New Research: Class of HIV Drugs May Protect Against Alzheimer's Disease
(aidsmap, Zekerie Redzheb) -- A cohort of people with HIV who took NRTIs (a class of HIV drugs) as part of HIV treatment showed lower rates of Alzheimer’s disease than people without HIV. The team of American researchers behind this study published in the journal of Pharmaceuticals suspect HIV-like sequences in our genome to be associated with the disease and thus these HIV drugs protect against its development.
In our genome there is a significant amount of virus-like DNA sequences (estimated at 8% of its length). They are believed to be an evolutionary leftover from previous pandemics. Once integrated in our genome, they are hard to eliminate, as is HIV DNA, therefore our immune system chose a different approach – ‘block, cripple and lock’. Because of this, most of these sequences are seriously damaged and cannot produce intact viruses but can still produce some viral proteins, including a couple of reverse transcriptase (RT) enzymes, thought to be unique to only two groups of viruses, one of which includes HIV.
Up to recently, it was thought that humans should not and cannot have such enzymes, since its function is to convert RNA back into DNA – a largely risky and unnecessary process for non-viral organisms since it is prone to errors. Therefore, the discovery of an RT gene in human genomes is attributed to past HIV-like infections.
Research suggests these RT enzymes may be still able to introduce random genetic recombinations and amplifications (increasing the copy number of certain harmful genes) in the brain cells causing them to produce dysfunctional proteins that clump up and harm the brains of people with Alzheimer’s disease.
Nucleoside reverse transcriptase inhibitors (NRTIs) are a class of drugs that block HIV’s RT enzyme. Since HIV’s RT is similar to the RTs produced in our cells, these same drugs may have the potential to block them too, possibly protecting against Alzheimer’s disease.
The study
The researchers collected data on three cohorts of people – those with HIV taking NRTIs; those with HIV either on an NRTI-free regimen or off treatment; and a third cohort who were not living with HIV nor taking NRTIs. They followed up each cohort for two years and nine months to see whether NRTIs reduced the rate of Alzheimer’s.
The data came from a large number of people, which reduces the likelihood of these findings being a chance event. Over 46,000 people were included in the cohort of those with HIV on NRTI-containing regimens. There were 33,000 people in the cohort of people with HIV not taking NRTIs and 151,000 people in the cohort without HIV and not taking NRTIs.
Only participants above 60 years of age and without a previous diagnosis of Alzheimer’s disease were included.
The median age in the first two cohorts was similar at 64 and 65 years, while the third cohort – without HIV and not taking NRTIs – was slightly older at 69 years. Over two-thirds of the participants in the first two cohorts were men, while in the third cohort two-thirds were women. Both age and sex can affect Alzheimer’s risk and since the first two cohorts and the third one had differing age and sex profiles, the researchers had to adjust for that in the analysis when deriving their final results.
Alzheimer’s rates per cohort
During the two years and nine months of follow-up, the rate of developing Alzheimer’s was lowest in the first cohort – people with HIV on an NRTI-containing regimen. In this cohort only 2.46 in 1000 people developed Alzheimer's disease.
In the second cohort of those with HIV either on an NRTI-free regimen or off treatment the rate of Alzheimer’s was higher compared to the first cohort, but still lower than the third cohort of those without HIV. However, the difference between this cohort and those without HIV became insignificant when age and sex were added to the analysis. In this cohort the rate of Alzheimer’s was 3.55 in 1000 people.
The third cohort had the highest rate of Alzheimer’s at 6.15 in 1000 people.
Interestingly, a further analysis of the first cohort revealed an increased rate of Alzheimer’s in those taking protease inhibitors (another class of HIV drugs) alongside their NRTIs. However, the difference was not statistically significant and it would be early to make any conclusions.
Concluding thoughts
Although previous research has linked different viruses and virus-like elements to Alzheimer’s disease – be it directly or indirectly (as a contributing factor) – the condition is multifactorial. Certainly, some viruses and inflammatory conditions have the potential to contribute to the development of the disease. However, genetic, lifestyle and other environmental factors cannot be ruled out.
While NRTIs seem to decrease Alzheimer’s risk, the mechanism may be different from the one proposed in this study. Some NRTIs can suppress the inflammasome (the inflammation complex in the body), which can indirectly protect the brain.
Last but not least, this was a retrospective study (one that collects data on the past medical records of people). Besides, it has a set of limitations such as a relatively short follow-up period and non-ideal match between cohorts with regards to age and sex. Randomised controlled studies would be required to get a more definitive answer to whether NRTIs protect against Alzheimer’s disease in people without HIV.
Chow T et al. Nucleoside Reverse Transcriptase Inhibitor Exposure Is Associated with Lower Alzheimer’s Disease Risk: A Retrospective Cohort Proof-of-Concept Study. Pharmaceuticals 17: 408, 2024 (open-access).
Nucleoside reverse transcriptase inhibitors (NRTIs) are a class of antiretroviral drugs used to treat HIV and other viral infections. They are often combined with other medications in HAART (Highly Active Antiretroviral Therapy) to suppress the virus and prevent the development of AIDS.
Here's a list of commonly used NRTIs:
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- Abacavir: (Ziagen)
- Emtricitabine: (Emtriva)
- Lamivudine: (Epivir)
- Tenofovir alafenamide: (Vemlidy)
- Tenofovir disoproxil fumarate: (Viread)
- Zidovudine: (Retrovir)
New Study: Exercise May be Secret Weapon Against Cancer Treatment Negative Effects
New Study Finds Physical Activity May Mitigate Some Side Effects of Cancer Treatment
(NICE NEWS) -- There’s no doubt exercise is good for your heart, bones, balance, and brain. And a new study found that physical activity can also mitigate some side effects of cancer treatment, such as brain fog and heart and nerve damage.
While prior research has shown that exercise can be generally helpful during cancer treatment, this study went a step further and systematically analyzed data from randomized controlled trial results published between 2012 and 2024. The takeaway: Exercise (e.g., tai chi, yoga, high-intensity and interval training) not only reduced adverse effects often associated with cancer and its treatment, but also improved psychological well-being, body composition, and overall quality of life.
“In conclusion, this study reinforces the efficacy of incorporating exercise into cancer treatment protocols,” the researchers wrote. Of course, every cancer patient has their own journey and circumstances, so there’s no one-size-fits-all workout plan.
“It’s important to take things at your own pace and do activities that are right for you,” Celene Doherty, a specialist cancer information nurse at Cancer Research U.K., who was not involved with the study, told The Guardian. She added that patients interested in learning more should speak to their doctors and care team.
NCMS 2025 White Coat Day Was Huge Success (And A Lot of Fun)!
A Great 2025 White Coat Day That Ended with the NC House Passing HB434!
April 3o, 2025, was a big day for the North Carolina Medical Society! Sixty-five members (and a few future members) joined together to share a unified voice at the North Carolina General Assembly. More than 90 meetings were held with lawmakers on issues important to all North Carolinians. In the end, the group cheered as HB 434 passed the NC House. The CARE FIRST Act is being championed by the NCMS as a way to reform prior authorization in the state. You can read more about it here.
Of course, it is always better to have more voices!
If you are not a member we would love to have you! If you are a member, forward this to your non-member friends! The NCMS is ready to take you on your next step in protecting the profession of medicine and in caring for North Carolinians. CLICK HERE TO JOIN TODAY!
Enjoy these photos of the North Carolina Medical Society 2025 White Coat Day!
2025 NCMS White Coat Day Ends With Huge Win for CARE FIRST Act!
2025 NCMS White Coat Day Ends With Huge Win for CARE FIRST Act!
This CARE FIRST Act passed the house in a 109-1 vote on April 29, 2025, the culmination of years of work by the North Carolina Medical Society staff and members. The announcement came at the end of the 2025 White Coat Day which was attended by more than 65 NCMS members.
The annual white coat day is a a chance for members of the NCMS to learn more about the legislative process and to put that knowledge into action at the NC General Assembly. More than 90 meetings were held with senators and representatives from across the state.
“(It) was a great day to be a member of the North Carolina Medical Society. Our members advocated for patients across the state when they met with legislators to discuss ways to keep North Carolinians healthy and safe. NCMS has been urging members of the General Assembly to pass the CARE FIRST Act (HB 434)—a piece of legislation that reforms the prior authorization process—and we were pleased to see the House pass it during White Coat Day.” -- NCMS Interim CEO Steve Keene
NCMS thanks the House of Representatives for their support of this essential legislation, especially the bill's primary sponsors. The CARE FIRST Act now heads to the Senate for consideration and is likely to be conferenced between the two chambers.
With the wellbeing of North Carolinians and their physicians at the top of its list of priorities, the North Carolina Medical Society supports House Bill 434, The CARE FIRST Act, which would reform the process of patients seeking prior authorization from their health insurance provider. NCMS firmly believes that physicians should be the ones to make medical decisions for their patients and health insurance companies should take responsibility for the outcome of denied medically necessary care.
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Set minimum clinical standards for provision of care.
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Consult with the patient’s physician before refusing to cover medical care.
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Set time frames and make timely decisions based on treatment urgency.
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Promote continuity of care for patients.
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Set limits on retrospective denials.
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Hold health insurance companies responsible for the outcome of denied care.
“The physicians and medical professionals NCMS represent have told us prior authorization reform will make healthcare more efficient and effective,” said NCMS VP of Advocacy John Thompson. “We are thrilled to see (Wednesday's) success and will continue to advocate for NC’s patients and medical professionals at the General Assembly.”
Here are some photos from White Coat Day. Look for more in future editions of Morning Rounds.
Metrolina Nephrology Associates Honored with Healthcare Innovation's 2025 Innovator Award
Charlotte, N.C. — April 29, 2025 — Interwell Health is proud to celebrate our partner, Metrolina Nephrology Associates, on being named a recipient of Healthcare Innovation’s 2025 Innovator Awards. This national recognition honors standout teams that are driving meaningful change in healthcare. Metrolina was honored for its groundbreaking work in value-based kidney care.
Metrolina is known for its proven record of tracking performance metrics and driving quality outcomes for patients. To expand its impact and enhance patient outcomes further, Metrolina partnered with Interwell Health to form the Charlotte Kidney Contracting Entity (KCE) and participate in the CMS Kidney Care Choices (KCC) model—a value-based initiative aimed at improving care for patients with chronic kidney disease and reducing costs by delaying the need for dialysis and incentivizing transplants.
“This award is more than recognition for nephrology innovation—it highlights a scalable, patient-centric care model that can be applied to other specialties to improve chronic disease management and a more sustainable healthcare future,” said Bobby Sepucha, CEO of Interwell Health. “We’re proud to support Metrolina in delivering high-quality, value-based kidney care.”
Metrolina's success was driven by three core strategies: leveraging data-driven insights to identify at-risk patients, expanding care coordination through interdisciplinary teams, and improving key quality measures such as optimal dialysis starts and depression screening rates.
"This work is about much more than hitting performance metrics—it's about fundamentally improving the lives of people living with kidney disease,” said Dr. Carl Fisher, President, Metrolina Nephrology Associates. “Value-based care allows us to intervene earlier, personalize care, and help our patients lead better, healthier lives.”
"We are proud of the strides we’ve made in improving kidney health and the quality of life for our patients and their families,” said Jennifer Huneycutt, CPA, CMPE, Executive Director of Metrolina Nephrology Associates. “Collaborating with Interwell Health has allowed us to proactively identify at-risk patients and provide personalized, coordinated care. This recognition underscores our commitment to delivering better outcomes through innovation and partnership, and we look forward to building on this success in the future.”
At a time when value-based care models are being carefully evaluated and refined for long-term viability, Metrolina’s partnership with Interwell Health offers a replicable blueprint for achieving better patient outcomes, reducing costs, and supporting sustainable care. To read a case study about this partnership, visit here.
To learn more about Healthcare Innovation’s Innovator Awards program and learn about the other winners, visit here.
About Interwell Health
As a leading provider of value-based kidney care, Interwell Health is on a mission to reimagine healthcare to help patients live their best lives. Interwell is setting the standard for the industry by producing sustainable savings and driving exceptional quality results at unmatched scale. The company leverages a two-pronged approach that includes total patient care and provider enablement to serve patients with chronic kidney disease (CKD) from stage 3 to kidney failure. In partnership with more than 2,200 nephrologists, the Interwell interdisciplinary care team leverages advanced machine learning algorithms to personalize care for patients in all 50 states and Puerto Rico. To learn more, visit interwellhealth.com.
About Metrolina Nephrology Associates
Metrolina Nephrology Associates is the region's most recognized and independent nephrology group in the Charlotte, North Carolina region, providing comprehensive care to patients with kidney disease The practice has been on the forefront of the treatment and management of kidney disease for more than 40 years. Composed of 40 Nephrologists and 41 Nephrology Advanced Practitioners, Metrolina serves patients from seven convenient locations. Its extensive network of physicians and offices allows the practice to deliver care in an atmosphere that is personal, caring, and compassionate.
Congratulations to NCMS member Dr. Christine Khandelwal on election to Federation of State Medical Boards' BOD
Congratulations to North Carolina Medical Society member Christine M. Khandelwal, DO for her election to the Board of Directors of the Federation of State Medical Boards. Dr. Khandelwal is a 2024 NCMS Golden Stethoscope Award winner.
She is a former North Carolina Medical Board Member and Past NCMB President.
Dr. Khandelwal was selected, from a field of eight candidates on April 26 during the FSMB House of Delegates meeting in Seattle, to one of three available At-Large seats on the FSMB Board. She will serve a three year term. FSMB is a national nonprofit organization representing all medical boards within the United States and its territories that license and discipline allopathic and osteopathic physicians and, in some jurisdictions, other health care professionals.
Dr. Khandelwal is a Professor of Family Medicine and Director of Geriatrics and Palliative Medicine with the Campbell University School of Osteopathic Medicine. She is Boarded in both Geriatrics and Hospice and Palliative Medicine, serving in Harnett County within the Cape Fear Valley Hospital System. Dr. Khandelwal rotated off of NCMB in October 2024, following six years of service, including a term as Board President in 2023-2024.
2025 White Coat Day Kicks Off With Huge Group Heading to General Assembly!
NCMS 2025 White Coat Day Attendees Block Traffic on Person St. Heading to General Assembly!
The North Carolina Medical Society 2025 White Coat Day is one of the biggest events of the year! This year, 65 physicians, PAs, residents, and students met at the NCMS headquarters on Person St. in Raleigh for a day of meetings with lawmakers.
The day began with a short orientation and breakfast and then the group gathered for an awesome photo on the steps of the NCMS. Then all 65 headed to meet senators and representatives to discuss the issues important to NCMS members.
The focus is HB 434, the CARE FIRST Act and HB 514, the Team-Based Care Act.
