Pakistan is the 3rd Largest Source of Foreign Doctors in America

Pakistan is the third biggest source of foreign doctors who make up a third of all practicing physicians in the United States, according to OECD. Vast majority of Muslim doctors in America are of Pakistani origin.

Foreign Doctors in America:

About 30% of the 800,000 doctors, or about 240,000 doctors, currently practicing in America are of foreign origin, according to Catholic Health Association of the United States. Predictions vary, but according to the American Association of Medical Colleges, by 2025 the U.S. will be short about 160,000 physicians. This gap will most likely be filled by more foreign doctors.

Foreign Doctors in US, UK. Source: OECD


Pakistani Doctors in United States:

As of 2013, there are over 12,000 Pakistani doctors, or about 5% of all foreign physicians and surgeons, in practice in the United States.  Pakistan is the third largest source of foreign-trained doctors. India tops with 22%, or 52,800 doctors. It is followed by the Philippines with 6%, or 14,400 foreign-trained doctors. India and Pakistan also rank as the top two sources of foreign doctors in the United Kingdom.

Dow University of Health Sciences, Karachi, Pakistan


Dow Medical University of Health Sciences:

There are 3,100 graduates of Karachi's Dow University of Health Sciences, contributing the largest pool of doctors among the 12,000 Pakistani doctors in the United States. About 1,900 are from Lahore's King Edward Medical College and the rest from Karachi's Agha Khan University, Lahore's Allama Iqbal Medical College and other medical colleges in Pakistan, according to Dr. Humayun Chaudhry, President and Chief Executive Officer of the Federation of State Medical Boards in the United States.

Doctor Shortages:

India has six doctors for 10,000 people and Pakistan has eight. The comparable figure for the United States is 25 doctors per 10,000. And yet, the United States continues to import thousands of doctors from these two South Asian nations. Predictions vary, but according to the American Association of Medical Colleges, by 2025 the U.S. will be short about 160,000 physicians. This shortfall will most likely be filled by foreign doctors from countries like India and Pakistan.

Summary:

Pakistani doctors make up the third largest source of practicing physicians and surgeons in the United States. And more are coming to make up the continuing shortages in spite of the fact that Pakistan has only eight doctors per 10,000 people, only a third of the 25 doctors per 10,000 in the United States. Will this change after President-elect Donald Trump takes office on January 20, 2017? Only time will tell.

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Comments

Riaz Haq said…
The US Distribution of Physicians from Lower Income Countries
E. Fuller Torrey1,* and Barbara Boyle Torrey2

The origin and distribution of the IMGs from lower income countries are both concentrated; 85 percent of them come from just 8 countries, and 67 percent of all IMGs are living in just 10 states (see Table S1). Forty-one percent of all IMGs from lower income countries come from India, and 22 percent of them are practicing in New York and California. The Philippines is the second largest provider of physicians from lower income countries (16 percent), and they are also practicing in disproportionate numbers in New York and California. Physicians trained in Pakistan, the third most important country of origin of IMGs in the United States (10 percent), practice disproportionately in Texas, New York, and Illinois.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310056/

Riaz Haq said…
#Pakistan to build first #nursing university named after #Bahrain's King Hamad, affiliated with RCS of #Ireland
http://tribune.com.pk/story/1286260/pm-nawaz-performs-groundbreaking-pakistans-first-nursing-university/

Prime Minister Nawaz Sharif on Friday performed the groundbreaking of the country’s first nursing university.

“The Bahrain funded state-of-the-art King Hamad University of Nursing and Associated Medical Sciences will help the country’s health sector prosper,” PM Nawaz said while addressing the groundbreaking ceremony. The university, being built in Chak Shehzad, is a gift from Bahrain and will be affiliated with Royal College of Surgeons, Ireland.

Addressing the event, the prime minister said in view of the dearth of trained nursing and training staff in the country, the noble project by Bahrain would help fill gap in healthcare sector.

Regional security: Bahraini commander meets army chief

PM Nawaz further said the university will raise the level of standard of health and will be significant in bringing quality nursing care in the country.

The prime minister stressed that health is one of the top priorities of the government. “The government aims to provide integrated healthcare spanning over the entire health spectrum from primary to tertiary care,” the premier said. He added that the “programme is unprecedented in terms of its magnitude and is being implemented in a phased manner and would provide coverage to 100 million people eventually. Work in this regard is being undertaken expeditiously.”

The ceremony also saw the announcement of construction for another 50 state-of-the-art hospitals throughout the country.

PM Nawaz to lay foundation of 1156MW power plant in Sheikhupura

The premeir said the government is focused on preventative measures and pointed out that the national immunisation programme provides free of cost vaccines to every Pakistani mother and child. “There has been significant improvement in the coverage of the programme and concrete steps are being taken to arrest the spread of polio,” he said.

