun. a ploy or technique that bypasses traditional methods or rules in order to improve oneself or one’s success. This more recent sense of the term is an extension of its use in the context of video games, in which it refers to a hidden command, code, etc., used to gain an advantage, such as by advancing levels or enhancing a character’s strengths.
noun. the apprehension or fear that an electric vehicle’s battery will run out of power before reaching one’s intended destination or a charging station.
enshittification noun. the gradual degradation of an online platform or service’s functionality, as part of a cycle in which the platform or service first offers benefits to users to attract them, then pursues more and more profits at the expense of users. Used in the critical discussion of platforms like TikTok, X (formerly Twitter), and others, this term was popularized by writer Cory Doctorow.
skiplagging noun. the practice of purchasing an air ticket for a flight with a layover at one’s true destination, getting off at the layover point, and skipping the last leg of the flight: a workaround to avoid paying a higher fare for a direct flight to one’s destination. The verb form is skiplag, a compound of skip, “to pass over,” and lag, “an instance of staying behind.”
bed rotting noun. the practice of spending many hours in bed during the day, often with snacks or an electronic device, as a voluntary retreat from activity or stress. Despite the negative connotation of rotting, many use this term in a positive way to refer to what they consider a form of self-care. The verb form is bed rot.
pretty privilege noun. an unearned and mostly unacknowledged societal advantage that a person has by fitting into the beauty standards of their culture. Pretty privilege uses the same construction as white privilege and similar terms.
Science
stellar nursery noun. Astronomy. a molecular cloud in which new stars are being formed. The James Webb Space Telescope has captured some stunning images of these star-forming regions, including the one pictured below, named 30 Doradus and nicknamed the Tarantula Nebula. Located in the neighboring galaxy known as the Large Magellanic Cloud, it is the largest and brightest stellar nursery in the Local Group, a group of galaxies near the Milky Way.

NASA, ESA, CSA, STScI, Webb ERO Production Team
boring billion noun. a period in the earth's development occurring between 1,800 and 800 million years ago that is characterized by relative geological and climatic stability, slow evolutionary development, and low levels of atmospheric oxygen.
geoglyph noun. a large-scale design or pattern on the surface of the land made by arranging stones, rocks, or earth, or by removing ground cover to expose the rock or soil beneath. Geoglyph is the most well-known of the terms listed here ending in -glyph, which comes from the Greek word for “a carving”; geo- means “earth.”
ammoglyph noun. a pattern or design originally created in sand by early humans and now fossilized. Coined in 2019 by Canadian geologist Charles William Helm and colleagues based on the Greek ámmo(s), meaning “sand.”
dendroglyph noun. an image, message, or symbol carved into a tree, especially by Indigenous people and often hundreds of years old, providing cultural and historical information not available from other sources. Coined in 1918 by Australian curator Robert Etheridge, Jr., with the combining form dendro-, meaning “tree." Its use has replaced that of the earlier term arborglyph.
Fashion
Barbiecore
noun. an aesthetic or style featuring playful pink outfits, accessories, decor, etc., celebrating and modeled on the wardrobe of the Barbie doll. We’re likely still fully within the trend of using -core to form names for niche aesthetics, such as cottagecore and normcore.
sustainable fashion noun. a genre of clothing and other fashion products intended to reduce negative impacts on the environment through the use of ecologically responsible materials and manufacturing, the promotion of longer-lasting style trends, and the popularization of product reuse.
slow fashion noun. a movement among clothing producers and consumers that emphasizes eco-friendly, well-made clothing, maintenance and repair of garments to extend their lifespan, and a general reduction of one’s consumption of new clothing items. This term is used in contrast with fast fashion. The fast/slow framing is perhaps best known for its use in the distinction between fast food and slow food, but it will likely continue to be applied in other contexts where there is interest in sustainable practices.
eco-chic noun. of or relating to a style, design, or product that is attractive and fashionable as well as eco-friendly and sustainable.
shacket
noun. a garment in the style of a button-down shirt, made of a thicker fabric and usually worn over other shirts. A combination of shirt and jacket.
shortalls noun. a pair of shorts with a bib or biblike piece to which shoulder straps are attached. A combination of short(s) and overalls.
Entertainment
cozy adjective. relating to a genre of mystery stories with little suspense, explicit violence, or sexual content, often also having amateur sleuths and idyllic, intimate settings. In this context, cozy is also sometimes used as a noun to refer to such a story itself, as in I started out reading cozies and moved on to the hard-boiled detective novels.
Bechdel test noun. a test of gender stereotyping and inequality in fiction, having a number of variations and used especially with movies, based on whether the work includes at least two fairly important female characters who talk to each other about something besides a man. The first recorded uses of the term Bechdel test come from between 2005 and 2010, but the concept was introduced by cartoonist Alison Bechdel in a 1985 comic strip.
Sports
Tommy John surgery noun. an operation to repair a torn ligament on the inner side of the elbow by replacing it with a tendon from elsewhere in the body or from a donor. Common among baseball players, the surgery gets its name from pitcher Tommy John, on whom the procedure was first performed in 1974. It is formally called ulnar collateral ligament reconstruction.
turf toe noun. a sprain at the joint between the metatarsus and the phalanx of the big toe, caused when the ligament connecting them under the toe is overextended: typically a sports-related injury, originally associated especially with artificial grass surfaces.
capped adjective. Chiefly British. (of a player) selected as part of a representative team. Example: When she plays her next match for England, she’ll become the most capped player of all time. Other newly added senses of capped include meanings related to loans, stocks, and landfills.
beer league noun. a community sports league, such as for hockey, softball, or soccer, whose members are amateurs of diverse ages and walks of life and play purely for the fun and socializing involved: games are usually accompanied or followed by alcohol and food
Family & relationships
girl mom noun. a mother of a daughter or daughters, especially one with only a daughter or daughters.
girl dad noun. a father of a daughter or daughters, especially one with only a daughter or daughters.
boy mom noun. a mother of a son or sons, especially one with only a son or sons.
boy dad noun. a father of a son or sons, especially one with only a son or sons. These proud terms are used informally to identify as a certain type of parent—you’re likely to encounter these phrases on T-shirts or as hashtags, for example.
squish noun. an intense feeling of infatuation that is not romantic or sexual in nature; a platonic crush. This term is also used in an entirely unrelated way in the context of U.S. politics as a derogatory term for a politician, especially a Republican, who is perceived by members of their own party as overly moderate or willing to compromise.
Health & wellness
sound bath noun. an instance of sustained listening to the pleasant sounds emanating from a collection of singing bowls, bells, chimes, etc., used to aid in relaxation or meditation and believed to help restore physical and mental wellness.
VO2 max noun. the maximum volume (V) of oxygen (O2) that a particular person’s body can absorb and use during intense exercise, measured in milliliters of oxygen per kilogram of body weight per minute and often used to assess cardiorespiratory fitness.
high-intensity interval training noun. a type of interval training for physical conditioning and fitness that uses short bursts of very intense exertion, alternating with short periods of rest or lighter exertion, to exploit the body’s systems for generating anaerobic energy. Commonly abbreviated as HIIT.
Tabata noun. an exercise or fitness program involving repeated alternation between usually 20-second bursts of strenuous exertion and 10-second periods of rest, totaling four minutes for an entire round. Named after Japanese professor Izumi Tabata, who created the program.
keto flu noun. a temporary feeling of illness or physical unease often experienced by those starting a ketogenic diet, characterized by fatigue, headaches, muscle soreness, etc., as the body adapts to using fat instead of carbohydrates for fuel. Also called carb flu.
micellar water noun. a liquid skin cleanser made up of tiny particles, or micelles, of mild soap or detergent dispersed in purified water, usually with the addition of moisturizers, vitamins, etc.
prebiotic noun. a substance containing dietary fiber that stimulates the growth or activity of beneficial bacteria in the gastrointestinal tract.
Food & drink
bottarga noun. the roe sac of a fish, especially the gray mullet, prepared by salting, pressing, and drying, and served in various ways, including as a grated garnish, on its own with seasoning, or with vegetables. Dining out pro tip: Use Dictionary.com as a menu companion for all those unfamiliar dish components.
soju noun. a colorless, clear, distilled alcoholic beverage from Korea, often made from a mixture of rice and other starches such as sweet potatoes, wheat, barley, tapioca, etc. The word soju comes from Korean, from a combination of so, “to burn, roast,” and ju, “alcoholic beverage.”
natto noun. Japanese cooking. a dish of fermented cooked soybeans, often eaten for breakfast over white rice or with toppings such as soy sauce and mustard.
Economics & finance
greedflation noun. a rise in prices, rents, or the like, that is not due to market pressure or any other factor organic to the economy, but is caused by corporate executives or boards of directors, property owners, etc., solely to increase profits that are already healthy or excessive. The verb form is greedflate. Other recently added inflation words include shrinkflation and shadow inflation.
dry powder noun. cash reserves, liquid assets, or easily liquidated assets such as readily saleable stocks and bonds, held by a corporation or an individual in order to cover current or future obligations, make new purchases, or take advantage of unforeseen opportunities.
bag holder noun. someone who retains an unprofitable investment rather than selling it at a loss, only to suffer an even worse loss when the investment eventually becomes worthless.
Climate, weather, & environment
climate breakdown noun. the collective effects of harmful and potentially irreversible trends in climate, specifically those resulting from unchecked global warming.
global boiling noun. a nonscientific term used to emphasize the trend toward and severity of extreme heat events, especially in regard to public health. Climate breakdown and global boiling have emerged as terms intended to communicate the severity of the effects of climate change, along with other prominent terms like climate crisis and climate emergency.
extreme heat event noun. Meteorology, Climatology. a heat event classified as being excessive enough to pose a serious threat to public health.
fire whirl noun. a tornadolike phenomenon created when turbulent air rapidly rising from the site of burning, as in a forest fire, sucks flaming gases, embers, and other fiery debris up into a twisting column, sometimes hundreds of feet in height.
fire tornado noun. a flaming tornado generated by intense wildfire, rarer, much larger, and more destructive than a fire whirl.
superfog noun. a combination of fog generated by weather conditions and wildfire smoke from damp, smoldering brush, leaves, trees, and other organic materials that often reduces visibility to less than 10 feet.
carbon market noun. a commodity trading system through which countries and organizations can buy and sell permits to produce a set amount of carbon dioxide emissions and other atmospheric pollutants. This term is just one example of how the word carbon has become shorthand for “carbon dioxide emissions.”
Social issues
intimate partner violence noun. acts of violence or abuse within a romantic relationship.
supervised injection site noun. a medically supervised facility at which people can inject illicit drugs they have brought with them, a practice intended to reduce overdoses, disease transmission, and other health problems associated with illicit drug use.
food insecure adjective. having or characterized by limited or uncertain access to adequate food. This is an adjective version of the more established noun form, food insecurity.
energy poverty noun. a lack of adequate access to safe, affordable sources of electricity or fuel for warmth, light, cooking, etc.
Even more words
Uluru noun. a large, isolated mass of red rock in central Australia, in southwestern Northern Territory: a sacred site for the Anangu people indigenous to the region, and a popular tourist attraction. 1,142 feet (348 meters) high. Also called Ayers Rock.
worlding noun. the act or process of bringing a people, culture, nation, etc., into a global sphere of influence, especially the sphere thought of as dominated by Western countries. The concept of worlding, influenced by literary theorist Gayatri Spivak, has become popular in academic discussions about colonialism.
Scouser noun. Informal. a resident or native of Liverpool, England. This other nickname for Liverpudlians comes from the word Scouse, a name for the Liverpool dialect. The word Scouse itself comes from a shortening of lobscouse, a type of sailor’s stew made of meat, vegetables, and hardtack.
fakeness noun. artificial, false, or insincere behavior, speech, etc.; pretense. More generally, fakeness is also used to mean “the quality or condition of being false, artificial, or insincere.”
kennel cough noun. a highly contagious but usually mild respiratory infection in dogs, characterized by a dry hacking or gagging cough and caused by a number of bacteria and viruses.
boobne noun. Informal. pimples or a rash in the area of the breasts or on the upper back, caused by a bra that chafes, is not clean, or is made of material that is allergenic or not breathable. Other acne blend words include bacne and maskne.
circular fashion
noun. a type of sustainable fashion that promotes minimal manufacturing through the ongoing reuse of garments and accessories or their components.
CDC: Syphilis cases at highest levels since 1950s

Racial and Ethnic Minorities Disproportionately Affected
The number of syphilis cases in the U.S. are on the rise. According to a new report from the Centers for Disease Control and Prevention, cases increased by nearly 80% to more than 207,000 between 2018 and 2022.
Rates increased among all age groups, including newborns, and in all regions of the country. In 2022, 3,755 cases of babies born with syphilis in the U.S. were reported, which reflects an alarming 937% increase in the past decade, the CDC said.
The report continued that racial and ethnic minorities are most disproportionately affected due to "long standing social inequities that often lead to health inequalities."
Experts point to various reasons for the increase, including increases in substance abuse tied to risky sexual behavior, decrease in condom use, ongoing social and economic conditions and reduction in sexually transmitted infections (STI) services at the state and local level.
"Because STIs often do not show symptoms, and screening is necessary for timely diagnosis and treatment, changes in access to sexual health care can affect the number of infections diagnosed and reported," the CDC said.
The stigma surrounding STIs can also keep people from seeking care, and "buries the truth that all people deserve quality sexual health care," said Laura Bachmann, acting director of the CDC's Division of STD Prevention, in an interview with NPR. "It also can cause issues at the provider level when it comes to talking with people about these issues."
The CDC said that its findings signal an urgent need for a closer look at public health efforts and prevention strategies.
"Some people face tremendous barriers to STI prevention and health services," said Bachmann in a statement. "So, the most important work is often outside the clinic, whether it be reaching out to communities with testing, interviewing patients to offer services to their partners, or delivering treatment directly to someone."
She added that there is still a need for more innovation around diagnosis, treatment and prevention.
"In the United States, syphilis was close to elimination in the 1990s, so we know it's possible to reverse this epidemic," said Jonathan Mermin, director of CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention, in a statement. "I have hope for innovative prevention tools – such as a pill after sex that prevents STIs, and better tests for syphilis – but they will only be successful if they reach the people who will benefit. And that is going to require coordinated and sustained efforts at the federal, state, and local levels."
The U.S Department of Health and Human Services is also continuing to address the issue through the establishment of a federal task force last year.
"Addressing the resurgence of syphilis and congenital syphilis requires a concerted effort," said Admiral Rachel Levine, assistant secretary for health and chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force, in a statement. "We can collectively work towards reducing the incidence of syphilis and its devastating consequences, and we will turn the tide on the syphilis epidemic."
Without the appropriate funding however, it's difficult for communities to follow through with the recommendations by government officials, said Elizabeth Finley, director of communications at the National Coalition of STD Directors.
Over the past year, there has been a shortage of Bicillin, an antibiotic used to treat syphilis. In addition, last year states lost funding for STD prevention, affecting their ability to respond to syphilis.
"The 2022 data is devastating to see, but it's already a year old," said Finley. As a result, she said that "we have every reason to believe that the 2023 numbers will be much worse."
The CDC report also included data on other sexually transmitted infections, stating that "reported gonorrhea cases declined for the first time in at least a decade while reported chlamydia cases were level."
There were more than 2.5 million cases of syphilis, gonorrhea, and chlamydia reported in the U.S. in 2022 alone.
Without treatment, syphilis can cause serious health problems including damage to the heart and brain, and can cause blindness, deafness and paralysis. If transmitted during pregnancy, it can cause miscarriage, infant death and lifelong medical issues. With the right antibiotics, the STI is curable.
Additional Reading:
Syphilis Among Newborns Continues to Rise
Does Morning After Pill for STI Work?
Old Drug Offers New Stop for STI
The Most Important Part of Super Bowl LVIII? The Commercials! Here Are All The Ones Already Released