HB 434 is a life-saving piece of legislation that will allow physicians to make medical decision for their patients by reforming prior authorization.
If passed, HB 514 would create risks and reduce patient safety by eliminating physician involvement and further prevent access for rural and underserved patient communities.
For more information on HB 434 click here.
For more information on HB 514 click here.
Look for more coverage of White Coat Day including the Legislative Reception in future Morning Rounds!
Plan Now for Professional Development in 2026!
Add Your Face to This Group in 2026!
The time is now to plan for next year! As you begin your budgeting, do you or members of your group want to take the next step in a leadership journey? Make sure you put a line item in your 2026 budget for the North Carolina Medical Society Professional Development programs.
The NCMS offers 2 healthcare leadership programs:
The NCMS Academy for Advanced Healthcare Leaders is an 8-month, project-based leadership development program tailored for practicing physicians, PAs, medical residents, and healthcare administrators.
The program focuses on enhancing leadership abilities by fostering meaningful connections, improving team dynamics, and driving change through individual initiatives.
Participants work on projects of interest using their leadership abilities to prepare for leadership roles within their workplace environments, local medical societies, specialty associations, and NCMS.
For more information on NCMS Advanced Healthcare Leaders click here.
The NCMS Academy for Executive Healthcare Leaders is a 9-month leadership development program designed to prepare healthcare leaders for executive-level roles within their organization, professional community, and beyond.
The program pairs a deeper understanding and awareness of one’s leadership abilities—gained through a comprehensive 360° leadership assessment and a personalized 1:1 executive coaching session—with an individual experiential change initiative project.
For more information on NCMS Executive Academy for Executive Healthcare Leaders click here.
Research shows that the long-term benefits of leadership development programs are immeasurable
Each program provides a unique leadership journey that is tailored to meet the needs of healthcare professionals at various stages in their careers. Ideally, we encourage newer/mid-career leaders and residents to enroll in the NCMS Academy for Advanced Healthcare Leaders (AHL) and more senior level healthcare clinicians and administrators to enroll in the NCMS Academy for Executive Healthcare Leaders (EHL). Both programs offer a distinctive curriculum that can support the leadership needs of healthcare professionals.
Click here for more information on all NCMS Professional Growth programs
If you have questions, please email Monecia Thomas at [email protected]
Let Your Patients Know! NCDHHS Distributing Free Fans Starting May 1
Operation Fan Heat Relief Distributing Fans to Eligible Recipients May 1 – Oct. 31
RALEIGH - The North Carolina Department of Health and Human Services’ Division of Aging is partnering with North Carolina area agencies on aging and local service providers to distribute fans statewide to eligible recipients through the Operation Fan Heat Relief program from May 1 – Oct. 31, 2025.
People aged 60 and older, as well as adults with disabilities, are eligible to sign up for assistance from May 1 – Oct. 31, 2025, with local service providers across the state.
Since 1986, the relief program has purchased fans for older adults and adults with disabilities, providing them with a more comfortable living environment and reducing heat-related illnesses. Last year, the NCDHHS Division of Aging received $86,000 in donations, allowing for the distribution of 3,670 fans and 35 air conditioners in 94 North Carolina counties.
Donations from Duke Energy Carolinas, Duke Energy Progress and Dominion allow regional area agencies on aging and local provider agencies to purchase fans for eligible individuals. Local provider agencies can also purchase a limited number of air conditioners for individuals with specific health conditions.
Keeping cool is important because older individuals with chronic medical conditions are less likely to sense and respond to changes in temperature, and they may be taking medications that worsen the impact of extreme heat. Operation Fan Heat Relief helps vulnerable adults at risk for heat-related illnesses stay safe during the summer.
In addition to applying for fans, people can take the following steps during high temperatures:
- Increase fluid intake
- Spend time in cool or air-conditioned environments regularly
- Reduce strenuous activity during the afternoon
- Speak with a physician before summer about how to stay safe while taking medication that can affect the body's ability to cool itself (e.g., high blood pressure medications)
Individuals may contact their area agency on aging or the NCDHHS Division of Aging at 919-855-3400 for additional details.
More information about Operation Fan Heat Relief, including tips on preparing for extreme heat and a list of local agencies distributing fans, is available at on the NCDHHS Operation Fan Heat Relief webpage.
White Coat Day is Wednesday! NCMS Has A Big Announcement on Prior Authorization!
The North Carolina Medical Society's White Coat Day is just two days away! This Wednesday, physicians and PAs from across the state will come together to demonstrate the medical community’s united stance on reforming prior authorization. It will be a pivotal moment as the NCMS Prior Authorization Bill is presented on the House floor.
Stay tuned throughout the day for updates on how NCMS and its members are advocating to improve healthcare for all North Carolinians.
Delayed care, higher costs: the prior authorization crisis.
Our current prior authorization is neither effective nor efficient, leading to weeks or even months of delayed care as patients wait on health insurers—in some cases even leading to patient death.
Physicians and patients across North Carolina agree: our healthcare can’t wait. Join our campaign to reform an unnecessary system that harms patients.
Take Action Now
The Frustrating Prior Authorization Process
So how do we reform the system?
NC AHEC Offering Free Clinical Precepting Courses Online
Clinical Precepting Online Series
FREE ONLINE COURSES
These courses are geared to an interprofessional audience of clinical preceptors who work with students, residents, or other advanced learners who are completing academic or program requirements in a clinical environment. Participants may complete any combination of courses.
Faculty:
- Lisa Johnston, PT, MS, DPT, DCE, Professor;
- Brenda O Mitchell, Ph D, CCC-SLP, Clinical Assist Professor;
- Laurie A Ray, MPT, PhD, Consultant; Kathryn L Sorensen, OTD, OTR/L, ADAC, Assistant Clinical Professor;
- Charlene Williams, PharmD, BCACP, CDCES, Clinical Associate Professor
Available Courses:
- Clinical Precepting 101: The Role of the Clinical Preceptor, Host Clinical Site, and Legal Considerations; 2.0 Contact Hours
- Clinical Precepting 102: Planning for and Providing Clinical Learning Experiences; 1.50 Contact Hours
- Clinical Precepting 103: Communication, Learner Self-Assessment and Preceptor Feedback; 1.50 Contact Hours
- Clinical Precepting 104: Managing Difficult Situations in the Clinical Learning Environment; 1.5 Contact Hours
- Clinical Precepting 105: Inclusive Precepting Practices; 1.0 Contact Hours
- Clinical Precepting 106: Disability Inclusion; 1.0 Contact Hours
CLICK HERE FOR MORE INFORMATION AND TO REGISTER
NC Institute of Medicine Hosting Task Force on Veterans' Health
The North Carolina Institute of Medicine invites you to join us for a gathering to kick off the start of a task force on Veterans' health!
REGISTER HERE!
Thursday, May 22 – 2:00 – 5:00 PM
Chapel Hill Post 6 – American Legion
3700 NC Highway 54 West, Chapel Hill, North Carolina 27516
** This event has no registration fee.**
The task force will identify actions to improve the access and experience of care in community-based health care settings for those who have served in the military, their families, and caregivers. With support from the North Carolina Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Use Services and NC AARP, NCIOM will be convening the task force from Summer 2025 to Spring 2026. A final report with task force recommendations will be published by Fall 2026.
Visit the task force website HERE.
At the event you will have an opportunity to:
- Hear about what NCIOM has learned in preparation for the task force
- Learn about the goals and objectives of the task force
- Share your perspectives on Veterans' health care
- Hear from some of the people who serve Veterans across the state
- Connect with others who are dedicated to serving North Carolina's Veterans, their families, and caregivers
We hope that you can join us to begin this year-long effort with a spirit of strong collaboration and energy! Please feel free to share this invitation with anyone you know who may be interested.
While we value and appreciate your attendance at this gathering, please note that attendance does not guarantee selection for task force membership. Task force members will be selected based on a variety of factors to ensure a diverse and balanced representation of perspectives and expertise.
Would you like to honor a Veteran in your life? We will be displaying pictures and stories of Veterans at the kick-off event. You can submit a photo and story using this easy form HERE.
More about the North Carolina Institute of Medicine:
The North Carolina Institute of Medicine (NCIOM) is an independent organization focused on improving the health and well-being of North Carolinians by providing analysis on the health and well-being of North Carolinians, identifying solutions to the health issues facing our state, building consensus toward evidence-based solutions, and informing health policy at the state and local level. One of the ways that we do our work is through task forces – convening stakeholder groups to identify evidence-based strategies to improve health and inform health policy.
***Previous NCIOM work related to Veterans’ health***
- North Carolina Medical Journal – Armed Services and Veteran Family Health in North Carolina (November/December 2023 Issue)
- Suicide Prevention and Intervention Plan: A Report of the NCIOM Task Force on Suicide Prevention and Intervention (2012)
- Honoring Their Service: A Report of the North Carolina Institute of Medicine Task Force on Behavioral Health Services for the Military and Their Families (2011)
Nearly Half of U.S. Gets Failing Grades for Air
Some NC cities rank high, but that could be changing.
(Axios, Alex Fitzpatrick) -- Nearly half of Americans are now exposed to potentially dangerous levels of air pollution, per a new report.
Why it matters: The findings, which predate the current Trump administration, come as the White House is reconsidering EPA rules and regulations meant to curb pollution and promote cleaner air.
Driving the news: Just over 156 million Americans — 46% of the population — are living in areas with unhealthy levels of ozone or particle pollution, per the American Lung Association's 2025 State of the Air report.
- That's almost 25 million more compared to last year's report, and the highest number in the past decade of the report's history.
Between the lines: Extreme heat, wildfires and drought are degrading air quality nationwide, the Lung Association says. All have been linked to climate change.
- Air pollution is associated with an array of health conditions, from wheezing and coughing to asthma and premature death.
How it works: The report uses local air quality data to grade and rank locations based on ozone pollution, daily particle pollution and annual particle pollution.
- This latest report includes data from 2021-2023, "the most recent three years of quality-assured nationwide air pollution data publicly available."
- Ozone is a gas that, at ground level, is a harmful irritant. Particle pollution involves tiny airborne particles from wildfires, fossil fuel burning and more.
Zoom in: Los Angeles, Visalia and Bakersfield — all in California — lead the Lung Association's new rankings of U.S. metros most affected by ozone pollution.
- Bakersfield; Fairbanks, Alaska, and Eugene, Oregon, topped the list of those most affected by daily particle pollution.
- Bakersfield; Visalia and Fresno, California, were the most affected by annual particle pollution.
Stunning stat: Hispanic people are almost three times more likely than white people to live somewhere with failing grades in all three categories.
The other side: Only one continental U.S. metro — Bangor, Maine — showed up on all three of the group's lists of cleanest cities.
The intrigue: The "geographic distribution of air pollution" shifted eastward towards the end of the covered period, the report notes.
- "The year 2023 ... brought improved conditions to the West Coast but also a deadly heat wave in Texas and an unprecedented blanket of smoke from wildfires in Canada that drove levels of ozone and particle pollution in dozens of central and eastern states higher than they have been in many years."
What they're saying: "Clearly, we need to do more to control the pollutants that are impacting our changing climate and worsening the factors that go into the wildfires and the extreme heat events that are threatening our health, instead of thinking about how to roll them back," says Katherine Pruitt, senior director of nationwide clean air policy at the American Lung Association and report author.
"I’m as Mad as Hell and I’m Not Going to Take This Anymore!” One Doctor's Thoughts on Prior Authorization
With thanks to Dr. David N. Korones and JAMA Neurology
"I’m as Mad as Hell and I’m Not Going to Take This Anymore!”
So shouted news broadcaster Howard Beale in the iconic 1976 film “Network” as he decried pollution, unemployment, inflation, crime, and all that was wrong in the world back then. And so shouted I, as I slammed down the phone after yet another denial from an insurance company—this time denial of treatment for an 8-year-old little girl with a brain tumor.
She is a happy, high-energy girl who showed only the slightest and most innocent of symptoms. Although these subtle changes did not slow her down in the slightest, it was enough to warrant additional investigation.
Her physician ordered a magnetic resonance imaging scan, and to his surprise, she had a large inoperable brain tumor. Fortunately, a biopsy showed it was a low-grade glioma, a treatable, potentially curable tumor. These days we can get a complete profile of the genetic makeup of children’s tumors, and that profile revealed a mutation in her tumor indicating that an oral US Food and Drug Administration (FDA)–approved drug could be effective. Such drugs (often referred to as targeted therapy) are an increasingly used option for children with cancer, and certainly an attractive option for this young girl. The other choice for treatment, the previously established standard, was a year of weekly intravenous chemotherapy. Her parents and I talked long and hard about these options. I explained that chemotherapy is the standard, but targeted therapy is showing promising results with less adverse effects and is rapidly evolving as a new and more humane standard. Not surprisingly her parents were quick to say “we’ll take the pill,” and the young patient promptly started pill training, enthusiastically honing her pill-swallowing skills with Tic Tacs (Ferrero Group).
“Denied,” the insurance company said in so many words when the prescription for targeted therapy was sent to them for review and approval. They went on to explain in their terse letter of denial that the drug is not FDA approved for this specific indication. The letter was not signed by a human being and provided only a phone number with a tangled algorithm of menu options. I did what we so often do when patients are denied a drug or service that we feel they should have, I asked for an urgent (72-hour) appeal. I wrote a letter outlining the rationale for the targeted therapy option and provided references, with data to support that this approach is not voodoo or magic. It really works! We got another anonymous communication that there is no 72-hour appeal, and we will have to wait the standard 30 days. That is a long time to wait when you have a brain tumor. At this point, I also wrote a letter that I did not send, a letter that served as an outlet for my vitriol, filled with many words I would not want my 8-year-old patient to see. It hangs in our nurses’ office, a testament to the daily frustrations we face getting pediatric patients with cancer the medical care they need.
Although that second letter was a necessary catharsis and a feel-good moment, there were more frustrations to follow. I called in an attempt to reverse their decision to wait 30 days to make a decision, requesting an
expedited review. After 30 minutes of pressing 5, then 3, then 8, then 1, and hearing polite and agonizingly slow moving voice messages, I finally reached a human being, who very kindly told me that I am in the wrong department and needed to call the HELP number on the family’s insurance card. So, I called the family, got the number, and started anew, again a morass of phone menus mixed with interminably long holds, and multiple transfers, each new person (or menu) asking for the same information about my patient. Finally, I reached a human being who told me they don’t have anything on record about my patient and couldn’t help me.