PM Nawaz thanked the government of Bahrain, especially King Hamad for his generousity in offering support for the establishment of the university, saying “the university symbolises strong bonds of brotherhood and friendship between the two countries.”

“This is reflective of leadership of Bahrain’s love for the people of Pakistan and its commitment to help improve the quality of life of our people,” he added.
Riaz Haq said…
Karachi to gain its own cancer hospital by Dec 2019

http://tribune.com.pk/story/1278799/evolving-healthcare-system-karachi-gain-cancer-hospital-dec-2019/

KARACHI: The groundbreaking ceremony of the third Shaukat Khanum Cancer Hospital in the country was performed by a 10-year-old cancer patient, Waleed Iqbal. Together with Shaukat Khanum Memorial Trust (SKMT) board of governors chairperson Imran Khan, Waleed unveiled the groundbreaking plaque on Thursday.

Waleed and many other cancer patients from Sindh and Balochistan previously had to travel to Lahore for cancer treatment but now patients will not have to bear expense of accommodation and travelling with the establishment of a cancer hospital in Karachi.

The ceremony, which was held at the site of the hospital in Defence Housing Authority (DHA) City near the Superhighway, was attended by board members of the SKMT, the hospital’s senior management, dignitaries, donors and celebrities.

The hospital will be built on 20 acres of land allotted by DHA, for which we are very grateful, said SKMT’s chief executive officer Dr Faisal Sultan. He told participants that the total cost of constructing the hospital is Rs4.5 billion and the facility will be completed on December 29, 2019.


Dr Sultan added that the hospital will have the similar state-of-the-art facilities as are being provided at the other Shaukat Khanum hospitals in Peshawar and Lahore. This includes surgery, radiotherapy, chemotherapy, hormone therapy and biological therapy facilities. The hospital will enhance and raise the healthcare standards in the region, claimed Dr Sultan.

Highlighting the details of the project, Dr Sultan said the new facility will have operating rooms, an intensive care unit, a chemo-bay facility, inpatient rooms, and outpatient clinics, initially. The hospital will have nine clinical departments – medical oncology, paediatric oncology, radiation oncology, brachy-therapy, CT simulation services, surgical oncology, anaesthesia, radiology with CT scanners, MRI scanners, X-ray machines, fluoroscopy, ultrasound machines, mammography scanners and a PET CT scanner. The pathology department will have haematology, clinical chemistry, microbiology, cytology, and a blood bank.


He added that this enormous facility would open up opportunities for oncologists, doctors, nurses and other health professionals to get training in the management, diagnosis and treatment of cancer.

Dr Sultan said around 75 to 80% of the patients at the facility are treated free of charge, while the remaining 20 to 25% of patients pay their own expenses. He also clarified that the hospital’s income depends on 40 to 45% of the revenue it generates, 25% on zakat and 35% on other donations.
Riaz Haq said…
#UK #NHS to bring 200 doctors each from #India and #Pakistan in 2017.

http://www.telegraph.co.uk/news/2017/01/12/nhs-could-bring-hundreds-doctors-india-stem-ae-crisis/


Hundreds of doctors may be drafted in from India and Pakistan to plug a spiralling crisis in Accident & Emergency departments, health officials say.

The scheme will start in Greater Manchester, with 20 medics due to be flown from India this year for up to three years.

The region’s eight Accident & Emergency departments have been under severe strain in recent weeks amid staffing shortages.


Officials behind the plans said the scheme, backed by Health Education England, could be expanded in respond to widespread shortages of A&E doctors across the country. The project is being run by the Greater Manchester devolution team and Wrightington, Wigan and Leigh Foundation Trust.


Andrew Foster, trust chief executive told Health Service Journal said the region's A&E departments were now "very reliant on locums."

Most of the trusts needed around 10 to 12 "middle grade" doctors, but only had two or three. "They're very reliant on locums," he said.

Such medics are junior doctors, who have finished basic training but are still learning specialist skills and have yet to qualify as a consultant.

Mr Foster, who was formerly Department of Health director of of human resources, said the plans could form part of a national recruitment exercise.

"We are talking about the possibility of getting 200 [trainees] from India and the same number from Pakistan," he said.

In November a report by the Commons health select committee warned that A&E departments need at least 8,000 doctors – 50 per cent more than the 5,300 currently employed - to keep pace with the rise in emergency admissions in the last five years.

Under the new scheme, the NHS will pay £16,000 towards the training costs for each recruit, as well as paying their salary. The middle grade doctors would be placed in emergency departments for 2-3 years while completing their training in emergency medicine, before returning to India.