Super Bowl LVIII will air on CBS this year, and stream live on Paramount+
Yes, we are all excited to see the San Francisco 49ers and the Kansas City Chiefs on Sunday. Yes, we are all excited to see Usher perform the halftime show, Yes, we are all wondering if Taylor Swift will be there. But, really aren't we all just watching for the ads?
Well, the NCMS is here to help! Here is a look at all of the 2024 Super Bowl commercials released so far!
2024 Super Bowl commercials (so far)!
Advertisers take the Super Bowl very seriously. They know around 1/3 of all Americans watch, and ads can go for millions of dollars. Because of that, advertisers often go all out, lining up celebrity-filled TV spots designed to raise interest in their products.
Paramount Plus Super Bowl commercial
What do Miami Dolphins quarterback Tua Tagovailoa, Patrick Stewart, Drew Barrymore, Arnold from "Hey Arnold" and Peppa Pig all have in common? They're all in the Paramount streaming service's new Super Bowl ad.
In the TV spot, the assorted characters are trapped on an icy glacier, unable to throw a rope to safety. When Tagovailoa says he could make the throw to the top, if there was a football.
Patrick Stewart suggests they use Arnold's football-shaped head to throw the rope all the way.
"We throw the child," the legendary actor plainly states. Despite reservations from some of his fellow stranded explorers, Stewart gets into some old-timey football gear and throws a perfect spiral — straight into the wall...as Creed sings "Higher."
Lamenting his inability to throw just a few feet higher, Stewart out wishes for some "pigskin" to toss. The commercial ends with a pan to Peppa Pig, potentially their last hope to avoid freezing to death.
While a condensed version is likely to be played at the Super Bowl because even a 30-second ad can cost millions of dollars, the full commercial clocks in just under two minutes.
Google's Super Bowl LVIII ad
Google's heartstring-pulling ad follows a blind man as he uses “Guided Frame” — Google's AI-powered accessibility feature for the Pixel camera that uses a combination of audio cues, high-contrast animations and tactile vibrations — to take pictures of the people and places in his life.
M&M Super Bowl commercial with several NFL greats
Retired Miami Dolphins quarterback Dan Marino, Buffalo Bills’ Bruce Smith and wide receiver Terrell Owens never got a Super Bowl ring, but M&M’s and Scarlett Johansson present the “Almost Champions” ring to the almost winners.
“Almost Champions” ring to the almost winners.


OREO Super Bowl ad with Kris Jenner
In OREO's 30-second Super Bowl spot, the iconic chocolate sandwich cookie is imagined at big events throughout the past, helping people make important decisions that altered the course of history.
In ancient Troy, two guards decide to "twist on it" when a man shows up at their gate with the trojan horse -- cream on the right, they let him in. Whoops! We all know how that one turned out. An OREO also helps two UFO witnesses decide not to report their alien sighting.


Then in a flashback scene to pre-"Keeping Up with the Kardashians" days, Kris Jenner, matriarch of the Kardashian empire and long-time OREO fan, is on the phone.
"So every little detail about our family will be on TV?" she asks. "Who would watch that?"
Jenner says she'll "twist on it" to decide, and pulls the cookie apart, and appears to decide to go for it. "Hope you can keep up," she says.
Booking.com Super Bowl ad with Tina Fey
Actress Tina Fey has so many choices on the online travel agency booking.com site she has to hire body doubles: an influencer type played by her 30 Rock co-star, Jane Krakowski, to stay at a fancy hotel, a bigfoot handled by another 30 Rock co-star, Jack McBrayer, to stay at a cabin, and even actress Glenn Close, who stays on a farm.
Doritos Super Bowl ad with Jenna Ortega
Two grandmotherly women ("Dina" and “Mita”) chase after “Top Gun: Maverick” actor Danny Ramirez, who took the last bag of Doritos Dinamita from a store shelf, leaving actress Jenna Ortega behind.


Mountain Dew Baja Blast Super Bowl commercial with Aubrey Plaza
Aubrey Plaza is always having a blast, whether she is stuck in an elevator or being abducted by aliens — or reuniting with her “Parks and Rec” co-star Nick Offerman while riding dragons.


Starry Super Bowl commercial with Ice Spice


"I just needed something more refreshing, more crisp," she says. After the rejection, the spurned soda/lover's head explodes in a fountain of clear soda.
Pringles Super Bowl commercial with Chris Pratt
The Pringles ad features Chris Pratt sporting the chip mascot's iconic mustache. Once a cashier notices and posts about the 'stache, the race is on, with more people commenting about his striking resemblance to the Pringles man.


By the end of the spot, Pratt has starred in a movie about the Pringles mascot, alongside a mustachioed child in a wagon on the prairie. It ends with the same clerk from the beginning of the clip asking "do I get a cut?" Pratt then offers her a tube of Pringles.
Dove Super Bowl LVIII commercial
Dove's ad begins seemingly whimsically showing young girls having mishaps playing sports to the tune of "It’s the Hard Knock Life."


But the ad cuts starkly to a girl looking self-consciously in the mirror. The message: low body-confidence leads to girls quitting sports, not the mishaps.
Budweiser 2024 Super Bowl ad
In Anheuser-Busch's nostalgic spot, a snowstorm threatens to derail a delivery of Budweiser to a small-town bar. But a team of Clydesdales and a Labrador retriever team up to help Budweiser make the delivery.


Experts say the feel-good spot strikes the right chord for Anheuser-Busch, which is trying to win back consumer sentiment following last year’s conservative backlash against Bud Light after the brand sent a commemorative can to transgender influencer Dylan Mulvaney. Bud Light also angered supporters of transgender rights who felt it abandoned Mulvaney.
Bud Light Super Bowl commercial with Post Malone
Speaking of Bud Light, they've also released their Super Bowl ad, aiming for some low-stakes chuckles with their commercial. In the newly-released spot, dubbed "Easy Night Out," a group of friends is hanging out in a garage. As one cracks open a Bud Light from the refrigerator, he unleashes the Bud Light Genie.


"Wishes? Yeah, it's my thing," the Bud Light Genie says. Want to be filthy rich? No problem! Need a sweet new set of wheels? How about a stretch DeLorean limo ride to the bar, where Bud Light magically replenishes itself at the tables. As the night gets crazier and the genie keeps granting wishes, NFL Hall of Famer Peyton Manning, Grammy nominee Post Malone and UFC CEO Dana White all make appearances.
T-Mobile Super Bowl spot with Jason Momoa
Jason Momoa shows off his singing chops in an ad that shows Scrubs duo Zach Braff and Donald Faison singing about T-Mobile home internet to the tune of “Flashdance ... What a Feeling." “Flashdance” star Jennifer Beals pops in to spray Momoa with water and ask him to sing it again — without his shirt.
Michelob ULTRA Super Bowl ad stars Lionel Messi and Ted Lasso star Jason Sudeikis
The Michelob commercial this year is pretty simple. While waiting for a beer at a beachside bar, Lionel Messi takes some time to have some fun with a soccer ball — namely dribbling circles around everybody else on the beach. It also features a brief cameo from "Ted Lasso" star Jason Sudeikis, who comments how the two of them "go way back."


At the end of the relaxingly low-key commercial, the bartender calls for the soccer icon to pick up his drink, and Messi kicks a goal into a volleyball net hanging between a pair of palm trees.
Hellmann's Super Bowl commercial
And a Hellmann's ad focusing on food waste starring Kate McKinnon features a cat that becomes a celebrity and dates Pete Davidson.


In the ad, McKinnon mistakes the cat's meow for the word "mayo," catapulting the "talking" cat to fame with a book deal, keynote speech and eventual red carpet moment with the former SNL cast member.
Kawasaki
A Kawasaki ad shows people riding in their Ridge “side by side” off-road vehicles growing mullets because the vehicle is “business in the front and a party in the back.”
The vehicle's ability to grow 80s hairstyles extends past the occupants, with a bald eagle and a tortoise also growing some luscious locks.
Uber Eats Super Bowl commercial with Jennifer Anniston, David Schwimmer, and David and Victoria Beckham
The ad for Uber Eats is all about being forgetful. From forgetting to put on pants in the morning to forgetting an old Friend, we all lose track of some things.
But the commercial, as it goes through the various forgetful scenarios, reminds watchers to always remember one thing: Uber Eats, because the delivery app has more than just food. You can get office supplies, flowers or beauty products through the app.
And isn't that worth forgetting something else to make room for?
DoorDash
The food delivery app's commercial is simple: they're offering to deliver everything (and yes, we mean everything) being advertised by the other ads during the big game, for free, to one lucky person.
In a teaser, DoorDash says they'll give out a promo code during their game-day ad, which can be redeemed here for a shot to win.
That means everything from Doritos to a new car to tax services. In fact, DoorDash doesn't know everything they're giving away for this promotion. "Who knows what else? We haven't fully thought this thing through," the teaser's narrator says.
Popeyes
Popeyes new it had to go big or go home for its first Super Bowl commercial.
The chicken chain's commercial, released on Feb. 6, features comedian and actor Ken Jeong trying Popeyes' new wings.
In the 60-second ad, Jeong is seen thawing out after he cryogenically froze himself in 1972. Jeong's character waited over 50 years for the "better" wing to be created.
Along with trying an array of Popeyes wings, Jeong goes on a venture to try all the things of the modern age: delivery drones, electric scooters, self-driving cars, robot vacuums and even goldendoodles.
Dunkin' Donuts
Ben Affleck and Dunkin' Donuts are a match made in heaven.
Affleck, who is the official brand ambassador for the coffee chain, returns for another Super Bowl ad this year.
In the minute-long teaser, Affleck is seen watching a news segment calling him the "boredest man in the world" as he sits beside his wife Jennifer Lopez.
The ad cuts to Affleck as he pursues his new dream of becoming a pop star. He's heading into studios, talking to producers and employing the help of TikTok star Charlie D'Amelio for some dance lessons.
Affleck is even seen pitching his "crazy" dream to JLO over the phone.
NCMS Past President Dr. Philip Brown to Present at CARE Project Professional Collaborative

'Do You Speak Patient: TELL ME' by Dr. Philip Brown at CARE Collaborative
(WRIGHTSVILLE BEACH) -- Dr. Philip Brown is speaking at the 6th Annual CARE Project NC Parent Professional Collaborative. Brown is a Past President of the North Carolina Medical Society, former Chief Physician Executive at New Hanover Regional Medical Center, and Chief Community Impact Officer at Novant Health.
The CARE Project Executive Director Dr. Johnnie Sexton, Au.D. says, "Dr. Brown’s ability to bring simplicity out of chaos to help lead organizations and individuals to accountable action is particularly needed in today’s environment. We are inundated with facts and data points that can be and are spun to obscure truth, creating clarity requires both quantitative and qualitative information. His transformational leadership is effective because he is willing to listen, hear and understand diverse perspectives through connection and earned trust.
Click here to attend.
NCMS Past President Dr. Palmer Edwards Appointed to NC Commission for Public Health

NCMS is Honored to Appoint Palmer Edwards, MD to the NC Commission for Public Health
(RALEIGH) -- The North Carolina Medical Society Nominating and Leadership Development Committee has appointed Dr. Palmer Edwards to the North Carolina Commission for Public Health. He fills the unexpired term of Douglas Sheets, MD. Edward's term will expire on November 30, 2027.
Edwards was born in Washington, NC and attended the University of North Carolina at Chapel Hill. He now lives in Winston-Salem with his wife Marty. Over the years, Edwards has served on various committees at the NCMS and been involved in the NCMS Foundation. He is currently a Foundation Trustee. He has been a member of the NCMS since 1992.
The Commission for Public Health is the public health rulemaking body for North Carolina. It is authorized and directed by the N.C. General Assembly to adopt rules to protect and promote the health of the public and to adopt rules necessary to implement public health programs administered by the Division of Public Health. The Commission was first established by the N.C. General Assembly in 1877 as the State Board of Health. It was renamed the Commission for Health Services in 1973 and became the Commission for Public Health in 2007. The Division of Public Health is staff to the Commission. The North Carolina General Assembly has invested the Commission for Public Health with statutory responsibilities to support the mission of the public health system, which is to promote and contribute to the highest level of health possible for the people of North Carolina.
Get Ready! North Carolina Will be Part of Solar Eclipse in April