My options were 2-fold: I could go outside and scream as Howard Beale did in Network in 1976, “I’m as mad as hell and I’m not going to take this anymore!” or I could call my congressman. I did both. My congressman sent me to a NY State Assemblywoman with expertise in health insurance snafus. She, in turn, put me in touch with an insurance-government liaison, who connected me with one of the insurance company co-executives who arranged the emergency appeal I was hoping for. The next day an independent, non–insurance affiliated pediatric neuro-oncologist called me and listened to my patient’s story. He immediately replied that this is a sound approach to therapy, and he would recommend approval. The following day, the medication was approved.
I wish this was a stand-alone story, but it is not. Every day the phone, email, and text messages mount: an antinausea medication is not approved, oral chemotherapy is denied to a child because it is in liquid form, and only tablets are approved, brain surgery is denied because the patient has the misfortune of not living in the same state as the neurosurgeon who has the unique skill set to remove it, an insurance company that had
previously approved an essential therapy for one of my patients now, for inexplicable reasons, denies refills half way through her prescribed course of treatment.
If we must make these dreadful calls for approvals of drugs and services, I wish it was as simple as calling a number at an insurance company and having a conversation. But it is not. Denials come on letters without names or contact information, a situation I fear now will only become worse. If a phone number appears, we clinicians take a deep breath, because we know it will be a long call, much of which is spent on hold. If we talk to a human being, they are often kind, but they do not share their last name or other department, and all my identifying information is needed again. My call today was “only” 33 minutes. I made out an invoice while I waited and sent them a bill, charging them $350 per hour for my time ($192.50). I do this from time to time, and not surprisingly, I’ve never received a response or a payment for the time I could be spending taking care of patients. But like the vitriolic letter I wrote, at least it provides some release for my mounting frustration.
I believe there is a method to these denials of services. Denial letters are anonymous, making it hard and time-consuming for us to push back. It is a system designed to rob us of time and to plunge us into a byzantine world of rules and regulations that we do not understand. It is designed to minimize human interaction and takeaway the heart that should be a part of good medical care. It is designed to wear us down, so that we say “screw it ,I’ll just try something they’ll approve.” Something cheaper.
I, for one, am still “mad as hell and I’m not going to take this anymore.” Perhaps the more we push back, send them bills for our time, follow that up with bill collectors, call our congressional representatives, and summon our hospital leadership, we can gather a chorus of physicians, patients, hospital leaders, and politicians who all open their windows and, following Howard Beale’s lead, scream in unison that they, too, are mad as hell, and it is long past time to change this unjust system of care. To paraphrase Howard Beale, “our children, our patients are human beings, goddammit, their lives have value!”
Published Online: April 21, 2025.
doi:10.1001/jamaneurol.2025.0782
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient’s
parents for granting permission to publish this
information.
1. Lumet S. Network film transcript. Accessed
March 18, 2025. https://sfy.ru/?script=network
NC State Health Plan Clear Pricing Project Update
NC State Health Plan Clear Pricing Project Update
Please Complete Survey at Bottom
The State Health Plan (Plan) would like to extend its sincere gratitude to the providers that have supported the Clear Pricing Project (CPP) by being a part of the N.C. State Health Plan Network.
The Plan is facing a $507 million deficit which we are actively trying to close. This means evaluating all programs, like CPP, to determine the best way to stabilize the Plan’s financials.
When CPP launched in 2020, the intention was to promote transparent health care pricing, while trying to promote quality primary care and behavioral health. CPP introduced provider reimbursement rates based on a percentage of Medicare with incenting members to visit participating providers by reducing their copay down to zero. Given that most of the providers that signed up for CPP received an increase in reimbursement rates coupled with members having no cost-share, this model has not proven to be financially viable for the Plan.
Given the current financial situation of the Plan, we must find other solutions that benefits all three parties: the Plan, members and providers. As such, the Plan will be ending CPP in its current form as of December 31, 2025.
The Plan is committed to continuing its effort in promoting affordable access to behavioral health services through reimbursement rates and member cost-share; however, it will not be at the current CPP reimbursement rate and will not have a $0 member cost share.
While the Plan does need to cut costs, we are not willing to compromise on improving member health and recognize this is a balancing act, therefore we are reaching out to the provider community for feedback so we can partner together on something more sustainable for all parties.
Please complete this brief survey by April 25, 2025.
CLICK HERE FOR SURVEY
Is a Blood Test for Postpartum Depression on the Horizon?
Fewer than 10 percent of women seek medical help for postpartum depression
(Sara Novak) -- Postpartum depression is the most common complication of childbirth, affecting about 1 in 7 women after delivery. It causes bouts of severe depression and anxiety, makes bonding with a newborn especially difficult, and can lead to thoughts of self-harm. Suicide is a leading cause of maternal death in the United States.
Yet, only about 6% of women with postpartum depression seek medical help. Shame, stigma, and lack of awareness can delay or deter diagnosis, causing long-term effects on both mother and child.
But a simple blood test that could predict the condition before symptoms appear is offering new hope – hinting at a future where treatments could shift from response to prevention.
The Value of a Predictive Test for Postpartum Depression
Research paving the way for the blood test has been piling up for a decade. Scientists have identified epigenetic biomarkers (indicators in our DNA that reflect changes in how genes are expressed) that can predict postpartum depression with 80% accuracy in the third trimester of pregnancy, according to a 2020 study in the journal Psychiatry Research.
These biomarkers were able to predict postpartum depression in women with a history of depression and in those who, at the time of the test, didn't show any signs of depression, according to results from several studies. If these findings can be used to create a standardized blood test, then high-risk patients would be able to seek treatment before symptoms occur, said Lauren Osborne, MD, second author of the 2020 study and vice chair of clinical research in the Department of Obstetrics and Gynecology at Weill Cornell Medicine in New York City.
Such a test "would alert the clinical care team to the potential risk," helping guide early and targeted intervention and bringing the power of precision medicine to psychiatry, said Jamie Maguire, PhD, a professor of neuroscience at Tufts University School of Medicine in Boston. (Maguire did not take part in the study.)
It could also go a long way toward ending stigma, said Jennifer Payne, MD, a professor at the University of Virginia and an expert in reproductive psychiatry. A blood biomarker provides an objective measure and a biological cause, highlighting the condition as a medical issue that needs treatment.
Two studies led by Payne and Osborne – one local, already underway, and one national, planned for the summer – will explore the test's potential. If they are successful, the test could become available in as little as a few years.
Research suggests there are at least two forms of postpartum depression, each responding to different treatments, said Payne. One is more likely to happen in women with a history of depression, while the other, described as "hormone-dependent," affects patients with no previous mental health issues. The latter is more likely to respond to hormone-based medications.
How Existing Treatments Could Work With a Blood Test
Treatment for postpartum depression typically uses medication along with therapy.
For patients with a history of depression or anxiety, continuing or resuming medications through pregnancy can be an option. Many common antidepressants – including citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft) – are often prescribed during pregnancy and generally considered safe, with benefits largely outweighing the risks to both mom and baby.
Patients with hormone-dependent postpartum depression have a dedicated drug treatment: In 2023, the FDA approved zuranolone (Zurzuvae) for postpartum depression. The drug contains neuroactive hormones that help improve mood regulation.
With a biomarker test, patients with positive results could start the two-week zuranolone treatment in the hospital after giving birth, said Morgan U. Patterson, MD, director of the Perinatal Mood and Anxiety Disorders Program at the University of North Carolina School of Medicine.
Psychotherapy, especially interpersonal therapy and cognitive behavioral therapy (CBT), can give patients better coping tools and help moms identify and change negative thought patterns.
"Therapy can help normalize a mother's experience, help her to process her emotions, and address any possible reproductive trauma," said Marilyn Cross Coleman, a therapist, perinatal treatment specialist, and owner of Shameless Mama Wellness in California. Trauma caused by a serious birth complication that endangers either the mother or child can increase the risk of postpartum depression.
In some cases, group therapy is especially effective. Many women suffer in silence due to feelings of shame, and sharing their experience with other moms helps them know they're not alone.
A biomarker test could lead pregnant people to seek mental health support early, which is crucial because finding care can take months, Osborne said.
How to Lower Your Risk of Postpartum Depression
Another huge thing that helps with postpartum depression is also hard for most new moms to come by: sleep.
Research shows that sleep disturbances put women at a higher risk of postpartum depression. A nightly four- to five-hour block of uninterrupted sleep can effectively stave off symptoms, according to a 2024 study.
That's not easy to achieve with newborns. Hiring a "night nurse" – a caregiver who watches the baby overnight – could help, though at $40-$50 per hour, it's cost-prohibitive for many new parents. You can ask friends and family to contribute through baby nurse registries. Payne also recommends accepting offers from friends and family to help with night feedings, relying on the proverbial village for help.
Have a plan to prevent or treat postpartum depression, Cross Coleman said, because the longer symptoms fester, the more serious the condition can become. "A mother's environment and support network will play a large part in her recovery," she said.
🎉It's New Member Monday!🎉 Say Hello to These New Members or the NCMS!
The NCMS is excited to welcome these new members!
We are thrilled to have you!
Michael A. Abdou, MD
Temitope E. Adebayo, MD
Amanda M. Allen, MD
Bailey C. Allen, MD
Levi A. Almond, PA
Aubrey E. Barker, MD
Cordell R. Beaton, DO
Shannon C. Blake, PA
Yaroslav D. Bodnar, MD
Hannah Boutros-Khoury, MD
Kelly P. Bowers, PA-C
Alexandra L. Chatterton, PA-C
Kendall L. Clark, PA
Tyia S. Clark, MD
Krishna K. Darji, PA-C
Alexis Dubiel
Lillian J. Dubiel, MD
Kate G. Farber, MD
Richard L. Ford, MD
Sarah C. Heminger, PA-C
Megan F. Hoppens, MD
Thomas W. Jenkins, PA-C
Brenna A. Keane, DO
Booker T. King, MD
Lunsford R. King, Jr., MD
Thomas J. Knackstedt, MD
Wafa A. Latif, MD
Jason E. Lee, MD
Julie E. N. Lindsey, MD
Anthony L. Lledo Torres, MD, MPH
Riddhi Mehta, PA-C
Katherine A. Miller, MD
Heather N. Moore, PA
Ward J. Myers, MD
Alvin L. Nguyen, DO
Kevin O. Nyabera, MD
Luther M. Richey, MD
Shiela Marie C. Romanick
Not a member?
Want to be?
Joining is simple.
Visit our membership center here.
What do you get for your NCMS dues dollars?
From advocacy to practice solutions, your membership has its advantages.
The NCMS employs a team of legislative, regulatory, and payer experts who closely monitor and respond to the latest developments that impact the profession of medicine and the care of patients. LEARN MORE...
Take advantage of leadership development opportunities through our award-winning Kanof Institute for Physician Leadership (KIPL) programs such as the NCMS Academy for FUTURE Healthcare Leaders, the NCMS Academy of ADVANCED Healthcare Leaders, and the NCMS Academy of EXECUTIVE Healthcare Leaders. LEARN MORE...
From special rates to specialized insurance options for yourself or your practice, take a look at your options. LEARN MORE...
Plan for your future with these retirement solutions. LEARN MORE...
The Community Practitioner Program (CPP) and CPP 2.0 offer loan repayment for practicing in rural or under-served areas. LEARN MORE...
Gain access to resources designed to improve the health and well-being of healthcare professionals. LEARN MORE...
Receive our daily Morning Rounds e-newsletter to stay up-to-date on all the issues impacting medicine.
Get the latest legislative developments happening at the state and national level delivered to your inbox with our Political Pulse video series, as well as breaking Advocacy Alerts.
Events and Networking Opportunities
Throughout the year we host a number of NCMS Socials, Town Halls, and Regional Meetings across the state to get members together for fun and to learn how to make North Carolina the healthiest state in the country!
NCMS and NCCHCA Hosting 'The Courage to Rebuild: A Fundraiser to Honor the Resilience of WNC Health Centers'
The NCMS is excited to announce we are joining NCCHCA to honor health centers of Western North Carolina
Join us as we come together to honor and support our Western North Carolina health centers as they recover from the devastating effects of Hurricane Helene. In the long road to recovery, the highest need is financial support to rebuild, restock, and offer new services to meet needs of their communities. Our goal is to raise $500,000 to support Western North Carolina community health centers. We thank those who have already donated and contributed to that goal, and are grateful for the continuing support.
The event is at the Umstead Hotel and Spa in Cary on April 23rd
There are several ways you can be involved:
Cant attend? Click here to donate directly to the Helene Recovery Fund
This fundraiser will be taking place at the beautiful Umstead Resort and Spa, located at 100 Woodland Pond Drive, Cary, NC 27513.
We will be located in the Ballroom for the fundraiser, so be sure to utilize the west entrance as opposed to the main entrance to lead you more directly to our space.
Parking is valet, and complimentary. You may give your keys to the valet upon your arrival before entering the event space.
In the Cary area, you have many choices for where to stay.
The Umstead Hotel and Spa - Host Site
Please note: The room block for The Umstead has closed, but you may make independent reservations
Other nearby options include:
Embassy Suites (Raleigh-Durham Airport) (3 minutes from Umstead)
Hilton Garden Inn (Raleigh-Durham Airport) (7 minutes from Umstead)
Sonesta Select (Raleigh-Durham Airport) (8 minutes from Umstead)
TownePlace Suites (Raleigh-Durham Airport/Morrisville) (12 minutes from Umstead)
Now Open: NHSC Scholarship Program
Accepting applications through Thursday, May 8 at 7:30 p.m. ET.
The National Health Service Corps (NHSC) Scholarship Program awards scholarships to students pursuing eligible primary care health professions training. In return, you commit to providing primary care health services in a Health Professional Shortage Area for a minimum of two years or a maximum of four years of full-time service.
What does the scholarship cover?
- Tuition and eligible fees
- Items including books, health insurance, and equipment
CLICK HERE TO LEARN MORE AND APPLY
You must meet all eligibility requirements:
- A U.S. Citizen (U.S. born or naturalized) or U.S. naturalized.
- Enrolled as a full-time student (or accepted for enrollment).
- Attending - or accepted to attend - an accredited school or program in one of the 50 states, the District of Columbia, or a U.S. territory.
- In an eligible discipline: physician, dentist, nurse practitioner, nurse midwife, or physician assistant.
- Eligible for federal employment.
- Without an existing service obligation.
Save the Date!
NHSC Scholarship Application Assistance Webinar
Wednesday, April 2 from 2:00 - 3:30 p.m. ET
New Security Feature: To start your application, you will sign in or set up an account in My BHW. My BHW requires multifactor authentication (MFA), which adds an extra layer of protection to your account and reduces the risk of fraud.
With MFA, you must use Google Authenticator on your mobile phone or tablet each time you log in. Follow the Quick Start Guide to set up your authentication.
NCDHHS: New Primary Care Physicians Initiative Loan Repayment Program
Placement Services Program
DHHS Division/Office issuing this notice: Office of Rural Health
Date of this notice: April 2, 2025
Applications will be accepted beginning April 21, 2025 at 8:00 a.m.
