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  • The Health of All Women

    By Aliye Runyan
    AMSA Education and Research Fellow

    Do you know Roe v. Wade is currently under attack and the health of all women is at stake?

    Cleverly disguised as "state-based regulation", seven states have passed or will soon pass devastating legislation affecting access to family planning, especially in rural and underserved areas. This impacts not only the women and families in those states, but taken collectively, is a serious and deliberate blow to national family planning services.

    AMSA believes matters of reproductive health to be private and sensitive, and support the right of patients to make these decisions in confidence with their physician without the interference of any third party. In that spirit, we disagree with and discourage wholeheartedly the recent legislation affecting Ohio, Wisconsin, Texas, North Carolina, Virginia, Alabama, and Mississippi. These laws, sometimes "stuck in" along with other, completely unrelated legislation, do nothing more than prevent access to safe options for abortion. In cases of such legislation where clinics like Planned Parenthood are defunded, this not only prevents safe abortion options ( in those clinics which provide it) but also restrict and discourage access to family planning resources such as contraception and scientifically based sexual education, which in turn, reduce the need for abortion.

    The way most of these bills decrease access is through TRAP laws. TRAP stands for Targeted Regulation of Abortion Providers. Six states have made it illegal for abortion clinics to operate unless the physician has admitting privileges at a nearby hospital. In rural areas of Virginia and Wisconsin, two states that have recently passed TRAP laws, there is not a hospital close by.

    Dozens of rural clinics face closure because of TRAP laws. Those who support TRAP laws say they help ensure the safety of women by requiring their doctors to have admitting privileges. The vast majority of abortions are outpatient procedures that are less invasive than some dental work, colonoscopies, vasectomies, and plastic surgeries, yet only abortion providers are targeted for these unnecessarily restrictive measures.

    In an article in today's Chicago Tribune, professor emeritus of obstetrics and gynecology Dr. John Sciarra writes, "in those days [before Roe v Wade], 20 American women died for every 100,000 live births, many from unsafe abortions. We knew that legalizing abortion could save many of those lives, and we were right: today's maternal mortality rate is half of what is was then, because legal abortion is safe and back alley attempts are much rarer. We were optimistic that society would hail legalized abortion as a win for everyone. [...] Rather than increasing contraceptive availability as we recommended in 1972, ideologues attack family planning and are making all reproductive health care less available to the poor."

    Sciarra concludes with "no law that has ever been passed and no law that ever will be passed can prevent a determined woman from trying to end an unwanted pregnancy. Society and hospitals must accept their role in keeping women safe in that process."

    As a physician in training who believes in her patient's abilities to make their own choices and in the privacy and privileges of the doctor patient relationship, I absolutely agree with Sciarra's words.

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  • DOMA Falls!

    Today was a historic day for the gay-rights movement! AMSA applauds the decision announced by the Supreme Court of the United States holding (5-4) the Defense of Marriage Act (DOMA) unconstitutional.

    “Today was historic in the gay-rights movement and AMSA commends the DOMA ruling as a significant step toward eliminating disparities for same-sex partners,” says Dr. Nida Degesys, AMSA national president. “Now, more than ever, we need to keep advocating for equal rights. As the nation’s next generation of physicians, we must stand up for our patients. Marriage equality is a public health issue and we want an equal and just healthcare system for all.”

    DOMA includes a federal definition of marriage that fails to encompass all forms of legal partnership. Equal protection under the law necessitates that all individuals, including same-sex couples, are eligible for all benefits afforded to legally married couples. According to today’s ruling, DOMA is unconstitutional as a deprivation of the equal liberty of persons that is protected by the Fifth Amendment.

    In Hollingsworth vs. Perry, the Supreme Court did not rule on the constitutionality of California’s law prohibiting same-sex marriage, or “Prop 8”, and sent the appeal back to the lower court with instructions to dismiss, currently leaving intact the district court’s ruling that Prop 8 is unconstitutional.

    The Court’s “Prop 8” decision sends the case back to California, where state judges and the state’s top officials have said same-sex marriage is a matter of equal rights. “We had hoped that the Supreme Court would have taken a stronger stance and ruled Prop 8 unconstitutional, so that all partners could marry,” continues Degesys. “But the ruling does allow for same-sex marriage to become legal again in California. Today we celebrate but tomorrow we must continue fighting to end institutionalized stigma and discrimination. We must advocate for equal rights for all.”

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  • More med student spots

    Data released at the Annual Physician Workforce Research Conference, projects that from 2002-2003 there will be a 30% enrollment increase, nearing well over 21,000 new medical students by 2017-2018. With the new and occupied desks over the next few years, 55% of those will be accompanied by students in public medical schools; the southern regions of the U.S. making up for a good amount of the increase now through 2017.