Millions of Americans live in the path of 2024’s solar eclipse. See where to watch
(CNN, Matt Stiles, Kenneth Uzquiano, Ashley Strickland, and Will Mullery) -- One of the year’s most anticipated celestial events — a total solar eclipse — will put on a dramatic show April 8 as it crosses over Mexico, the United States and Canada.
A total solar eclipse occurs when the moon passes between Earth and the sun, completely blocking the sun’s face and causing the golden orb to temporarily disappear from view. The phenomenon has inspired myths and folklore for millennia.
The event will be visible to millions — including 32 million people in the US alone — who live along the route the moon's shadow will travel during the eclipse, known as the path of totality. For sky-gazers in the areas experiencing totality, the moon’s shadow will completely cover the sun. Those along the very center line of the path will see an eclipse that lasts between 3 ½ and 4 minutes, according to NASA.
The total duration for all phases of the eclipse, however, lasts for hours. Since the moon doesn’t just suddenly appear between Earth and the sun, the event begins with a partial eclipse. The moon's shadow will slowly move across the sun's face during the approach to totality, causing the sun to appear like a sharpening crescent. Depending on your location, the partial eclipse can last between 70 to 80 minutes, according to NASA.
The eclipse will first appear over the South Pacific Ocean and begin its journey across North America. Mexico’s Pacific coast is the first point of totality on the path, expected at 11:07 a.m. PT (2:07 p.m. ET) and the eclipse is expected to end on the Atlantic coast of Newfoundland at 5:16 p.m. local time (3:46 p.m. ET).
During totality, the sky will darken as if it’s dusk or dawn. Depending on humidity and cloud cover, expect to feel a roughly 10-degree Fahrenheit (5-degree Celsius) drop in temperature when the sun disappears from view, according to NASA.
Look out for Baily’s beads just before and after the sun disappears. This scintillating phenomenon occurs when the sun’s rays shine around valleys on the lunar horizon, creating glowing drops of light around the moon.
The location that will experience the longest duration of totality is near Torreón, Mexico, where the peak of the eclipse will last 4 minutes and 28 seconds. But you don’t have to be squarely in the path of this solar spectacle to witness some of its wonders.
Millions more outside of the path of totality, across an area that includes 49 US states, will see a partial solar eclipse, in which the moon blocks a portion of the sun and appears to take a crescent-shaped “bite” out of it.
And be sure to find a pair of certified ISO 12312-2 compliant eclipse glasses ahead of the big day to safely view every stage of the eclipse and enjoy the celestial show while you can. Another total solar eclipse won’t be visible across the contiguous US again until August 2044.
Click here to see how the eclipse will impact your location.
NCCPRW Meets to Talk Future of North Carolina Clinician and Physician Well-Being

Well-Being Consortium Meets at NCMS Headquarters in Raleigh
RALEIGH -- The North Carolina Clinician and Physician Retention and Well-Being Consortium met Thursday at the NCMS headquarters in Raleigh. The agenda included a history of the Consortium by NCMS COO Shawn Scott and a look forward from NCMS CLO Ashley Rodriguez.
The meeting also included an update from Corey Feist from the Dr. Lorna Breen Heroes' Foundation about the Foundation’s partnership with the Consortium to lead the All In: Caring 4 NC’s Caregivers campaign. This initiative is designed to improve and protect the mental health and well-being of clinicians in NC and will be a core focus of the Consortium’s work for 2024.
In attendance were executives from around the state including Thomas Mansfield, CEO of the NC Medical Board, Rep. Timothy Reeder, President of the NCMSF Board of Trustees, NCMS Board member Dr. Charul Haugan, and members of the North Carolina Medical Board.
Here are some photos from the event:
Could A Saliva Test Help Diagnose Cancer in the Future?

- The global number of cancer cases is expected to hit 28.4 million by 2040.
- For most cancers, early detection and treatment can provide better outcomes.
- Researchers from the University of Gothenburg in Sweden have found that structural changes in sugar molecules that occur in cancer cells can help identify specific types of cancers.
- Scientists believe this research could eventually be used to develop a blood or saliva test for detecting cancer.
(Medical News Today - Corrie Pelc) -- In 2020, about 19.3 million new cases of cancer were diagnosed around the world, and that number is expected to reach 28.4 million cases by 2040.
Although there are currently no cures for any type of cancer, for most cancers the earlier it is detected and treated, the better the outcome. For this reason, scientists are constantly exploring new ways to identify cancer quickly.
Contributing to this effort, a team of researchers from the University of Gothenburg in Sweden, has recently found that structural changes in sugar molecules called glycans that occur in cancer cells can help identify specific types of cancer.
Scientists believe that with the help of artificial intelligence (AI), this research could eventually be used to develop a blood or saliva test for detecting cancer.
This study was recently published in the journal Cell Reports Methods.
What are glycans?
According to Dr. Daniel Bojar, associate senior lecturer in bioinformatics at the University of Gothenburg and lead author of this study, glycans are complex sugar molecules that are attached to proteins and fats in our bodies.
“They are intricate chains of different sugar units linked together in various ways,” Dr. Bojar explained to Medical News Today. “If those connections are changed, the function of the glycan changes. In cancer, several processes can change glycans.”
“Mutations in the tumor may change the proteins that build up these sugar chains, leading to altered glycans,” he continued. “Additionally, inflammation and various other systemic conditions that may accompany a tumor also have a known impact on which glycan structures are being produced.”
While scientists know that glycans are systematically changed in cancer, aiding the tumor in its development, Dr. Bojar said most of this knowledge is not based on rigorous statistical analysis, compared to standards in other scientific fields.
“We were convinced that we could gain more insights from these molecules with newly developed methods,” he continued. “As the most information-rich type of molecule in our bodies, it is a natural proposition for a data scientist to use this information for predictions.”
“Further, glycans are present on proteins and particles secreted by the tumor and can thus be found in convenient locations such as saliva or blood, which allows us to remotely monitor the tumor without having to perform an actual biopsy,” Dr. Bojar added.
AI-powered cancer detection method
For this study, Dr. Bojar and his team analyzed tumor and healthy tissue data from about 220 people with diagnosed cancers, focusing on gastric, skin, liver, prostate, colorectal, and ovarian cancers.
“Our main concern here was to select types of cancer for which high-quality glycan data was available so that our results would be more reliable,” he said when asked why they decided to focus on those types of cancer.
Using a new method of studying the substructures of glycan using AI, the scientists were able to identify differences in the substructure of the glycan depending on the type of cancer.
“Glycans are structurally very complex, much more so than proteins or DNA, and are best understood with advanced analytical methods such as AI,” Dr. Bojar explained. “Further, the way that glycans are currently measured — via mass spectrometry — typically leads to very heterogeneous data, including missing data points due to a lack of sensitivity. This has really hindered the field from making robust assessments from this type of data in many cases.”
“Methods such as AI allow us to improve the data quality, which we have shown in the paper describing this method, and this allows us to identify these relevant substructures with high statistical significance.”
– Dr. Daniel Bojar
Potential for early-stage cancer detection
While this study focused on specific types of cancer, Dr. Bojar said there is no reason to think this test would not translate to other types of cancer.
“Especially the glycans that we find to be present in most or all of the types of cancer we analyzed should also be present in other types of cancer,” he added.
Dr. Bojar also said a blood or saliva test developed through this research could possibly result in a faster detection of cancer in its early stages, although further research would be required to determine conclusively.
“Another benefit of this technique is that cancer can be monitored, since samples such as saliva or blood are minimally invasive, compared to biopsies for example,” he continued. “This could also extend to monitoring for re-emergence of a treated tumor, which could be rapidly done using the method we present.”
For the next steps in this research, Dr. Bojar said they plan to collect more cancer data, specifically from saliva samples of lung cancer patients, to extend and improve their results.
“In parallel, we plan to use the universal as well as specific cancer markers we have identified so far and develop tests for them, using specific glycan-binding proteins that allow for rapid and reliable measurement of patient state,” he continued. “This would then be also much cheaper than mass spectrometry and is only possible because we now know what we are looking for.”
“While it is hard to judge when such a test would be commonly available to patients, we are planning to validate these tests on clinical samples of patients within the next four to five years,” he added.
Breaching new ground for cancer testing
MNT also spoke with Dr. Richard Reitherman, a board-certified radiologist and medical director of breast imaging at MemorialCareBreast Center at Orange Coast Medical Center in Fountain Valley, CA, about this study. Dr. Reitherman was not involved in this research.
“When cancers are detected, they’re detected by multiple means,” Dr. Reitherman explained. “The blood usually carries the usual components of red blood cells, platelets, proteins, [and] white cells, but it also carries DNA, RNA, proteins, glycoproteins, glycans, [and] lipids that are not normal, and therefore they test to recognize those. They are shed from the cancer cells elsewhere in the body because the bloodstream happens to go everywhere.”
“It’s kind of like panning for gold,” he noted. “You have the river running down, but you have to put your dish in there with its proper sieve, and it has to be the right size and the right place in the river, or you’re never going to detect the gold nuggets. And once you detect the gold nuggets, you can start to develop strategies of therapy for a particular cancer at whatever stage it is, so this is really exciting.”
Dr. Reitherman also said that he was very excited about the use of AI in this study.
“AI is becoming increasingly essential in the analysis of metadata, which is what this is,” he told us. “These studies generate so many data points and metrics of what they’re measuring, whether it’s glycans or proteins, DNA, [and] RNA in the blood or the saliva, that we can no longer rely upon little spreadsheets where smart people can look and say, oh, this means this, and this means that.”
Plan Now to Attend 2024 AMA National Advocacy Conference

Join us on Capitol Hill
The AMA’s National Advocacy Conference is scheduled for February 12-14, 2024. This yearly event offers an opportunity for personal involvement in the health policy debate on Capitol Hill. We need increased NCMS member engagement with our members of Congress, so mark your calendar and stay tuned for forthcoming details.
Some helpful details and links . . .
- Preliminary agenda – additional details forthcoming
- Event registration
- Hotel reservations

Sign up today!
https://www.ama-assn.org/about/events/national-advocacy-conference
What to know about the RSV vaccine approved for pregnant people

- The RSV virus affects about 64 million people around the world each year, causing about 160,000 deaths.
- RSV may cause severe symptoms, leading to hospitalizations and possible death, in newborn infants and older adults.
- Health officials recommend pregnant people get Pfizer’s maternal RSV vaccine during the third trimester of pregnancy to protect their baby during the first six months of life.
The Centers for Disease Control and Prevention (CDC) recently issued a health advisory alerting healthcare providers about low vaccination rates against influenza, COVID-19, and respiratory syncytial virus (RSV).
The CDC warns that low vaccination rates may lead to more severe disease and increased healthcare capacity strain during peak respiratory virus season.
RSV is an infection of the lungs and respiratory tract that globally affects about 64 million people every year and causes about 160,000 deaths each year.
For most healthy adults, RSV presents mild symptoms similar to the common cold.
In vulnerable populations — such as newborn infants and older adults 65 years and older — RSV can cause severe symptoms and develop into conditions such as pneumonia and bronchiolitis, potentially leading to hospitalization.
For this reason, the CDC and the American College of Obstetricians and Gynecologists (ACOG) recommend that pregnant mothers receive the maternal RSV vaccine made by Pfizer during the third trimester to pass antibodies to their unborn baby.
Getting the maternal RSV vaccine could help protect infants from severe illness from birth through the first 6 months of life.
Why should pregnant people get the RSV vaccine?
Dr. Laura E. Riley, chief OB-GYN at New York-Presbyterian/Weill Cornell Medical Center and chair of the Department of Obstetrics and Gynecology at Weill Cornell Medicine in New York City, told Medical News Today that RSV is dangerous for babies and young children, as it can cause serious respiratory illness.
“In fact, [RSV] is the leading reason infants are hospitalized in the United States,” she said. “We should do everything we can to protect babies from RSV, and that’s why the vaccine is so important.”
Dr. Silvia M. Abularach, an obstetrician-gynecologist affiliated with multiple hospitals in Maryland, including Mercy Medical Center in Baltimore, agreed.
“For the first few weeks of life, infants are not able to mount a vaccination response and immunity and adequate immunity response,” Dr. Abularach explained to MNT.
“So that’s why infants don’t get vaccinated for a couple of months. The first few months of life is the most vulnerable time for these infants.”
“The take-home point is [that RSV] is not going to kill a young mother,” noted Dr. G. Thomas Ruiz, a board-certified OB-GYN and lead OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA. “They’re not going to get very sick — they’re going to get cold-like symptoms and maybe a cough. It doesn’t tend to affect adults.”
“But [RSV] can be a devastating disorder for newborns, leading to hospitalization and death from pneumonia,” Dr. Ruiz continued. “So you’re really [getting] the vaccine to protect your baby.”
Which RSV vaccine is approved for pregnant people?
Currently, the only RSV vaccine FDA approved as a maternal vaccine is Pfizer’s Abrysvo vaccine.
The pharmaceutical company GSK plc also makes an RSV vaccine called Arexvy. However, the FDA has only approved it for use in older adults 60 and older.
Dr. Riley advised that pregnant people who want to arm themselves with accurate information on the vaccine they should be taking can talk with a healthcare professional or visit credible websites from organizations and agencies such as the CDC.
“Abrysvo is the only RSV vaccine approved for use in pregnancy,” Riley noted.
“Not all doctors’ offices and pharmacies have Abrysvo yet. Pregnant people can search for pharmacies that have the vaccine on the Abrysvo website,” she added.
Dr. Abularach said a pregnant person can always ask their doctor to confirm which RSV vaccine they should have.
“If they choose to go to a commercial pharmacy like CVS or Walgreens, which have them available now — obviously confirmation there as well — asking the question to make sure that they’re getting the right vaccine,” she added.
It is recommended that pregnant people get the maternal RSV vaccine between 32–36 weeks gestation to prevent RSV in their infants once they’re born.
“The idea is to vaccinate the mothers in this particular window to protect these infants at their most vulnerable time, which is immediately after birth and for the first six months, especially for infants that are born during the RSV season,” Dr. Abularach explained.
“The antibodies [the infants] get is via the mother and the placenta, so that process takes about two weeks. A mother who is vaccinated at least two weeks in advance of the baby’s birth would allow the baby that protection,” she added.
Dr. Jourdan Triebwasser, assistant professor of maternal-fetal medicine at the University of Michigan Health, added that ACOG recommends the maternal RSV vaccine for pregnant individuals during RSV season, which runs from September through January in most regions of the U.S.
“Thousands of infants under (the) age (of) 6 months are hospitalized each year nationwide because of RSV infection,” Dr. Triebwasser told MNT.
“While some babies may only need observation or supplemental oxygen, others need intensive care and mechanical ventilation. Vaccination during pregnancy is a powerful tool to reduce the risk for your baby,” Dr. Triebwasser said.
Is the RSV vaccine safe during pregnancy?
The RSV vaccine Abrysvo made by Pfizer Inc. was approved by the Food and Drug Administration (FDA) in August 2023 for use as a maternal vaccine to help protect infants at birth and through the first 6 months of life.
The FDA approval was based on results from the vaccine’s phase 3 clinical trial where no safety signals were detected in either pregnant study participants or the children born after they received the vaccine.
Dr. Ruiz told MNT the RSV vaccine is incredibly safe, and there’s no reason for a pregnant person not to get one unless they are allergic to the vaccine’s carrier medium.
He also said another benefit of the maternal RSV vaccine is that it’s preservative-free.
“Preservative-free means there’s less things within the vaccine that’s going to cause an allergic reaction [for] the mom,” Dr. Ruiz explained.
“(With) the maternal vaccine, they make sure to give them something that is as nonreactive to the body as possible, so the term we use is preservative-free.”
Dr. Triebwasser noted the RSV vaccine is a recombinant antigen vaccine, meaning it’s not a live virus vaccine.
“Some people are hesitant to receive vaccines during pregnancy, although we have a lot of data on older vaccines, including the flu vaccine, that maternal vaccination is safe for the pregnant person and babies. There may be an association between RSV vaccination and preterm birth, although that is not certain. To limit (the) potential risk of preterm birth, the recommendation is to give (the) RSV vaccine at 32–36 weeks.”
— Dr. Jourdan Triebwasser, assistant professor of maternal-fetal medicine
What are the side effects of the maternal RSV vaccine?
According to Dr. Edward Liu, chief of infectious diseases at Hackensack Meridian Jersey Shore University Medical Center, currently, the reported side effects of the RSV vaccine seem mild and include:
- pain at the injection site
- muscle ache
- sore arms
- headache
- nausea
“No side effects are reported for babies,” Dr. Liu continued. “(The) RSV vaccine cannot be given to a newborn infant. Babies’ immune systems are not fully developed and sometimes do not respond to vaccines.”
Dr. Abularach agreed and stated the studies that have so far been published about the RSV vaccine in pregnant women have not reported any safety concerns.
“The main side effects have been mild to sort of moderate,” she continued. “And it’s really the same side effects that you would expect with most vaccines — pain at the injection site, muscle pain, sometimes nausea or headache, relatively mild things. Some people have concerns about vaccines, and we always recommend that they discuss that with their provider, and shared decision-making takes place between the provider and the patient, so this would be no exception — we would recommend that as well.”
— Dr. Silvia M. Abularach, OB-GYN
Before You Buy! Toy Safety Warning