Ged Byrne, director of education and quality for Health Education England in the North West, said: “This work is helping to increase the number of doctors who are available to support acutely ill patients.

"The relationship benefits both the UK as it helps to fill an immediate need and the doctors themselves who gain access to high quality training and a unique skills set.”
Riaz Haq said…
#US Patient Mortality Lower With Foreign-Trained #Physicians from #India, #Pakistan, #Philipinnes, etc http://www.medscape.com/viewarticle/875356 … via @medscape


Medicare patients admitted to the hospital and treated by internists who graduated from medical schools outside the United States had lower 30-day mortality than matched patients cared for by graduates of US schools, according to results of a study published online today in the British Medical Journal (BMJ).

To practice in the US, international medical school graduates must pass two exams on medical knowledge and one assessment of clinical skills, and complete accredited residency training here. However, medical schools outside the US are not accredited by any domestic agency. In response to concerns about quality of care from internationally trained physicians, the Educational Commission for Foreign Medical Graduates will require accreditation of medical schools outside the US by 2023.

Studies comparing the quality of care provided by internationally trained physicians with that by domestically trained physicians are few and small in scope. Yet, physicians trained outside the US may be perceived by some as not as competent as physicians who attended medical school in the US.

To compare the two, Yusuke Tsugawa, MD, MPH, PhD, from the TH Chan School of Public Health at Harvard, and colleagues conducted a large observational study of hospitalized Medicare beneficiaries to assess whether outcomes differ depending upon whether or not their general internists were trained domestically or abroad. The study excluded graduates from Central America and the Caribbean to minimize inclusion of US citizens trained outside the country. The countries that contributed the most internists to US hospitals were China, Egypt, India, Mexico, Nigeria, Pakistan, the Philippines, and Syria.

The researchers assessed 30-day mortality rate (the primary outcome), readmission rate, and costs of care (total part B spending), and whether clinical condition influences differences in patient outcomes and care costs between the two groups of patients. In addition, they adjusted their models for patient characteristics (age, sex, race or ethnic group, diagnosis, and income), physician characteristics (age, sex, and patient volume,) and hospital fixed effects (characteristics of hospitals).

Results indicated that 44.3% (19,589 of 44,227) of general internists in the US graduated from medical schools outside the country. They were slightly younger than US graduates (46.1 v 47.9 years; P < .001), and were more likely to work in medium-sized, nonteaching, for-profit hospitals without intensive care units.

In addition, their patients were more likely to be nonwhite, have Medicaid, have lower median household income, and have more chronic comorbidities (congestive heart failure [CHF], chronic obstructive pulmonary disease [COPD], and diabetes)


The mortality analysis included 1,215,490 patients admitted to the hospital under the care of 44,227 general internists between 2011 and 2014. Patients treated by international graduates had lower mortality (adjusted mortality, 11.2% v 11.6%; adjusted odds ratio, 0.95; 95% confidence interval [CI], 0.93 - 0.96; P < .001).

"Based on the risk difference of 0.4 percentage points, for every 250 patients treated by US medical graduates, one patient's life would be saved if the quality of care were equivalent between the international graduates and US graduates," the authors write.

The cost analysis included 1,276,559 patients treated by 44,680 physicians during the same study period.

Overall, patients of internationally trained internists had slightly higher adjusted costs of care per admission ($1145 v $1098; adjusted difference, $47; 95% CI, $39 - $55; P < .001).

Meanwhile, adjusted readmission rates among 1,182,268 patients who were treated by 44,201 physicians did not differ between the two patient groups.
Riaz Haq said…
$15 million Gift to Notre Dame Catholic University from #Pakistani-#American #Muslim Physician Couple in #Indiana

https://www.nytimes.com/2017/03/17/your-money/norte-dame-muslim-philanthropists.html?_r=1

Rafat and Zoreen Ansari, medical doctors who were born in Pakistan, have spent the last four decades working and raising their three children in a suburb of South Bend, Ind., where they also have earned a reputation as civic leaders.

By their estimation, they have given at least $1 million and thousands of hours of their time to nonprofits focused on children with autism, which afflicts their youngest child, Sonya.

But a year and a half ago the couple and their children, all Muslim, began working on a larger gift in terms of money, impact and risk: Their goal was to fund something that would foster better understanding of religion, including Islam, Judaism and Christianity, with the belief that all religions should be treated with equal respect.

The family’s inclination to leave a legacy is not uncommon among people who have grown wealthy. But their focus could land them in the middle of one of the most charged issues of the day.

“We came as immigrants, and this country has given us so much,” Mrs. Ansari said in an interview ahead of the announcement. “We want to give something back to America, but also to humanity. We want to promote the idea of equality.”