NEW Primary Care Physicians Initiative: Loan Repayment Program
NC DHHS: Medical, Dental, and Psychiatric Recruitment Opportunities for Providers
The Office of Rural Health (ORH) offers qualifying physicians, with educational (student) loan debt, incentive payments to repay their loans tax-free through the Primary Care Physicians Initiative (NC PCPI). With the passage of Session Law 2023-134, incentive payments are awarded to eligible physicians in exchange for providing comprehensive primary care services in outpatient settings at eligible sites serving those with the highest need located within Tier 1 and Tier 2 of the North Carolina’s County Distress Rankings (Tiers).
Funding is limited and the awards will be based on a first-come, first-served basis for eligible and complete applications. ORH anticipates up to 16 awards in each of the six Medicaid Regions. The application portal will not accept more than 20 applications per Medicaid Region.
Applicants are strongly encouraged to review these guidelines carefully and gather necessary documentation so that when the application portal opens on April 21, 2025, at 8:00 am, applicants will be prepared to complete the on-line application in its entirety.
Click here for full details, eligibility, awards and commitments
Crowd Gathers for First NCMS Social and Regional Meeting in New Bern!
The first NCMS Social and Regional Meeting in New Bern Draws Crowd of Local Clinicians!
NEW BERN -- The North Carolina Medical Society (NCMS) hosted a Social and Regional Meeting in New Bern on Tuesday evening, bringing together a dynamic group of area clinicians to learn more about the NCMS mission, activities, and member opportunities.
NCMS Board members Dr. Tracy Eskra and Dr. Claude Jarrett led an engaging presentation, making the event both informative and enjoyable!
Toni Hill, the NCMS Director of Membership and Engagement says, "Our first visit to beautiful New Bern was an unforgettable experience! We were thrilled to meet the dedicated professionals in the region and spend an evening connecting, socializing, and learning about the incredible work NCMS does for its members. The NCMS team truly enjoyed engaging with guests, exploring ways to support them in their work—because that’s exactly why NCMS exists! I want the rest of the state to know that these meetings are more than just gatherings—they’re opportunities to share stories, explore solutions, and help NCMS grow even stronger!"
The next NCMS Regional Meeting is in Asheville on May 22. Click here to register.
Don't forget about the NCMS White Coat Day and Legislative Reception on April 30. Click here to register.
Attorney General Jeff Jackson Sues Federal Government Over Cuts in NC Healthcare Funding
Last week, the U.S. Department of Health and Human Services told several states, including North Carolina, that it was terminating $11 billion in health care funding.
(WITN Web Team) -- North Carolina Attorney General Jeff Jackson has filed a lawsuit against the federal government over hundreds of millions of dollars in healthcare funding cuts.
Last week, the U.S. Department of Health and Human Services told several states, including North Carolina, that it was terminating $11 billion in health care funding.
Jackson says the cuts, which include over $230 million to North Carolina, are unlawful and that the funds were congressionally appropriated.
Jackson is filing the lawsuit jointly with dozens of other state attorneys general.
Jackson listed several items he says would suffer because of the cuts:
- Local health programs in at least 77 of North Carolina’s 86 health departments, particularly in North Carolina’s rural counties.
- Community-based organizations and community health workers who have been providing care and resources to people impacted by Hurricane Helene in western North Carolina.
- County-based nurses who investigate disease outbreaks.
- Collection and analysis of infection control data, which is critical for humans as well as North Carolina’s farming economy and livestock industry.
- EMS programs in six counties (Davie, Durham, Gaston, Surry, Orange, and Cumberland counties).
- Response to outbreaks of infectious disease in high-risk places like nursing homes and assisted living facilities, where North Carolina’s older population is at risk.
- Effective control and prevention of the spread of infections, like the flu. North Carolina just experienced its worst flu season in 15 years, leading to more than 382 deaths.
- Substance use disorder treatment programs, especially in rural areas, and the loss of behavioral health therapists and substance use treatment specialists who are critical to North Carolina’s fight against the addiction crisis.
- Collegiate substance misuse recovery programs that operate in 14 North Carolina colleges and universities (Appalachian State University, Elizabeth City State University, East Carolina University, Fayetteville State University, North Carolina A&T State University, NC State University, North Carolina Central University, UNC Asheville, UNC Charlotte, UNC-Chapel Hill, UNC Greensboro, UNC Pembroke, UNC Wilmington, and Winston-Salem State University).
2025 Match Data Shows Increase in Primary Care
National Resident Matching Program Releases the 2025 Main Residency Match Results, Celebrates the Next Generation of Physicians
The National Resident Matching Program® (NRMP®) proudly announces the results of the 2025 Main Residency Match® (“the Match”), the largest in its 73-year history. A total of 52,498 applicants registered for the Match, an increase of 2,085 (4.1 percent) over last year, and 47,208 of those applicants submitted a certified a rank order list (“active applicant”). This year’s active applicant pool competed for 43,237 positions, an increase of 1,734 (4.2 percent) from 2024. Today at 12:00 pm ET, matched applicants learned where they will begin their medical training.
“This year’s Main Residency Match marks a milestone of continued success for the graduate medical education community as a record number of applicants and residency training programs matched,” said NRMP President and CEO Donna L. Lamb, DHSc, MBA, BSN. “The NRMP continues to be a service that welcomes all who wish to participate, capably advocating for and supporting the aspirations of young physicians and the priorities of residency training programs to collectively address the varied heath needs of communities across the nation.”
Record Breaking Program Participation. This year the NRMP welcomed two new specialties to the Match; Public Health and Preventive Medicine and Occupational and Environmental Medicine. All told, the 2025 Main Residency Match included 6,626 certified program tracks, an all-time high and increase of 231 programs over last year. Of the 43,237 training positions offered, 94.3 percent (40,764) filled when the matching algorithm was processed.
Multiple Application Service Providers. In response to the changing landscape of graduate medical education, the 2025 transition to residency cycle included for the first time multiple application services for applicants to secure residency positions. The NRMP played a pivotal role in fostering collaboration among application service providers, namely working to streamline processes, improve transparency, and fortify data integrity for a more efficient transition experience for applicants.
Performance in the Match. As the primary source of data on physician matriculation into the national pipeline, the NRMP informs constituents, health policy experts, and stakeholders within and outside the medical education community about trends, noting changes over time in match rates among distinct applicant groups, program fill rates, and applicant interest in specialties.
For the 2025 Main Residency Match:
I. Applicant Participation and Match Rates. Among all registrants, 47,208 applicants certified a rank order list of program preferences, an increase of 2,355 or 5.3 percent over last year. Of the applicants who certified a rank order list, 37,667 matched to either a categorical or preliminary (both post graduate year-1 or ‘PGY-1’) position, an increase of 1,683 (4.7 percent) from 2024.
- There were 8,392 active Osteopathic (DO) seniors in the 2025 Main Residency Match, an increase of 4.5 percent over last year. DO seniors achieved a 92.6 percent PGY-1 match rate, an all-time high, and an increase of 0.3 percentage points. DO senior PGY-1 match rates have grown 3.5 percentage points since 2021.
- U.S. MD seniors are the largest applicant type in the Match with 20,368 active applicants. At 93.5 percent, their PGY-1 match rate remained unchanged from last year, despite an increase of 3.1 percent (613) in active applicants. The U.S. MD senior PGY-1 match rate remains within the 92 – 95 percent range that has been steady since 1982.
- There were 4,587 active U.S. citizen international medical graduates (IMGs) in the Match, a decline of 3.5 percent, with a PGY-1 match rate of 67.8 percent, which represents a 0.8 percentage point increase over last year.
- Non-U.S. citizen IMGs saw a large increase in participation this year with 11,465 active applicants, up 14.4 percent over 2024. The marked increase in participation served to push the PGY-1 match rate down but only slightly, 0.5 of a percentage point, to 58.0 percent.
II. Primary Care Positions Continue to Increase. The NRMP routinely reports on the primary care specialties that provide the full training required for board certification in Family Medicine, Internal Medicine, Internal Medicine-Pediatrics, and Pediatrics.
This year’s Match saw continued strength in filling primary care specialties, with 20,300 categorical positions offered, an increase of 877 positions over last year and a new high. Overall, primary care specialties earned a 93.5 percent fill rate.
- Internal Medicine increased the positions placed in the Match by 679 to 11,750, a 6.1 percent increase over 2024. The specialty filled 11,379 positions, up 7.6 percentage points, giving them a fill rate of 96.8 percent.
- Last year, the fill rate for Pediatrics declined from 97.1 to 91.8 percent. This year, Pediatrics offered 3,193 categorical and primary positions, an increase of 54 from 2024, and filled 3,043 for a 95.3 percent fill rate.
- Family Medicine saw a lower fill rate this year, filling 85.0 percent of their 5,357 positions compared to 87.8 percent last year, largely due to the increase of 144 positions placed in the Match.
III. Renewed Interest in Emergency Medicine. In 2025, Emergency Medicine offered 3,068 positions, an increase of 42 positions from 2024, and achieved a 97.9 percent fill rate, an increase of 2.4 percentage points. The specialty had experienced a decline, with an 81.8 percent fill rate in 2023 before climbing back up to a 95.5 percent fill rate in 2024. This year’s performance edges Emergency Medicine even closer to its pre-Covid fill rate of 98 to 99 percent. There were 3,003 applicants who matched to the specialty, a rebound from 2023 which saw 2,456 applicants obtaining PGY-1 positions. The increase in matched applicants to Emergency Medicine is due primarily to increases in DO seniors and IMGs matching to the specialty.
IV. OB-GYN Remains Competitive. Obstetrics and Gynecology continues to be a specialty of interest as national conversations about reproductive healthcare persist in light of the Dobbs v. Jackson Women’s Health Organization Supreme Court decision in 2023. Despite the changing policy landscape, interest in the specialty remains strong. In the 2025 Main Residency Match, only one categorical position and nine preliminary PGY-1 positions remained unfilled out of 1,604 Obstetrics and Gynecology residency positions offered. MD Seniors accounted for 69.4 percent of those who matched, while DO Seniors accounted for 19.6 percent, up from 18.9 percent in 2024. International medical graduates accounted for 6.0 percent of matched applicants in the specialty.
V. Applicant Impact on Specialty Fill Rate. Data also can be examined to assess how various applicant groups impact specialty fill rates, offering a glimpse into shifts and changes in the landscape over time of applicant and specialty preference.
Of note this year:
- U.S. DO seniors increased the percent of positions filled in several specialties including categorical Child Neurology (4.9 percentage point increase), Medicine-Pediatrics (2.9 percentage point increase), and Orthopedic Surgery (1.3 percentage point increase).
- U.S. MD seniors saw increases in the percent of positions filled in a few specialties including categorical Radiation Oncology (16.7 percentage point increase), Anesthesiology (1.8 percentage point increase), and Psychiatry (1.5 percentage point increase).
- Non-U.S. citizen IMGs saw increases in primary care, filling 33.3 percent of categorical Internal Medicine positions (a 1.9 percentage point increase), 20.4 percent of categorical Pediatrics positions (a 2.0 percentage point increase), and 17.6 percent of Family Medicine positions (a 2.2 percentage point increase).
Supplemental Offer and Acceptance Program® (SOAP®). The NRMP’s Match Week Supplemental Offer and Acceptance Program (SOAP) affords eligible applicants who did not match to a residency position the opportunity to try to obtain positions that went unfilled after the matching algorithm was processed. A total of 2,521 positions were placed in SOAP, including positions in programs that did not participate in the algorithm phase of the Match. The number of available positions in SOAP represents a decline of 54 positions (2.1 percentage points) compared to last year, despite an increased number of positions in the Match, a further indication of the success of the NRMP’s Matching Program for placement of young physicians in training programs.
Detailed SOAP results will be available in the Results and Data: 2025 Main Residency Match Report, which is published in the Spring.
New Study: Shingles Vaccine May Protect Against Dementia
It’s been shown that reactivation of the chickenpox virus can lead to the accumulation of aberrant proteins associated with Alzheimer’s.
(NBC News, Linda Carroll) -- Getting vaccinated against shingles — a painful and debilitating condition that can flare up years after infection from varicella zoster — not only lowers the risk of infection, but may also offer some protection against dementia, a provocative new study suggests.
The new research, published Wednesday in Nature, analyzed data from more than 280,000 older adults in Wales and found that people who received the original shingles live virus vaccine were 20% less likely to develop dementia of any type than those who were not vaccinated.
Previous research has found an association between the Shingrix shingles vaccine, which replaced the live virus version in 2020, and a lower risk of dementia, especially in women. But that link wasn't considered as strong because that study design couldn’t account for potential differences between those who were vaccinated and those who were not, such as the possibility that the vaccinated people might have been healthier overall. Shingrex, which targets a tiny bit of viral DNA, turned out to have a longer lasting effect than the original vaccine.
The new study was possible because of an unusual public health policy in Wales that provided a “natural experiment” to explore the potential impact of the vaccine on dementia risk. With the rollout of the vaccine on Sept. 1, 2013, in Wales, shots were offered to people who were 79 on that date but not given to people who had turned 80.
That allowed the German and Stanford University researchers to compare two groups of people with similar health characteristics who differed only by one week in age, making them essentially the same except that the vaccine was available to the younger population but not the older, said Dr. Pascal Geldsetzer, an assistant professor of medicine at Stanford University and senior author of the study.
What’s exciting about the study is that it’s essentially like a randomized controlled trial, considered the gold standard in research, he said.
The way the original vaccine was rolled out in Wales provided a unique opportunity, said Allison Aiello, a professor of epidemiology at the Columbia University Aging Center in New York City.
“It’s like having a control group compared to a treated group,” said Aiello, who was not associated with the new research. “What’s interesting is the finding of 20% protection. That is a pretty strong effect, which does fit with other research suggesting that herpes viruses might have an influence on dementia.”
Scientists don’t know exactly how the chickenpox virus raises the risk of dementia. It’s been shown that reactivation of the virus can lead to the accumulation of aberrant proteins associated with Alzheimer’s, for example, Geldsetzer said. It’s also possible that the virus might spark a reactivation of herpes simplex, which earlier research has linked to dementia.
Herpes viruses never completely go away, but instead lurk in the body until the immune system weakens. Aging leads to a natural weakening of the immune system that can allow the virus to resurface as shingles, a nasty side effect of chickenpox.
The age effect is why the shingles vaccine has been offered only to people ages 50 and older in the U.S. It's given as two doses, two to six months apart.
Herpes viruses, including oral and genital herpes simplex, appear to have the ability to get into the central nervous system, experts said.