Amazon, Walmart and Target stop selling water beads marketed toward children
(CNN, Ramishah Maruf) -- Amazon, Target and Walmart have voluntarily stopped selling water beads marketed for children after government officials, lawmakers and public health professionals called for a ban on the toys.
Water beads are tiny balls made out of extremely absorbent polymer material. When exposed to liquid, they can expand to 100 times their initial size and weight, according to the Consumer Product Safety Commission.
Because they can grow inside the body once ingested, these toys pose immense health risks to young children, say experts.
And, because they’re mostly made up of water, typical X-rays often do not pick them up. In a safety alert in September, the CPSC reported that these beads “can cause severe discomfort, vomiting, dehydration, intestinal blockages and life-threatening injuries” and may require surgery to remove.
They’re sold as popular children’s toys to promote counting or develop motor skills. But the water beads have drawn scrutiny from lawmakers and the CPSC.
Last month, US Rep. Frank Pallone Jr. of New Jersey introduced legislation aimed at instating a national ban on beads marketed to kids.
“They are specifically marketed to kids. In a single small package you can have 25, 50, or even 75 thousand of these beads and it just takes one to cause harm to a child,” Pallone said in a November news conference. “They are not labeled as dangerous to small children, there’s no warning, and they’re not hard to get.”
An Amazon spokesperson confirmed the company updated its water bead policy on Tuesday. The e-retailer said it would remove listings for water beads if it refers to or includes images of children, or is described using toy, sensory play, arts or crafts.
“In the interest of safety, Amazon will no longer allow the sale of water beads that are marketed to children, including as toys, art supplies or for sensory play,” a company spokesperson said. “We work hard to ensure the products offered in our store are safe, and we have teams dedicated to developing and updating our policies, evaluating listings, and continuously monitoring our store to prevent unsafe and noncompliant products from being listed.”
In a statement Tuesday, Target also said it will no longer sell water beads marketed to children, in-store or online.
Walmart, in an email sent Tuesday, said protecting customers is its top priority.
“We decided to voluntarily stop selling expanding water bead toy and craft items marketed to young children and have already taken steps to remove them from our stores and online,” a spokesperson in an email.
Consumer Reports first reported the voluntary bans on Amazon and Walmart.
In the same November news conference in which Pallone introduced the legislation, CPSC Chairman Alex Hoehn-Saric said, “It is far too easy for beads to be lost, dropped, and a short time later a baby or small child ends up finding them, picking them up and ingesting them.”
CPSC urges parents and caregivers to remove products from the proximity of small children.
Most recently, in September, Buffalo Games recalled “Chuckle & Roar Ultimate Water Beads Activity Kits” sold exclusively at Target after one infant death was reported.
– CNN’s Eva Rothenberg contributed to this report.
Is An End to Breast Cancer in Sight? A Groundbreaking Vaccine Shows Promise

(CBS News - Ashley Sharp) -- An estimated one in eight women will develop breast cancer in their lifetime, killing on average 42,000 women a year in the United States.
What if there was a vaccine that would significantly lower each woman's chance of ever getting it in the first place? In that question lies what could be the answer to one day eliminating the deadly disease.
A groundbreaking vaccine created through decades of research at the Cleveland Clinic and developed by Anixa Biosciences in San Jose, California is driving innovation by targeting triple-negative breast cancer, the disease's deadliest and most aggressive form.
"This vaccine could potentially eliminate breast cancer," said Dr. Amit Kumar, Anixa CEO.
The vaccine's findings from its first trial with 16 women were published Wednesday, with each participant reporting no bad side effects and no resurgence of their cancer so far.
Jennifer Davis, a brave woman from small-town Ohio, was the first woman in the world to get the vaccine in October 2021.
"This is how we advance medicine. It's important to be a part of those things," Davis said. "I am just beyond grateful."
When Davis heard the dreaded words "you have cancer" in September 2018, it came six months after her first alert to an abnormality on a routine mammogram and ultrasound.
At the time, her biopsy turned up negative for cancer.
"I really wanted to believe everything was OK, but I knew something wasn't right," Davis said.
At 41 years old, she had no history of cancer. Still, she could feel a lump growing and decided to go for a second opinion and a second biopsy.
She was diagnosed with triple-negative breast cancer. Her mind instantly went to her family and three children.
"It was very hard to tell them and try and be strong for them," Davis said. "With triple negative, there is nothing for us to take — no pill or anything to prevent recurrence. The rate is high and outcomes are poor if it does come back."
After chemotherapy, a double mastectomy and radiation, Davis was finally free of cancer, but she was not free of the fear that lingers.
"I was always nervous and afraid of it coming back," she said.
So when she learned of an experimental vaccine trial while receiving her cancer care at the Cleveland Clinic, she thought, "What do I have to lose?"
"It was something that was going to give me peace of mind," Davis said. "If this could work for me, then I wouldn't have to worry about a recurrence."
She became the first woman in the world to take the breast cancer vaccine.
A registered nurse herself, what eased her mind was the fact that in years of trials in animals, there had been no cancer recurrence and no anaphylactic reaction.
"That was all I needed to hear," said Davis, who reports that in the two years since taking the vaccine, she has never felt better.
The vaccine has been studied for more than two decades at the Cleveland Clinic, pioneered by pre-clinical research led by the late Dr. Vincent Tuohy.
Inspired by this and what it could mean for the future of cancer diagnosis, Dr. Kumar approached the clinic about developing the vaccine.
"I looked at it and I saw the vision," Kumar said.
So how does it work?
"Is it, in essence, teaching your body not to grow a tumor?" CBS13 reporter Ashley Sharp asked.
"That's exactly right. It's teaching your body to destroy the cells that can grow a tumor," Kumar said.
If a virus shows up in the body, the immune system teaches itself how to destroy it, knowing, easily, which cells are bad.
In cancer, it is more difficult, Dr. Kumar explained.
"All of the cells that become cancerous in your body came from normal, healthy cells," Kumar said. "The difference is not big, so the immune system has a harder time recognizing a cancer cell and distinguishing it from a healthy cell."
According to the Cleveland Clinic, the vaccine works by targeting a lactation protein called α-lactalbumin, which is no longer found after lactation in normal, aging tissues. It is, however, present in most triple-negative breast cancer patients. If breast cancer develops, the vaccine is designed to instruct the immune system to attack the tumor and keep it from growing entirely.
"The results are incredibly promising," Kumar said. "The vision is one day to be able to give this to any woman who wants to prevent cancer from ever occurring in her body. It's a small step and we have many more steps to go, but it's incredible if we can make this happen."
It's a promising find for the future of fighting cancer that started with one woman but hopefully ends with every woman.
"The bigger picture of this is overwhelming for me," Davis said.
The second vaccine trial is set to start in 2024, this time with 600 women instead of 16. This study will be on a much larger scale, where half the women will get the vaccine and the other half will get a placebo.
The hope is that within five years, they can get FDA approval to distribute the vaccine to the public.
The Science of Swoon! New Discovery May Explain Why People Faint

(NPR - Jon Hamilton) -- A newly discovered pathway between the heart and brain may explain why healthy people faint.
The pathway appears to carry signals from the heart's lower pumping chambers to an area of the brainstem that controls heart rate, blood pressure and breathing, says Vineet Augustine, a neurobiologist at the University of California San Diego.
When scientists stimulate nerve cells along that pathway in mice, Augustine says, "the heart rate immediately dips, they wobble around a little bit and then they fall over."
The finding, published in November in the journal Nature, offers a biological explanation for fainting that isn't caused by an underlying medical condition.
"A lot of people faint at the sight of blood," Augustine says, "or when they're having blood drawn or exposed to a very intense emotional stimulus."
The study also offers a clearer picture of how the brain and body usually work together to keep us from passing out, says Robert Wilson, a neurologist at the Cleveland Clinic who was not involved in the research.
"There's this whole orchestra that responds to how blood is flowing, that tells the heart how to speed up, how much to pump," Wilson says.
Understanding that orchestra has become especially urgent since the arrival of COVID-19. The disease often affects a person's autonomic system, which regulates functions including heart rate, blood pressure and breathing.
In the past, autonomic disorders didn't get much attention, Wilson says. "Then COVID occurred, and a lot of the long COVID patients have autonomic dysfunction, dizziness, fainting, and it's a big deal."
Old science, new understanding
About 40% of people pass out at some point in their lives. Most of the time, there's no medical reason.
Doctors call this sort of fainting vasovagal syncope, and it occurs when there is a sudden drop in heart rate and blood pressure. That reduces blood flow to the brain, which shuts down the circuits that keep us conscious.
Research dating back to the 19th century links this type of fainting to the vagus nerve, a wandering tract that connects the brain to internal organs including the heart, lung and gut.
"But what was not clear was which part of the vagus nerve," Augustine says. "The vagus nerve is big. It's a major highway between the body and the brain."
Scientists once thought the vagus nerve was merely a way for the brain to control internal organs. But studies show it's a two-way street. The gut, for example, can affect the brain.
Augustine's team figured that this might be true of the heart as well.
"We were trying to argue [that] the heart also sends signals back to the brain which can influence its function and behavior," he says.
The team used genetic tools and advanced imaging techniques to study a cluster of sensory neurons in the vagus nerve of mice.
By identifying which genes were switched on in each neuron, the researchers were able to identify a distinct population of cells that hadn't been studied.
Then, using a technology that makes certain tissues transparent, the team showed that these cells form a fiber communication pathway that leads from the heart's ventricles (the lower pumping chambers) to the area postrema, a region of the brainstem best known for its ability to induce vomiting.
The researchers used laser light to stimulate the pathway in mice, which caused not only fainting but several other signs seen in people as they lose consciousness. The mice's pupils would dilate, their eyes would roll back, their breathing and heart rate would slow, and their blood pressure would plummet.
Swooning's many unknowns
Scientists are just beginning to understand how the heart and brain communicate.
For example, it has been less than a decade since researchers explained the baroreflex, which keeps blood flowing to the brain whether we're sitting or standing.
That finding helped Ardem Patapoutian of Scripps Research win a share of a Nobel Prize in 2021. It also has given researchers a target for treatment of conditions that affect the baroreflex.
Augustine once worked with Patapoutian. Now, his team's apparent discovery of a fainting reflex could help patients with other disorders that affect blood flow to the brain.
Wilson agrees.
"This is probably a new door to go through for treatments and for understanding," he says.
Right now, Wilson says, he has limited options when it comes to treating people who become lightheaded or faint.
"Sometimes people just need to avoid triggers," he says, "and sometimes people might need an actual medication."
Often the medication used to prevent fainting simply raises a person's blood pressure. The new study could lead to treatments that more directly address the underlying problem.
NCMS Member Dr. Jonas Swartz Receives Dogwood Award
Jonas Swartz, MD, MPH, Receives Dogwood Award

Jonas Swartz, MD, MPH, director of Family Planning at Duke Health, has been awarded a 2023 Dogwood Award by North Carolina Attorney General Josh Stein. These awards are given out annually to recognize people who are working to improve the health, safety and well-being of their fellow North Carolinians. Dr. Swartz was among 34 recipients selected for the recognition. He has been a staunch supporter of women's reproductive rights and has played an integral role in the Duke Reproductive Health Equity & Advocacy Mobilization (DREAM) Team to advocate for policies that preserve and enhance women's health care access.
Are You Ready? Shipping Deadlines Start Next Week!

