THE
PPC JOURNAL
Volume 6, Issue 2
Page 2
Pages 3-4
by Laura Cantu
by Sam Arcas
A Letter from Your
PPC Rep
Healthcare Access
for Veterans
Pages 8 – 10
Where Are They
Now?
In This Issue
Welcome
by Laura Cantu ………………………………………………………….……………........................….... Page 2
Healthcare Access for Veterans
by Sam Arcas ………………………………………………….……………………………………....... Pages 3-4
2016 Presidential Candidates on Healthcare
by Kayla Yoshida ……………………….…………………………………….……………………....….. Pages 5-6
A Chat with Dr. Rothfeld, MD
by Andrew Gurewitz …………………………………………………...……....……………..…..…….... Page 7
Where Are They Now? ……………………….…........................................................................................................… Page 8-10
Library Comic Strip
by Sara Littrell……………………………….…………………………………………………………... Page 11
Phabulously Phun Crossword (PPC) 2016
by Sam Arcas …………………………………………………………………………………………… Page 11
Volume 6, Issue 2
A Final Word
from the PPC Rep
To my fellow future-physicians,
When did semester 2 module 1 happen? We have flown through this last half of the year! I am impressed with
everything that our cohort has accomplished in this short year at KGI.
We have become scribes, researchers, physician shadows, master's candidates, and more! You have joined and
founded clubs, discovered new fields of research and medicine, and networked with inspiring leaders. Every day,
someone in our cohort has achieved a goal, contributed to the community, and come one step closer to medical
school.
Moving forward into this final home stretch, I know that we will all be faced with our own challenges. But we have
already overcome challenges on our way to this point and I encourage you to reach out to each other for support.
We are surrounded by a wealth of knowledge and experience, together we are strong enough to navigate the stress
of the next few months.
As our MCAT dates creep up on us and deliverables begin to take their toll, know that it will be ok. You are made
of magic, you just have to remember to use it.
Laura Cantu
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Volume 6, Issue 2
Healthcare
Access for
Veterans
by Sam Arcas
Picture this, you are a U.S. marine
strapped inside of a huge flying tin
can called the Boeing C-17
Globemaster. All around you sit
fellow marine brothers and sisters,
some who have served beside you in
live combat. As your transport lands,
you are elated to finally be on U.S.
soil again, this time for good. The
cargo door opens and you catch a
glimpse of the crowd wherein your
family is waiting to receive you. An
intense feeling of happiness and joy
rushes over you. But this is not
without a lingering feeling of
concern because you are wounded
from combat and require long-term
rehabilitation. The line ends with
you. In front of you stand countless
other veterans waiting for healthcare
as well, some who have served as far
back as World War 2. For those
veterans fortunate enough to return
home with no physical injuries, there
still exists a strong possibility of
mental health disorders. But for
those with physical injuries and
mental health disorders, the
department of veterans affairs (VA)
is something veterans can’t live
without.
Since the 1600s, U.S. soldiers
disabled by war were offered
monetary
compensation
and
healthcare benefits for their wartime
efforts.1 Over the years, these
benefits evolved to include families
of veterans, and have grown into the
most extensive system of assistance
for veterans in the world. Currently,
the VA healthcare system consists of
152 hospitals, 800 outpatient clinics,
126 nursing homes, and 35
domiciliaries,
employing
over
270,000 and serving nearly 6 million
enrolled veterans out of a total of 22
million nationwide.1,2 The state of
California alone is home to 2 million
veterans.3 But even for the 6 million
enrolled, it remains a challenge for
the VA to effectively serve all
veterans.
Problems
such
as
ridiculous
wait
times
for
appointments,
imperious
bureaucracy, and fraudulent behavior
have all caused public scrutiny of the
VA. Collectively, these acts have led
to an inconsistent and error prone
scheduling system that may have
cost the lives of veterans.
In 2014, a budget of $164
billion dollars was dedicated to
managing the VA’s numerous
hospitals and outpatient clinics. But
even with this amount of money,
problems within the VA persisted,
causing public outcry against the VA
and its administration staff. For
example, the VA was accused of
excessively lacking to deliver
overdue payments to private
hospitals that provided veterans with
“non-VA” services, which includes
any kind of healthcare that the VA is
unable to provide. For many
veterans, a VA hospital either does
not offer a very specific healthcare
service or is too far a distance for
veterans to travel. Thus, veterans are
prompted to visit private hospitals.
Some of the longer cases that the
VA has lacked payment on extended
as far back as 3 years. Due to these
extreme
cases
of
“payment
tardiness”, private hospitals have
completely terminated contracts with
the VA, forcing veterans to either
travel the long distance to a VA
hospital, or worse, not pursue
healthcare at all.