In fact, a 2024 study found that among 70-year-olds without dementia at the outset, older adults with a herpes simplex diagnosis were more than twice as likely as uninfected people to develop dementia over a 15-year follow-up.
Herpes simplex can wreak havoc if it passes through the blood-brain barrier. It can cause inflammation of both the meninges (meningitis) and the brain (encephalitis). Both can be fatal.
Bolstering the case for the shingles vaccine protecting against dementia were the findings from a study published in Nature Medicine in 2024 that analyzed medical records from more than 100,000 patients. That analysis suggested the newer shingles vaccine was associated with even better protection against dementia.
In that study, researchers also investigated whether two other vaccines — for influenza and tetanus, diphtheria and pertussis — had any impact on the risk for dementia. They did not.
The most important take-home message from the Stanford study is that getting vaccinated might lower the risk for dementia, said Dr. Aarati Didwania, a professor of medicine and medical education at Northwestern University’s Feinberg School of Medicine in Chicago.
Exactly how the vaccines might protect against dementia isn’t clear, Didwania said. “But it’s an intriguing question,” she added. “Is it by decreasing inflammation or preventing the virus from reactivating?”
There’s certainly a good reason for getting vaccinated, Didwania said.
“Shingles is a terrible, painful and debilitating condition that can lead to horrendous long-term pain,” she said.
There are limitations to the new study. While it indicates the benefit of the vaccine in a real-world setting, it's not the same as a randomized controlled trial, said Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University Medical Center in Nashville, Tennessee. But it wouldn't be ethical to randomly assign people to get the vaccine or not, he said.
“It’s provocative, interesting and exciting,” he said of the research.
It’s possible that the Food and Drug Administration could review research linking shingles vaccines to a lower risk of dementia and allow the drug company to add that indication to the label, Schaffner said.
Even if that doesn’t happen, doctors can use the study findings to convince patients to choose to be vaccinated.
“Clearly there are lots of people 50 and over who have not received the vaccine,” he said. “If you say there are some data that suggest the vaccine might prevent some cases of dementia, people might be persuaded.”
NC Breaks Records for Pollen Count in 2025
Pollen across state is troubling for allergy sufferers
CHARLOTTE, N.C. (QUEEN CITY NEWS) – If you’ve noticed your allergies seem to be much worse this year – you’re not alone. The Asthma and Allergy Foundation of America reports that allergies are worse this year and may continue in that direction.
The North Carolina Division of Air Quality measured a new record at the end of March. The agency typically measures pollen from February through October. Last week, it measured the highest grass pollen of all time for the month of March since it started gathering data in 1999.
Although spring is blooming in Uptownn (Charlotte), it comes at a price. Deepti Bhave has lived in Charlotte for 20 years and says she’s never had trouble like she is now.
“It’s so beautiful in Charlotte,” Bhave said. “I love the colors in the spring and everything else, but the allergies just dampen the spirit.”
This was a common theme among people at Romare Bearden Park Wednesday.
Daryl Goodman said he’s never had allergies before this year.
“It makes my eyes red, it makes my eyes watery,” Goodman said. “It’s a terrible season. I haven’t had any issues, but this season is definitely an issue.”
They’re not alone. The Asthma and Allergy Foundation of America (AAFA) says a warmer climate is to blame.
Kenny Mendez is the CEO of AAFA. He says allergy growing season starts a lot sooner and ends much later.
“That supercharges the release of pollen so that’s why you have a longer and then a more intense allergy season because of those intense releases of pollen,” Mendez said. “Now because there’s so much more people who’ve never had it before, now their bodies are reacting more. Their triggers might have been much lower, but now because there’s so much more, year-round, then that can be a bigger factor for people.”
Mendez said trees are typically to blame this time of year and the Division of Air Quality has show high levels of tree pollen these last few days.
“It’s really important to have your triggers under control and understand if you have something like allergic asthma and work with a specialist to understand what your triggers are,” Mendez said.
Mendez said we spend close to 90 percent of our time indoors, so if you go outside, he said it helps to leave your shoes at the door when go home and if you walk your dog – wash him or her to keep allergens low in your home. AAFA also reported this year that Charlotte hit No. 18 of the most challenging places to live because of allergies.
NC AHEC Announces Next CoCM Provider Learning Collaborative
Collaborative Care Model (CoCM) Provider Learning Collaborative
April 17, May 29, June 19, 2025
Time: 12:00 - 1:00 p.m.
Location: Livestream Webinar
Target Audience
These Learning Collaboratives are for primary care providers, behavioral health professionals, and anyone else who has implemented or is considering the Collaborative Care Model (CoCM) for integrating behavioral health in a primary care setting. Independent primary care practices, FQHCs, and rural health clinics may find this collaborative especially helpful for meeting some of the behavioral health needs of their patients.
Program Description
The Collaborative Care Model (CoCM) is an integrated modality that provides patients with medical and behavioral health care in a primary care setting. The CoCM Learning Collaborative sessions will highlight collaborative care team integration and the role of the CoCM Behavioral Health Care Manager for practices new to the model and those established with implementing CoCM.
Objectives
- Participants will be able to describe the principles of the Collaborative Care Model (CoCM).
- Participants will be able to identify key concepts and team member roles/responsibilities for effective implementation of CoCM.
- Participants will be able to explain the value and evidence for measurement-based, treatment to target CoCM care.
- Participants will be able to discuss the contributing factors to successful Collaborative Care implementation.
For more information and to register click here.
NCMS is Sending Match Day Congratulations!
The North Carolina Medical Society congratulates all the new graduating medical students on their Match Day success!
Jonathan Bowling matched into the Internal Medicine-Pediatrics residency at the Medical University of South Carolina in Charleston. He earned his undergraduate degree from UNC-Chapel Hill and will graduate from ECU Brody School of Medicine in May.
Jonathan is also a scholar in the current cohort of the North Carolina Medical Society Future Healthcare Leaders program.
Congratulations Jonathan!
NCMB Board Leadership Opportunities
NCMB is accepting applications for Board Members
NC DHHS Secretary and former NCMS President Dr. Devduttta Sagvai has an important message for potential NCMB Board members.
Click here to hear his thoughts on Board membership..
Board Members are appointed by the Governor. Physicians and PAs must apply according to a process established by state law (N.C. Gen. Stat. § 90-2 and 90-3), which requires interested parties to apply to an independent panel that nominates candidates for the Governor’s consideration. The deadline to apply is June 23, 2025.
Board Members participate in bimonthly meetings as well as disciplinary hearings, which are held up to six times per year depending on caseload. Board Members spend about 20 hours preparing for each meeting or hearing. In addition, many Board Members contribute articles to the Board’s quarterly newsletter and present to medical students, residents, professional meetings, community groups and other audiences as part of their work on the Board. Board Members are appointed to three-year terms and may serve up to two consecutive terms.
Visit the website of the Review Panel for the North Carolina Medical Board for more information.
By law, NCMB has three public members. One is appointed at the discretion of the Governor and two are appointed by the General Assembly upon the recommendations of the Speaker and President Pro Tempore.
For more information application criteria click here.
Take a Look! NCMS Future Healthcare Leaders 3rd Session
RALEIGH -- The NCMS in action! The Future Healthcare Leaders are a group of interdisciplinary graduate healthcare students from across the state.
During their 3rd Learning Session in March, they participated in Leading with Others and Communication Skills workshops.
It is part of the NCMS Kanof Institute for Physician Leaders.
Each program provides a unique leadership journey that is tailored to meet the needs of healthcare professionals at various stages in their careers.
- The Academy for FUTURE Healthcare Leaders (FHL) is an interprofessional leadership development program open to medical, PA, pharmaceutical, and nursing students throughout NC.
- Newer/mid-career leaders and residents can enroll in the NCMS Academy for ADVANCED Healthcare Leaders (AHL) .
- Senior level healthcare clinicians and administrators can enroll in the NCMS Academy for EXECUTIVE Healthcare Leaders (EHL).
For more information click here.
Genomic Sequencing Reveals Previously Unknown Genes That Make Microbes Resistant to Drugs and Hard To Kill
This article was written by Nneka Vivian Iduu, a graduate research assistant in pathobiology at Auburn University, for The Conversation — a nonprofit news organization dedicated to sharing the knowledge of researchers and scientists, under a Creative Commons license. Read the original article here.
(The Conversation) -- In the 20th century, when a routine infection was treated with a standard antibiotic, recovery was expected. But over time, the microbes responsible for these infections have evolved to evade the very drugs designed to eliminate them.
Each year, there are more than 2.8 million antibiotic-resistant infections in the United States, leading to over 35,000 deaths and US$4.6 billion in health care costs. As antibiotics become less effective, antimicrobial resistance poses an increasing threat to public health.
Antimicrobial resistance began to emerge as a serious threat in the 1940s with the rise of penicillin resistance. By the 1990s, it had escalated into a global concern. Decades later, critical questions still remain: How does antimicrobial resistance emerge, and how can scientists track the hidden changes leading to it? Why does resistance in some microbes remain undetected until an outbreak occurs? Filling these knowledge gaps is crucial to preventing future outbreaks, improving treatment outcomes and saving lives.
Over the years, my work as a microbiologist and biomedical scientist has focused on investigating the genetics of infectious microbes. My colleagues and I identified a resistance gene previously undetected in the U.S. using genetic and computational methods that can help improve how scientists detect and track antimicrobial resistance.
Challenges of Detecting Resistance
Antimicrobial resistance is a natural process where microbes constantly evolve as a defense mechanism, acquiring genetic changes that enhance their survival.
Unfortunately, human activities can speed up this process. The overuse and misuse of antibiotics in health care, farming and the environment push bacteria to genetically change in ways that allow them to survive the drugs meant to kill them.
Early detection of antimicrobial resistance is crucial for effective treatment. Surveillance typically begins with a laboratory sample obtained from patients with suspected infections, which is then analyzed to identify potential antimicrobial resistance. Traditionally, this has been done using culture-based methods that involve exposing microbes to antibiotics in the lab and observing whether they survived to determine whether they were becoming resistant. Along with helping authorities and researchers monitor the spread of antimicrobial resistance, hospitals use this approach to decide on treatment plans.
However, culture-based approaches have some limitations. Resistant infections often go unnoticed until antibiotics fail, making both detection and intervention processes slow. Additionally, new resistance genes may escape detection altogether.
Genomics of Antimicrobial Resistance
To overcome these challenges, researchers have integrated genomic sequencing into antimicrobial resistance surveillance. Through whole-genome sequencing, we can analyze all the DNA in a microbial sample to get a comprehensive view of all the genes present — including those responsible for resistance. With the computational tools of bioinformatics, researchers can efficiently process vast amounts of genetic data to improve the detection of resistance threats.
Despite its advantages, integrating genomic sequencing into antimicrobial resistance monitoring presents some challenges of its own. High costs, quality assurance and a shortage of trained bioinformaticians make implementation difficult. Additionally, the complexity of interpreting genomic data may limit its use in clinical and public health decision-making.
Establishing international standards could help make whole-genome sequencing and bioinformatics a fully reliable tool for resistance surveillance. The World Health Organization recommends laboratories follow strict quality control measures to ensure accurate and comparable results. This includes using reliable, user-friendly computational tools and shared microbial databases. Additional strategies include investing in training programs and fostering collaborations between hospitals, research labs and universities.
Discovering a Resistance Gene
Combining whole genome sequencing and bioinformatics, my colleagues and I analyzed Salmonella samples collected from several animal species between 1982 and 1999. We discovered a Salmonella resistance gene called blaSCO-1 that has evaded detection in U.S. livestock for decades.
The blaSCO-1 gene confers resistance to microbes against several critical antibiotics, including ampicillin, amoxicillin-clavulanic acid and, to some extent, cephalosporins and carbapenems. These medications are crucial for treating infections in both humans and animals.
The blaSCO-1 gene likely remained unreported because routine surveillance usually targets well-known resistance genes and it has overlapping functions with other genes. Gaps in bioinformatics expertise may have also hindered its identification.
The failure to detect genes like blaSCO-1 raises concern about its potential role in past treatment failures. Between 2015 and 2018, the Centers for Disease Control and Prevention began implementing whole-genome sequencing for routine surveillance of Salmonella. Studies conducted during this period found that 77% of multistate outbreaks were linked to livestock harboring resistant Salmonella.
These missed genes have significant implications for both food safety and public health. Undetected antimicrobial resistance genes can spread through food animals, contaminated food products, processing environments and agricultural runoff, allowing resistant bacteria to persist and reach humans. These resistant bacteria lead to infections that are harder to treat and increase the risk of outbreaks. Moreover, the global movement of people, livestock and goods means that these resistant strains can easily cross borders, turning local outbreaks into worldwide health threats.
Identifying new resistance genes not only fills a critical knowledge gap, but it also demonstrates how genomic and computational approaches can help detect hidden resistance mechanisms before they pose widespread threats.
Strengthening Surveillance
As antimicrobial resistance continues to rise, adopting a One Health approach that integrates human, animal and environmental factors can help ensure that emerging resistance does not outpace humans’ ability to combat it.
Initiatives like the Quadripartite AMR Multi-Partner Trust Fund provide support for programs that strengthen global collaborative surveillance, promote responsible antimicrobial use and drive the development of sustainable alternatives. Ensuring researchers around the world follow common research standards will allow more labs – especially those in low- and middle-income countries — to contribute to global surveillance efforts.
NC Trend: Duke University Drives to Become Bigger Healthcare Force in NC
Business NC takes look at expansion efforts by Duke University
(Business NC, David Mildenberg) -- It hasn’t attracted attention like Blue Devil basketball phenom Cooper Flagg, but the pace of change at Duke University’s healthcare operation has accelerated dramatically.
In December, Duke Health said it would invest $280 million to buy Lake Norman Regional Medical Center and related businesses in Mooresville in Iredell County. It marks the Durham-based system’s first entry into the Charlotte metropolitan area, pending regulatory approval.
In January, Duke Health said it would partner with UNC Health to build a proposed $2 billion pediatric hospital on an undisclosed site in the Triangle. The state-owned, Chapel Hill-based system announced the freestanding 500-bed children’s hospital in September 2023. Beyond its globally respected medical pedigree, Duke is providing fundraising muscle needed to execute the project, a first of its type in the state.
In March, Duke Health announced a partnership with Novant Health to develop locations across the state to improve health outcomes. No specific projects or financial details were provided by the state’s second-largest hospital operator (Novant had about $10 billion in annual revenue last year) and third-biggest (Duke had $6.8 billion of revenue in fiscal 2024.)
The organizations said construction of the first sites would begin this summer, with the facilities opening about 18 months later.
Duke Health officials decline to discuss what is sparking the ambitious moves. But consolidation is a major trend in the healthcare industry because of increasing costs of remaining competitive and perceived advantages from economies of scale. Hospital system executives say they need to achieve a significant size to better negotiate contracts with insurance companies and invest in talent, technology and real estate.