On Friday, the Ansaris announced a $15 million gift to the University of Notre Dame, one of the top Catholic universities, to create the Rafat and Zoreen Ansari Institute for Global Engagement With Religion. The institute will aim to deepen knowledge of religion and look to explain how the traditions and practice of various religions influence world events.

“Whenever you get a gift of this size, it’s tremendous, but particularly to have this named for the Ansari family, who is Muslim, is tremendously meaningful to us,” said the Rev. John I. Jenkins, the president of Notre Dame, in an interview. “We believe religion is very important in our world. It can have a negative impact, but it should be possible to study the ways religion can be a force for human development and peace.”

Father Jenkins said the institute would look at religion not through a sociological or political lens, but through one focused on the religions themselves.

While the couple and the university said the gift, which was 18 months in the making, was not conceived as a way to make a political statement, all parties acknowledged that it came at a politically charged time, given the debate over Muslim immigration in America and Europe.

“In the last couple of years, the majority of problems have been created by the misunderstandings among the religions,” said Mr. Ansari, an oncologist and hematologist. “Is this the right time for the announcement? Yes, because there is so much going on.”

The Ansaris thought long and hard about how to achieve their goal. Their hometown, Granger, Ind., is just a few miles from Notre Dame. While the Ansaris were educated in Pakistan, their daughter Sarah graduated from Notre Dame Law School.

Riaz Haq said…
AMERICAN MUSLIMS – VITAL PART OF U.S. HEALTH CARE SERVICES AND MEDICAL ACHIEVEMENTS
Around 10 % of all physicians in the U.S. are Muslims; An example of remarkable American success story

http://www.viewsnews.net/2017/06/10/american-muslims-vital-part-u-s-health-care-services-medical-achievements/

Under unprecedented spotlight since the 2016 election campaign, American and immigrant Muslims have found a new ally in the form of a treasure trove of authentic statistics springing from research institutions, analyses and informed sources.

President Donald Trump’s decision last week to seek Supreme Court’s reinstatement of his federal court frozen travel ban for citizens from six Muslim majority countries provides another opportunity to showcase the role American Muslims play in wide-ranging areas.

One area, where immigrants from Muslim majority countries have contributed crucially to the United States’ well-being is health care services.

For example, The Medicus Firm, a company recruiting medics, reveals that 15,000 doctors working in the U. S. came from the seven Muslim majority countries – Libya, Iraq, Iran, Somalia, Syria, Sudan, Yemen – initially included in the travel ban executive order.

Of these, 9,000 doctors emigrated to the U. S. from Iran, while 3,500 came from Syria and more than 1,500 from Iraq, which no longer is on the list of countries covered under the proposed travel ban.

Just one percent of the total population, American Muslims have contributed to the American health care sector enormously. In several rural areas and small towns Americans get health care services from immigrant medical practitioners, including Muslim doctors.
Pakistan, a large Muslim majority country, is one of the top five countries contributing medical experts including doctors to the U. S. According to a Pakistani organization, the number of Pakistani-American doctors is nearing 20,000. They work all over the United States, with many of them practicing in states which need them the most, in rural areas far away from the East and West coasts.

In fact, one of the most prominent doctors in recent world history was a Pakistani-American neurosurgeon, Dr. Ayub Ommaya, who famously invented the Ommaya reservoir, which is employed to provide chemotherapy drugs directly to the tumor site for treating brain tumors.

He has been described as one of the most important Americans ever who shaped America with their individual achievements.

According to figures cited by organization IntraHealth International, there are 656,000 doctors and surgeons working in the U. S. with 254,000 of them being immigrants.

Riaz Haq said…
Hospitals in #Trump country suffer as #Muslim #doctors denied visas to U.S. https://interc.pt/2x7ChDd by @MaryamSaleh_

EVERY MARCH, DOCTORS across the United States and the world eagerly await “Match Day” — the day they find out what residency, internship, or fellowship program they’ve been matched with. By that point, residency candidates have completed medical school and passed a series of rigorous qualifying exams. For those who are not American — about a quarter of all doctors in the U.S. are foreign-born — there’s one additional step: securing a J-1 visa, a nonimmigrant exchange visa conditioned on an individual’s return to their home country for at least two years at the conclusion of the program.

In the weeks following the March 17 match, dozens of Pakistani physicians had their J-1 applications denied in Islamabad and Karachi, said Shahzad Iqbal, a Pakistani-American physician in New York.

