Christian Brothers University

Caduceus Newsletter: 2014.16 , Week of May 5  


Image from the U.S. Department of Energy Genome Program web site:  

Dr. Stan Eisen, Director
Preprofessional Health Programs
Christian Brothers University

650 East Parkway South
Memphis, TN  38104

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Caduceus Newsletter Archives:

It’s amazing how EXTREMELY OLD technology still influences today’s society.


To find out why, please go to Marginalia.  


Table of Contents:


1. The US Healthcare System vs The US Postal Service, a presentation by Dr. George D. Lundberg, from  
2.  Discuss gun violence with patients, ACP (American College of Physicians) Says.  
3.  ===AAMC STAT===, News from the Association of American Medical Colleges, April 28, 2014 issue.  
4.  The Universidad Autónoma de Guadalajara (Mexico) offers a 4-week Medical Spanish course where students will learn Spanish medical terminology, experience a new culture, and enjoy the delights of Mexico.    
5.  The University of Vermont offers a Summer Medical Program to provide foundational knowledge in key medical science courses.  
6.  The Nature Conservancy encourages you to observe Arbor Day by planting a tree. 

Marginalia:  It’s amazing how EXTREMELY OLD technology still influences today’s society. 


1. The US Healthcare System vs The US Postal Service, a presentation by Dr. George D. Lundberg, from  

The video of his presentation and its transcript can be accessed at .


Here’s the transcript:


The US Healthcare System vs The US Postal Service

George D. Lundberg, MD

April 23, 2014

Hello and welcome. I am Dr. George Lundberg, and this is At Large at Medscape.

Back in the old days of discussion about healthcare reform, leaders of the American Medical Association used to warn about a government takeover of medicine by sarcastically describing such a system as combining the "efficiency of the US Postal Service (USPS) with the compassion of the Internal Revenue Service." Such rhetoric was received with loud guffaws by appreciative antigovernment audiences.

Fear-mongering such as that, combined with hefty lobbying, helped prevent significant American healthcare reform for the entire 20th century, except for Medicare and Medicaid. Indeed, that metaphor remains in wide use among certain political groups.

So, I decided to take the 11-factor grid that I have used for comparing healthcare systems since 1993 and apply it to the current US healthcare (USHC) system and the USPS. A perfect score for each item is 9; a perfect total would be 99.

The Scorecard

1. Provides access to basic care for all. USHC: 5; USPS: 9. Some 40 million Americans remain uninsured; another 40 million are underinsured. Everyone can access the post office; it has walk-in service, no appointment needed.

2. Produces real cost control. USHC: 3; USPS: 7. Healthcare costs remain out of control in the United States; they are the most expensive in the world. A first-class stamp costs 49 cents, well below the cost in most other countries.

3. Promotes continuing quality and safety. USHC: 3; USPS: 7. Errors in medicine kill some 400,000 Americans a year; undeliverable mail totals about 4%. Dead letters are very different from dead people.

4. Reduces administrative hassle and cost. USHC: 3; USPS: 8. Obamacare makes it an even bigger hassle. Stick a stamp on a correctly addressed envelope and drop it into a box, and more than 99% get to where they belong.

5. Enhances disease prevention. USHC: 4; USPS: NA. Medicine is improving on this one.

6. Encourages primary care. USHC: 3; USPS: 9. To make big money, docs must specialize. Postal employees have no such perverse incentives, and they make house calls 6 day a week.

7. Considers long-term care. USHC: 3; USPS: 7. Unsolved for medicine; a political football for the postal service.

8. Provides necessary patient autonomy. USHC: 4; USPS: 9. Insurance companies, Medicare, health systems, and physicians still tell patients what to do. By contrast, you can use the USPS, FedEx, UPS, DHL, email, text messaging, Facebook, Twitter, phone calls, Skype, WhatsApp. You decide.

9. Safeguards physician autonomy. USHC: 4; USPS: NA.

10. Limits professional liability. USHC: 3; USPS: 9. Almost all physicians still run scared of malpractice allegations, and defensive medicine rules. Suing the postal service is a non-starter.