Novant Health, which owns hospitals in the Charlotte, Winston-Salem and Wilmington areas, has said it wants to triple its annual revenue to the $30 billion range over the next few years.
That followed a similarly aggressive expansion effort at Atrium Health sparked after the 2016 hiring of CEO Eugene Woods. The Charlotte-based institution now dwarfs its North Carolina peers, with annual revenue topping $32 billion and operations in six states.
Duke Health’s moves follow a restructuring of leadership after the June 2023 retirement of Eugene Washington as the university’s chancellor for health affairs. He had held the post since 2015.
Upon Washington’s departure, Duke Health created two positions. Dr. Craig Albanese became CEO, overseeing the clinical enterprise, and Dr. Mary Klotman was named executive vice president for health affairs. The dean of Duke School of Medicine since 2017, she would “oversee Duke Health’s academic mission,” university President Vincent Price said in a June 2023 release.
Albanese came to Duke in January 2022 from New York-Presbyterian Hospital, where he had been group senior vice president and chief medical officer of the $9.2 billion, 10-hospital academic health system. He is a surgeon who previously had senior leadership jobs at Stanford University and its healthcare business.
Money won’t be a problem at Duke. The university reported an endowment of $11.9 billion last year and has an alumni roster that includes billionaires such as Apple CEO Tim Cook and Carlyle Group co-founder David Rubenstein.
In December, an anonymous donor gave $50 million to the proton beam therapy center, which is scheduled to open in 2029. It is expected to provide fewer side effects than traditional radiation therapy.
“Hospital affiliations are the new merger,” says Barak Richman, a law professor at George Washington University, referring to the Novant agreement. He is an expert on N.C. healthcare after previously working at Duke. “The idea is you secure patient flows, and you lock up different parts of the market. And, sometimes, that requires less regulatory scrutiny or oversight.”
Duke operates its internationally recognized flagship hospital and a smaller regional one in Durham, plus a third hospital in Raleigh that was acquired in 1998. Since 2011, it has been a partner with Brentwood, Tennessee-based LifePoint Health in the ownership of smaller community hospitals, including nine in North Carolina.
“We recognize the healthcare landscape is changing,” Albanese said about the Iredell County expansion. “While we continue to expand access to care within the communities we serve, it’s also time to do more and deliver care to more people — in more communities.”
NCMS is Sending Match Day Congratulations!
The North Carolina Medical Society congratulates all the new graduating medical students on their Match Day success!
Sophie Hockran matched in General Surgery at St. Elizabeth Hospital.
"I am so excited to match General Surgery in Youngstown, Ohio at St Elizabeth Hospital!" Hockran said. "North Carolina will always hold a special place in my heart for propelling my medical career. It’s been a privilege to work with NCMS the last four years!"
Look for more Match Day successes soon!
Powerful Partnership for Clinician Well-Being – NCCPRW Joins the Joy & Wholeness Summit 2025
NCCPRW Joins the Joy & Wholeness Summit 2025
In every corner of healthcare, there is a growing call for change. A call to prioritize the well-being of the people who care for others, to build systems that support clinicians, and to create a future where physicians and APPs don’t just endure—but flourish.
We are honored to announce that the North Carolina Clinician and Physician Retention and Well-Being Consortium (NCCPRW) has joined the Joy & Wholeness Summit 2025 as a Platinum Sponsor!
NCCPRW is a driving force in North Carolina, tackling the urgent need for physician and APP retention, well-being, and systemic change. With this sponsorship, they are deepening their impact—bringing North Carolina’s voices, innovations, and solutions to the national stage in Asheville this July.
What This Means for the Future of Clinician Well-Being
- A Spotlight on North Carolina’s Leadership – NCCPRW is strengthening its presence not just regionally, but nationally, ensuring that North Carolina-based initiatives are part of the broader movement for clinician well-being.
- Collaboration That Transcends Borders – With over 200 attendees from more than 100 organizations, this Summit is a gathering place for ideas, strategies, and partnerships that can reshape the future of healthcare.
- A Commitment to Real Change – Attendees will leave with tangible strategies to take back to their organizations, inspired by the collective wisdom in the room.
A Message from The Coalition for Physician & APP Well-Being
“Clinician well-being is not a solitary effort—it’s a shared responsibility. The work being done by NCCPRW to retain, support, and advocate for physicians and APPs aligns so closely with our mission, and we are thrilled to welcome them as a key partner for this year’s Summit. Their presence will help us strengthen the movement for well-being, ensuring that those who care for others receive the support and community they need to thrive.”
— DeAnna Santana, PhD, Executive Director, The Coalition for Physician & APP
Well-Being
A Message from NCCPRW
“Joining the Joy & Wholeness Summit allows NCCPRW to elevate our mission, connect with like-minded organizations, and continue advocating for sustainable solutions in clinician well-being. This partnership represents a shared commitment to creating lasting change for the physicians and APPs we serve.”
— Monecia Thomas, PhD, MHA, Executive Director, NCCPRW
Be Part of the Joy & Wholeness Summit 2025
July 23-25, 2025
Crowne Plaza Asheville, NC
Exclusive Opportunity for North Carolina-Based Attendees: Thanks to NCCPRW’s sponsorship, attendees from North Carolina will have access to an exclusive 15% discount to attend the Summit.
Surrounded by the breathtaking Blue Ridge Mountains, this is a space designed not just for learning, but for renewal.
This isn’t just another conference. This is an invitation to be part of something bigger.
Reserve Your Spot Today
Let’s Make This a Moment That Moves Healthcare Forward
NCCPRW will also be sharing this announcement with their network, ensuring that this message reaches clinicians, healthcare leaders, and organizations who are eager to be part of the conversation. If your organization is looking for meaningful ways to engage in the movement for clinician well-being, we invite you to connect with us.
Together, we are shaping the future of healthcare—one conversation, one partnership, and one bold step forward at a time.
The Coalition for Physician & APP Well-Being
www.bethejoy.org
CDC: Nearly 500 Cases of Measles Reported Across 19 States
Almost all of the cases are in unvaccinated individuals or in individuals whose vaccination status is unknown
(ABC News, Mary Kekatos, Youri Benadjaoud, Sony Salzman) -- The number of measles cases associated with an outbreak in western Texas has grown to 400, with 73 cases reported over the last three days, according to new data released Friday.
Almost all of the cases are in unvaccinated individuals or in individuals whose vaccination status is unknown, according to the Texas Department of State Health Services (DSHS). At least 41 people have been hospitalized so far.
Children and teenagers between ages 5 and 17 make up the majority of cases at 164, followed by children ages 4 and under comprising 131 cases, according to the data.
It comes as the CDC has so far confirmed 483 measles cases this year in at least 19 states: Alaska, California, Florida, Georgia, Kansas, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont and Washington
This is likely an undercount due to delays in states reporting cases to the federal health agency.
Meanwhile, reports have emerged that some unvaccinated children hospitalized with measles in Texas are showing signs of vitamin A toxicity.
Health and Human Services Secretary Robert F. Kennedy Jr. and other vaccine skeptics have promoted vitamin A amid the measles outbreak. During an interview on Fox News with Sean Hannity earlier this month, Kennedy said that HHS was currently providing vitamin A to measles patients for treatment, claiming vitamin A can "dramatically" reduce measles deaths.
Vitamin A can be used as part of supportive treatment for those who are already sick, with the World Health Organization recommending two doses of vitamin A in children and adults with measles to restore low vitamin A levels, which can help prevent eye damage and blindness.
However, vitamin A does not prevent measles infections, experts previously told ABC News, nor does it directly fight the virus when used as a treatment.
Covenant Children's Hospital, which has treated dozens of measles patients in Texas amid the outbreak, told ABC News in a statement that some parents appear to have given their unvaccinated children vitamin A for "treatment and prevention." Some of those children now show signs of vitamin A toxicity.
Fewer than 10 children have come in with abnormal liver function in routine lab tests, indicating possible vitamin A toxicity, according to Covenant Children's.
Vitamin A toxicity occurs when someone consumes too much vitamin A, and can result in severe complications including liver and kidney damage.
The American Academy of Pediatrics and the Centers for Disease Control and Prevention says vaccination is the most effective way to prevent measles.
The CDC currently recommends that people receive two vaccine doses, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective, the CDC says. Most vaccinated adults don't need a booster.
State health data shows that Gaines County, which is the epicenter of the Texas outbreak, has seen its number of vaccine exemptions grow dramatically in the last dozen years.
In 2013, roughly 7.5% of kindergartners in the county had parents or guardians who filed for an exemption for at least one vaccine. Ten years later, that number rose to more than 17.5% -- one of the highest in all of Texas, according to state health data.
Among the nationally confirmed cases by the CDC, about 97%, are in people who are unvaccinated or whose vaccination status is unknown, the agency said.
Of those cases, 1% are among those who received just one dose of the MMR inoculation and 2% are among those who received the required two doses, according to the CDC.
DEA Again Delays New Telehealth Prescribing Rules for Veterans, Buprenorphine
As of March 20, 2025, the effective dates of the final rules amending 21 CFR part 1306 and 42 CFR part 12 published in the Federal Register on January 17, are effective December 31, 2025.
(Healthcare Brew, Caroline Catherman) -- As every chronic procrastinator knows, nothing feels better than an extension on a due date.
So we bet it was a big relief for the US Drug Enforcement Administration (DEA) and the Department of Justice (DOJ) to push back the effective date of two new telehealth rules from March 21 to Dec. 31.
The rules would permanently expand some temporary telehealth flexibilities for prescribing buprenorphine—a medication used to treat opioid dependence—and for Department of Veterans Affairs (VA) clinicians to prescribe controlled substances.
These telehealth flexibilities were enacted during the pandemic and are set to expire Dec. 31. But telehealth clinicians have long called for a permanent solution, and these rules—two of three final controlled substances guidelines released on Jan. 16—were part of that solution.
“Unfortunately, the DEA’s decision fosters uncertainty for both healthcare providers and their patients,” Hari Prasad, CEO of mobile patient intake management system Yosi Health, told Healthcare Brew. “Delaying the implementation of these rules signals hesitation at a time when we should be prioritizing access and continuity of care for vets.”
Tell me more. This isn’t the first extension, either. The rules were initially set to take effect on Feb. 18, but were pushed back to March 21 after President Trump took office and issued a regulatory freeze.
Rule one, Expansion of Buprenorphine Treatment via Telemedicine Encounter, would let telehealth providers prescribe the drug for up to six months without an in-person visit. Pre-pandemic, a patient needed to have an in-person medical evaluation to get more than an initial 30-day supply of buprenorphine.
The other rule, Continuity of Care via Telemedicine for Veterans Affairs Patients, would give special prescribing privileges to VA practitioners, allowing them to prescribe controlled substances remotely to patients they have never met in person, as long as that patient has received an in-person medical exam from another VA clinician.
Non-VA providers would have to get special registrations to prescribe Schedule II–V controlled substances—such as hydrocodone, oxycodone, Adderall, or Ritalin—without an in-person visit.
Christopher Adamec, executive director of industry group Alliance for Connected Care, previously told Healthcare Brew he felt these laws didn’t go far enough to expand telehealth access, adding that the buprenorphine rule’s six-month limit means a doctor could be forced to cut off treatment “in a potentially harmful way when the patient needs it most.”
The DOJ said in federal documents that it’s postponing the effective date to address public comments and to add more time to review “any questions of fact, law, and policy that the rules may raise.”
NCMS is Sending Match Day Congratulations!
The North Carolina Medical Society congratulates all the new graduating medical students on their Match Day success!
Pankti Sheth, a 4th year medical student at ECU Brody School of Medicine, matched at Duke for Internal Medicine!
Look for more Match Day successes soon!
Vaccine and COVID Research, LGBTQ Studies Among NC Projects Hit by NIH Cuts
More than two dozen NIH grants have been canceled at North Carolina research groups, including Duke and UNC-Chapel Hill.
(The News & Observer, Drew Jackson and Brian Gordon) -- Nearly two dozen grants and millions in research dollars have been canceled at UNC-Chapel Hill, Duke University and other North Carolina institutions as part of the growing list of projects cut by the National Institutes of Health.
Since February, the Trump administration has taken the unprecedented step of canceling hundreds of active research grants at many of the country’s top health and medical institutions.
The national list of cuts to NIH has grown to 638 canceled grants, including 20 at North Carolina colleges and institutions. Another 700 grants have been cut by the Centers for Disease Control and Prevention.
The cuts follow a pledge President Donald Trump made in a February memo called “Radical Transparency About Wasteful Spending”.
“The American people have seen their tax dollars used to fund the passion projects of unelected bureaucrats rather than to advance the national interest,” Trump said in the memo.
Joining UNC-Chapel Hill and Duke among those impacted are UNC Charlotte, the North Carolina Department of Health and Human Services and the Research Triangle Institute.
The canceled grants largely focused on COVID-related research, gender, minority groups, climate research and overseas communities, topics the Trump administration has been critical of since returning to power. In all, the cuts total billions of dollars in federal funding for medical research.
UNC-Chapel Hill saw the highest number of grant cuts in the state, with funding canceled for 11 projects. Among those, funding dollars ranged from $40,441 for a study of addiction within the adolescent LGBTQ+ community, to $65 million for an effort to develop new oral antiviral drugs.
Each of the canceled grants at UNC-Chapel Hill focused on either COVID response, gender identity or minority topics.
The same was true for Duke’s canceled grants, with the largest, a $176 million project, studying the potential effectiveness of six different drugs on treating COVID. Included in that study was the effectiveness of Ivermectin against COVID-19.
Other Duke grants ranged from $116.6 million for COVID testing research and $28 million for general coronavirus vaccine development to $42,014 for a study of sexual health among of Black gay men.
To systematically end active awards is a departure for NIH, the world’s biggest public funder of biomedical research. In past years, the agency had canceled on average around 20 of its approximately 60,000 annual grants early for obvious fraud or potential harms.
“Terminating funding has previously been an uncommon action,” said Cat Long, research communications manager at UNC-Chapel Hill.
This past week, the Centers for Disease Control and Prevention announced it would be scaling back COVID-related funding, canceling more than $11 billion in funding to states.
In North Carolina, that means the department of health and human services will lose around $115.5 million in remaining funding. The department said this past week it anticipated cutting more than 80 jobs.
The funds were part of an $800 million package of COVID funding.
At RTI, two grants were canceled, totaling $250,000. One was intended to study the “Social influences on sexual health among Latinx adolescents and emerging adults who identify as LGBTQ+ in an agricultural community.” The other canceled RTI grant aimed to improve health regulations in Nigeria.
