Longer looks: A dentist tries to clear his debt; Bringing mental health services to the marines; Learning to laugh in the doctor's office

Nov 16 2012

Every week Shefali S. Kulkarni selects interesting reading from around the Web.

The Los Angeles Times: For Dentist With Student Debt, Repaying Is Like Pulling Teeth
His jaw clenched beneath a blue surgeon's mask, Opanin Gyaami jerks his right arm and pulls out a prize: the decayed tooth of patient Larry Butler, also known as state prison inmate J22312. By the time he is done, Gyaami's smock and mask are spotted with the inmate's blood. He gently pats Butler on the shoulder and wishes him well. The 71-year-old dentist reports to the state prison in Vacaville day after day, long past retirement age. He wishes he could have hung up his drill and forceps years ago, but he's still paying off a student loan. After borrowing $50,000 in the 1980s and ignoring payment notices, Gyaami owes more than $500,000 with penalties and interest. The Justice Department took him to court and is seizing $3,000 from his paycheck each month. ...By the time Gyaami graduated from Loma Linda University in 1983 with a degree in dentistry, he had taken out five loans to pay for his education, including $50,000 from the federally guaranteed Health Education Assistance Loan program. The special loan program, offered from 1978 to 1998, lent $4 billion to 157,000 aspiring doctors, dentists, podiatrists, chiropractors and other health professionals. The Department of Health and Human Services, which oversaw the loan program, reports that 935 of the borrowers are in default, owing $115 million collectively (Stuart Pfeifer, 11/12).

The Miami Herald: Baby Boomers: The Hooked Generation?
(A) 66-year-old Fort Lauderdale man, who asked that his real name not be used, is the new face of addiction: a baby boomer long past the typical youthful phase of experimentation. He's clean now, but as a member of Narcotics Anonymous, he says he meets plenty of older recovering addicts just like him. Local and national figures show that more people in their 50s and 60s are abusing illegal and prescription drugs. While the use of illicit drugs remains relatively uncommon among people 65 and older, the number of illicit drug users 50 to 59 years old tripled between 2002 and 2011, from 900,000 to 2.7 million, according to the National Institutes of Health. The increase even prompted the NIH to post its first consumer alert on its website, NIHSeniorHealth. More older adults are also seeking treatment for substance abuse. Drug-related hospitalizations and visits to emergency rooms were up 116 percent in the 55-to-64 age group from 2004 to 2010 (Ana Veciana-Suarez, 11/13).

The Daily Beast: A Proactive New Response To The Service-Member Suicide Crisis
"There are only two kinds of people that understand Marines," said U.S. Army Gen. William Thornson: "Marines and the enemy. Everyone else has a second-hand opinion." Working with the Corps to try and help stem its suicide crisis, I have come to learn that there is some truth to that claim-;but if we can't bridge that gap, things aren't going to change. ... A few years ago, I was approached to do some short-term anonymous counseling at the Marine Corps Recruit Depot in San Diego. Being a psychotherapist, I was fascinated by the military and wanted the opportunity to work with its members. I put my private practice on hold for a couple of months and headed to the base with hopes of giving back. But by the end of my second week, not a single Marine had approached me. It didn't take long for me to realize that the likelihood of them voluntarily coming in for help was very slim. These are men and women that carry enormous pride, and asking for help can be seen as a sign of weakness. Plus, accessing mental-health services has the potential of hurting one's chance for promotion (Marjorie Morrison, 11/14).

American Medical News: How To Create A Positive Practice Environment
Before seeing a patient, family physician James W. Ferguson, MD, reviews the individual's medical chart and quickly runs through a few jokes. He's not trying to perform a stand-up routine for patients. He just wants to make them laugh a little. "We need some humor in medicine," said Dr. Ferguson, who has run a solo practice in East Islip, N.Y., for 30 years. "We need to lighten up and show that we're more than doctors. We're humans." Using humor with patients strengthens the physician-patient relationship, health professionals say. It makes physicians more approachable. And it can relieve patients' anxiety about the medical visit. Just as important, incorporating humor can rejuvenate physicians who experience burnout due to the challenges of their job, said Mark Greenawald, MD, associate dean for student affairs at Virginia Tech Carilion School of Medicine in Roanoke (Christine S. Moyer, 11/12).

The New York Times: The Problem Is Clear: The Water Is Filthy
Seville, with a population of about 300, is one of dozens of predominantly Latino unincorporated communities in the Central Valley (of California) plagued for decades by contaminated drinking water. It is the grim result of more than half a century in which chemical fertilizers, animal wastes, pesticides and other substances have infiltrated aquifers, seeping into the groundwater and eventually into the tap. An estimated 20 percent of small public water systems in Tulare County are unable to meet safe nitrate levels, according to a United Nations representative. In farmworker communities like Seville, a place of rusty rural mailboxes and backyard roosters where the average yearly income is $14,000, residents like Rebecca Quintana pay double for water: for the tap water they use to shower and wash clothes, and for the five-gallon bottles they must buy weekly for drinking, cooking and brushing their teeth. It is a life teeming with worry: about children accidentally sipping contaminated water while cooling off with a garden hose, about not having enough clean water for an elderly parent's medications (Patricia Leigh Brown, 11/13).