Another problem with the VA stems
from its administrators who have
been alleged to directly interfere with
the patient appointment scheduling
system,
effectively
altering
scheduling so that less patients are
seen daily by doctors.4,5 This
fraudulent behavior painted the
façade to regulatory officials that
patients were receiving timely
appointments, when in reality they
were not. As a result of such gross
manipulation and abuse of power, a
system-wide scheduling catastrophe
ensued, causing patients to wait an
exorbitant amount of time to see a
doctor, some as long as 6 months.
Although it was difficult to gauge
exactly how and how many veterans
were affected by this catastrophe, a
single VA hospital in the Southwest
estimated that 40 patients had died
due to being denied timely
appointments.5
3
In the grand scheme of things, it is
incomprehensible how the VA
system allowed itself to be victim to
such irresponsible and negligent
behavior. In any case, the issue
persists that millions of veterans
remain neglected by a healthcare
institution that promised lifelong
healthcare in exchange for military
service. Government officials and
veteran advocacy groups agree that
in order to change the VA’s way of
offering healthcare, the entire system
must be revamped to hold
employees accountable for their
actions, create an employee-wide
culture of service, and strictly
regulate these changes in the future.
However, all of these changes must
be practiced long-term in order to
fully take effect, and we cannot
expect our veterans to wait any
longer for healthcare that they
desperately need.
Over the past few years, the most
practical and effective measure taken
was the “Veterans Choice” program,
initiated by the “Veterans Choice”
Act. This allowed veterans to visit
non-VA institutions if they lived
more than 40 miles away from a VA
hospital or if their appointment wait
time exceeded two weeks. With a
budget of $10B wholly dedicated to
this program, the VA provided
prompt payment directly to non-VA
healthcare institutions that took care
of veterans. Due to this program’s
success, more private institutions
have begun providing healthcare
again to veterans at the expense of
the VA. Additionally, 2 programs in
New Jersey have begun training
veterans with extensive knowledge
of the VA healthcare system, to
educate and instruct other veterans
on how to navigate the system
complexities and effectively utilize
their healthcare benefits. Lastly, for
senior citizen veterans who require
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Volume 6, Issue 2
in-home care or live in a long-term
care facility, solutions have proposed
to lower taxes to ease the cost of living
and certain healthcare expenses are
even allowed by the IRS to be taxdeductible, with the hope of easing the
cost of living for senior citizen
veterans.
With a veteran healthcare
system that was once in shambles,
there lies hope for our veterans yet.
Our nation’s leaders recognize that
VA healthcare is not perfect and must
continuously be improved until
veterans receive the exact healthcare
they
deserve.
Although
some
legislation has targeted the faulty
points of VA healthcare, much more
must be done in order to truly make
the VA healthcare system the beacon
of hope and good will that it was
constructed to be. We cannot rely on
veterans to be responsible for helping
their own receive benefits promised to
them. Additionally, although deferring
care to non-VA hospitals helps to ease
much of the strain that is put on the
VA, the VA needs to address those
veterans that are “out of their reach”
and healthcare should be easily
accessible to every single veterans that
accessible to every single veterans
that is enrolled.
References:
History - Department of Veteran Affairs
(VA). at
<http://www.va.gov/about_va/vahistor
y.asp>
Viranga Panangala, S. Healthcare for
Veterans: Answers to Frequently Asked
Questions. (2015).
Bureau, U. C. How Do We Know? A
Snapshot of Our Nation’s Veterans. at
<http://www.census.gov/library/infogr
aphics/veterans.html>
Congress acts to address VA issues.
AHA News 50, 1–3 (2014).
McDonnell, P. J. Cheating at expense of
veteran care. Ophthalmol. Times 39, 4–4
(2014).
Volume 6, Issue 2
2016 Presidential Candidates
on Healthcare
by Kayla Yoshida
The presidential election year is upon us once again.
What does that mean for us? Well, for one, it means that
we will all be voting for a new president come
November 8th. However, it also means that we,
members of the PPC Class of 2016, will have an
opportunity to voice our opinions on important
healthcare policy by making an informed vote. Which
presidential candidate will you vote for, and why? While
the candidates have shared their visions for the future
through recent events such as rallies, press conferences,
and official committee debates, it is rare that we see them
all laid out on the table in one place. Here, I will take
you on a quick tour through the current field of
presidential candidates. This will definitely be valuable
in your medical school interviews to come!