When is the Christmas shipping deadline for 2023? See the last days to order and mail packages.
The holiday shopping season is in full swing and it won't be long before time runs out on deadlines for mailing Christmas packages. Shippers, as well as retailers, have announced Christmas 2023 cutoff dates for getting gifts to their destinations on time.
USPS Christmas deadline
The United States Postal Service has announced its cutoff dates for deliveries in time for Christmas.
- December 16 is the cutoff for 5-day shipping using USPS Ground Advantage and First-Class Mail services.
- If you pay for 4-day-shipping, you have until December 18 to mail parcels and have them arrive under the tree by Christmas.
- Consumers have until December 21 if they use the USPS's Priority Mail Express 1-day shipping option.
Keep in mind, the USPS won't be delivering regular mail on Christmas Day. And because Christmas Eve falls on a Sunday this year, the last scheduled day for regular USPS delivery is Saturday, December 23.
For Priority Mail Express mail, if a holiday premium is paid, the last scheduled delivery day is Sunday, December 24.
Postage costs vary depending on the type of parcel you are mailing and its destination.
FedEx Christmas deadline
With FedEx, the deadline for mailing Christmas packages also varies depending on the service.
- The last day to ship a package using FedEx Ground Economy services is December 13.
- For FedEx Ground 5-day shipping, it's December 15.
- For 1-day shipping, it's December 21 — the Thursday before the holiday.
FedEx also offers express services that buy last-minute gift-givers more time.
- The last day to ship packages so that they arrive on or before Sunday, December 24 is Friday, December 22, via FedEx SameDay delivery.
All FedEx services, except for FedEx Custom Critical, are closed on Christmas Day.
UPS Christmas deadline
UPS, which is also closed on Christmas, recommends the following deadlines for package deliveries in time for the big holiday.
- Ship gifts by December 19 using UPS's 3-day delivery option, called UPS 3 Day Select, so they'll arrive on December 23.
- Ship by December 21 under UPS Next Day Air services.
- Customers have until December 22 with the shipper's Saturday delivery options.
Major retailers
Some major retailers have announced their own purchase deadlines for timely holiday delivery.
- Bookseller Barnes and Noble says December 16 is the last day for Christmas delivery with its standard shipping option. Expedited shipping lets shoppers purchase gifts online until December19. Picking up items in stores is also an option.
- Order from outdoor retailer REI by 9 a.m. PT on December 19 for Christmas delivery via standard shipping. Pick up goods in-store for faster retrieval.
Where you might want to order even earlier
- Given that it personalizes items, custom card and giftmaker Shutterfly has earlier shipping cutoff dates. If selecting basic economy shipping, Shutterfly's last day to order for Christmas is December 14, to allow for 6-10 days for production and delivery. Visit the site for more details.
- Similarly, many sellers on Etsy, a marketplace where independent makers sell handcrafted goods, make gifts that take time to fabricate and require more lead time to guarantee delivery by Christmas.
(Dates from CBSNEWS.COM)
United Nations Takes Action on PFAS in NC as Residents Prepare for Exposure Study

The United Nations has recognized the PFAS contamination crisis occurring in the Lower Cape Fear Region as a violation of international human rights law.
The Cape Fear River is the primary drinking water supply for over 1.5 million residents in NC.
On Thanksgiving Day, the U.N. published five letters to Dupont, Chemours, Corteva, the United States and the Netherlands. The letters are in response to a communication filed on behalf of Clean Cape Fear, which is seeking compensation for human rights violations connected to PFAS exposures coming from the Chemours Fayetteville Works Facility.
Clean Cape Fear is a grassroots community action group working to restore and protect soil, water, and food supplies from PFAS contamination.
Tanner Blue with WWAY in Wilmington reports that Clean Cape Fear says the acknowledgement feels warranted.
“I will say at first this is really validating" said Clean Cape Fear Co-Founder Emily Donavan. "There’s a lot of people that in our community that do feel that their rights have been violated, and it’s been very frustrating to watch a company like DuPont and now Chemours, kind of be given safe harbor, or really just a slap on the wrist.”
Chemours, the Netherlands and Corteva have responded to the United Nations. The United States and DuPont have not.
As those letters come to light, some in North Carolina are rolling up their sleeves to give blood and learn more about PFAS exposure.

Navassa, a predominantly Black community in Brunswick County, gets its drinking water from the Cape Fear River. So does its neighbor Wilmington, which is about six miles southeast. That makes the town’s residents prime candidates to join the GenX Exposure Study, a multisite study where environmental health researchers are examining the blood of people who’ve been exposed to per- and polyfluoroalkyl substances (PFAS), which have contaminated waterways throughout the state.
In 2017, the year that GenX chemicals, which are a class of PFAS, were found in the Cape Fear River, N.C. State University epidemiologist Jane Hoppin and colleagues, including East Carolina University epidemiologist Suzanne Lea, launched the GenX Exposure Study to answer some of the many questions about the potential health impacts of the chemicals on humans.
Before the launch of the GenX Exposure Study, Lea and Hoppin had worked together on environmental health issues as part of the Center for Human Health and the Environment at N.C. State University. The center brings together researchers within the university and those from the East Carolina University’s Brody School of Medicine, North Carolina Central University and the N.C. Department of Health and Human Services to investigate and lessen environmental effects on humans.
Lea recalls developing an action plan soon after Detlef Knappe, a professor in the N.C. State University Dept. of Civil, Construction and Environmental Engineering, shared research with the Wilmington Star News that detailed the presence of GenX compounds in the Cape Fear River.
“I said [to Jane], ‘Let me call the health director with the New Hanover County Health Department and see what we can do,’” Lea said. “And we wrote a grant to the National Institute of Health, and the New Hanover County health director talked to the city council and county commissioners and we started …”
In the lower Cape Fear Region, the study includes public water users in New Hanover and Brunswick counties and well water users in Bladen, Cumberland and Robeson counties, whose wells have been tested for contamination by Chemours or the N.C. Department of Environmental Quality.
Chemours’ Fayetteville Works plant, on the border of Cumberland and Bladen counties, has been fingered as the culprit in the GenX contamination in the lower Cape Fear, both for dumping chemicals into the river and for the PFAS that came out of smokestacks and drifted on the wind to surrounding municipalities.
In the upper Cape Fear Region, the study includes residents of Pittsboro whose drinking water comes from the Haw River — a tributary of the Cape Fear — where contaminants emanating from industries in Greensboro and elsewhere have added to the level of chemicals.
Since 2017, the study has recruited roughly 1,400 participants, and researchers want to add more African Americans, Lea said.
“We really feel like at least 20 percent of that total group should be African Americans to reflect the size in our state,” she said.
African Americans account for roughly 22 percent of North Carolina’s population, according to U.S. Census data.
(This story contains reporting by Will Atwater of NC Health News and Tanner Blue of WWAY)
Additional Reading:
Navassa residents roll up their sleeves to participate in PFAS exposure study
Fighting PFAS contamination in the Lower Cape Fear Region
Overview of PFAS in North Carolina
CDC: Covid Variant BA.2.86 Triples in New Estimates

(CBS News Health Watch, Alexander Tin) -- Nearly 1 in 10 new COVID-19 cases in the U.S. are from the BA.2.86 variant, the Centers for Disease Control and Prevention estimated Monday, nearly triple what the agency estimated the highly mutated variant's prevalence was two weeks ago.
Among the handful of regions with enough specimens reported from testing laboratories, BA.2.86's prevalence is largest in the Northeast: 13.1% of cases in the New York and New Jersey region are blamed on the strain.
Monday's figures mark the first time BA.2.86's prevalence has surged enough to be listed as a standalone variant on the CDC's estimates. Scientists first warned of the highly mutated strain's discovery over the summer.
"In previous Nowcast updates, BA.2.86 was too uncommon to be shown separately and was grouped with other BA.2 strains," the CDC said Monday.
Before this point, officials have said the vast majority of new COVID-19 cases have been blamed on the XBB variant and a crowd of XBB's closely related descendants. Those include the HV.1 and EG.5 variants that are currently predominant nationwide.
However, this latest estimate – 8.8% through Nov. 25 – is virtually triple what it was on Nov. 11, when 3.0% of new cases were estimated to be BA.2.86. The CDC typically publishes its variant estimates every other Friday, but had delayed last week's release until after the Thanksgiving holiday weekend.
"It is important to note that early projections tend to be less reliable, since they depend on examining growth trends of a smaller number of sequences, especially as laboratory-based testing volume for SARS-CoV-2 has decreased substantially over time," the agency said.
The World Health Organization also recently stepped up its classification of BA.2.86 and its descendants to a "variant of interest" after a rise in cases from the strain.
Early data on BA.2.86 suggests it does not appear to lead to worse or different symptoms than previous strains, the WHO said in its Nov. 21 risk evaluation, but noted a "substantial rise" in recent BA.2.86 reports.
The CDC said it did not disagree with the WHO's assessment that BA.2.86 likely posed a "low" public health risk, adding that for now the strain "BA.2.86 does not appear to be driving increases in infections or hospitalizations in the United States."
It comes as the CDC has begun to track a renewed increase in indicators tracking COVID-19's spread across the U.S. headed into the winter.
After weeks of largely slowing or flat trends, the CDC said this month that figures like emergency department visits had begun to increase nationwide from COVID-19. Virtually all regions of the country are now seeing at least slight increases.
Some of the highest increases are in the Midwestern region covering Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin, where trends are nearing levels not seen since early January.
Is the JN.1 variant to blame?
Since August, BA.2.86's broad array of mutations did not appear to be enough for the strain to gain a foothold over XBB and its descendants. Months of the highly mutated variant's spread only resulted in a small share of cases throughout the world.
But scientists in recent weeks have been studying a steep increase in a BA.2.86 descendant called JN.1, which quickly rose to become the fastest-growing subvariant worldwide.
Many cases have been reported in Europe, which has seen increasing cases from BA.2.86 and its descendants.
Authorities in France said on Nov. 13 that JN.1 was largely driving that country's increase in BA.2.86 infections, climbing to 10% of sequences in the country. Early investigations of JN.1 had not turned up any worrying signals so far compared to other BA.2.86 infections, they said, though more in-depth analyses were underway.
Data from recent weeks tallied from the GISAID virus database suggests as much as a third of COVID-19 variants reported from labs in the U.S. have been of JN.1.
"Currently, JN.1 is the most common version of BA.2.86 in the U.S. CDC projects BA.2.86 and its offshoots like JN.1 will continue to increase as a proportion of SARS-CoV-2 genomic sequences," CDC spokesperson Jasmine Reed told CBS News in an email.
Last month, the CDC said it expected COVID-19 tests and treatment would remain effective against JN.1, which is closely related to BA.2.86 aside from a single change to its spike protein that early research suggests is enabling it to spread faster.
This season's vaccines are also expected to work against JN.1 similar to what was estimated for its BA.2.86 parent, the agency said.
Medicaid Expansion Begins Friday, NC Raising Rates for Behavioral Health Providers

Rate Change is First Since 2012
(NC Health News - Jamie Baxley) -- Medicaid expansion, a decade-in-the-making measure that is expected to provide health insurance to more than 600,000 low-income North Carolinians, will take effect in less than two weeks.
But the coverage created by expansion is only useful if eligible residents have access to health care providers that accept Medicaid. That’s particularly true for people looking for mental health care, which has been in even higher demand since the COVID-19 pandemic.
Behavioral health providers of all types across the state— but particularly mental health practitioners — have complained for years that they are not adequately reimbursed for services covered by the government-funded program. In fact, they often lose money by treating Medicaid patients, and that has prompted an exodus of providers from the program.
The N.C. Department of Health and Human Services hopes to make the situation more tenable by raising the minimum reimbursement rates for behavioral health care for the first time since 2012.
The new rates announced Wednesday by DHHS will apply to most Medicaid-covered treatments for mental health and substance use disorder. They will also apply to services for patients with intellectual and developmental disabilities, along with services for patients living with traumatic brain injury.
In an interview with NC Health News, Kody Kinsley, head of DHHS, said the increased rates, which take effect on Jan. 1, will be permanent thanks to $200 million in recurring funds allocated by the General Assembly.
“It’s a huge investment in our provider community,” he said. “It’s a huge investment in increasing the amount of provider workforce, and it’s going to open up the tap and access for people who so desperately need it.”
Behavioral health providers, he added, couldn’t “stay in business on the rates that were being paid.”
“We’re in a situation where we hear all the time every single day that we don’t have providers,” state Sen. Sydney Batch (D-Raleigh) said on a bipartisan panel this week at the North Carolina Institute of Medicine annual meeting. “I know a lot of therapists that are not practicing because the reimbursement rates are too low.”
Under the current fee schedule, facilities are paid less than $500 a day for inpatient psychiatric care. They will receive nearly $900 under the new rate, according to Kinsley. Reimbursement for inpatient psychiatric care is expected to increase by 30 percent overall.
“You can have a child in the ED and you will get $3,000 a day, potentially, for that child if they’re sick, but if they’ve had a mental health crisis, you’re gonna get pennies on the dollar,” Batch said. “We do not value behavioral health at the same level as we do physical health.”
Psychiatrists will also see more than double the reimbursement for psychological assessments, a process which, if done well, can take several hours, if not longer. DHHS says the new rate will pay $229 per assessment, up from $100.
Psychiatric residential treatment facilities, however, will not see an increase — at least not for the time being. Kinsley said DHHS is working to establish a separate, long-term rate structure for providers in those settings.
“We didn’t do a rate increase on PRTFs right this moment because we have a different process underway [for them],” he said. “We’re trying to determine not just how do we increase their rate, but how do we pay for quality?”
Expansion approaches
The rate changes were announced ahead of an anticipated surge in Medicaid enrollment in North Carolina.
On Friday, the state’s long-standing income limit for eligibility will increase to 138 percent of the federal poverty level. That means single adults, a population that has been effectively ineligible for coverage under the current criteria, will qualify if they make less than $20,000 a year.
The first residents expected to benefit from the expansion are those currently enrolled in so-called Medicaid family plans, which offer fewer benefits than traditional Medicaid. DHHS estimates that 300,000 family plan enrollees will be automatically upgraded to full coverage.
Kinsley said the department is making an “all hands on deck” effort to ensure that expansion is implemented as smoothly as possible. Still, he stopped short of promising a totally seamless rollout.
“I’m confident that we’re going to have a bolus of people that come forward on [Dec. 1] that is going to be larger than what the performance of the statewide system, as far as our staff and our DSS office, can manage all on one day,” Kinsley said, referring to the Division of Social Services. “That’s normal for any type of new launch — any new product launch — that you bring out.”
He likened the state to an Apple store “with a line down the street” waiting to buy the latest iPhone. DHHS, he said, anticipates seeing “some full waiting rooms” once expansion goes live.
But the bigger challenge, according to Kinsley, might be sustaining that excitement after the initial rush.
“While I want a really smooth Day One, I also want to keep that energy up so that, come April, we’re still trying to find every potential person in this state that is eligible and get them enrolled,” Kinsley said. “Eighty percent of the people that are going to be in the Medicaid expansion benefit are coming from working families. These are hardworking people who maybe have multiple jobs and are taking care of their kids and are getting ready for the holidays.”
More than 2.8 million North Carolinians were enrolled in Medicaid as of October, according to data from DHHS.
On The Lighter Side - November 17, 2023 - The Leonids Are Coming and So Are the Holidays!
Here are some things NCMS employees, members, and YOU are talking about this Weekend and Beyond!
Leonid meteor shower: All you need to know in 2023

The famous Leonid meteor shower will be free of moonlight on the shower’s peak morning, November 18. You might also try watching on the morning of November 17.
Predicted peak: is predicted** for November 18, 2023, at 5:33 UTC.
When to watch: Watch late on the night of November 17 until dawn on November 18. The morning of November 17 might be worthwhile, too.
Duration of shower: November 3 through December 2.
Radiant: Rises around midnight, highest in the sky at dawn.
Nearest moon phase: In 2023, first quarter moon falls on November 20. So there will very little interference from moonlight in 2023.
Expected meteors at peak, under ideal conditions: Under a dark sky with no moon, you might see 10 to 15 Leonid meteors per hour.
For more information click here.
The Rink is back!