11. Possesses staying power. USHC: 3; USPS: 9. Do any of you believe that Obamacare will fix the broken system? Will it prevent more needed health system reform? For the postal service, "Neither snow nor rain nor heat nor gloom of night stays these couriers from swift completion of their appointed rounds."

Remembering that 99 is a perfect score, USHC scores 38 -- pretty awful, but consistent with earlier rankings. USPS scores 74 -- not great; a gentleman's C. But it is a blowout. If this were Little League, the mercy rule would stop the game at 4 innings; if this were boxing, a TKO would be called at about round 3. The USPS, a frequent scapegoat, wins by a landslide. And here is the dagger: The USPS receives no -- zero -- tax dollars for operations. Oh my.

That is my opinion. I am Dr. George Lundberg, at large at Medscape.


Medscape Internal Medicine © 2014  WebMD, LLC 

Cite this article: The US Healthcare System vs The US Postal Service. Medscape. Apr 23, 2014.



2.  Discuss gun violence with patients, ACP (American College of Physicians) Says.  

Discuss Gun Violence With Patients, ACP Says

Megan Brooks

April 10, 2014

Physicians have a right and responsibility to discuss gun violence with their patients, according to a new position paper from the American College of Physicians (ACP).

"Patients have long trusted their physicians to advise them on issues that affect their health," ACP president Molly Cooke, MD, FACP, said in a statement. "Physicians can play a critical role in educating the public on the risks of firearm ownership and the need for firearm safety through their encounters with their patients."

The position paper was released today at the Internal Medicine 2014 in Orlando, Florida, and was published simultaneously in the Annals of Internal Medicine.

To inform its policy position, the ACP Health and Public Policy Committee reviewed available data on the impact of access to firearms, mental health, state and federal firearms laws, and efforts to reduce firearms violence. The policy outlines 9 strategies to address the societal, healthcare, and regulatory barriers to reducing firearm-related violence, injuries, and deaths in the United States.

ACP Supports Universal Background Checks

The ACP recommends that firearm safety be approached as a public health issue so that policy decisions are based on scientific evidence.

"As such, ACP strongly supports universal criminal background checks to keep guns out of the hands of felons, persons with mental illnesses that put them at greater risk of harming themselves or others, people with substance use disorders, and others who current regulations prohibit from owning guns," according to an ACP statement.

"The United States has the highest firearm-related mortality rate among industrialized nations," Dr. Cooke said during a media briefing. "ACP believes that a comprehensive, multifaceted approach is necessary to reduce this epidemic of gun violence and that physicians play a vital role."

Other Recommendations

ACP supports appropriate regulation on the purchase of legal firearms to reduce firearm-related injuries and deaths, acknowledging that any such regulation must be consistent with the Supreme Court ruling establishing that individual ownership of firearms is a constitutional right under the Second Amendment of the Bill of Rights.

ACP recommends that guns be subject to consumer product regulations regarding access, safety, and design. In addition, the College supports law-enforcement measures to aid in the identification of weapons used in crimes.

ACP believes that firearm owners should adhere to best practices to reduce the risk for accidental or intentional injuries or deaths from firearms.

ACP cautions against broadly including those with mental illness in a category of dangerous individuals. ACP recommends that every effort be made to reduce the risk for suicide and violence through the prevention and treatment of the subset of individuals with mental illness who are at risk of harming themselves or others. ACP believes that diagnosis, access to care and treatment, and appropriate follow-up are essential.

ACP believes there is enough evidence to enact legislation banning the sale and manufacture for civilian use of firearms that have features designed to increase their rapid killing capacity (often called "assault" or semiautomatic weapons) and of large capacity ammunition, and retaining the current ban on automatic weapons for civilian use.

ACP supports efforts to improve and modify firearms to make them as safe as possible, including the incorporation of built-in safety devices.

ACP believes that more research needs to be funded on firearm violence and on intervention and prevention strategies to reduce injuries caused by firearms. Access to data should not be restricted.


A Public Health Threat

There is "very broad support" among internists for the ACP position on gun violence, Robert Doherty, BA, senior vice president for government affairs and public policy at ACP, said during a press briefing.

