Goal 4: Develop Workforce and Resources

Early Career Physician Scientists are heading toward extinction

As seen by ~ 40% steady decline in number of K-08 grant applicants over 2005-2014 period, early career physician scientists who can do both basic-translation research and take care of patients are dwindling. Lack of institutional support, lack of ACGME support, increasing demands of clinical training, increasing compliance requirement, and disadvantaged position (i.e., significantly less preparation time and continued ...more »

Submitted by (@ctong0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Physician scientists are needed to provide the bridge between clinical needs and scientific endeavors. Physician scientists can take the needs to scientific community for research and bring new discoveries toward known diseases. Without this bridge, mismatch between clinical need and research will grow.

Feasibility and challenges of addressing this CQ or CC :

NHLBI has reported only about 50% of K-08 awardee apply for R01 in a different critical challenge note. Thus, combination of decreasing number of K-08 applicants and then less than half of the awardees are applying for R01 show that the next generation of physician scientists is now threatened.

Name of idea submitter and other team members who worked on this idea : Carl Tong

Voting

13 net votes
26 up votes
13 down votes
Active

Goal 4: Develop Workforce and Resources

Pharmacy-Physician Cross-Reference System Required

Why does a cross-reference gap occur when prescriptions are filled through a patient's one and only pharmacy. How can a pharmacist double check a physician's work when the physician prescribes a medication that should NOT be taken if the patient has a diagnosis the pharmacist has no documented evidence to REJECT the prescription and NOT dispense the dangerous drug-interaction, drug vs. medical condition information? Since ...more »

Submitted by (@louisecompanion)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

#1) Tramadol/Ultram was prescribed by hospital discharging physician #1. Prescription paperwork clearly stated that Tramadol should not be administered if you take Cymbalta/Duloxetine. I took Tramadol and Cymbalta together for two (2) years.

 

#2) Seroquel/Quentiamine (generic name ??) was prescribed by physican #2. Prescription paperwork indicates this drug should NOT be taken with the drug SOTALOL/BETAPACE or patients who have Prolonged Q-T Interval or Long QT. I have Long QT and the pharmacist's response to filling the Seroquel prescription, which made me ill, was the Seroquel dose was not too high. That pharmacy also fills my Sotalol.

 

#3) I have been allergic to sulfa drugs. Physician #3 prescribed Polymyxin B Sulfate and Trimethoprim Ophthalmic Solution USP. I was initially prescribed the eye drops on 04-02-2015. Because my left eye continued to bother me, I returned to the same urgent care. I have a Medtronic ICD (implantable cardioverter defibrillator). Medical records clearly indicate that Sulfa drugs affect my cardiovascular system. On 04-14-2015, I returned to the same urgent care for eye pain but, based on my abnormal ECG, cardiovascular was my primary reason for the visit, not my eye. I was told to resume the Polymyxin (full eye drop name above).

 

I didn't find out this data until just recently. If the pharmacist KNEW I had Long QT, perhaps Seroquel would have NEVER been filled, which harmed my conditions.

Feasibility and challenges of addressing this CQ or CC :

Based on the above information, how can pharmacist's double check the doctor's (unfilled) prescriptions without knowledge of the patient's health history? How could a pharmacist fill a drug Seroquel when it shouldn't be combined with Sotalol or those with Long QT? How can this drug-interaction be avoided? How do we fill the gap? I am a serious disabled person who has exhausted herself because she HAS HAD to become a self-appointed, her OWN HEALTH ADVOCATE.

Name of idea submitter and other team members who worked on this idea : Louise Companion

Voting

-10 net votes
0 up votes
10 down votes
Active

Goal 3: Advance Translational Research

When will NIH truly support translational research?

There is a huge gap between basic science discoveries (some of which have no clinical application) and clinic practice (even when the basic science is related). Rarely do physicians, physician scientists, and basic scientists get together to answer a question that has public health or patient health impact. Without such an effort, a lot of taxpayer money is wasted on 'science for the sake of science' as well as in applied ...more »

Submitted by (@sanjivkaul)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

We will start solving relevant clinical issues using the support of basic science

Feasibility and challenges of addressing this CQ or CC :

infrastructure within NIH

Voting

39 net votes
71 up votes
32 down votes
Active