Inside Medicine: Five on Friday (March 1, 2024).

This week in medicine, what I'm thinking about, etc. You know, an actual newsletter.

We are back with “Five on Friday", the feature where Inside Medicine behaves like an actual medical/health/science newsletter. Below are some top-of-mind things that I’m thinking about right now. And please vote in the polls at the end!

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If you value this feature—and Inside Medicine in general…

Thanks and here we go…

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Item 1: A genuinely meaningful gift to the future of medicine.

This week, the world of medicine suddenly came to know the name Dr. Ruth Gottesman. Dr. Gottesman surprised and delighted the students of Albert Einstein College of Medicine when she announced that starting this fall, the school will be tuition free. The video of the announcement is enough to make your week.

The gift is thought to be the largest ever to a medical school and the 3rd largest to any institute of higher learning. But there’s more to it than that. Dr. Gottesman’s gift comes with no strings. No buildings to be named. No pet projects. It’s simply a reflection of the fact that, having actually worked at Einstein for decades (i.e., being a pretty under-the-radar billionaire), she knew what is needed most: to give students a chance to enter medicine without the fear of massive debt. This, in turn, may make it easier for promising students to choose fields where shortages have mounted—including those that typically serve poorer patient populations. So, extraordinary actions like these truly matter for keeping the pipeline of diversity in medicine strong, and reaching people who are most in need of better healthcare. Einstein joins NYU in being entirely tuition-free, without strings. The more places that do this, the better the field will be.

But, honestly, just watch this video of the announcement. It’ll restore your faith in humanity.

Item 2: Good news on nursing shortages.

Did you read about nursing shortages during the height of the pandemic? Looks like the outlook has improved. A new study in JAMA Health Forum shows that by the year 2035, the nurse workforce will be around 4.5 million strong, which is in line with pre-pandemic predictions.

There had been concerns that nursing shortages would cripple the medical profession with some signs of mass exodus during the Covid-19 pandemic. But last year, an article by Monique Brouillette (which I edited) for the Annals of Emergency Medicine’s news section basically predicted the type of finding in the new JAMA Health Forum paper. At that time, experts pointed out to us that the number of nurses is not really the issue. Rather, it seems like younger nurses don't stay in one job very long, as price competition lures them from one place to another. So, this could still be a problem—because a nurse who spend, say, a quarter of their time in a job learning a new hospital system is not as efficient as one who is fully comfortable with the intricacies of any one hospital (or which there are many). Still, a robust force is important, and we’ll take any good news.

Item 3: Attitudes on vaping are making my head 🤯.

A new study in JAMA Network Open found that attitudes about vaping in England have gone in the wrong direction. To be clear, while vaping is bad, smoking cigarettes is worse. Vaping does not cause cancer in the way cigarettes do. Full stop.

Vaping seems to break the brains of otherwise bright colleagues of mine who clearly otherwise understand the concept of harm reduction in health. So, it’s a downer to see that in England (and I imagine elsewhere), there has been an increase in people who think vaping is more harmful than traditional cigarettes (and a decrease in those who understand that vaping is indeed less harmful).

Before you rip my head off here on Friendly Five of Friday, let me say, of course, that we do not want vaping to become a gateway drug to normal cigarettes for anyone. We want it to be an off-ramp for those trying to quit. Nor are the cognitive effects on young brains to be ignored. The question is whether you’d rather walk in on your kid (or anyone) vaping or smoking a cigarette. The answer is neither, ideally; but if you were forced to choose, you’d choose vaping, if you follow the data. I’ll write more on this often confusing (and certainly controversial) topic in the future.

Item 4. National Eating Disorders Awareness Week.

President Biden made a proclamation highlighting some resources marking National Eating Disorders Awareness Week (February 26-March 3). Here’s a link to resources for people who need help. Also, below is the first part of the President’s remarks. You can read the whole statement here. This is an issue that affects many people, and they should not suffer in silence.

Part I of the President’s statement on Eating Disorders Awareness Week. Here's the link to the full statement.

Item 5. Poll of the Week results.

Here are the results to last week’s Inside Medicine poll. This basically aligned with what I might’ve predicted. Really, folks, not bad! A full 82% percent of you are masking while traveling in some way. And I even think that some in the 18% might be throwing on a mask here and there when it matters most. Good on you.

Item 5a. Poll of the Week for this week!

And here is this week’s poll. February is over. It’s New Year’s Resolution check-in time. Two-parter!

That’s it. Your “Friday Five!”

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