Of a nationally representative sample of 573 internists surveyed by ACP, 85% said they believe that firearm injury is a public health issue and 71% believe that it is a bigger problem today than it was a decade ago.

In addition, 66% of respondents said they believe that stricter gun control legislation would help reduce the risk for gun-related injuries or deaths. Roughly two-thirds believe that physicians should have the right to counsel patients on preventing deaths and injuries from firearms, yet 58% reported never asking whether patients have guns in their homes.

The survey was published today in the Annals of Internal Medicine.

"We concluded that firearm violence is not just a criminal justice issue, but also a public health threat that requires the nation's immediate attention," Thomas Tape, MD, FACP, chair of ACP Health and Public Policy Committee, said in a statement.

"As an organization representing physicians who have first-hand experience with the devastating impact of firearm-related violence, ACP has a responsibility to participate in efforts to mitigate needless tragedies," he added.

Ann Intern Med. Published online April 10, 2014. Position paper, Survey


Medscape Medical News © 2014  WebMD, LLC 

Send comments and news tips to

Cite this article: Discuss Gun Violence With Patients, ACP Says. Medscape. Apr 10, 2014.



3.  ===AAMC STAT===, News from the Association of American Medical Colleges, April 28, 2014 issue.

News from the Association of American Medical Colleges

April 28, 2014

• Supreme Court Upholds Ban on Race-Conscious Admissions in Michigan
• Certain Groups of Medical Students Disproportionately Affected by Stress
• Competition Seeks Educators to Prepare Next Generation of Physicians
• LCME Publishes Reformatted Accreditation Standards
• NIH Research Funding Benefits By State
• On the Move

Supreme Court Upholds Ban on Race-Conscious Admissions in Michigan

The U.S. Supreme Court upheld a referendum by Michigan voters that prohibits state universities and colleges from considering race in the admissions process. In a statement, AAMC President and CEO Darrell G. Kirch, M.D., expressed disappointment in the ruling but was grateful that it was limited to Michigan. “We are pleased that Justice Kennedy emphasized that the case is not about the constitutionality of race-based admissions policies in higher education,” he stated. “Using a holistic consideration of each applicant’s background and experiences, medical schools are working toward a more culturally competent physician workforce that can meet the health needs of an increasingly diverse nation.” The AAMC joined the American Council of Education and 47 other organizations in submitting an amicus brief on the case to the Supreme Court in August 2013.

Certain Groups of Medical Students Disproportionately Affected by Stress

A recent AAMC pilot study examined medical student well-being and whether or not specific populations of students are disproportionately vulnerable to psychological distress. Reported in an April Analysis in Brief, the results showed significant group differences across five measures of well-being. For example, higher levels of stress were reported among first generation college status, female, LGB, Asian (compared to white), and students underrepresented in medicine (compared to white) respondents. The results showed that well-being is associated with students’ quality of life, which can alter perceptions of the learning environment and student outcomes, such as changes in empathy, academic achievement, and attrition.

Competition Seeks Educators to Prepare Next Generation of Physicians

The AAMC, in collaboration with the Khan Academy and Robert Wood Johnson Foundation, is seeking talented medical students, residents, and faculty to help complete the MCAT® Collection, which offers free tutorials to help students prepare for the new MCAT exam. The competition seeks talented video-based educators and innovative question and article writers. Winners will receive hands-on training with Khan Academy leaders as well as the opportunity to create free pre-health and medical education resources for a global audience. The entry deadline is June 13, 2014. For competition details and entry information, visit The AAMC will host a free webinar about the competition on May 12. To register, visit

LCME Publishes Reformatted Accreditation Standards

Following completion of a multi-step revision process that began in July 2012, the Liaison Committee on Medical Education (LCME) has published a substantially reformatted set of accreditation standards in the 2014 edition of Functions and Structure of a Medical School.  Among the more notable changes are the consolidation of 132 individual areas of compliance into a set of 12 comprehensive standards, each comprising multiple related elements, and the data collection instrument used by schools to collect data for the self-study. The new format will continue to promote the highest standards for quality medical education, while streamlining existing accreditation processes and facilitating use of the LCME standards for continuous quality improvement efforts. The 2014 standards are in effect for all accreditation activities  taking place after July 2015. More information is available at