Jan Pederson has spent the last 30 years of her legal career representing foreign-born physicians coming to the U.S. for residency or fellowship programs. It’s an unheralded but essential line of work, because without foreign doctors, the U.S. healthcare system would simply collapse, with the pain felt most acutely in rural areas. U.S. medical schools don’t produce anywhere near enough graduates to meet the needs of the country, particularly in places where people are reluctant to move to.

Like any legal practice, Pederson’s hasn’t always been smooth. Every so often, a client’s visa application is denied. It happens. In the years following the Sept. 11 terror attacks, doctors from countries, such as Iran and Syria, saw their applications get stuck in administrative processing until U.S. officials could affirmatively say the physicians posed no national security threat, she said.

But this spring, weeks after President Donald Trump issued a revised version of an executive order restricting immigration from six Muslim-majority countries, Pederson saw the same thing Iqbal did — what she called an “epidemic of Pakistani visa denials.”

Advocates say there is no way to separate the attempted Pakistani physician ban from the so-called Muslim ban and other Trump administration immigration policies.

“I think it’s a confluence of factors” that caused the visa denials, Pederson said. “It would be hard to escape the conclusion” that there is a correlation between the visa denials and the president’s anti-immigration rhetoric and policies.

“This year, we had about 34 J-1 refusals that were reported to us. This is kind of a historic number,” said Iqbal, who chairs the Committee on Young Physicians, which is a part of the Association of Physicians of Pakistani Descent of North America. APPNA only knows about denials that rejected applicants reported to them, so it may be just the tip of the iceberg. Many reapplied, starting from scratch, and were successful, but started their programs late.

APPNA has lobbied on behalf of Pakistani doctors hoping to train in the United States since 2003, Iqbal said. Heightened post-9/11 security measures meant that many visa applications were held up in administrative processing, but “it never happened before that there was a mass number of denials,” he said. “Before, there were security clearances, and people were placed in security clearance for six months to two years.”

For the last five years, APPNA received reports of, at most, one or two physicians whose visa applications were denied, and usually it was because of an issue with an applicant’s immigration history.

This is concerning, Iqbal said, since Pakistan is one of the top suppliers of foreign doctors to the U.S. In 2015, 12,125 doctors of Pakistani descent were practicing medicine in the U.S., second only to India’s 46,137 doctors, according to the U.S. Organization for Economic Cooperation and Development.

Riaz Haq said…
#Pakistani-#American #medical grad Dr. Faisal Cheema from #Karachi's Aga Khan University gets $4 million research grant for heart transplant #research

https://dailytimes.com.pk/213442/pakistani-scientist-awarded-4-million-to-lead-research-on-heart-transplantation/

ISLAMABAD: A Pakistani physician/scientist Dr Faisal H Cheema was awarded $4 million to lead a cutting edge research on heart transplantation.

Dr Faisal H Cheema belongs to the rural areas of Wazirabad and Hafizabad and got his education from Crescent Model School as well as the Government College, Lahore before moving to Karachi to attend medical school at Aga Khan University.

After graduation, he moved to the United States and further trained and worked at Columbia University , Loyola University, Johns Hopkins University, University of Maryland and University of California Berkley. He is currently a faculty member at Baylor College of Medicine and Texas Heart Institute in Houston, TX.

He has served as Senator for the Ivy-League Columbia University and is involved with several professional, academic, community and philanthropic organisations. Dr Cheema’s passionate and selfless work for young physicians culminated in the establishment of Committee for Young Physicians within Association of Physicians of Pakistani-descent of North America, on which he served for more than a decade that included chairing it. He has helped hundreds of students in their search for residencies and or advancing their medical careers in the US. He loves to mentor medical students and young physicians.

Ever since he left his motherland, he continues to collaborate with various institutions in Pakistan and guides students from medical schools across the country. Dr Cheema has published more than 110 scientific manuscripts in high impact journals. In due course of time, through strategic partnerships among academic, corporate, governmental and philanthropic institutions, Dr Cheema’s mission is to make heart and lung transplant and artificial devices for end-stage heart failure and lung disease a reality in Pakistan.

He also aspires to develop a national organ donation and allocation system for Pakistan. Dr Cheema and his colleague Dr Jeffrey A Morgan have been awarded $4 million in funding from Brockman Medical Research Foundation to lead cutting edge research on heart transplantation.
Riaz Haq said…
Pakistani-American Doctor is the Second Highest Medicare Biller

Dr. Asad Qamar, a graduate of Lahore's King Edwards Medical College, received $18.2 million in payments from US Medicare program in 2012, making him the second highest billing doctor in America. Dr. Qamar is a member of APPNA, Association of Physicians of Pakistani Descent in North America. He was a candidate for the presidency of APPNA in 2013.


Asad Qamar M.D.