Enjoy the thrill of ice skating in a winter wonderland created in the heart of downtown Raleigh! THE RINK presented by UNC Health features a natural ice skating rink with stunning views of the Raleigh skyline. All you need to know to lace up your skates is here.
Time for the 41st Annual Seagrove Pottery Festival

Join the largest pottery community in the U.S. Saturday and Sunday as everyone comes together with traditional craftspeople to sell their wares. The festival features potters market, auction of signed and dated pottery, demonstrations and food vendors. All you need to know is here.
The holidays are kicking off this weekend!

Trans-Siberian Orchestra, Sunday 3-7pm, Greensboro Coliseum Complex, Greensboro

Straight No Chaser, Sunday 3-7, Durham Performing Arts Center, Durham
If you have an event you would like added to On The Lighter Side, email Randy Aldridge at [email protected].
US Climate Assessment: Climate Change Impacting Every Facet of American Life, Including Health

(AP - Seth Borenstein and Tammy Webber) -- Revved-up climate change now permeates Americans’ daily lives with harm that is “already far-reaching and worsening across every region of the United States,” a massive new government report says.
The National Climate Assessment, which comes out every four to five years, was released Tuesday with details that bring climate change’s impacts down to a local level. Unveiling the report at the White House, President Joe Biden blasted Republican legislators and his predecessor for disputing global warming.
“Anyone who willfully denies the impact of climate change is condemning the American people to a very dangerous future. Impacts are only going to get worse, more frequent, more ferocious and more costly,” Biden said, noting that disasters cost the country $178 billion last year. “None of this is inevitable.”
Overall, Tuesday’s assessment paints a picture of a country warming about 60% faster than the world as a whole, one that regularly gets smacked with costly weather disasters and faces even bigger problems in the future.
Since 1970, the Lower 48 states have warmed by 2.5 degrees (1.4 degrees Celsius) and Alaska has heated up by 4.2 degrees (2.3 degrees Celsius), compared to the global average of 1.7 degrees (0.9 degrees Celsius), the report said. But what people really feel is not the averages, but when weather is extreme.
With heat waves, drought, wildfire and heavy downpours, “we are seeing an acceleration of the impacts of climate change in the United States,” said study co-author Zeke Hausfather of the tech company Stripe and Berkeley Earth.
And that’s not healthy.
Climate change is ”harming physical, mental, spiritual, and community health and well-being through the increasing frequency and intensity of extreme events, increasing cases of infectious and vector-borne diseases, and declines in food and water quality and security,” the report said.
Compared to earlier national assessments, this year’s uses far stronger language and “unequivocally” blames the burning of coal, oil and gas for climate change.
The 37-chapter assessment includes an interactive atlas that zooms down to the county level. It finds that climate change is affecting people’s security, health and livelihoods in every corner of the country in different ways, with minority and Native American communities often disproportionately at risk.
In Alaska, which is warming two to three times faster than the global average, reduced snowpack, shrinking glaciers, thawing permafrost, acidifying oceans and disappearing sea ice have affected everything from the state’s growing season, to hunting and fishing, with projections raising questions about whether some Indigenous communities should be relocated.
The Southwest is experiencing more drought and extreme heat – including 31 consecutive days this summer when Phoenix’s daily high temperatures reached or exceeded 110 degrees – reducing water supplies and increasing wildfire risk.
Northeastern cities are seeing more extreme heat, flooding and poor air quality, as well as risks to infrastructure, while drought and floods exacerbated by climate change threaten farming and ecosystems in rural areas.
In the Midwest, both extreme drought and flooding threaten crops and animal production, which can affect the global food supply.
In the northern Great Plains, weather extremes like drought and flooding, as well as declining water resources, threaten an economy dependent largely on crops, cattle, energy production and recreation. Meanwhile, water shortages in parts of the southern Great Plains are projected to worsen, while high temperatures are expected to break records in all three states by midcentury.
In the Southeast, minority and Native American communities -- who may live in areas with higher exposures to extreme heat, pollution and flooding — have fewer resources to prepare for or to escape the effects of climate change.
In the Northwest, hotter days and nights that don’t cool down much have resulted in drier streams and less snowpack, leading to increased risk of drought and wildfires. The climate disturbance has also brought damaging extreme rain.
Hawaii and other Pacific islands, as well as the U.S. Caribbean, are increasingly vulnerable to the extremes of drought and heavy rain as well as sea level rise and natural disaster as temperatures warm.
The United States will warm in the future about 40% more than the world as a total, the assessment said. The AP calculated, using others’ global projections, that that means America would get about 3.8 degrees (2.1 degrees Celsius) hotter by the end of the century.
Hotter average temperatures means weather that is even more extreme.
“The news is not good, but it is also not surprising,” said University of Colorado’s Waleed Abdalati, a former NASA chief scientist who was not part of this report. “What we are seeing is a manifestation of changes that were anticipated over the last few decades.”
The 2,200-page report comes after five straight months when the globe set monthly and daily heat records. It comes as the U.S. has set a record with 25 different weather disasters this year that caused at least $1 billion in damage.
“Climate change is finally moving from an abstract future issue to a present, concrete, relevant issue. It’s happening right now,” said report lead author Katharine Hayhoe, chief scientist at the Nature Conservancy and a professor at Texas Tech University. Five years ago, when the last assessment was issued, fewer people were experiencing climate change firsthand.
Surveys this year by The Associated Press-NORC Center for Public Affairs Research show that.
In September, about 9 in 10 Americans (87%) said they’d experienced at least one extreme weather event in the past five years — drought, extreme heat, severe storms, wildfires or flooding. That was up from 79% who said that in April.
Hayhoe said there’s also a new emphasis in the assessment on marginalized communities.
“It is less a matter ... of what hits where, but more what hits whom and how well those people can manage the impacts,” said University of Colorado’s Abdalati, whose saw much of his neighborhood destroyed in the 2021 Marshall wildfire.
Biden administration officials emphasize that all is not lost and the report details actions to reduce emissions and adapt to what’s coming.
By cleaning up industry, how electricity is made and how transport is powered, climate change can be dramatically reduced. Hausfather said when emissions stops, warming stops, “so we can stop this acceleration if we as a society get our act together.”
But some scientists said parts of the assessment are too optimistic.
“The report’s rosy graphics and outlook obscure the dangers approaching,” Stanford University climate scientist Rob Jackson said. “We are not prepared for what’s coming.”
NCDHHS Encouraging Mpox Vaccinations After New Cases Reported
NCDHHS Encourages Mpox Vaccination for People at Higher Risk After Recent Cases Reported

In addition to the two cases, the mpox virus was recently detected in one out of 12 wastewater sites where monitoring is being conducted. These cases and wastewater detections were all in different counties, suggesting an increased spread of mpox in North Carolina.
Numbers and cases have been low due to vaccinations and community engagement, but now is the time to get vaccinated if you are at higher risk for mpox and have not yet received the vaccine. Eligibility criteria have expanded to include:
- Anyone who has or may have multiple or anonymous sex partners;
- Anyone whose sex partners are eligible per the criteria above;
- People who know or suspect they have been exposed to mpox in the last 14 days;
- Anyone else who considers themselves to be at risk for mpox through sex or other intimate contact.
Take steps to lower your risk during sex or at social gatherings, like using a condom correctly every time you have sex. Avoid close contact with people who have a rash that looks like mpox, avoid contact with objects and materials a person with mpox has used and wash your hands often.
Read more about how the disease is spread, symptoms of mpox, and what NCDHHS is doing to enhance communication efforts with local health departments and community partners, in a news release.
Join NCMS for 2024 National Advocacy Conference in Washington

October 16, 2023
Join us on Capitol Hill
The AMA’s National Advocacy Conference is scheduled for February 12-14, 2024. This yearly event offers an opportunity for personal involvement in the health policy debate on Capitol Hill. We need increased NCMS member engagement with our members of Congress, so mark your calendar and stay tuned for forthcoming details.

2024 National Advocacy Conference
Save the date and join us for our return to Capitol Hill.
February 12-14, 2024
Grand Hyatt / Washington, DC
Plan now to join your colleagues as we advocate for
patients and the medical profession on . . .
Prior Authorization Relief
Medicare Payment Reform
Step Therapy Reform
Workforce Shortage Solutions
Physician Wellness
Registration and additional information coming soon.
https://www.ama-assn.org/about/events/national-advocacy-conference
Wild Raccoons Rabies Vaccine Initiative Underway in Western NC. Find a Packet, Leave it!

RALEIGH -- The North Carolina Department of Health and Human Services is working with the U.S. Department of Agriculture to help prevent the spread of rabies. Wildlife Services will be distributing oral rabies vaccine for wild raccoons in Western North Carolina.
Beginning Oct. 4, 2023, baits containing the oral rabies vaccine will be aerially distributed in Alleghany, Ashe, Buncombe, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Madison, Macon, Mitchell, Swain, Transylvania, Wilkes and Yancey Counties.
"Avoiding contact with wild animals and vaccinating our domestic animals and pets is the best way to prevent rabies, which can often be fatal," said NCDHHS Deputy State Public Health Veterinarian Erica Berl, DVM, MPH. "The wildlife rabies vaccination program prevents the spread of rabies among animals in the wild, which in turn prevents humans, pets and other animals from becoming infected."
The baits consist of a sachet, or plastic packet, containing the oral rabies vaccine. To make the baits attractive to raccoons, the packets are sprinkled with a fishmeal coating or encased inside hard fishmeal–polymer blocks about the size of a matchbox. When a raccoon bites into a bait, the vaccine packet is punctured, and the animal is exposed to the vaccine. This activates the animal’s immune system to produce antibodies that provide protection against rabies infection.
Anyone who comes in contact with the liquid vaccine should wash the affected area thoroughly with soap and water and call the phone number listed on the bait for further instructions and referral.
Although the oral rabies vaccine products are safe, the USDA Wildlife Services program has issued these precautions:
- If you or your pet find a bait, leave it where you found it unless it is on your lawn, driveway or other area unlikely to attract raccoons. While wearing a glove or other barrier, you can move the bait to an area of thicker cover where raccoons are more likely to find it and pets are less likely to encounter it.
- Eating the baits won’t harm your pet but consuming several baits might temporarily upset your pet’s stomach.
- Do not try to remove an oral rabies vaccine packet from your pet’s mouth, as you could be bitten.
- Wear gloves or use a towel when you pick up bait. While there is no harm in touching undamaged baits, they have a strong fishmeal smell.
- Instruct children to leave baits alone. If a bait is ingested by a child or adult, call 1-866-4-USDA-WS. NCDHHS has never received a report of a human ingesting a bait packet.
- Wash your hands thoroughly with soap and water if there is any chance the vaccine packet has ruptured.
- A warning label on each bait advises people not to touch the bait and contains the rabies information line telephone number.
Rabies is most commonly found in wild animals in North Carolina. This poses a risk to people and domestic animals that encounter wildlife. It is a fatal disease in mammals, including people.
However, there are highly effective vaccines that prevent infection and illness in people and domestic animals. By North Carolina law, cats, dogs and ferrets must be vaccinated by four months of age and be kept up to date throughout their lives.

For more information on rabies prevention or the oral rabies vaccine program, call the USDA Wildlife Services toll-free rabies line at 1-866-487-3297 or the NCDHHS Division of Public Health at 919-733-3419.
Baiting should be completed by late October. The Oral Rabies Vaccination program, originally implemented in the 1990s, helps prevent the raccoon rabies epizootic from moving west of the Appalachian Mountains, where raccoon rabies does not exist. The program has been successful in that regard and the vision is to gradually move the vaccine barrier east until raccoon rabies is eliminated. [source]
You can also find information about the national program on the USDA website.
For general information on rabies, please visit the CDC website.
On the Lighter Side - October 6, 2023 - Jazz, 9 to 5, Football, Plus Lots and Lots of Seafood!
Here are some things NCMS employees, members, and YOU are talking about this Weekend and Beyond!
Fall football is in full swing!

Tonight
- Cornell at Harvard, 7pm (ESPNU)
Saturday
- Maryland at Ohio State, noon (Fox)
- Marshall at NC State, 2pm (CW Network)
- Virginia Tech at Florida, 3:30pm
- Syracuse at UNC, 3:30pm
- Wake Forest at Clemson, 3:30pm (ACC Network)
Don't duck out on the Duck Jazz Festival!

On the Outer Banks, Columbus Day weekend has become synonymous with the lively sounds of jazz. Plenty of music and fun in Duck! More information is here.
Stumble out of bed for 9 to 5 in High Point

Set in the male-dominated 1980’s workplace, audiences will be rooting for Violet, Doralee, and Judy as they face off against their sexist, egotistical, oppressive boss. Witty dialogue, powerful songs, and hilarious scenes make 9 to 5 an instant classic. Music from Grammy Award winner Dolly Parton shines bright, and will have you humming along and dancing in your seats. Tickets are still available here.
You won't go hungry in Morehead City this weekend!