NIH Research Funding Benefits by State

The Federation of American Societies for Experimental Biology recently released updated factsheets for fiscal year 2013 on how funding from the National Institutes of Health (NIH) benefits each of the 50 states, Washington, D.C., and Puerto Rico. Each factsheet demonstrates how NIH research grants add value to local communities by improving health, training the next generation of scientists, and boosting the economy through the creation of new businesses and higher paying jobs. Information about how much NIH funding each state lost due to sequestration also is included.

On the Move

David J. Cole, M.D., chair of the Medical College of South Carolina (MUSC) Department of Surgery and president of MUSC Physicians, has been named the college's next president. He succeeds Raymond S. Greenberg, M.D., Ph.D., who left to become executive vice chancellor for health affairs of the University of Texas System.

Jonathan Blum has stepped down as Medicare director and principal deputy administrator for the Centers for Medicare and Medicaid Services. He has served in the position since March 2009.


4.  The Universidad Autónoma de Guadalajara (Mexico) offers a 4-week Medical Spanish course where students will learn Spanish medical terminology, experience a new culture, and enjoy the delights of Mexico.    

UAG Summer Medical Spanish

Hello  Stan Eisen,

Are your students looking for a great summer opportunity? The UAG Medical Spanish program offers a 4-week course where students will learn Spanish medical terminology, experience a new culture, and enjoy the delights of Mexico.

Activities & Benefits include:

  • Immersion in the theory and practice of medical Spanish terminology.
  • Development of medical skills in Spanish at the UAG community clinics.  
  • Valuable insights and knowledge from native Spanish speaking doctors.
  • Opportunity to venture into the many cultural sights Guadalajara has to offer.

Please share this with your students and clubs. It’s a great opportunity to learn Spanish, engage with patients, and enjoy the summer!

Course dates summer 2014: June 16, June 30, July 14, and July 28.


Students may be eligible for a $100 USD discount on groups of 3 or more.
-Group discount form should be endorsed by Pre-med/Pre-Health Advisors (
-Students receiving the discount must be enrolled in the same college or university.


UAG Medical Spanish Courses.




Group Discount Form


University Name: ______________________________


Student Names:












Pre-medical/Pre-Health Advisor: Stan Eisen 


Pre-medical/Pre-Health Advisor (signature):                                                                        



Find UAG on Facebook See UAG Videos on Youtube

110 Gallery Cir | San Antonio, TX 78258 | Tel: 1-800-531-5494 | Fax: (210) 377-2975

© Copyright 2014 - Universidad Autónoma de Guadalajara


5.  The University of Vermont offers a Summer Medical Program to provide foundational knowledge in key medical science courses.


UVM College of Medicine courses for medical, graduate, post-baccalaureate, and undergraduate students.

The Summer Medical Program offered by the UVM College of Medicine is designed to provide foundational knowledge in key medical science courses. UVM College of Medicine faculty provide students the opportunity to immerse themselves in a specific content area, guided by experts in their field. This program has a long track record of academic excellence and draws an international population.


Program Highlights:


Medical Pharmacology - PHRM 301 (60154)
John McCormack -
Course Dates: May 28 - June 25, 2014
Courses in biochemistry, physiology, and microbiology. Requires instructor permission.

Medical Physiology - MPBP 306 (60039)
Robert Low -
Course Dates: June 16 - July 21, 2014
Students must obtain the permission of the Department of Molecular Physiology and Biophysics to enroll.

Summer Medical Program Housing is available. Find out more on our website.


To request more information about our Summer Medical courses or other related programs available through the UVM College of Medicine and UVM Continuing and Distance Education, contact the Healthcare Advisor, Jennifer Lian, at 800.639.3210.




6.  The Nature Conservancy encourages you to observe Arbor Day by planting a tree. 

Plant a Billion Trees



You'll do more than plant a seedling in the ground; you'll plant roots for tomorrow. One gift. One Tree. One Planet.