Dr. Qamar, a Pakistani-American cardiologist, and his family have given at least $300,000 to politicians and political causes in the 2012 election cycle and in 2013, according to contribution disclosure records reported by Reuters. Dr. Asish Pal, a Florida-based Indian-American, is the second highest billing cardiologist in America. Dr. Pal was paid $4.5 million by Medicare.

Dr. Qamar has been subjected to lengthy reviews of his billing practices by US Department of Health and Human Services. He has complained to President Obama and other officials that the contractors conducting the reviews for the HHS were slow and unresponsive. Dr. Qamar told New York Timesthat his payments were high because his practice, which has 150 employees and a caseload of 23,000 patients, routinely handles complicated procedures like opening blocked arteries in the legs of older patients, which normally would be billed by a hospital.

Only Dr. Salomon Melgen, a Florida Ophthalmologist, billed Medicare for a larger amount than Dr. Qamar did in 2012. Dr. Melgen, too, is a major contributor to Democratic party. Dr. Melgen’s firm donated more than $700,000 to Majority PAC, a super PAC run by former aides to the Senate majority leader, Harry Reid, Democrat of Nevada. The super PAC then spent $600,000 to help re-elect Senator Robert Menendez, Democrat of New Jersey, who is a close friend of Dr. Melgen’s. Last year, Mr. Menendez himself became a target of investigation after the senator intervened on behalf of Dr. Melgen with federal officials and took flights on his private jet, according to The Times story.


http://www.riazhaq.com/2014/04/pakistani-american-doctor-is-second.html
Riaz Haq said…
NY Times History of Islam in America

https://youtu.be/lSycg4APyu4

Muslims arrived with Columbus and have been leaving their mark on American culture and society ever since. Did you know that the Statue of Liberty was based on an Egyptian Muslim woman and that two of the oldest mosques in the United States are in Ross, N.D., and Cedar Rapids, Iowa? In the video above, we explain many other ways Muslim history is tightly woven into American life.

Muslims have been here since the time of the earliest explorers and have left their mark on everything from the White House to the Marine Corps uniform.

By Hussein Rashid, Negin Farsad and Joshua Seftel

Source: https://www.nytimes.com/2018/12/17/opinion/contributors/muslims-united-states-history-islam.html
Riaz Haq said…
'State Of The Heart' Cardiologist Assesses Breakthroughs In Heart Health (Pakistani-American cardiologist Dr. Haider Warraich)


https://www.wknofm.org/post/state-heart-cardiologist-assesses-breakthroughs-heart-health


This is FRESH AIR. I'm Terry Gross. Breakthroughs in heart medicine, including surgical procedures, devices and medications, have changed how various forms of heart disease are treated and enabled many people to live longer lives. We're going to hear about some of those new developments from Haider Warraich, author of the new book "State Of The Heart: Exploring The History, Science, And Future Of Cardiac Disease." We're also going to talk about cholesterol and blood pressure.

Warraich previously joined us to talk about his book "Modern Death: How Medicine Changed The End Of Life." He's a cardiologist who began his medical training in Pakistan, where he's from, and continued his training in cardiology at Harvard Medical School and Duke University. In September, he joins the faculty of Brigham and Women's Hospital at Harvard Medical School and the Boston VA.

Doctor Haider Warraich, welcome back to FRESH AIR. You write that during the time that you were a medical student, you saw so many changes in heart medicine and technology. Tell us about one that you think is most significant.

HAIDER WARRAICH: When I was a medical resident up at the Beth Israel Deaconess Medical Center in Boston, this was around the time when a new device had just started to be used in clinical practice that I had really never heard about before. And this was a device called a left ventricular assist device. And really what it is, is it is a mechanical pump that can be sewn directly, right into a patient's heart, and basically takes over the pumping function of the heart. And I know when this program started, there was a specific row in the hospital, in the wards, where these patients would be taken care of. And at least initially, residents were not even allowed to take care of these patients. So they had this aura, this mystery to them.

But the interesting thing about this therapy is that it fundamentally changes so many of the things what we consider to be, you know, the key fundamental principles of being a human being. So, you know, these patients who had these mechanical pumps, you know, they didn't have a pulse. If you performed CPR on them, it could actually do more harm than good. And these patients were basically dependent on their batteries for their life.

So this was such a dramatic departure from really any type of other medical intervention that I'd ever even heard about, which is, you know, part of the reason why I actually pursued this and now I actually specialize in taking care of these patients.

GROSS: Yes, and you describe this device, which is an LVAD - which stands for left ventricular assist device - you describe it as representing the dawn of a new era in human life, the union of man and machine. Because you're totally dependent on the machine, I mean, every second of the day. But really, the idea of, like, no pulse. I can't - it's, like, hard for me to conceive of that.