First up is Hillary Clinton, former Secretary of
State and the leading candidate for the democratic
national committee nomination, who stands as a large
supporter of the currently instated Affordable Care Act
(ACA).1 Clinton opposes the ‘Medicare-for-all’ or
‘single-payer system’ and believes that the future of the
nation is in ObamaCare. The premise of Secretary
Clinton’s plan is that the ACA is working. And in some
regards, she may be right.
According to the
Commonwealth Fund Biennial Health Insurance Survey,
since the enactment of ObamaCare in 2010, the
percentage of uninsured working-age Americans has
decreased significantly from 20% to 16% by 2014. 2
However, it is debatable whether this is due to
confounding factors, such as the timely end of the Great
confounding factors, such as the timely end of the Great
Recession in June of 2009.
Furthermore, other
researchers project that under the ACA, insurance
premiums are increasing due to low nationwide
enrollment and an inability to file income tax returns. 3
While a stated proponent of the ACA, Hillary has at the
same time promoted her own piece of legislation. For
instance, in September of 2015, she promoted her own
addendum to the ACA labelled the “Affordable
Healthcare and Prescription Drug Platform” and
separately released a plan to address the outrage caused
by pharmaceutical monopolies such as those made by
Turning Pharmaceuticals (Martin Shkreli, CEO) in
August of 2015.1 Moreover, Secretary Clinton has
announced plans to allocate $2 billion toward
Alzheimer’s research and drug development.1 All in all,
Senator Clinton strives to defend the ACA in hopes of
improving access to healthcare.
Next up is Senator Bernie Sanders, who has
served as senator for the state of Vermont since 2007.
This trademark ‘democratic socialist’ is a large proponent
for the ‘Medicare-for-all’, single-payer system. While
Bernie’s ideas call for radical change, his supporters are
passionately behind his plans and surprisingly youthful.
Senator Sander’s main goal is to eliminate private
insurance companies, while creating universal healthcare
consisting of exclusively public insurance (Medicare).
While just an estimate, this system is projected to cost
20% less than the average cost of health insurance today. 1
Furthermore, in an effort to mimic the Canadian healthcare
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Volume 6, Issue 2
Furthermore, in an effort to mimic the
Canadian healthcare system, Bernie
states,
“I believe we've got to go further. I
want to end the international
embarrassment of the United States of
America being the only major country
on earth that doesn't guarantee health
care to all people as a right, not a
privilege.”
-Bernie Sanders at the 2nd Democratic
Primary Debate
Senator Sanders agrees ObamaCare has
moved the nation in the right direction
but is still looking for more. Alike to
Secretary Clinton, he put his interests
in curtailing ‘big-pharma’ by proposing
the Prescription Drug Affordability Act
of 2015 in partnership with U.S.
Representative Elijah Cummings.1
Senator Sanders offers his trademark
‘political revolution’ and intends to do
so to make healthcare a right for all
American citizens.
It seems that Clinton and Sanders aim
to build upon what has been laid out to
date through ObamaCare. On the
other hand, it seems that republican
candidates stand firmly to repeal
ObamaCare. While it may be easier to
pinpoint what is lacking in the current
healthcare policy, it often takes great
ingenuity to propose a new system that
aims to address these problems. The
fear of ‘all talk, no walk’ is a leading
concern for GOP supporters. Only
time will tell if these republican
candidates can act upon their
intentions. Noteable GOP contenders
on healthcare include, Dr. Ben Carson,
a pediatric neurosurgeon, and Senator
Ted Cruz, Senator for the state of
Texas and the self-proclaimed leader of
the effort to repeal the ACA.
First up is Dr. Ben Carson. The retired
6
Senator Ted Cruz, a front-runner
for the republican nomination,
currently leads the effort to replace
the ACA with the Health Care
Choice Act (HCCA).1 The HCCA
would repeal only Title 1 of the
ACA, with the restoration of the
free-market for health insurance as
a desired result. In theory, market
competition would rise and patients
would be empowered to choose
their own health insurance. Senator
Cruz brands the HCCA as personal,
portable, affordable healthcare.
Unlike many of his fellow
candidates, it seems so far that Cruz
offers the most concrete plan to
transform the current state of
healthcare. For instance, he plans
to reinstate the ability for patients
to purchase health insurance across
state-lines by creating a private
system with many different
companies (the direct opposite of
ObamaCare). Cruz projects that
this will restore the free marketplace
and directly diminish the role of
government within health affairs.
He also believes in Carson’s design
for health savings accounts for
those who are able. Finally Cruz
calls for the de-linkage of health
insurance
from
employment,
making health insurance ‘portable’
with the patient.
Other GOP
candidates, not to mention Donald
Trump, have similar beliefs, but
have
however
shown
little
leadership in spearheading new
healthcare policy reform.