Dear Stan Eisen,

Did you know that trees provide life-giving benefits to everyone on our planet? They regulate our climate, filter our water, give us shade and shelter, provide a home to millions of plants and animals, and even help support local economies.

This Arbor Day, you can support forests around the globe when you give to our Plant a Billion Trees program. Established in 2008 to restore Brazil's Atlantic Forest, we're now working to restore vital forests the United States and China as well -- forests that are essential to the livelihood of people and nature around the globe.

Forests like Longleaf and Shortleaf Pine forests, the forests of the Central Appalachians, and Mississippi River Bottomland Hardwood forests in the United States, where our work has resulted in great successes. The West Virginia Flying Squirrel, native to the Central Appalachians, is no longer endangered as of 2013, thanks to efforts to restore its forest habitat.

Or the forests of the Yunnan and Sichuan Province -- forests that are home to the iconic panda and Yunnan golden monkey -- where Plant a Billion restoration efforts will connect small fragments of trees to create a larger habitat for these species, as well as support local communities with jobs and training in forest management.

Trees give us life -- they provide us with clean water, air and food -- all of the things we need to thrive. Celebrate Arbor Day this year by giving back to the forests that give so much to us.


Bill Toomey
Conservation Lead for Plant a Billion Trees
The Nature Conservancy

PHOTO: Longleaf, planted pines and native grasses at The Nature Conservancy's Green Swamp Preserve, North Carolina © Mark Godfrey/TNC.


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7.  Marginalia:  It’s amazing how EXTREMELY OLD technology still influences today’s society. 

4 Feet 8.5 Inches - true and really interesting!


You'll love the logic here.

The U.S. Standard Railroad Gauge (distance between the rails) is 4 feet, 8.5 inches. That's an exceedingly odd number.  Why was that gauge used? Because that's the way they built them in England, and English expatriates designed the U.S. Railroads.  Why did the English build them like that? Because the first rail lines were built by the same people who built the Pre-Railroad Tramways, and that's the gauge they used.  Why did 'they' use that gauge then? Because the people who built the tramways used the same jigs and tools that they had used for building wagons, which used that wheel spacing.
Why did the wagons have that particular odd wheel spacing?
 Well, if they tried to use any other spacing, the wagon wheels would break on some of the old, long distance roads in England, because

that's the spacing of the wheel ruts. So, who built those old rutted roads? Imperial Rome built the first long distance roads in Europe (including England) for their legions. Those roads have been used ever since.   And the ruts in the roads?  Roman war chariots formed the initial ruts, which everyone else had to match for fear of destroying their wagon wheels.
Since the chariots were made for Imperial Rome, they were all alike in the matter of wheel spacing. Therefore, the United States standard Railroad gauge of 4 feet, 8.5 inches is derived from the original specifications for an Imperial Roman war chariot.
In other words, bureaucracies live forever.
  So the next time you are handed a specification, procedure, or process, and wonder, 'What horse's ass came up with this?', you may be exactly right.  Imperial Roman army chariots were made just wide enough to accommodate the rear ends of two war horses.

 Now, the twist to the story:
When you see a Space Shuttle sitting on its launch pad, you will notice that there are two big booster rockets attached to the sides of the main fuel tank. These are Solid Rocket Boosters, or SRBs. The SRBs are made by Thiokol at their factory in Utah. 

The engineers who designed the SRBs would have preferred to make them a bit larger, but the SRBs had to be shipped by  train from the factory to the launch site. The Railroad line from the factory happens to run through a tunnel in the mountains, and the SRBs had to fit through that tunnel.  
The tunnel is slightly wider than the Railroad track, and the Railroad track, as you now know, is about as wide as two horses' behinds.

So, a major space shuttle design feature of what is arguably the world's most advanced transportation system was determined more than two thousand years ago by the width of a horse's ass. 
Now you know: Horses' asses control almost everything ...
 Explains a whole lot of stuff, doesn't it?



Dr. Stan Eisen, Director
Preprofessional Health Programs
Biology Department
Christian Brothers University

650 East Parkway South
Memphis, TN 38104

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