    This is exciting news for the aspiring first year medical students. Depending on how you want to see it, I am sure to them, the glass is only half full waiting to be overflowed by the endless opportunities and possibilities.

    Read the full article from the Triangle Business Journal here.

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  • Calling Dr. iPhone

    Technology is in boom, especially in today’s medical world which is constantly growing and evolving to match the most up to date research and discoveries. Check out this Associated Press article, which appeared in USA Today, introducing the hottest new product on the market; your annual physical through your smart phone.

    Discussed at the 2013 TEDMED conference in Washington, D.C, this up and coming technology is designed to help patients independently monitor their health outside the doctor’s office. Whether it be checking your blood pressure, listening to your heart beat, or checking out the ears, nose and throat for possible infection - all can be done from your hand held device, and on the GO! In addition, sonograms can also be performed by your ultrasound technician with your smart phone, allowing them to be performed from virtually anywhere, and at a much more affordable price.

    It seems as though doctors believe these tools will be helpful to collect the patient’s data, and monitor their ongoing health conditions and concerns. With these types of applications and devices available office visits can essentially be reduced, allowing urgent and serious treatments to be readily available for patients in emergency situations. Although some products are still waiting for FDA approval, tools are available for purchase now.

    Read more from http://www.smartphonephysical.org, or watch a brief educational video from the Associated Press.

    Would love to hear what our nation’s next generation of physicians thinks of this trend. Do you think “iPhone physicals” are the next big thing?

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  • Why I'm Opting Out of the AMA Masterfile

    It’s hard for me to believe that I’ll have the privilege of calling myself someone’s doctor in a few short months. As a graduating medical student, I look back on my education and see that it was driven by a spark shared by all in all AMSA members: the fervent hope to help my future patients. And it’s precisely this hope that drives me to pledge to opt out of drug company access to my future prescribing information. I urge you to join me.

    When I started medical school, I had no idea that pharmaceutical companies know exactly what medicines each doctor prescribes to his or her patients. I was even more surprised to learn that this capacity is enabled by the American Medical Association through the sale of a database called the “Masterfile.” All medical students and doctors are automatically enrolled in the Masterfile—regardless of whether or not we are AMA members. Each year, the AMA makes more than $40 million selling this information, which allows pharmaceutical companies to link prescribing records to doctors’ identities. The result is targeted marketing pitches, often designed to promote more expensive medicines that aren't necessarily more effective. 

    The spooky nature of being watched by Big Brother/Big Pharma might be reason enough for many to opt out of this practice. But if that weren’t sufficient enough, this type of data mining hurts also hurts patients. First, prescribing more expensive medicines increases the cost of care without necessarily improving outcomes. Drug companies spend more than $30 billion marketing to doctors each year, and these expenses are surely reflected in the high price of medicines. Notably, the tremendous amount spent by these companies on advertising dwarfs by almost two-fold the amount they invest in research and development, which is often cited as why drugs are so expensive. 

    Second, this type of data mining encourages a brand of medicine that is neither evidence-based nor patient-centered. Surveys already show that 7 out of 10 patients feel that doctors’ prescribing habits are too-influenced by drug companies. Allowing drug companies to use the Masterfile for marketing purposes will further corrode the trust at the heart of the doctor-patient relationship. A new study further shows that an increasing number of patients are skimping on medicines in this tough economic climate. Why allow drug reps to leverage your own prescribing practices to promote expensive medicines through one-sided presentations?

    Today, I’m pledging to opt out of drug rep access to my future prescribing practices. As AMSA President Dr. Liz Wiley has stated, “Physicians should practice evidence-based medicine using the best existing clinical evidence—not carefully-packaged advertising—and continue to uphold personal and professional integrity.” I couldn't agree more.

    The AMA has made a mechanism by which residents and doctors can opt-out of drug salesperson access to prescribing information of doctors. Unfortunately, students cannot use this Prescription Data Restriction Program even though they have already been included in the AMA’s Masterfile. However, AMSA has set up a mailing list that will remind you to opt out through the PDRP when you’re able to do so. I hope that you will consider adding your name to this list and encourage your classmates to do the same.

    David Tian is a fourth-year student at Harvard Medical School and the Chair of AMSA’s PharmFree Campaign.

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  • Release of AMSA PharmFree Scorecard!

    Tomorrow is the launch of the 2013 AMSA PharmFree Scorecard! Join us in person or via Webcast. This would be a great chapter event!