This coming election questions the
boundaries of conservative and
socialist, as well as whether
healthcare is a right or a privilege.
Nonetheless, healthcare is a
necessity and must continue to be a
chief concern for our nation’s
president. This election season
next president.
This election
season proves to be an exciting
time for healthcare reform, so you
can trust that this PPC will be
following
these
presidential
candidates closely… after MCATstudying of course.
References:
The Lucy Burns Institute. 2016
Presidential Candidates on Healthcare. 2015.
https://ballotpedia.org/2016_presidentia
l_candidates_on_healthcare (accessed
January 2016).
ObamaCare Facts. Rise in Healthcare
Coverage and Affordability. January 15,
2015.
http://obamacarefacts.com/2015/01/15
/rise-in-healthcare-coverage-andaffordablity/ (accessed January 2016).
Tanner, Michael. What's Wrong with
Obamacare? October 28, 2015.
http://www.nationalreview.com/article/
426121/obamacare-bad-news (accessed
January 2016).
Photo References:
http://www.motherjones.com/politics/
2015/04/bernie-sanders-hillary-clintondemocrat-2016-press-questions
http://www.washingtontimes.com/news
/2015/mar/23/ted-cruz-immigrationcrackdown-advocacy-sparksfie/?page=all
Volume 6, Issue 2
A Chat with Dr. Alan Rothfeld, MD
by Andrew Gurewitz
In continuing with the faculty profile
section, this issue we will delve
deeper into the life of everyone’s
favorite
clinical
pharmacology
professor Alan Rothfeld MD. He
graduated from medical school in
1974 and then completed a
fellowship in pulmonology/critical
care medicine in 1979. After
completing the fellowship he was
recruited by USC where he was an
attending physician as well as
professor in their medical school. In
recent year he began to transition to a
hospital administration role. He
worked as essentially a medical
director for a hospital system and set
up a few clinics in the Los Angeles
area. If you want to hear a good story
ask him about the cheap vegetables.
He joined the KGI faculty in 2007
after a chance meeting with a KGI
faculty member who addressed the
need for a clinical faculty member.
He said that teaching here was a
refreshing change from teaching
medical students although he admits
now that the PPC class is half of the
SALS class, things have become
more like teaching medical students.
Having such a distinguished career in
Having such a distinguished career in
medicine I was curious as to how
medicine has changed over his
career. Some of the changes that
that he has seen include better
protocols, improvements in patient
safety, the overuse of antibiotics and
something that he stresses in clin
pharm – Medical Care is the
leading cause of death in the
United States. I then asked for 3
areas that can be fixed in modern
medicine. His responses were quite
clear: 1) curtail the use of medicine
2) simplify the payment system 3)
Rationalize physician practices. Being
an attending physician to medical
students I was curious if he had any
advice that he would give potential
medical students. He said that
satisfaction needs to be emphasized,
remind them that you don’t have to
be OCD in practice and be true to
your own personality. Like many of
you are or should be doing I am
working on my personal statement
and one of the most difficult
questions
is
why
medicine.
According to him he felt that
medicine was relevant and not
theoretical and is the best education
theoretical and is the best education
you can get, you can’t fool nature.
When I asked him why medicine
now his response was intellectual
satisfaction, seeing how medicine
has changed and the ability to
command vast resources to solve
problems. My final question
concerned the opioid epidemic
sweeping the country and what he
thought could be done about it. I
was quite surprised, I was expecting
him to say that it was caused by
overzealous physicians but instead
he said that the problem lies with
the state relicensing of physician,
making them take a pain control
class a few years ago. Before that
class was mandatory no one was
really using narcotics but since then
the use has been on the rise until
recently. The problem with all of
this according to him is now we
have patients that are addicted to
narcotic pain control. According to
Dr.Rothfeld,
physicians
have
realized this and greatly curtailed
the use of narcotic pain control in
their practice. Overall I enjoyed my
time with Dr. Rothfeld, he seemed
more than willing to chat about
anything medicine related and was a
great resource about our future
career.
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Where Are They Now?
Volume 6, Issue 2
Jixi (Lucy) He PPC ‘13, MBS’14
Ben-Gurion University Medical School for International
Health, MD Class of 2019
How has your PPC/KGI experience impacted your career path and where
you are at today?
Some of the courses I've taken at KGI directly contributed to my knowledge at
med school (like clinical pharmacology, medical devices, pharmaceutical discovery
and development, biostatistics etc) and the others made me feel privileged that I
got to learn all those things that med school wouldn't provide (like accounting,
marketing, having the chance to actually work with Amgen in our master project,
and the wine club was probably the best club I've ever joined). I'm very glad that
PPC/MBS (KGI) gave me so many chances to learn all about the health related
industries. When the teachers here talk about drug approval, biologics, patent
exclusivity, I secretly smile inside.