Given North Carolina’s stature as a national leader in research and public health, funding cuts have hit hard. At RTI, which is also affected by cuts to the U.S. Agency for International Development, there have been two rounds of layoffs since Trump returned to office.
Combined, Duke and UNC-Chapel Hill accounted for more than half of the nearly $2 billion in NIH funding North Carolina received in 2024. Driven by these two Research Triangle institutions, North Carolina saw the sixth-most NIH dollars of any state, outpacing its population ranking (No. 9).
Beyond specific grant cuts, other changes at NIH mean universities can expect even less funding. The NIH has put a cap on “indirect grant payments” at 15%, funding that typically covers facility and administrative costs.
In anticipation of these funding cuts, Duke implemented a hiring freeze earlier this month.
All About National Doctors' Day
NATIONAL DOCTORS DAY 2025
All About Doctors Day
We celebrate National Doctors Day in America on March 30 each year, honoring the dedication and compassion displayed daily by more than one million physicians providing healthcare to patients nationwide.
These providers are the heart of the American healthcare system. In the US, doctors provide care to over 1 billion patients yearly, with an average of 3.2 doctor visits per person — 50% of those visits are made to a primary care physician. About 85% of adults and 95% of children in America visit with a doctor each year.
This country has had a persistent physician shortage in recent years, and the American Association of Medical Colleges predicts a shortage of up to 86,000 physicians by 2036. Our doctors are feeling the heavy demands placed on them daily by the healthcare industry. Most doctors work over 50 hours a week, and many work 80-plus.
If anybody has earned a day of appreciation, it is our doctors. Without their efforts and courage in the face of adversity, our country would be much worse for the wear. Without an adequate supply of doctors, healthcare systems are left with significant strain, leading to longer patient wait times, increased workloads for existing medical staff, and an overall reduced quality of care. In such scenarios, there’s often a greater reliance on locum tenens physicians and other advanced practice providers. We need doctors and want them to know how important they are to each of us.
NationalDoctorsDay.org is here as a resource, with tools to help healthcare staffing agencies celebrate and recognize their doctors. Join us by honoring the dedicated physicians who improve our lives this National Doctors Day, and utilize our marketing toolkit to facilitate your company’s marketing outreach to doctors and the healthcare industry.
A Brief History of Doctors Day
In 1933, Eudora Brown Almond, the wife of a family medicine physician, Dr. Charles B. Almond, felt doctors deserved a little extra recognition in American society for their extraordinary, life-saving, and often thankless work.
Almond turned to her fellow citizens in rural Georgia to send greeting cards to each of their physicians and lay flowers on the graves of late physicians. March 30 was not chosen at random. The day of observance for National Doctors Day was picked to commemorate the first use of anesthesia during surgery in 1842 by physician Dr. Crawford Long, a well-known doctor from Jefferson, Georgia.
On March 30, 1958, Congress adopted a resolution commemorating March 30 as National Doctors Day after the movement gained traction in the medical community over two decades.
In 1990, President George H.W. Bush designated National Doctors Day an official day of recognition by the US government. These days, doctors’ contributions are celebrated nationwide on March 30 and around the world by employers, coworkers, and patients of physicians.
Since National Doctors Day’s founding, the traditions once introduced by Almond to the Winder community have evolved a bit — from hand-written, personalized greeting cards to posts made on social media, where more and more people can show their appreciation for their physicians. Healthcare facilities and physician staffing agencies typically showcase their appreciation for doctors in digital and print marketing campaigns.
The medical field has changed vastly since National Doctors Day’s first celebration. An increasing number of women are pursuing careers in medicine. From 2004 to 2022, the active physician workforce saw a 97% increase in women, compared to a 13% rise in men. Physician diversity has also improved, with more medical students drawn to a broader range of specialties. By 2023, 23% of active physicians across all specialties were 65 or older.
Our doctors’ dedication has remained constant despite the changes in the medical community. Many doctors say that the connection they build with their patients is one of the most rewarding parts of their job. Physicians are entrusted to hold other human beings’ lives in their hands. As we navigate the evolving healthcare landscape, let’s use National Doctors Day to let doctors know we see them, appreciate them, and wholeheartedly support them.
Facts & Stats about Doctors
Here are a few facts and statistics about doctors in the United States that you might not know.
- Physicians played an important role in the formation of this country. John Morgan, Joseph Warren, the director general of the Medical Department of the US Continental Army, and Benjamin Rush were all pivotal figures in establishing medical practice in America. Rush actually signed the Declaration of Independence.
- John Morgan, who had earned his medical degree at the University of Edinburgh, founded the first medical school in the country, which is now part of the University of Pennsylvania.
- Before creating dedicated medical schools, doctors learned by apprenticeship.
- At the end of the Civil War, there were over 12,000 doctors in the Union Army and over 3,000 in the Confederate Army.here are currently over 1.1 million licensed doctors in the US; California has the most licensed physicians, with over 119,000.
- The average age of a doctor is 54, compared to a median age of 42 across other professions.
- 72% of doctors say they are satisfied with their profession. In 2024, physician burnout rates dropped to 48%, the first time below 50% since 2020.
- Women account for about 38% of active physicians, an increase from 26% in 2004.
- According to the most recent Bureau of Labor Statistics Data, the average salary of physicians and surgeons across all specialties is $239,000 a year
- About 52,000 doctors work as locum tenens physicians across the US.
- Doctors typically see 11-20 patients a day.
- According to the most recent AAMC data, 20,855 US medical school students graduated in 2024.
NCMS Member Dr. Damian McHugh Pens Letter: Reflections on National Doctors' Day
Courtesy of the Curi Blog:
Whether or not you subscribe to the popularity of nationally recognized days or weeks for almost anything you can think of, they certainly do exist for our awareness and consumption. These registered days range from the fun and whimsical (National Spanish Paella Day, anyone?) to the more educational and serious, like National Skin Barrier Day, recently celebrated on March 12, and National Health Workforce Well-Being Day celebrated on March 18. One significant standout, though, and one I am proud to reinforce each and every year is National Doctors Day.
National Doctors Day is celebrated annually on March 30 and honors the numerous and varied contributions of my peers. Notation of it was first made March 30, 1933. It flags the date of the first usage of general anesthesia in major surgery by Dr. Crawford Long, way back in 1842. It became officially recognized as a day of appreciation when George H.W. Bush designated it as such in 1990.
Why celebrate our nation’s doctors and designate a day for them?
Well, firstly they deserve it. Before seeing their very first paying patient, most of these dedicated young individuals give up the best years of their lives to study, to tramp the corridors of hospitals day and night, and to sit and be taught by those they are learning how to help and heal. Delayed gratification and delayed “real earnings” happen in the arduous years of Residency and Fellowship. With debt typically north of $300,000, the nervous first-year attending and newly minted medical graduate sets out on their official career pathway somewhere around age 30.
I typically ask new acquaintances, new business contacts, and new colleagues, “What’s your why?” If you know your why, you will find the how. So many of Curi’s member-owners that I get to spend time with knew they were lightworkers at an early age and wanted to train, learn, invest, and grow themselves into a force for good—for the betterment of our country and our broader humanity.
Over the last quarter millennium, we have seen a darkening of the light that burned in these lightworkers. A jaded response to becoming commoditized. An indignant, actually angry retort to a system where for-profit payers and their pharmacy benefit managers call all the shots and erode the autonomy which we once enjoyed as a profession. Wendy Dean coined the term “moral injury.” She plucked that from military medicine, and so many physician leaders agree with her that this is now endemic and eating away at our healthcare system. The Surgeon General confirmed his agreement of the term in the New England Journal of Medicine in 2022:
“Burnout manifests in individuals, but it’s fundamentally rooted in systems. And health worker burnout was a crisis long before Covid-19 arrived. Causes include inadequate support, escalating workloads and administrative burdens, chronic underinvestment in public health infrastructure, and moral injury from being unable to provide the care patients need. Burnout is not only about long hours. It’s about the fundamental disconnect between health workers and the mission to serve that motivates them.”
The terms depression, burnout, and moral injury are simply constructs of physician distress. They culminate in a dilemma that has no actual solution. The term, “wicked problems,” was coined in the 1960s to describe that class of social system problems which are ill-formulated, where the information is confusing, where there are many clients and decision makers with conflicting values, and where the ramifications in the whole system are thoroughly confusing.
The U.S. healthcare system is plagued with complex inter-related wicked problems. If you don’t or can’t believe me, start following one of the many excellent physician threads on LinkedIn and follow some passionate doctors who care enough to disrupt, but always in a polite and positive fashion.
My message and humble request for doctors as we note National Doctors Day is three-fold:
- Despite the ever-increasing headwinds, please try to do the next right thing. Please strive to serve the patient in front of you and not the insurer on the card they carry.
- Build relationships with both patients and colleagues, to support and enjoy one another. This requires the commitment to make social connection a priority and the courage to be vulnerable and truly real and honest with each other.
- Seek out your County or State Medical Society. Attend specialty society meetings and stay an extra couple of days. Go back to our mosques, synagogues and churches or just to our school halls and ball fields.
In his departing prescription, Surgeon General Dr. Vivek Murthy states, “Today, we are faced with a profound choice. Do we continue with the status quo marked by pain, disconnection, and division? Or do we instead choose a different path, the one of joy, health, and fulfillment where we turn toward each other instead of away from each other, where we choose love over fear, when we recognize community as the irreplaceable foundation for our well-being?” In completing his tenure as Surgeon General, his final wish for all of us was the same as mine: choose community.
Curi is proud to be a vibrant part of your community, and we salute you and your teams on National Doctors Day.
🎉It's New Member Monday!🎉
Join us in welcoming these new members to the North Carolina Medical Society!
- Bradley W. Alsip, PA-C
- Maximiliano M. Cavallini Martin, MD
- Sean R. Costello, DO
- Michael P. Cowherd, MD
- Stefano Crosio, DO
- Mili Dave
- Ankita S. Desai, MD
- Erin E. Dunneback, MD
- Raisa J. Durrani, MD
- Jeffrey Foster
- Matthew Greene, PA-C
- Neelam J. James, DO
- Richard T. Kiok, MD
- Adam Z. Kline, MD
- Stanley E. Koontz, Jr., MD
- George D. Kryder, MD
- Amanda R. M. LaBenne, MD
- Kathryn M. Langley, MD
- Jackeline C. L. Larker, DO
- David Lehrburger, BS
- Yasmeen M. Mansour, MD
- Lauren P. Marino, MD
- Divyesh Mehta, MD
- Rodrigo D. Munoz Dayaa, MD
- Ravyn S. T. Njagu, MD
- Reece N. Nuessmeier, PA-C
- Evan A. Plunkett, MD
- Lincoln F. Pratson, II, MD
- Anish Raj, MD
- Katy L. Reines, MD
- Andrew J. Sampson, MD
- Nicolette M. Schreiber, MD
- Katherine S. Schroeder, MD
- Shivani R. Sheth, PA-C
- Lisa M. Spencer, MD
- Ricci St Jules, DO
- Benjamin W. Topper, DO
- Luis M. Vazquez-Montesino, MD
- Daniel P. Waddell, PA-C
- Rukiayah A. Warner-Moxley, MD
- Sebastian A. Werner, MD
- Keith G. Whitlock, MD
- Tyler D. Williams, DO
- Chloe Worner, PA
We are thrilled to have you!
Not a member but would like to be? Joining is simple. Visit our membership center here.
NCMS is Sending Match Day Congratulations!
The North Carolina Medical Society congratulates all the new graduating medical students on their Match Day success!
Daniel van Rooyen will continue to serve Harnett County through the Campbell University Harnett Health Family Medicine Residency. He completed his undergraduate and master’s degrees at Campbell University and will graduate from Campbell University School of Osteopathic Medicine in May.
Look for more Match Day successes soon!
A Message from Western Carolina Medical Society Six Months After Hurricane Helene
Six Months That Changed a 140-Year-Old Institution
Western Carolina Medical Society (WCMS) started in 1885, but, in many ways, it has been “reborn” since Hurricane Helene hit western North Carolina. The agency, which serves as the philanthropic arm of more than 670 physician assistant and physician members, has long been known for Project Access, a program that coordinates free specialty healthcare for individuals ineligible for Medicaid with no other insurance. Over the years, more than $95 million in free care has been arranged through the program.
“WCMS has five incredible programs,” notes Karen Wallace-Meigs, executive director of the nonprofit organization. “We have Project Access, our signature program, but we are also proud of WIN, the largest interpreter network in western North Carolina. CRCSI, the Colorectal Cancer Screening Initiative, is a vital WCMS’ program, as is a scholarship program named in memory of Dr. Charles Blair for high school seniors who complete an internship at MAHEC. Another initiative is the Healthy Healer Program, through which we offer six free, confidential therapy sessions to physician assistant and physician members.”
So, how did the aftermath of Hurricane Helene change the agency? “It added greater urgency to our work. Existing needs were exacerbated, and more people needed our help,” says Wallace-Meigs, who had been on the job less than four months when the storm hit. As soon as each WCMS staff member was accounted for - some on the staff of ten were displaced to far-flung places -they jumped into action, picking up a sixth program: emergency relief to meet pressing Social Determinants of Health Needs.
From September 27, 2024, until today, the WCMS team has:
- Enrolled 153 patients in Project Access while streamlining the application process.
- Made 375 referrals for free, specialty medical services valued at hundreds of thousands of dollars and added new care providers to their roster.
- Donated:
- Rent Assistance: $21,000
- Groceries: $13,750
- Utilities: $5,800
- Medical (bills and Durable Medical Equipment): $4,400
- Transportation: $700 in gas cards to area Federally Qualified Health Centers so patients could reach their appointments
- Provided translation services at 2,722 appointments so patients and providers could understand and pursue the best possible treatments.
- Made scores of free, confidential Healthy Healer therapy appointments for healthcare provider members.
- Distributed dozens of pieces of donated durable medical equipment, boxes of Benadryl, and wasp repellent.
“We did what we needed to do, like many agencies and neighbors,” Wallace-Meigs asserts. “It was challenging emotionally and physically. Our work continues, but we are coming through it as a more responsive, nimble, determined agency. None of this would have been possible without the generosity of so many partners, and my team, which refused to give up on each other or our community.”
For more information about the Western Carolina Medical Society Foundation, contact Niki Duff, Director of Development & Communications, at [email protected] or visit www.mywcms.org.
Register Now! Webinar on Tools to Manage Measles Outbreaks Effectively
Join South Piedmont AHEC (part of NC AHEC) for a FREE live webinar to gain critical insights and practical tools for managing measles outbreaks effectively.