    April 9, 2013: Launch of the 2013 AMSA PharmFree Scorecard 12-1pm (EST)
    Join National Physicians Alliance & AMSA Online Webcast or Live In-Person
    The AMSA Scorecard: The State of Medical School Conflict-of-Interest Policies and Cultivating a New Era of Effective Change

    Georgetown University Medical Center, Med-Dental Building, Room SW107,
    3900 Reservoir Road, NWSE408, Washington, DC 20057

    Speakers:

    Reshma Ramachandran, PharmFree Fellow
    American Medical Student Association

    Daniel Carlat, MD
    Director of the Pew Prescription Project

    RSVP to attend this live event in-person

    or
    Register to participate in this live online webcast

    This event offered as part of the Partnership to Advance Conflict-free Medical Education. This partnership and related materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin. Learn more at www.npalliance.org/conflict-free.

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  • An Open Letter to Dr. Ben Carson Regarding Same-Sex Marriage

    April 3, 2013

    Dear Dr. Carson,

    Thank you for your recent keynote address at the 2013 American Medical Student Association (AMSA) Annual Convention & Exposition. We appreciate you sharing your inspiring story and words of wisdom with our community of physicians-in-training.

    On behalf of AMSA, we would like to express our concern regarding your recent public statements concerning same-sex marriage. On March 26, on Sean Hannity's Fox News program, you compared gay relationships with pedophilia and bestiality: "Well, my thoughts are that marriage is between a man and a woman. It's a well-established, fundamental pillar of society and no group, be they gays, be they NAMBLA, be they people who believe in bestiality. It doesn't matter what they are. They don't get to change the definition."

    We retain the highest respect for your achievements and value your right to publicly voice your political views. Nevertheless, we feel that these expressed values are potentially harmful to patients and incongruous with the values of the American Medical Student Association.

    AMSA, along with many other national organizations, believes equal access to the institution of marriage is a public health issue. The American Medical Association,# the Gay and Lesbian Medical Association,# the American Psychiatric Association,# the American Academy of Pediatrics,# the American Academy of Nursing,# the American Congress of Obstetricians and Gynecologists# and many other professional organizations all agree that discriminatory policies and social practices are likely to perpetuate stigmatisation of lesbian, gay, bisexual, transgender and intersex persons, resulting in negative health effects for individuals and their families.

    While we can appreciate the power of your personal narrative to inspire physicians and physicians-in-training to believe in themselves and their vision for a life of service to people and communities, and are thankful for your recent presentation at AMSA’s Annual Convention featuring this as a central element, we are disappointed in your statements which are contrary to the evidence that has been generated regarding the experiences of LGBTQI people, their relationships, and relation to and function within the larger society. Your statement, aside from being not rooted in objective, scientifically-sound evidence, is dehumanizing by virtue of comparing mutual, consensual adult relationships with exploitative, non-mutual, non-consensual relationships between adults and children and between humans and animals, and is consistent with statements routinely made by hate groups designated by the Southern Poverty Law Center.

    Your statement propagates the kind of misinformation and discrimination that is detrimental to the health and well-being of LGBTQI people.# Gay and lesbian patients are much more likely than their heterosexual counterparts to delay care or not access health care entirely because of fear of discrimination and mistreatment by their physicians.# LGBTQI physicians-in-training, many of whom are AMSA members, face patients who would actively refuse care from them just for being gay or lesbian,# and they move through their training and careers constantly worrying if living true to themselves will one day cost them a recommendation, residency position, job, or opportunity for advancement.

    As a highly regarded, widely respected, world-famous physician scientist, we urge you to reconsider your statement and fully consider the weight of your words - their effect on patients, physicians-in-training and fellow colleagues. We call on you to acknowledge that your statements and statements of this type are dehumanizing expressions that are antithetical to the humanistic commitments of our profession.

    Respectfully,

    Elizabeth Wiley, MD, JD, MPH
    AMSA National President

    Nida Degesys, MD Candidate
    AMSA National President-Elect

    Jeff Koetje, MD
    AMSA Education & Research Director

    Aliye Runyan, MD
    AMSA Education & Research Fellow

    Deborah V. Hall, MD Candidate
    AMSA National Secretary

    Lexi Light, MD/MPH Candidate
    AMSA Gender & Sexualtiy Chair

    Carl Streed, MD Candidate
    AMSA LGBT Policy Coordinator

    Perry Tsai, MD/PhD Candidate
    AMSA LGBT Programming Coordinator

    Justin Neisler, MD Candidate
    AMSA LGBT Policy Coordinator - Elect
    ------------------------------

    # For complete footnote references, please see this link: 
    http://www.amsa.org/AMSA/Libraries/Misc_Docs/LetterToBenCarson.sflb.ashx

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  • Medical Students Support Marriage Equality as Supreme Court Hears DOMA and Proposition 8 Cases

    As the Supreme Court of the United States heard oral arguments this week in two marriage equality cases, Hollingsworth v. Perry and Windsor v. United States, the American Medical Student Association reiterates its longstanding support of marriage equality for same sex couples.

