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Eli Lilly’s experimental Alzheimer’s treatment is denied accelerated approval by the United States Food and Drug Administration. Though the findings in the Phase 2 trial were positive, which included indication that the experimental drug donanemab could lead to less cognitive and functional decline , the associated adverse events led the FDA to request more data. Eli Lilly and Company announced they will continue with their confirmatory TRAILBLAZER-ALZ 2 Phase 3 trial and file for traditional FDA submission.

The US Food and Drug Administration has halted the emergency use authorization of Evusheld, as it appears that it does not offer protection against the most widespread and occurring COVID-19 viral variants currently circulating the United States. Data has shown Evusheld is unlikely to work against XBB, XBB.1.5, BQ.1 and BQ.1.1; combined, these variants are estimated to be causing nearly 93% of new US Covid-19 cases.

To update the current blood donation policy, the US Food and Drug Administration proposes guidelines to ask all prospective donors about new or multiple sexual partners in the past three months. This proposal seeks to eliminate time-based deferrals for men who have sex with men (MSM) and women who have sex with men who have sex with men.

Autism spectrum disorder (ASD) diagnoses are on the rise, yet cases are being seriously underreported. Due to the strong correlation between ASD diagnoses with race and socioeconomic status, some experts advise closing this gap with universal autism screening for all children.

Increase in insomnia discovered as the percentage of Americans using sleeping pills has doubled since 2010 according to a recent finding. According to the CDC, 8.4% of adults are using sleeping pills, with women being more likely than men to use such medications.

Addressing the reported shortage of infectious disease specialists in the U.S.

According to the Infectious Diseases Society of America (IDSA), the United States is currently experiencing a major shortage of infectious disease specialists, and that trend is likely to continue based on the trajectory. This specialty’s importance was just highlighted with the COVID-19 pandemic, but their critical value has also been demonstrated during combating HIV/AIDS crisis, as well as Monkeypox most recently.

Surprisingly, just over half of infectious disease training programs were filled during Match Day, with unfilled programs residing in rural areas most commonly. As a result, these unfilled programs were forced to reach out to unmatched applicants, which is obviously alarming from a talent, capability, and passion standpoint.

• Immediately following the COVID-19 outbreak, the “Fauci Effect” saw a clear and instant rise in popularity of such public health programs, alongside a massive increase in applicants to medical school. These findings regarding the infectious disease specialty in particular indicate a decisive inverse of that “Fauci Effect.”
  
  
• According to a survey of 30 specialties by Medscape, only 44% of infectious disease physicians felt that they were fairly compensated in 2021 , which was the lowest of the 30 specialties gauged by the survey.
  
  
• In addition to compensation and lifestyle concerns of the specialty, experts suggest that polarization, publicity, and politicalization of the field has discouraged many from traveling down this career path.
  
  

What the author of the study is saying: “In 2017, some 208 million U.S. citizens lived in counties in which there was either no infectious disease physician coverage at all — or an inadequate number of infectious disease doctors — according to a study published in October 2020 in Annals of Internal Medicine, a medical journal. The study estimated that 80% of counties in the U.S. did not have even one infectious disease specialist .”

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Alarming Results of the 2023 Physician Burnout & Depression Report

Medscape surveyed over 9100 physicians across more than 29 specialties to gather this 2023 US Physician Burnout & Depression Report. The results are damning and disappointed, highlighted briefly in the attached graphic contributed by Jon McKenna of Medscape.

This report, which I urge each health care provider to view in its entirety, indicates that burnout and depression among our nation’s physicians and their cohorts is here to stay, due to widespread frustration, sadness, and anger that seems to be systematically integrated in our healthcare system’s current construction.

Key takeaways

• Most if not all specialties surveyed increased in both burnout and depression rates when compared to the survey results of 2018.
  
  
• The top three contributing factors of burnout are too many bureaucratic tasks (61%), lack of respect from coworkers (38%), and too many work hours (37%).
  
  
• The top three workplace measures that would most help with burnout are increased compensation (45%), more manageable work schedule (44%), and more support staff (37%).
  
  
• “The impact of COVID on physician burnout will remain for years,” says John Whyte, MD, WebMD chief medical officer. “The focus has changed. Now it’s all about helping patients catch up all the care, especially preventative that they missed. This is causing very busy days and long lines, which frustrates everyone. And COVID taught us more about the social determinants of health; now everyone wants us to measure and do more things in a brief office visit .”
  
  

By the digits

• 53% of physicians are burned out, up from 42% back in 2018.
  
  
• 23% of physicians are depressed, up from 15% back in 2018.
  
  
• 65% of emergency medicine physicians indicate burnout, which is the specialty that tops this year’s list.
  
  
• 37% of public health and preventative medicine physicians indicate burnout, which is the lowest reported burnout specialty of those surveyed this year.
  
  
• 50% of surveyed physicians believe that a physician union would help combat burnout .
  
  

Is There a Doctor in the House?

Take our weekly quiz and see how you stack up against your peers

A 54-year-old woman with severe rheumatoid arthritis comes to the office for a routine follow-up examination. Rheumatoid arthritis was diagnosed at age 35 years, and the patient has been unable to work for the past 10 years. She has difficulty bathing and dressing, but she can stand and walk independently. Medical history is otherwise unremarkable. Medications include etanercept, methotrexate, prednisone, and tramadol. She tells you that her husband of 30 years left her 6 months ago. She appears depressed. Vital signs are normal. Physical examination discloses marked joint deformities in the hands, wrists, shoulders, and feet; the findings are unchanged from previous visits. The patient says, "I cannot continue to live as I am. I've had it."
Which of the following is the most appropriate response?

Both DNA damage and cancer-causing mutations in human cells found to be caused by a common nail salon tool. Similar to tanning beds, which are registered carcinogens, UV nail lamps serve a similar purpose to cure the gel nail.

Analysis of participants in the Atherosclerosis Risk in Communities study found that one head injury was linked to a 66% increased risk for all-cause mortality. Additionally, the study found that those with two or more head injuries were associated with double the risk in comparison with the group lacking any head injuries.

New study establishes the role and responsibility of the gut microbiome as a potential regulator of body temperature, both in good health and during life-threatening infections. A few major factors in Dr. Dickson’s hypothesis and eventual discovery involved the critical role that temperature variation and regulation plays in survival outcome of sepsis, as well as the information that temperature provides in relation to the body’s inflammatory and metabolic state.

Link discovered between schizophrenia and specific vascular alterations in the brain. The study found a connection between astrocytes (central nervous system cells) from patients with schizophrenia and formation of narrow blood vessels. This finding leads to a greater understanding of the underpinnings of schizophrenia as well as identifies a potential therapeutic target.

Thank you for reading! More next week,

My best wishes for a productive and idea-filled week ahead. Thanks for your ongoing efforts to improve the lives of the patients we all serve. Please send any news, comments, suggestions and ideas to hello@morningmed.email.

Quiz answer: The correct answer is D) "Would you like to tell me more about why you feel this way?"

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