Chief Medical Officer at Northwestern Medicine Dr. Kevin Most joins the Steve Cochran Show to talk about how the experimental Melanoma skin cancer vaccine decreased the risk of relapse, effective ways to get rid of hives this Spring, and he explains why the nursing shortage isn’t going away anytime soon.
Dr. Kevin Most’s Notes from the Steve Cochran Show:
Nursing shortage potentially worsening?
- A study from researchers at the University of Michigan found that 39% of those nurses responding are ready to leave nursing within a year
- This is the largest number and largest increase and highest rate in the 25 years they have been doing the survey
- The typical rate is 10%
- Large survey of over 9,000 nurses was reported out last week
- The impact of this would be devastating as Covid had already had some nurses head for retirement before they had planned in the past.
- The survey also looked at responses from over 1200 nurses who had already left nursing
- The major complaint was staffing levels and the work environment
- The scary part of the survey was those 25 years and younger had a 59% intended departure rate, and 53% of those aged 25-35 planned to leave within a year.
- The younger nurses looking to leave is very worrisome as the pipeline to fill is based on retirement data from decades
- Staffing, burnout and patient and family violence were the key triggers
- Patients and families need to understand the service nurses deliver, and treat them with respect and kindness.
- Many nurses are going straight from nursing school to an advanced degree of an APN, Advanced Practice Nurse. This is impacting the number of frontline at the bedside nurses.
Chat GPT- Could it upend medicine as we know it?
- How long did we think it would take before Chat GPT extended into the medical field, remember this application was just launched in November and has taken the world by storm.
- Last week it was shared that Chat GPT 4 had taken and passed the US medical licensing exam, as well has scored well on the MCAT and board exams.
- Chat GPT 4, correctly answered 90% of the test questions, this was much better than Chat GPT 3 and 3.5
- Given symptoms and test results, it has diagnosed rare medical conditions. This is based on data and does not involve true understanding
- Doctors are concerned that patients will use this tool for their doctor, yet we know it is not guaranteed to be correct.
- There are many examples where Chat GPT has been totally incorrect with many conditions simple to complex
- Chat GPT has some good uses for physicians, it can share suggestions about bedside manner, it can share suggestions about communicating more compassionately
- Chat GPT 4 can read long reports and give a summary in seconds
- When used in the simulation lab, Chat GPT is given information about a patient in a critical situation and is asked for advice.
- When treating a patient for a condition and advice for medication choice is requested based on the individual’s ethnicity, medical history and current medications- will it give a safer, less expensive medication than the drug that the doctor just learned about from a pharma rep.
- Will this give doctors more time with patients instead of typing in a computer, Chat GPT will capture documentation, correct spelling and organize medical notes
- What is the future?
- It appears we will have machines that can assimilate, organize and come to a conclusion faster and more accurately than doctors for some conditions
- How far away are we from physicians using Chat GTP? Probably a lot closer than we think
Chat GPT- uses in the future for healthcare- This is phase one and is rapidly changing
- With Covid we saw an increase in Telemedicine- Chat GPT can accelerate that by making appointments, gathering information, get treatments scheduled and manage the medical record
- Chat GPT can give up to date real time evidence based recommendations- again go back to Covid where we were learning every day with fragmented information
- Chat GPT can identify drug interactions much quicker and easier than a physician can, and will use potentially more accurate information
- Chat GPT could summarize and organize a patient’s medical history- saving physicians hours of review time as well as increase safe care.
- Chat GPT could have a physician dictate in one language and have the records transcribed into a different language- real time translation
- Research studies are published every day in hundreds of medical journals- Chat GPT could take information validated yesterday and recommend it today
- Will we see more medical work being done by someone other than a physician
- We will not use this as cookbook medicine, the compassion, ethics and communication from a physician will continue to be needed
- Will we see more patients using this, instead of Dr Google, absolutely this will happen
Gout- do people still get gout??- controlling it may be as simple as probiotics
1 Globally close to 50 million people have episodes of gout
- There is no “cure” for gout however there are many treatments
- Gout is an arthritic condition that causes pain, swelling and stiffness of joints.
- Gout is caused by having too much uric acid in their body, this is a breakdown of Purine
- Uric Acid is a breakdown product in our body and is usually cleared by the kidney
- Some individuals do not clear the uric acid well and if forms crystals in some joints
- Foods high in Purine can lead to flare ups- Beer, shellfish, sardines, bacon, meats
- A recent study showed that individuals who take a specific probiotic, ( L. Salivarius) can have a significant decrease in flare ups.
- This may be very helpful for some patients and eliminate the need to take gout medication
- Also many patients with gout also have problems with heart, kidney and liver disease
- This probiotic may also minimize the impact on the other organs impacted.