If you had to offer one piece of advice to your past PPC self, what would it
be?
To my past self? My serious advice would be: DON'T relax the summer before
med school, start STUDYING for med school the moment you get your first
acceptance. Always think about how to provide patients (and the people around
you) with maximal comfort because when medicine fails at least you can try to
make them smile (watch Patch Adams!).
My lighthearted advice: Don't give up what's most important to you (i.e. EAT,
SLEEP, and be SANE) I haven't stopped going to band, and I've developed
newfound interests in cooking and origami because that relaxes me. Actually this is
a serious advice too: BE HEALTHY YOURSELF! How can I take care of others
when I'm sick?
Would you be receptive to being in contact with current PPC students?
I would love to! I also have a not so active blog if people want to check out how's
life and study in Israel.
Shalomdoctor.com
My email: jixi@post.bgu.ac.il
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Where Are They Now?
Volume 6, Issue 2
Kate Brown PPC ‘12, MS’13
Touro College of Osteopathic Medicine, New York, DO Class of
2017
How has your PPC/KGI experience impacted your career path and how has
it contributed to where you are at today?
While I am not sure what I would be doing if it weren't for KGI, I am confident
that I wouldn't be in medical school. KGI’s ample research opportunities allowed
me to get involved in a few different projects and the small class sizes made it
reasonably easy to get to know the professors and to gain leadership skills. The
countless lunch lectures helped me figure out what kind of school was a good fit
and the MBS-style internships and classes gave me plenty to talk about during
interviews.
If you had to offer one piece of advice to your past PPC self, what would it
be? (perhaps one serious and one lighthearted).
The first piece of advice I would give is try not to compare yourself too much to
other students. I think it is easy to get caught up in the “this student got this
MCAT score and got an interview here, so I need to get the same score to have a
chance” or “this student is doing three research projects, should I be doing more
research?” You each have something that makes you a unique applicant. If you
don’t know what makes you stand out, Joon will tell you (he told me). I was a nontraditional student who overcame some significant hurdles in obtaining my degree
and I often felt pressured into keeping up with other pre-meds. What I didn’t
realize until I had overexerted myself was that schools weren’t comparing me
against other traditional students. I was being compared against other nontraditional students with similar circumstances (whose average GPA and MCAT
scores were lower than their published numbers). Focus on doing your best and try
not to worry about what everyone else is doing.
Would you be receptive to being in contact with current PPC students and if
so, what would be the best place to reach you?
Yes, I would be happy to talk to any student. My email address is
KBrown9@student.touro.edu
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Where Are They Now?
Volume 6, Issue 2
Erica Liu PPC ‘13
Rosalind Franklin University Physician Assistant Program,
Class of 2019
How has your PPC/KGI experience impacted your career path and where
you are at today?
How has your PPC/KGI experience impacted your career path and where you are
at today?
My time in the PPC program helped me to better articulate my beliefs and goals.
During my time at KGI, I also began to develop greater professionalism and
improved public speaking skills. All of these were tremendous assets when it came
time to apply to PA school; I felt like I could comfortably convey to various
admissions committees/interviewers the things that are really integral to who I am
(which is actually much harder to do than one might think).
I actually switched from the med school track to the PA school track during my
time at KGI. Though I don’t actually think that anything in the PPC/KGI
experience directly contributed to my decision, I was fortunate to be in an
environment that was very supportive of all medical professions. In fact, anytime
that we visited a med school or hosted a representative from a med school that has
a PA program, Joon made sure that we were given information on both programs.
Funnily enough, one of these sessions was with an admissions counselor from
Rosalind Franklin University, which is where I now go to school!
If you had to offer one piece of advice to your past PPC self, what would it
be?
When telling people that you have decided to switch career paths, use these
conversations to advocate for your chosen profession and to educate others about
your new career path. And don’t preempt your explanations with excuses! Though
others may sometimes doubt the legitimacy of the PA profession or cast it as
hopelessly inferior to being an MD, you shouldn’t feel pressured to disparage your
own profession simply for the sake of fitting in. Also, always order a side of truffle
sauce with your fries at Eureka Burger!
Would you be receptive to being in contact with current PPC students?
Sure – my email address is ericaliu228@gmail.com
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Volume 6, Issue 2
Art by Sara Littrell
Concept by Cyrus Nguyen
Phabulously Phun Crossword (PPC) 2016
By Sam Arcas
A Work in Progress
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Walking is man’s best medicine.
- Hippocrates
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