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Apr 10, 2025 | 12:00 PM - 1:00 PM EST | Live Webinar
Description
Measles is a highly contagious viral disease that can lead to severe health complications. Join us for an in-depth panel discussion where we will explore the critical aspects of measles management tailored specifically for healthcare
professionals. Our distinguished panel of experts will share their extensive knowledge and provide valuable insights on effectively handling measles cases, addressing vaccine-related questions, and implementing effective infection control practices. This session is designed to equip healthcare providers with the essential knowledge and practical tools necessary to manage measles outbreaks and ensure patient safety
This session promises to be an invaluable resource for healthcare professionals seeking to enhance their understanding and management of measles. Don't miss this opportunity to learn from leading experts and improve your practice in the face of measles outbreak
Speakers
Katie Passaretti MD,
Chief Infection Prevention Officer Advocate Health,
Clinical Professor Infectious Diseases Wake Forest
Amina Ahmed MD,
Medical Director Pediatric Infectious Disease and Immunology Levine's Children's Hospital, Pediatric Director Hospital Epidemiology, Professor Pediatrics Wake Forest
Shelley Kester MHA, BSN, RN, CIC, CPHQ,
Enterprise Infection Prevention Lead, Advocate Health
Erica Wilson MD, MPH,
Medical Director, Medical Consultation Unit, Epidemiology Section, Division of Public Health, North Carolina Department of Health and Human Services
Click here for more information and to register
The Life of a Medical Board Complaint
The NC Medical Board Wants to Demystify the Process When a Complaint is Filed
The life of a Medical Board complaint
Imagine checking your email and finding a message indicating that you are the subject of a complaint to the North Carolina Medical Board (Board). While no licensee of the Board wants to receive such a message, knowledge of the Board’s investigatory process may help reduce the stress and anxiety related to the experience. It should be noted that in most Board investigations, the Board’s case review process determines that there is not evidence of misconduct or substandard care.
This article will walk you through the life of a Board complaint from start to finish, to demystify the process and provide you with information to respond appropriately, should the need arise.
Step 1: Information received
The Board is a complaint-driven organization that receives information from a variety of sources, the largest of which is complaints from patients and the public. Staff carefully review each complaint to determine if there is a possible basis for Board action in the form of a violation of the NC Medical Practice Act, the Board’s authorizing statute. In a typical year, staff determine about one in four patient complaints do not allege actionable misconduct or they allege matters outside the Board’s jurisdiction, and the matter ends there with no further investigation. Licensees are notified of ALL complaints but are only asked to respond if the Board investigation advances. You should never ignore a request for information – failure to respond to a Board inquiry is itself a basis for the Board to take disciplinary action, and the licensee’s written response is your first chance to tell your story and ensure that the Board has enough information to understand what occurred.
Step 2: Investigation
Next, Board staff will investigate the allegations. If the case involves the quality of medical care provided, staff review the licensee’s statement, the medical records and, when appropriate, an outside medical review by a medical professional who practices in the same specialty as the licensee, to determine whether care met accepted standards. In some instances, a Board investigator may also seek to interview you and others involved in the case. If you have any doubt about whether you are being contacted by a legitimate agent of the Board, contact the Board by telephone at 919-326-1100 and ask to speak with the Investigations Department.
Step 3: Senior Staff review
At this stage, a committee of senior staff members that includes representatives from the Office of the Medical Director and the Investigations and Legal Departments review the results of the investigation and recommend a possible resolution for each case. If senior staff find insufficient evidence of a violation, the case is closed without further action, and the licensee and complainant are notified. If senior staff determine the case involves one or more violations, they will recommend the Board take either public or private action to resolve the case and submit those recommendations for review by members of the Board.
Step 4: Board review and case resolution
The Board’s Disciplinary Committee reviews all cases in which private or public action is recommended. Board Members who serve on the Committee may accept the staff
recommendation, recommend something new, or request more information. The Board does not decide cases lightly and has the authority to extend an investigation if it does not feel it has a clear understanding of what occurred.
Once the Board votes on a case, the licensee is notified of the resolution. If public action is authorized, Board attorneys negotiate the specific terms of the case resolution with the licensee or, if applicable, their attorney. If the licensee refuses to accept the authorized case resolution, they have the right to a hearing, which is a process similar to a trial, with a panel of Board Members sitting as judges. The Board strongly encourages licensees to obtain counsel to advocate for their interests, but it is ultimately up to you to decide.
At the end of the day, each case is decided on its unique facts and circumstances. Where discipline or remediation is called for, the Board favors a targeted approach to ensure any concerns are addressed fairly and the public is protected.
NCMS in the News: WRAL Posts Story on Possible Changes to Healthcare Rules
RALEIGH -- As nurses gathered in downtown Raleigh, a news station was on hand to cover the event. WRAL Capitol Bureau Chief Laura Leslie covered the story, including reaction from the North Carolina Medical Society.
Additional reading:
NC DHHS to Cut 80 Jobs, Lose $100 Million in Federal Funding
The North Carolina Department of Health and Human Services’ reductions are due to the federal government’s “abrupt and immediate termination of several federal grants,” a department spokesperson said in a statement.
(WRAL) -- The North Carolina Department of Health and Human Services is planning to cut 80 jobs and will lose more than $100 million in funding.
The reductions are due to the federal government’s “abrupt and immediate termination of several federal grants,” a department spokesperson said in a statement.
The cuts are part of the Trump administration cutting $12 billion in federal grants to state health services.
The U.S. Department of Health and Human Services on Thursday said it would eliminate 10,000 more jobs as it restructures. Overall, the agency, which is responsible for monitoring infectious diseases, inspecting foods and hospitals and overseeing health insurance programs for nearly half the country, says it will decrease its workforce from 82,000 to 62,000 positions. That includes 10,000 in layoffs as well as another 10,000 workers who are taking early retirements or buyout offers that were given to nearly all federal employees by the Trump administration.
The $100 million North Carolina is losing in funding directly contributes to the “health, safety and wellbeing of the people we serve,” the NCDHHS spokesperson wrote.
Specifically, the federal grant funding impacts several areas of work, including immunization efforts, funding for the new NC Immunization Registry, infectious disease monitoring and response, behavioral health, substance use disorder services and more. Some of the impacted funding supports work that is done by local health departments, universities, hospitals and local departments of social services.
The NCDHHS is also putting impacted vendors on notice to pause work supported by the funding.
NC AHEC Needs Your Help Assessing AI Adoption Across the State
Survey Should Take 10 Minutes to Complete.
As artificial intelligence (AI) continues to evolve at a rapid pace, organizations across disciplines are exploring its opportunities, challenges, and impact. To better understand the current AI landscape, NC AHEC is conducting a high-level environmental scan, gathering insights from a diverse range of stakeholders and partners like you.
This survey aims to assess the state of AI adoption, key trends, opportunities, and concerns across academia, practice, and regulatory bodies. Your input will help us develop a clearer picture of how AI is being utilized today and where it is headed in the near future. We will share high-level themes and key findings to help inform ongoing discussions in this space while keeping individual response confidential.
The survey should take approximately 10 minutes to complete. Thank you for your time and insights—we appreciate your participation!
Click here to complete survey.
New Research: Chewing Gum Can Shed Microplastics Into Saliva
Pilot Study Could Burst Your Bubble on Chewing Gum
(CNN) -- Are you keeping a mental list of all the sources of microplastics finding their way into your daily life? You may have another culprit to consider: It’s gum, according to a new pilot study that found chewing just one piece can release hundreds to thousands of microplastics into saliva.
The study is currently being peer-reviewed and will be presented at the biannual meeting of the American Chemical Society in San Diego Tuesday. Once the review is complete, the authors hope the report will be published in the Journal of Hazardous Materials Letters later this year.
“Our goal is not to alarm anybody,” said senior study author Dr. Sanjay Mohanty, associate professor at the Samueli School of Engineering at the University of California, Los Angeles. “Scientists don’t know if microplastics are unsafe to us or not. There are no human trials. But we know we are exposed to plastics in everyday life, and that’s what we wanted to examine here.”
Microplastics are fragments of polymers that range in size from less than 0.2 inch (5 millimeters) to 1/25,000th of an inch (1 micrometer). Plastics smaller than that are considered nanoplastics, which are measured in billionths of a meter.
Polymers are chemical compounds with long chains of large and repetitive molecular units called monomers, which are known for durability and flexibility. Most plastics are synthetic polymers, whereas natural polymers include cellulose from plants. Chewing gum typically contains synthetic or natural polymers for better texture, elasticity and flavor retention, the authors said.
Microplastics enter the body via ingestion and inhalation, according to previous research, and scientists have discovered their presence in various body parts or fluids including the blood, lungs, placenta, brain and testicles. That’s why the authors said they wanted to identify other possible sources of microplastic ingestion and their concentrations.
“Chewing gum is one of the foods we chose because it is the only food where plastic polymer is used as an ingredient,” Mohanty told CNN via email. “Other foods are contaminated with microplastics because of how they are processed and packaged.”
To the authors’ knowledge, their study is the first “that examined or compared microplastics in chewing gums available commercially,” Mohanty added.
Isolating microplastics from gum
The team’s findings are based on 10 gums popular in the United States. Half of the samples were synthetic, and the other half were made with natural ingredients.
Most, if not all, gum product labels and websites do not disclose what their gum base includes nor how they are processed. This lack of transparency also leaves researchers “no way to know where and how microplastics came into the gums we tested,” Mohanty said — and no way for consumers to know the full composition of the gums they are buying.
One human participant would chew a gum for four minutes; during that time frame, every 30 seconds a researcher collected the secreted saliva in a centrifuge tube.
The participant then rinsed their mouth three to five times with highly purified water, and the researchers mixed the rinse sample with the saliva sample to ensure all microplastics in the mouth were captured. This entire process was repeated seven times for each gum.
Some gums were chewed for 20 minutes total with saliva collected every two minutes, so the team could determine how the number of microplastics shed depended on the chewing time.
To identify the types and amounts of microplastics in gum, the authors used various methods of filtration and chemical analysis such as microscopy. The research team also subtracted microplastics found in an initial rinse sample from those in the chewing gum saliva samples to accurately estimate the number of microplastics released from chewing gum.
Analysis revealed that just 1 gram of chewing gum released approximately 100 microplastics on average, with 1 gram of some gums releasing as many as 637 microplastics. A typical stick of gum can weigh anywhere from 1 gram to several grams, according to various reports.
Additionally, 94% of microplastics were released within the first eight minutes of chewing.
The authors were surprised to find that chewing natural gums didn’t really make a difference. The average number of microplastics in 1 gram of synthetic gum was 104, and in natural gum it was 96.
Both types also predominantly released four types of synthetic polymers: polyolefins, polyterephthalates (or polyethylene terephthalate), polyacrylamides and polystyrenes. These are some of the same plastics used in everyday plastic consumer products, Dr. Tasha Stoiber, senior scientist at the Environmental Working Group, a nonprofit environmental health organization, said via email. Stoiber wasn’t involved in the research.
“That microplastics were released is not unexpected,” said Dr. David Jones, a teaching fellow in the School of the Environment and Life Sciences at the University of Portsmouth in England, via email. Jones wasn’t involved in the study.
“If we subject any type of plastic to stress, be it heat, friction, sunlight, seawater, or in this case vigorous mastication, we know that microplastics will be released from the plastic material,” Jones, also founder and CEO of the marine conservation charity Just One Ocean, added. “We inhale, ingest and drink something like 250,000 plastic particles a year without trying. … But at least we now have some robust data and it is a good starting point for further research.”
“Gum is safe to enjoy as it has been for more than 100 years,” the National Confectioners Association said via email. The trade group has member companies that make and sell gum. “Food safety is the number one priority for U.S. confectionery companies, and our member companies use only FDA-permitted ingredients.”
What’s unknown about gum microplastics
The average size of gum microplastics was 82.6 micrometers — think the thickness of paper, or the diameter of some human hairs. The chemical analysis tools used in the study can’t identify particles smaller than 20 micrometers, Mohanty said.
This constraint means the findings missed any smaller microplastics and nanoplastics and therefore may be underestimates, said Dr. Leonardo Trasande, director of the New York University Center for the Investigation of Environmental Hazards, via email. Trasande wasn’t involved in the study.
Why synthetic polymers were found in the natural gums, too, is also questionable, experts said. But polyolefins are commonly used in the food industry for packaging, so this could be a reason why, the authors said.
The unexpected finding may also occur if manufacturers use polymers when they shouldn’t, if there was a lab contaminant or if there was a measurement error, Dr. Oliver Jones, a professor of chemistry at RMIT University in Australia, said in a statement released by the Science Media Centre. Jones wasn’t involved in the study.
“As producers rarely report the composition of gums, it is difficult to ascertain the source of microplastics found in natural chewing gums,” they added.
Also, some of the polymers — such as polyterephthalates, often found in water bottles — identified in the synthetic gums aren’t known to be present in synthetic gums in general, Dr. David Jones of the University of Portsmouth said.
Some regulatory agencies have taken the stance that there is no need to be concerned about microplastics in food and water since there isn’t evidence that they cause harm, he said.
“This is totally the wrong approach. We should be taking the precautionary approach and assume that they do,” he added. “We need to be investing in research to understand how this will impact on our health now so that we can start to mitigate the consequences.”
Even if any potential effects on the human body are unknown, the study does put into perspective the other ways chewing gum can contribute to environmental pollution when inappropriately discarded, experts said.
Make Your Plans Now to Attend 3rd Annual Smoky Mountain Primary Care Conference
Smoky Mountain Medical Society 3rd Annual Primary Care Conference is April 26
The event is being held at the beautiful Lake Junaluska and features sessions on weight loss medications, rheumatology, POTS, and psychiatry.
The day long event includes breakfast and lunch with exhibitors and a long list of faculty on hand.
Registration is open. Click here for more information and to register.
NC AHEC Announces Quality Improvement Course for Practice Managers
Quality Improvement Course Starts April 3
Target Audience
Practice managers or leader-providers who are knowledgeable or experienced in other areas of practice management but desire an introduction to the basics of quality improvement.
About the Practice Manager Bootcamp
The Practice Manager Boot Camp (PMBC) is part of the NCAHEC Practice Management Academy. It is designed for the novice practice manager, but experienced practice managers that want to fill gaps in their knowledge of practice management will also benefit, as well as providers who want to learn more about practice management. The PMBC has six virtual modules: financial management, insurance and the revenue cycle, leadership, human resources and customer service, operations management and quality improvement. To accommodate the needs of busy practice managers, sessions are presented live and made available as recordings. The Practice Management Academy’s mobile app makes it easy for you to learn any time or any place that works for you.
Program Description
This completely virtual course is a module of NCAHEC Practice Management Academy’s Practice Manager Boot Camp (PMBC). In this module, you’ll learn quality improvement concepts and skills that will help your practice not only survive but thrive.
Click here for full course outline and to register.