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Study Provides Greater Understanding Of Lyme Disease-Causing Bacteria
Lyme disease in the U.S. is caused by the tick-borne bacteria Borrelia burgdorferi and usually begins with a skin lesion, after which the bacteria spread throughout the body to the nervous system, heart or joints. About 60 percent of untreated individuals develop arthritis, which affects the knees in particular. Lyme disease usually responds well to antibiotic therapy, but in rare cases arthritis can persist for months or years after treatment, a rare condition known as antibiotic-refractory Lyme arthritis. Joint fluid usually tests negative for B burgdorferi after treatment, indicating that joint inflammation may persist even after the bacteria has been eradicated.
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President Obama Picks New York City Health Commissioner Thomas Frieden For CDC Director
President Obama on Friday appointed New York City Health Commissioner Thomas Frieden as CDC director, according to Obama administration officials, the New York Times reports. According to the Times, Frieden, an infectious disease specialist, has "cut a high and sometimes contentious profile" in his seven years as health commissioner in New York City, during which time he has advocated for a smoking ban in restaurants and bars, made HIV testing part of routine medical exams and protected a program that distributes 35 million condoms a year. According to the Times, Frieden is expected to take office next month. The Times reports that he will "inherit a host of immediate and long-term problems," including questions surrounding a vaccine for the H1N1 influenza virus, also known as swine flu, health care reform and organizational issues at CDC.The Times reports that a potential advantage for Frieden is a positive relationship with likely FDA Commissioner Margaret Hamburg, who also was New York City health commissioner. Frieden would work with Hamburg to combat the H1N1 flu virus and to re-evaluate the U.S. food safety system (Harris/Hartocollis, New York Times, 5/15).
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Senators Fear Health Reform Could Endanger Employer-Sponsored Insurance
Some Senators "struggled" Wednesday with the possibility that the health reform overhaul could derail America"s tradition of employer insurance plans, The New York Times reports.
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New Study Evaluates Role Of Clinic Environment On Physician Job Satisfaction

Adverse work conditions may be to blame for the decline in the number of primary care physicians nationwide, according to a study published in the latest issue of the Annals of Internal Medicine. "Unfavorable work conditions are associated with stress, burnout and intent to leave for primary care physicians," said Dr. Anita Varkey, study author and assistant professor in the department of medicine, Loyola University Chicago Stritch School of Medicine. "These factors contribute to poor job satisfaction, which is among the reasons we are seeing a decrease in the number of primary care physicians." The Association of American Medical Colleges estimates that the overall shortage of doctors may grow to 124,400 by 2025. "There are not enough primary care physicians to meet current needs," said Varkey, who also is medical director of the general medicine clinic at Loyola Outpatient Center, Loyola University Health System. "These findings suggest that a chaotic clinic environment may further exacerbate this problem and potentially lead to lower quality of patient care due to physician turnover and lack of continuity in care." Data for this study were collected from 422 family practitioners and general internists and 1,795 of their adult patients with diabetes, hypertension or heart failure at 119 clinics in New York and the Midwest. Study participants were asked about perception of clinic workflow (time pressure and pace), work control, organizational culture, physician satisfaction, stress, burnout and intent to leave practice. More than half of the physicians (53.1 percent) reported time pressure during office visits, 48.1 percent said their work pace was chaotic, 78.4 percent noted low control over their work and 26.5 percent reported burnout. Adverse workflow (time pressure and chaotic environments), low work control and unfavorable organizational culture were strongly associated with low physician satisfaction, high stress, burnout and intent to leave. Some work conditions also were associated with lower quality of patient care and more errors, but findings were inconsistent across work conditions and medical diagnoses. The authors indicated that interventions in primary care clinics should target measures to reduce physician burnout, clinic chaos and work control measures. A healthier workplace for physicians may result in better recruitment and retention of primary care physicians, which may then translate to higher quality patient care. "While further research is needed, health care reform strategies should consider the role that work environment plays in physician job satisfaction and quality of patient care," Varkey added. Notes: Varkey is an internist who specializes in primary care, preventive medicine and women"s health. She sees patients at Loyola Outpatient Center. Co-authors of the Archives study include Linda Baier Manwell, M.S.; James A. Bobula, Ph.D.; Dr. Mark Linzer, Roger L. Brown, Ph.D., all of the University of Wisconsin-Madison; Dr. Ann Maguire of Medical College of Wisconsin; Dr. Bernice Man of Rush Medical College; Dr. Julia McMurry of William S. Middleton Memorial Veterans Hospital; Eric S. Williams, Ph.D., of the University of Alabama; Dr. Barbara A. Horner-Ibler, of the University of Wisconsin-Milwaukee; and Dr. Mark D. Schwartz of Veterans Affairs New York Harbor Healthcare System. Nora Plunkett Loyola University Health System


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