The North Carolina Seafood Festival is among the most popular free festivals in the state. It takes place on the first weekend of October in Morehead City, attracting more than 200,000 attendees. All you need to know is here.
If you have an event you would like added to On The Lighter Side, email Randy Aldridge at [email protected].
TBT: Celebrating 20 years of Leadership in Medicine! Here is Dr. Sandhya Thomas-Montilus's MEDTalk from 2022
The North Carolina Medical Society is celebrating 20 years of Leadership in Medicine!
Here is a Throwback Thursday to Sandhya Thomas-Montilus, MD's MEDTalk from 2022 on "Resident Requirements and Their Impact on Access to Care"
Look for a new TBT every Thursday until the 2023 LEAD Conference and Golden Stethoscope Gala, October 13-14.
https://youtu.be/fIwWUxYeZ3I
The 2023 LEAD conference registration is OPEN.
Click here for more information.
Please contact Erica Hall at NCMS to organize a class table at the LEAD Gala of your own.
NCMS Contingent Meets with Congressman Don Davis

Capitol Chronicle
September 2023
Advocacy Engagement with Congressman Don Davis
Congress’ recent recess afforded the opportunity of scheduling in-district meetings with those who represent North Carolina in the US House of Representatives. One such meeting was with first-term member representing North Carolina’s 1st Congressional District, Rep. Don Davis. Rep. Davis was elected in 2022, having served in the N.C. Senate.
Meeting participants included: Lacy Hobgood, MD / Greenville, NC; Jennifer Parker-Cote, MD / Greenville, NC; Martha Chesnutt, MD / Rocky Mount, NC; Robert Frere, MD / Greenville, NC; and W. Alan Skipper, CAE / NCMS Vice President, External Affairs.
Issues discussed included:
- Medicare Physician Payment Reform – inflationary adjustment
- Prior Authorization relief for patients and physicians
- Step Therapy’s impact on patient care and outcomes
- Workforce needs for North Carolina

Pictured: Hobgood, Frere, Davis, Parker-Cote, Chesnutt, Skipper
_________________________________________________________________________________
Do you know your state and federal legislators? More importantly, do your legislators know you?
The NCMS can help you connect with policy makers as a constituent and advocate!
_________________________________________________________________________________
Support our political advocacy efforts
Be a Key Contact for your legislators

On the Lighter Side - September 29, 2023 - Fall Festivals, Disney, Tim Allen, Plus Lots and Lots of College Football!
Here are some things NCMS employees, members, and YOU are talking about this Weekend and Beyond!
Temps may be cooling down, but entertainment is heating up! Here is a list of festivals this weekend:

- 2023 Lumbee Pow Wow, Maxton
- IBMA Bluegrass Live, Raleigh
- Carolina Indie Fest, Sanford
- North Carolina Muscadine Festival, Kenansville
- NC Bourbon and Spirits Festival, Weldon
- Blue Ridge Pride Fest, Asheville
- Mountain Makers Craft Festival, Waynesville
Disney on Ice skates into Charlotte!

Experience the magic and enchantment as Disney On Ice returns to Bojangles Coliseum! . Get ready to be captivated by stunning ice skating, dazzling costumes, and breathtaking choreography that will transport you to a realm where dreams come true. Times and tickets are here.
See comedy legend Tim Allen tonight!

Get ready for a night of laughter and entertainment as a Tim Allen takes the stage in Charlotte! Don't miss your chance to witness this comedy icon live in action. Secure your tickets now for an unforgettable evening of laughter at Ovens Auditorium! More info is here.
And don't forget about football!

Tonight
- Louisville at NC State, 7pm (ESPN)
Saturday
- Florida at Kentucky, noon (ESPN)
- Texas A&M at Arkansas, noon (SEC ESPN Network)
- Clemson at Syracuse, noon (ABC)
- Virginia at Boston College, 2pm (CW Network)
- Georgia at Auburn, 3:30pm (CBS)
- Michigan at Nebraska, 3:30pm (Fox)
- Indiana at Maryland, 3:30pm (BTN)
- Notre Dame at Duke, 7:30pm (ABC)
- South Carolina at Tennessee, 7:30pm (SEC ESPN Network)
- Appalachian State at UL Monroe, 8pm (ESPN+)
- Alabama at Mississippi State, 9pm (ESPN)
If you have an event you would like added to On The Lighter Side, email Randy Aldridge at [email protected].
Political Pulse September 29, 2023
The North Carolina 2023 budget was finally given to Governor Roy Cooper. The journey to his desk and the millions of dollars important to North Carolina Medical Society members is the subject of this week's Political Pulse. Randy Aldridge and Emma Kate Sowder outline the highlights of the budget and the changes you can expect.
https://youtu.be/iLG8HxupZTQ
TBT: Celebrating 20 years of Leadership in Medicine! Here is Dr. Vinay Saranga's MEDTalk from 2019
The North Carolina Medical Society is celebrating 20 years of Leadership in Medicine!
Here is a Throwback Thursday to Vinay Saranga, MD's MEDTalk from 2019 on "Smoking Cessation Training"
Look for a new TBT every Thursday until the 2023 LEAD Conference and Golden Stethoscope Gala, October 13-14.
https://youtu.be/oRL--8Cd1Ns
The 2023 LEAD conference registration is OPEN.
Click here for more information.
Please contact Erica Hall at NCMS to organize a class table at the LEAD Gala of your own.
NCMS Member Dr. Seth Bleier Testifies before House Ways and Means Committee, Full Testimony Included
NCMS Member Dr. Seth Bleier testifies before House Ways and Means Committee
Will be on panel about implementation of No Surprises Act

The North Carolina Medical Society is happy to announce that our member Dr. Seth Bleier of Wake Emergency Physicians, has been invited by the Ways and Means Committee of the US House of Representatives to testify on a panel about the implementation of the No Surprises Act. The meeting is on Tuesday, September 19th at 10 am.
The NCMS supports protecting patients from unanticipated bills due to non-network medical services and is working to improve the federal rules governing the process for negotiating payment disputes between physicians and health insurers.
Dr. Bleier is testifying through coordination with the American College of Emergency Physicians. Great strides have been made toward gaining relief from surprise medical bills. The NCMS continues to collaborate with state and federal partner organizations to support litigation challenging portions of the rules that unfairly disadvantage physicians.
The North Carolina Medical Society supports the following actions to protect patients:
- Discontinue attempts to fix surprise bills on a case-by-case basis through any post-service reconciliation process for insured patients.
- Require robust network adequacy standards and up-front arbitration of contracts between physicians/providers and insurers before services are rendered to prevent non-network medical bills for insured patients.
- Maintain the existing shared principles of holding the patient harmless, providing fair compensation for medical services, and protecting access to care for patients.
- Study ways to address similar concerns for the uninsured.
The following is the Testimony of Seth Bleier, MD:
Testimony of Seth Bleier, MD, FACEP
Vice President of Finance, Wake Emergency Physicians, PA (WEPPA)
House Committee on Ways and Means
Hearing on “Reduced Care for Patients: Fallout from Flawed Implementation of Surprise Medical Billing Protections”
September 19, 2023
Chairman Smith, Ranking Member Neal, and members of the Committee, thank you for the opportunity to testify during today’s hearing, entitled “Reduced Care for Patients: Fallout from Flawed Implementation of Surprise Medical Billing Protections.”
My name is Seth Bleier, MD, FACEP, and I am a board-certified emergency physician from Raleigh, North Carolina. I currently serve as the Vice President of Finance for Wake Emergency Physicians, PA (WEPPA), I am also a member and fellow of the American College of Emergency Physicians (ACEP) which represents nearly 40,000 members, and a member of the North Carolina College of Emergency Physicians. On behalf of our practice and the emergency medicine specialty as a whole, we appreciate the Committee's ongoing commitment to ensuring the No Surprises Act is implemented fairly and according to congressional intent.
Wake Emergency Physicians, PA is an emergency medicine practice serving central North Carolina. Since our founding in 1992, we have always been physician-owned, and have never had any corporate or private equity backing or interests. Every owner regularly works in our emergency departments. WEPPA currently employs more than 200 dedicated emergency medicine specialists, comprised of about 120 residency trained, board certified emergency physicians and 95 advanced practice providers. We serve in 11 different emergency departments across four different hospital systems in the region. Four of those emergency departments are located in rural communities. Our providers care for more than 450,000 patients every year. Our goal is and has always been to be in-network with every payer, and until the first regulations for the NSA were issued, we were in-network with all four major insurance carriers in our region of the state.
To be clear, the No Surprises Act is a critical bipartisan accomplishment that removes patients from the middle of billing disputes between physicians and insurers, and we strongly supported this goal. In an emergency where seconds and minutes are often a matter of life or death, patients should never have to think about their insurance coverage or whether they will receive a bill they did not expect.
Beyond these important patient protections, the law established an equitable solution to resolve billing disagreements - at least in intent. Unfortunately, the implementation of the law to date has proven to be exceptionally challenging for smaller practices like ours. While we have so far been able to weather some of the impacts, if these challenges are not resolved, we are deeply concerned that practice models like ours may not be viable in the near future, and access to lifesaving emergency care may be severely affected, especially for rural and underserved patients.
As noted above, WEPPA had historically been in-network with all major carriers in our region of North Carolina. Most of those contracts had been in place for at least a decade without any changes or updates. Not only did our reimbursement rates not increase, they have actually significantly decreased due to factors such as inflation not being included in the contracts, as well as an increased patient burden due to high deductibles without the ability to pay.
In November 2021, WEPPA and many other physician groups in the state received letters from one of these insurers demanding significant cuts to our contract rates. The letters explicitly cited the Interim Final Rule on the NSA as justification for the reduction, and stated that if we did not agree to these new payment terms, our contract would be terminated. Thankfully this did not come to pass, but we have since had two other payers unilaterally terminate a long-standing contract. These insurers are now paying at rates that are up to 70 percent less than our previous contracts for what are now out of network services. These actions have pushed about 9 to 10 percent of our total patients out of network.
Our practice is a critical safety net for a substantial portion of our patients and for our communities. Approximately 44 percent of our patients are either uninsured or covered by Medicaid, which pays far less than the cost of care. 26 percent of our patients are covered by Medicare or TRICARE, and the remaining 30 percent are covered by commercial insurance. While these newly out-of-network patients only represent about 9 to 10 percent of our total patient population, it represents about one-third of our total commercial population and is a significant reduction in our practice’s reimbursements.
Adding to this burden is the fact that the IDR process has been virtually inaccessible for small practices once we are out of network. Many smaller practices have been advised by their billing contractors to avoid going through IDR altogether as the costs outweigh any benefit. Most emergency department provider bills are less than $1,000. We cannot afford to challenge every underpayment when just the non-refundable portion of the arbitration fee is $50, much less $350. Even though the government’s own statistics show providers prevail the majority of the time over insurers in IDR, to date we have only submitted about 200 IDR claims. Batching rules, the IDR processing backlog, and delay tactics by payers (for example, failing to abide by the arbitrators ruling and promptly remitting payment for cases won by the provider group, as has happened to WEPPA, or in some cases, not paying at all) have also contributed to this substantial burden. Now that at least some of these issues have been resolved due to recent court decisions and the resulting pending regulatory changes, we do hope to reengage with the IDR process when the portal reopens.
This increased focus on our collections and the rates being paid by insurers takes up valuable provider and staff time as well as resources that we would rather devote to patient care. We would rather not be forced to submit IDR claims. We WANT to go back to being in-network with every payer and our long-lasting contracts in place prior to passage of the NSA show that we always did our best to be in network. If these conditions persist, we may be forced to confront a financial reality where we must reduce salaries, reduce physician and advanced practice provider staffing hours, cut positions, or make difficult decisions about what areas we can realistically serve. The current climate not only threatens our ability to provide “everyday” emergency care, but it also significantly diminishes our readiness for a major disaster, mass casualty event, pandemic, or other significant event.
Frequently throughout the surprise billing debate at the federal level, emergency physicians as a profession were vilified by erroneous assertions that they purposely stay out of network so that they can charge higher rates. But our group and countless others are evidence of local, community-based emergency department (ED) practice groups who have been (or were) in long-term, stable contracts with the major insurers, and who would continue to be in network were it not for the regulatory implementation of the No Surprises Act – particularly the continued efforts to establish an artificially-low payment standard via the Qualifying Payment Amount (QPA).
Emergency physicians provide care under circumstances and laws that are unique among other physician and provider specialties. We provide more uncompensated care than any other physicians, as the federal Emergency Medical Treatment and Labor Act (EMTALA) requires that anyone coming to an emergency department must be stabilized and treated, regardless of their insurance status or ability to pay. The burden of uncompensated care only continues to grow, particularly in communities with high populations of uninsured patients. Additionally, in order to ensure 24/7/365 access to the emergency department, we work under stricter staffing and standby requirements than other types of medical providers so that we can meet the needs of patients who experience a wide range of emergencies every day, such as heart attacks, strokes, trauma, and mental health conditions, or as we have all experienced over the course of the last several years, the ravages of the global COVID-19 pandemic.
Those who support the approach that has been taken to date in implementing the No Surprises Act have suggested that cutting reimbursements to physicians and providers will enable insurers to lower premiums, allowing for more affordable and accessible coverage for Americans. Yet there is nothing in the law, or in its regulatory implementation, to ensure that happens. Several of our contracts were in place for a decade without any sort of increase to the negotiated reimbursement rates. If rising costs were “forcing” insurers to raise premiums year-over-year, it was not due to our contracts. In the meantime, insurers continue to see record profits, in no small part due to lower health care utilization during the height of the COVID-19 pandemic. Premiums for employer-sponsored family health coverage continue to grow, averaging $22,463 in 2022 and representing a 20 percent increase since 2017.[1] Meanwhile, UnitedHealth Group posted nearly $5 billion in quarterly profit in the final quarter of 2022, and more than $20 billion total over the year – a more than 16 percent increase from 2021.[1] We remain skeptical that any savings, borne on the backs of providers under the implementation of the law to date, will ever be passed on to consumers.
Emergency departments throughout the country are already under immense strain due to the ongoing ED “boarding” crisis, where patients must wait hours, days, and even months for care or to be transferred to the appropriate setting they need and deserve. This has exacerbated physician stress and burnout – a persistent, pervasive issue for emergency physicians who consistently report the highest rates of burnout among any physician specialty (65 percent in 2021).[2] Continued cuts of this magnitude combined with growing frustrations in our attempts to negotiate in good faith for reasonable and fair contracts will have ripple effects throughout our practice, throughout the health care system in North Carolina, and throughout our country.
There is no doubt that these effects will be felt even more deeply in our rural and underserved communities, where the health care safety net is already under threat. Many emergency physician practices will be unable to afford to continue to operate in the areas where patients need them most, and millions of your constituents will have less access to the lifesaving emergency care they need and deserve. The growing trends of health care consolidation will only accelerate as practices are unable to endure the weight of these economic pressures.
WEPPA is only one practice, but sadly we know our experience is not unique. We believe the No Surprises Act clearly struck a delicate balance as to not tip the scales too far in favor of any party, but the regulations have not been consistent with the law that Congress passed. Thank you once again for your attention to these issues and for the opportunity to be here to share our experience. I look forward to any questions you may have.
[1] https://www.fiercehealthcare.com/content/which-payer-raked-most-cash-last-year-answer-likely-wont-surprise-you
[2] https://www.prnewswire.com/news-releases/medscape-physician-burnout-and-depression-report-burnout-worsening-depression-increasing-301732504.html
[1] https://www.kff.org/report-section/ehbs-2022-section-1-cost-of-health-insurance/
Ways and Means Committee Press Release Following Hearing.
Maui Recovery Remains Slow, Hawaii Medical Association Reports Huge Need for Help