WARRAICH: I mean, it's hard as a physician. I mean, checking someone's pulse is part of the - you know, one of the sort of purest and oldest rituals in medicine. When you come up to someone, you shake their hands, and you're examining them. And you almost always start by checking the pulse in their wrist. And the other thing that happens in these patients is that if you put a stethoscope to their chest, usually, you'll hear, you know, the gallop of the heart kind of, you know, running away as it has been since, you know, we were in our mothers' womb.

Riaz Haq said…
Saudi Arabia and UAE have decided to de-recognize Pakistani MD degree. Do the Arabs know something the Americans and the Brits don't? Pakistan is the second largest source of foreign doctors in the UK and the 3rd largest source in America.

https://www.riazhaq.com/2016/12/pakistan-is-3rd-largest-source-of.html
Riaz Haq said…
Dr. Gul Zaidi featured in CBS 60 Minutes tonight is a graduate of Shifa Medical College #Islamabad #Pakistan. She is a critical care specialist in pulmonary diseases. She says "continue the lockdown" to manage the load on health care system. #coronavirus https://www.cbsnews.com/news/new-york-city-coronavirus-epicenter-united-states-peak-60-minutes-2020-03-29/

Scott Pelley: To those who question whether businesses should be closed, whether entire cities or states should be locked down, you say what?

Dr. Gul Zaidi: You have to keep it locked down. The influx already is so much that if this continues, there's no resources in the world that'll be enough to deal with this and contain this. And we have to keep it locked down. Anything else would be irresponsible.

---------------

Scott Pelley: Tell me about the battle you're fighting.

Dr. Gul Zaidi: It's hard. We're ICU doctors, we're used to pressure. We're used to seeing a lot of things that normal people don't see. But this is really beyond anything I've seen in my career.

Dr. Gul Zaidi has been a critical care specialist nine years at Long Island Jewish Medical Center in Queens.

Dr. Gul Zaidi: There's no time to sit, let alone eat or do simple things like take bathroom breaks. We just keep going. And it's essentially one room to the next.

Scott Pelley: When was the last time you slept?

Dr. Gul Zaidi: I don't know. I don't remember when was the last time. Probably before this exploded like this.

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Dr. Gul Zaidi: It's just the sheer magnitude of patients that are coming in, the influx not just into the hospital, but into our ICUs is beyond anything that we've seen before. We're doing our best, but it feels like wartime.

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Dr. Gul Zaidi: We're all scared. I'm scared. But I have to lock those fears away in a box, because once I set foot into the hospital, it's all about the patient. So, we try to be cautious. We try to use the protective equipment. But it's not perfect. We all know that. But this is what I do. It's my job. So, I do what I have to do to help these people.
Riaz Haq said…
American Immigration and Ethnicity by Gerber and Kraut.



Today, new arrivals, legal and undocumented alike, find ample opportunities for employment in the United States. Migrant workers cross the Mexican border plant and harvest. Their low-cost labor keeps the prices of fruits and vegetables inexpensive for Americans. They often take jobs in the service sector that are either so low-paying or undesirable that native-born workers refuse them. However, at the other end of the scale, well-educated newcomers from China, India and Pakistan are transforming America's high-tech industries, especially in the areas of computer technology. The computer has rejuvenated home work. Men and women can support their families, working in a variety of industries that require online labor.



The expansion of hospital based medical care, and the institutions of broad-based social programs, such as Medicare and Medicaid in 1965, resulted in the need for thousands of skilled professionals. The 1965 Immigration Act, which abolished national quotas in favor of those based on professional status, aimed to encourage the immigration of professionals. Thousands of unemployed professionals from India and Pakistan flocked to the United States............Medical graduates especially were encouraged , with offers of free apartments and secure jobs at hospitals.



https://books.google.com/books?id=-20YDAAAQBAJ&q=purification#v=onepage&q=Pakistan&f=true
Riaz Haq said…
Eight #UK Doctors Died From #Coronavirus . All Were Immigrants from former #British colonies: #Egypt , #India, #Nigeria, #Pakistan, #SriLanka and #Sudan


https://www.nytimes.com/2020/04/08/world/europe/coronavirus-doctors-immigrants.html

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The coronavirus has taken a devastating toll on migrant doctors across Britain, leaving at least six others dead: Dr. Habib Zaidi, 76, a longtime general practitioner from Pakistan; Dr. Alfa Sa’adu, 68, a geriatric doctor from Nigeria; Dr. Jitendra Rathod, 62, a heart surgeon from India; Dr. Anton Sebastianpillai, in his 70s, a geriatric doctor from Sri Lanka; Dr. Mohamed Sami Shousha, 79, a breast tissue specialist from Egypt; and Dr. Syed Haider, in his 80s, a general practitioner from Pakistan.