    “The institution of marriage should be extended to any two individuals who love each other, period.” says Dr. Elizabeth Wiley, national president of AMSA-USA. “As the nation’s next generation of physicians, we must stand up for our patients. Marriage equality is a public health issue.”

    Discriminatory policies and social practices are likely to perpetuate stigmatisation of lesbian, gay, bisexual, transgender and intersex persons, resulting in negative health effects. According to a study done at Emory University, states' constitutional bans on gay marriage escalate new HIV infections at a rate comparable to four cases per 100,000 people.

    This comes as there is growing support internationally among medical students for marriage equality. Earlier this month in Baltimore, the International Federation of Medical Students’ Associations (IFMSA) General Assembly announced its support for marriage equality worldwide . This month, more than 1,000 medical students from across the globe gathered in Baltimore for the International Federation of Medical Students’ Associations (IFMSA) March Meeting.

    The Australian Medical Students’ Association (AMSA - Australia) tabled the statement, calling on governments worldwide to recognize same-sex marriage. The American Medical Student Association (AMSA-USA) and the New Zealand Medical Students’ Association (NZMSA) co-seconded the policy that was submitted to the IFMSA, which represents over 1.3 million medical students across more than 100 nations.

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  • Planned Parenthood Says New Regulations Ensure Women Can Get Birth Control at No Cost

    Planned Parenthood Federation of America today said that the revised accommodation to the Affordable Care Act’s birth control benefit will ensure that women can access no co-pay birth control as part of basic health care. Following is a statement issued by Cecile Richards, President of Planned Parenthood Federation of America:

    “This policy delivers on the promise of women having access to birth control without co-pays no matter where they work. Of course, we are reviewing the technical aspects of this proposal, but the principle is clear and consistent. This policy makes it clear that your boss does not get to decide whether you can have birth control.

    “Birth control is a basic and essential component of women’s preventive health care. Women have been fighting for access to birth control for decades, and this is a historic advance for both health care and equality. As one of the nation’s leading providers of reproductive health care, Planned Parenthood has led the charge for access to contraception for nearly a century, and we will continue to work tirelessly to ensure that women have access to birth control without hurdles or co-pays.”

    For more information, click here

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  • 40th Anniversary of Roe v. Wade

    Kathy Wollner

    Health Policy Chair, AMSA

    Today is the 40th anniversary of Roe v. Wade, the historic Supreme Court decision that ensured a woman's right to safe and legal abortion. Unfortunately, since 1963, federal and state legislators have worked very hard to chip away at that right, decreasing access for women throughout the United States through restrictions on insurance coverage; waiting periods; and mandatory, medically unnecessary ultrasounds to name a few. The most significant of these is the Hyde Amendment, which keeps Medicaid from paying for terminations, leaving the poor and marginalized, those often at greatest risk for unplanned pregnancy, with the worst access. In the last couple years, we've even seen attacks on birth control. As future physicians, I believe it is our responsibility to be scientists in the face of ideology and stand up for the health and rights of our patients and communities.

    On this day, I'd like you all to take just a little bit of time to read about the current attacks on reproductive health in the U.S., and the new restrictions that have come into effect even in just the last year. Texas actually defunded Planned Parenthood and Mississippi is on a crusade to make sure the state's last abortion clinic closes its doors as soon as possible. This anniversary post on Mother Jones is a fantastic summary, including great research from the Guttmacher Institute, and here's another post on five states we need to be watching in 2013. In case your interested, here's some up to date Pew Forum polling.

    Today, I encourage you all to take action in support of reproductive health and rights:

    • Tell your legislators and President Obama how you feel, and visit This is Personal for additional info ways to be involved. 
    • Contribute to Not In Her Shoes a tumblr voicing that no one can walk in another woman's shoes but her and no one else can describe her personal experience. 
    • Check out the 1 in 3 Campaign, which brings stories and faces to the 1 in 3 women who will have an abortion in her lifetime.
    • Get involved with Medical Students for Choice at your school or create a chapter if there isn't one already.
    • Consider holding an event on women's health this semester to educate your classmates on this important issue.

    Not into reading today? I've got graphics!







    Please stand with me in saying we should treat reproductive health care like health care, by respecting women's decisions in the face of their own unique realities. Take a moment today to be thankful that our obstetric wards aren't flooded with self-induced, septic abortions as they were pre-Roe v. Wade, but also to realize that our past may come around to be our future if we don't take action!

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