As Island Transitions from Response to Recovery, the Need for Help Continues in All Sectors Including Healthcare
For more than 15,000 people, Monday marks a big step to rebuilding their lives. It is the first day that reentry begins for people who were living in the impact zone of the Maui wildfire. To date, 97 bodies have been recovered, 80 have been identified. There are 23 active investigations into missing persons for unaccounted individuals. Reports say Maui is losing more than $13 million per day and recovery of the important tourist industry is lagging.
Marc Anderson of the Hawaii Medical Association tells NCMS VP Alan Skipper that there is "still a huge recovery need and an ongoing effort to meet the needs of those impacted by the fire." He as supplied NCSM with the Hawaii Medical Association's detailed report of ways physicians are helping with Maui support.
The report has several key findings:
- Disillusionment is increasing. People are grieving and also wanting to protest over reentry issues.
- Clinics in West Maui are open with no appointments necessary. Health insurance is not required and translation services are available.
- Challenges remain in outreach for the displaced elderly population.
- Particulate level analysis is ongoing and could take weeks.
- Mental health triage continues.
The report has detailed and time-stamped recovery efforts since the fire. It includes links to volunteer options, healthcare resources, and the latest news.
To read the full report from the Hawaii Medical Association click here.
Here are some options to make donations:
- The American Psychiatric Association (APA) Foundation has created a Maui Disaster Relief Fund in partnership with the Hawai’i Psychiatric Medical Association and in support of the Hawai’i Community Foundation’s Maui Strong fund.
- To kick start these fundraising efforts, the APA Foundation will match up to $25,000
- Donate online at the American Psychiatric Association Foundation Maui Donation page
- Kākoʻo Maui fund: The Council for Native Hawaiian Advancement, Alakaina Foundation Family, and Kako’o Haleakala will match up to $100,000 in donations for Kako’o Maui. Funds will go to families and businesses. You can donate here .
- American Red Cross of Hawaii: They’re asking for your monetary donations and for volunteers. Click here for details.
- Hawaii Emergency Management Agency: Donations and volunteer support information at ready.hawaii.gov or 808-733-4300.
- Maui United Way: The Fire Disaster Relief Fund is providing financial assistance through grants to nonprofits at the forefront of relief efforts, as well as directly to households that have been deeply affected. Those who would like to donate may do so at mauiunitedway.org/disasterrelief.
- The Hawaii Salvation Army will start providing meals for thousands displaced in Maui emergency shelters. They are asking for monetary donations and large volume meal donations from restaurants and certified kitchens to aid in mass meal service at Maui shelters. All money donated for disaster relief will go to disaster operations. Donate to Hawaii Salvation Army here
- The Hawaii Community Foundation Maui Strong Fund will support Maui communities affected by recent fires, including response and recovery efforts. The proceeds from our bake sale will go to this fund. Donate to the Hawaii Community Foundation Maui Strong Fund here
- UH Maui College students and their families are directly impacted by the fires, whether they have lost homes, businesses, or jobs. As the new school year starts, you can help keep students, faculty, staff, and their families resilient during this unprecedented emergency. Donate to the UH Maui College Student Aid Fund here.
- The UH Maui College Faculty and Staff are in the same situation as students. Donate to the UH Maui College Faculty and Staff Aid fund here.
- Matson: Nonprofit organizations needing assistance in getting goods to Maui are asked to apply for such assistance on the company’s website at matson.com/community.
- United Public Workers: Donate nonperishable items at any UPW headquarters across the state from 6 a.m. to 7 p.m. Locations of headquarters are: Oahu: 1426 N. School St.; Hawaii island: 362 E. Lanikaula St.; Maui: 841 Kolu St.; and Kauai: 2970 Kele St. Suite 213.
- Hawaii Restaurant Association: To contribute food, water, medical supplies or shelter from Maui or Oahu, fill out the form at tinyurl.com/2a9jfjdy.
On The Lighter Side - September 22, 2023 - Fall Foliage, Octoberfest, and the Jonas Brothers!
Here are some things NCMS employees, members, and YOU are talking about this Weekend and Beyond!
Tomorrow is the first day of fall! Here is your Fall Foliage Predictions for NC!
October is when North Carolina (especially the mountains) will have peak colors. October 23 will be the best weekend for fall colors across much of the state, but look for things to start popping in early October. The western portion of the state will have the best viewing spots. Here is a look at when you Fall color peaks occur so you can plan your trip!

Fall color along the Blue Ridge Parkway is an event that everyone should see. The mixture of vibrant colors with some of the most beautiful scenic vistas in the world, is truly magical.
To find out the 22 best stops along the Parkway to see fall color click here. Make sure you let NCMS know your favorite spots!
It is also time for Grahamtoberfest!

The 3rd Annual Grahamtoberfest is tomorrow! Enjoy Beer Tents, Food Trucks, Live Music, Vendors, Beer Garden, Crafts and Contests. Click here for all you need know!
Carolina in the Fall Music and Food Festival in Wilkesboro

Food, food, and more food! The Carolina in the Fall Music and Food Festival brings together a famous lineup of food trucks, paired with some of the hottest performers in the state. It last all weekend and it is fun for the whole family. More details on the festival are here.
Fall means more college football!

- Florida State vs Clemson at Death Valley, noon
- Ole Miss vs. Alabama at Bryant–Denny Stadium, 3:30pm
- Duke vs. Connecticut at UConn, 3:30pm
- Ohio St. vs. Notre Dame at Notre Dame, 7:30pm
- UAB vs. Georgia at UGA, 7:30pm
- UNC vs. Pittsburgh at Acrisure Stadium, 8pm
What A Man Gotta Do? Get out of the Waffle House and be Cool! The Jo Bros are coming to town!

On Thursday, you will be able to hear the crowd for miles close to the PNC Arena! Here is what you need to know!
If you have an event you would like added to On The Lighter Side, email Randy Aldridge at [email protected].
TBT: Celebrating 20 years of Leadership in Medicine! Here is Elyse Watkins, PA-C and Christen MacKorell, PA's MEDTalk from 2016
The North Carolina Medical Society is celebrating 20 years of Leadership in Medicine!
Here is a Throwback Thursday to Elyse Watkins, PA-C and Christen MacKorell, PA's MEDTalk from 2016 on "Perceived Barriers to the Utilization of Physician Assistants in OB-GYN Practices in North Carolina"
Look for a new TBT every Thursday until the 2023 LEAD Conference and Golden Stethoscope Gala, October 13-14.
https://youtu.be/cptwm_DI78E
The 2023 LEAD conference registration is OPEN.
Click here for more information.
Please contact Erica Hall at NCMS to organize a class table at the LEAD Gala of your own.
Mental Health Awareness 5K Run/Walk in Lumberton Honors Dr. Jeffrey P. Campbell

The Mental Health Awareness 5K/Walk, honoring Dr. Jeffery P. Campbell is Saturday, September 23 at the Downtown Lumberton Pocket Park in Lumberton. It is co-hosted by Robeson County Medical Society and Robeson Road Runners. Proceeds will be donated to NC Professionals Health Program.
The 5K/Walk will begin in Downtown Lumberton and makes its way along the scenic Lumber River before heading through the quiet Tanglewood neighborhood. A straight shot down Elm St. will get runners to the finish line! This is not a timed race. Participants are encouraged to go at their own pace, including walking.
The first 75 registrants will receive a shirt.
For more information and to register click here.
TBT: Celebrating 20 years of Leadership in Medicine! Here is Dr. Scott Paviol's MEDTalk from 2018
The North Carolina Medical Society is celebrating 20 years of Leadership in Medicine!
Here is a Throwback Thursday to Dr. Scott Paviol's MEDTalk from 2018 on "Creating Space for Mindfulness"
Look for a new TBT every Thursday until the 2023 LEAD Conference and Golden Stethoscope Gala, October 13-14.
https://youtu.be/yYBIiFPrnrY
The 2023 LEAD conference registration is OPEN.
Click here for more information.
Please contact Erica Hall at NCMS to organize a class table at the LEAD Gala of your own.
State Treasurer Report: NC Hospitals Charge Huge Markups, Hide Prices. NC Healthcare Association Responds.
NC State Treasurer Dale R. Folwell, CPA, released report showing extreme variations in hospital prices, huge price markups from Medicare rates, and widespread failures in price transparency.
NC Healthcare Association: Hospitals are not price setters and do not negotiate with Medicare nor Medicaid; transparency is a work in progress and a majority of NC hospitals are already in compliance.

(Raleigh) — North Carolina State Treasurer Dale R. Folwell, CPA, released a report saying “too many North Carolina hospitals are violating federal rules to hide prices from patients. The anti-competitive infractions thwart patients’ ability to make informed decisions about their health care.”
Among the findings:
- NC hospitals levy price markups of up to 1,120% on routine care and basic services. The most expensive subset charged commercially insured patients as much as 1,670 percent more than other hospitals for the same service.
- Workers lose 20 percent of every paycheck to health care costs with hospital systems receiving almost half of the health care spending in the United States. North Carolina’s public employees and taxpayers face a $24 billion unfunded liability for the State Health Plan.
- Services such as a urinalysis can carry a 1,120 percent median markup from Medicare, forcing patients to pay a median $28.80, while Medicare pays a median of just $2.36. The majority of North Carolina hospitals self-reported profiting off Medicare rates over six years.
- The largest price disparities appear in radiological services. Hospitals inflated their $1,167.23 median commercial price for a CT scan of the brain by 976 percent from Medicare’s $108.44 median rate. These disparities have ties to state Certificate of Need (CON) laws, which restrict the supply of health care equipment and facilities.
- Across the majority of the 16 common shoppable services, hospitals charged uninsured patients more than 150 percent more than Medicare rates. A fourth of the 16 analyzed shoppable services had a higher markup on “cash” prices than on commercial rates.
- The most expensive subset of North Carolina hospitals charged commercially insured patients as much as 1,670 percent more than other hospitals for the same service.

The North Carolina Healthcare Association responded to the report directly to the North Carolina Medical Society. NCHA says it supports “transparency around patient care quality, safety and other data and information to support consumer decision-making. It is the right thing to do and is in the best interests of our patients and communities.”
Highlights of NCHA response:
- The effort toward pricing transparency is a work in progress for all U.S. hospitals.
- The suggestion that hospitals “hide” prices from patients is absolutely false. A majority of North Carolina hospitals are already compliant.
- Hospitals do not negotiate with Medicare nor Medicaid. Government payers reimburse healthcare providers a set amount which is typically not sufficient to reimburse providers for care they deliver to patients.
- Hospitals do negotiate with commercial payers and those negotiations are conducted between two mature organizations at arms-length, like other legal business arrangements.
TBT: Celebrating 20 years of Leadership in Medicine! Here is Dr. Latonya Beatty's MEDTalk from 2018
The North Carolina Medical Society is celebrating 20 years of Leadership in Medicine!
Here is a Throwback Thursday to Dr. Latonya Beatty's MEDTalk from 2018 on "Postpartum Depression Screening at Well Child Visits"
Look for a new TBT every Thursday until the 2023 LEAD Conference and Golden Stethoscope Gala, October 13-14.
https://youtu.be/KTc6GKLPPo4
The 2023 LEAD conference registration is OPEN.
Click here for more information.
Please contact Erica Hall at NCMS to organize a class table at the LEAD Gala of your own.
On The Lighter Side – September 1, 2023, Labor Day Weekend Means Apples, Jazz, Tennis, Band Battles, and Concerts!
Here are some things NCMS employees, members, and YOU are talking about this Labor Day Weekend!
John Coltraine International Jazz & Blues Festival

Check out Keb' Mo', Dave Koz, and Samara Joy and others Saturday and Sunday in Highpoint. Since its inception, the John Coltrane International Jazz and Blues Festival has succeeded in bringing the very top names in jazz, paid homage to the blues, and celebrated the life and musical legacy of the jazz genres greatest artists. The festival attracts a growing audience and enjoys a burgeoning reputation as the destination for Labor Day weekend. For all you need to know click here.
2023 Charlotte HBCU Labor Day Classic: Battle of the Bands

The perfect safe event for the entire family, food trucks, vendors and more. Come see 9 HBCU Bands put on halftime shows like never before. Check it out Sunday at 3pm at American Legion Memorial Stadium in Charlotte. For tickets click here.
NC Apple Festival in Hendersonville

The Apple Festival is held on Labor Day Weekend each year (Friday through Monday) to recognize the importance of the apple and the apple industry to Henderson County and North Carolina. All you need to know is here.
It's time once again for the Chaos Slam! US Open keeping everyone guessing again this year!

Djokovic, Gauff, Alcaraz, Swiatek, Medvedev, Pegula, Jabeur, Tiafoe, and more are still looking to the title as the US Open continues (it ends September 10). Americans will be glued to their TVs this weekend to see all the action. Click here to find out all you need.
The unofficial end of summer weekend means lots of concerts!

TONIGHT
- ZZ Top, PNC Music Pavilion, Charlotte
- Moon Taxi, Greenfield Lake Amphitheater, Wilmington
- Band of OZ, 97 Pinebridge, Spruce Pine
SATURDAY
- Late Night Music Fest, Greensboro Coliseum, Greensboro
- Nickelback, Veterans United Home Loans Stadium, Virginia Beach, VA
- Scream Tour, Koka Booth Amphitheatre, Cary
- Dave Koz, John Coltrane Statue, High Point
- 3 Doors Down, Skyla Credit Union Amphitheater, Charlotte
SUNDAY
- 5 Seconds of Summer, Red Hat Amphitheater, Raleigh
- Billie Eilish, Coastal Credit Union Midtown Park, Raleigh
- Michael McDonald, Enmarket Arena, Savannah, GA
- Duke Symphony Orchestra Pops Concert, Duke University, Durham
- Emmylou Harris, Earl Scruggs Center, Shelby






































