News in brief - Oct. 25, 2004

AMA, WMA defend indoor smoking ban - Pain experts discuss drug dependence, tolerance at attorneys general seminar - Women's health expert to lecture in Philadelphia, receive service award - International virtual medical school moves forward with online curriculum

AMA, WMA defend indoor smoking ban

The AMA and the Washington State Medical Assn. in September joined with other anti-tobacco groups in a friend-of-the-court brief defending a law that bans smoking in most indoor public places in the Tacoma, Wash., area. The Washington State Court of Appeals is considering a lower court decision that granted a preliminary injunction that stops the law from being enforced.

The Entertainment Industry Coalition challenged a resolution passed by the Tacoma-Pierce County Board of Health and Tacoma-Pierce County Health Dept. that bans smoking in most indoor public places.

The brief from the AMA and WMA argues that the county has the right to regulate tobacco use and it discusses the harm of secondhand smoke.

Pain experts discuss drug dependence, tolerance at attorneys general seminar

Physical dependence on and tolerance to opioids are not the same as addiction. That was the message two prominent pain experts told state law enforcement officials at the National Assn. of Attorneys General's End of Life Health Care Seminar held Oct. 5 in suburban Chicago.

"Pain is man's oldest problem and medicine's newest specialty," said American Pain Society immediate past President Richard Payne, MD, director of the Institute on Care at the End of Life at Duke University in Durham, N.C.

Dr. Payne said he has seen patients who were "absolutely mutilated" with back surgeries and nerves cut when all they really needed was medication. He also said policy measures that try to restrict the availability of certain controlled substances "are not a good thing for clinicians" because one of the drugs that these policies often seek to restrict is methadone, which Dr. Payne described as an "excellent pain medication" that costs only pennies a day for treatment.

David Joranson, director of the Pain and Policy Studies Group at the University of Wisconsin in Madison, noted that 16 states have measurably improved their pain treatment policies since his institution first reported on the issue four years ago. But, while policy has gotten better, he said, "regulatory scrutiny -- as perceived by many -- has worsened."

Women's health expert to lecture in Philadelphia, receive service award

Surgeon Christine Haycock, MD, will give the lecture "The Boomerang Returns" at 6:15 p.m. on Oct. 28 at the College of Physicians of Philadelphia. She will receive the 5th Annual Alma Dea Morani, MD, Renaissance Woman Award.

Dr. Haycock, a New Jersey native, is an authority on women's health and co-founder of the Assn. of Women Surgeons. She has devoted decades of service to the American Cancer Society and in 1980 became president of the National Women's Medical Assn.

Her lecture, co-sponsored by the college and the Foundation for the History of Women in Medicine, is free to the public. Seating is limited, so advance phone reservations are required. For information, call 484-945-2106.

International virtual medical school moves forward with online curriculum

First announced two years ago, the International Virtual Medical School (IVIMEDS) is slowly getting off the ground. Hull York Medical School in Britain, a new medical school opened to help alleviate a shortage of physicians in the United Kingdom, piloted the program for the first time last year. The entire four-year IVIMEDS curriculum is expected to be finished in 2006.

The project is more than text on a computer screen. Students are introduced to a number of virtual patients and can access such things as the patient's x-rays or audio of heartbeats. The course work is developed around organ systems, the first one being the cardiovascular system.

The program is expected to be used as a tool for brick-and-mortar medical schools, not as an entirely online education. It might run parallel to traditional on-site programs, with students studying from home until they need to move to the school for clinical work. It could also serve schools in developing countries by bringing the e-curriculum into their medical centers. Students wouldn't have to leave the country for medical training, and their clinical experience would be more culturally relevant.

Family physician Stephen Smith, MD, associate dean for medical education at Brown Medical School in Providence, R.I., created the patients used in the virtual practice. He said one of the advantages to having such a computer-based curriculum is that it makes it more feasible for schools to expand.

"You don't have to hire a lot of new faculty," he said. "Brown is bursting at the seams. There's no physical capability to enlarge the class. There may be a way to expand through distance learning."