Barry Hudson, a longtime patient of Dr. Zaidi in southeastern England, recalled their exam table conversations about England’s cricket team.

“He was a big figure in the community,” Mr. Hudson said. “He had a proper doctor’s manner. He didn’t rush anybody.”

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It is a story tinged with racism, as white, British doctors have largely dominated the prestigious disciplines while foreign doctors have typically found work in places and practices that are apparently putting them on the dangerous front lines of the coronavirus pandemic.

“When people were standing on the street clapping for N.H.S. workers, I thought, ‘A year and a half ago, they were talking about Brexit and how these immigrants have come into our country and want to take our jobs,’” said Dr. Hisham el-Khidir, whose cousin Dr. Adil el-Tayar, a transplant surgeon, died on March 25 from the coronavirus in western London.

“Now today, it’s the same immigrants that are trying to work with the locals,” said Dr. el-Khidir, a surgeon in Norwich, “and they are dying on the front lines.”

By Tuesday, 7,097 people had died in British hospitals from the coronavirus, the government said on Wednesday, a leap of 938 from the day before, the largest daily rise in the death toll.

And the victims have included not just the eight doctors but a number of nurses who worked alongside them, at least one from overseas. Health workers are stretched thin as hospitals across the country are filled with patients, including Prime Minister Boris Johnson, who this week was moved into intensive care with the coronavirus.

Britain is not the only country reckoning with its debt to foreign doctors amid the terror and chaos of the pandemic. In the United States, where immigrants make up more than a quarter of all doctors but often face long waits for green cards, New York and New Jersey have already cleared the way for graduates of overseas medical schools to suit up in the coronavirus response.

But Britain, where nearly a third of doctors in National Health Service hospitals are immigrants, has especially strong links to the medical school systems of its former colonies, making it a natural landing place.

That was true for Dr. el-Tayar, 64, the oldest son of a government clerk and a housewife from Atbara, Sudan, a railway city on the Nile.

He had 11 siblings, and one left a special impression: Osman, a brother, who became ill as a child and died without suitable medical treatment. Though Dr. el-Tayar rarely spoke of his brother’s death, he gave the same name to his oldest son.

“In my mind, I think that’s what led him to medicine,” Dr. el-Khidir said. “He didn’t want anyone else in his family to feel that.”

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By recruiting foreign doctors, Britain saves the roughly $270,000 in taxpayer money that it costs to train doctors locally, a boon to a system that does not spend enough on medical education to staff its own hospitals. That effectively leaves Britain depending on the largess of countries with weaker health care systems to train its own work force.
Riaz Haq said…
#Coronavirus: #British-#Pakistani doctors saving lives in both countries. Dr Akhtar is an intensive care unit consultant in #Britain's #NHS. He's using #telemedicine to share his experiences with counterparts in his country of birth, #Pakistan. #COVID19 https://www.bbc.com/news/world-asia-53282823

"We are very proud of the NHS service we are giving here," Dr Akhtar said. "And because of our relationships both in medicine and otherwise, it was very important for us to help our colleagues and to help the people of Pakistan."

Dr Akhtar told the BBC the huge number of coronavirus cases meant that even in the UK it was not possible for intensive care doctors alone to treat seriously ill patients - doctors from different specialties also had to be drafted in. In Pakistan, the difficulties would be amplified, he said, making it useful for those doctors to have "someone they can talk to, someone they can take advice from".

Dr Muhammad Ashraf Zia, who heads the Covid-19 ICU in Jinnah Hospital, told the BBC it was "very useful" to exchange ideas with Dr Akhtar - even though he is a senior doctor himself, as coronavirus is such a new disease. He said his team had begun using certain medicines to treat patients that they previously had not, and they were now producing "very good results".

There have been about 250,000 coronavirus cases and 5,000 deaths recorded in Pakistan. That's substantially lower than in Britain, where more than 44,000 people have died, even though it is likely fatalities in Pakistan have been undercounted.

However, Pakistan has far fewer doctors per capita than the UK, and at times hospitals there have been stretched. According to the World Health Organization, there are under 10 medical doctors per 10,000 of the population in Pakistan, about three times fewer than in the UK.

Dr Suhail Chughtai, another UK-based doctor of Pakistani origin, built the telemedicine software used to connect to the intensive care unit in Lahore. The software allows doctors to talk via video link and exchange copies of case notes as they speak. His aim was "to plug the gap" in Pakistan caused by a relative lack of intensive care specialists, by "importing" those doctors from the UK via telemedicine, he said.

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