06Jun

The world may be lauding healthcare workers as heroes, but the professionals themselves are exhausted, worn down physically and emotionally by their efforts to treat the sick and stem the COVID pandemic.

“The pandemic has had a terrific strain on nurses,” Dr. Ernest Grant, president of the American Nurses Association, told ABC News.

As the COVID death toll reached a half million, the network broadcast a special report on the looming mental health crisis among frontline medical professionals.

“It’s hard for us health care workers,” said respiratory therapist Kelsey Copely. “I’ve seen more deaths these past few months than I had seen in years, and it’s not normal and it takes a lot. It takes a toll on someone’s mental health.”

A 2018 study of physician suicides estimated that 300 to 400 physicians commit suicide annually. It’s too early to assess the impact of the pandemic on doctors, though the American Medical Association says stress levels have risen.

“Acute stress among physicians, which was already significant before the pandemic, has increased dramatically for many physicians during the last several months as the pandemic has brought new challenges and exceptional demands,” AMA President Dr. Susan R. Bailey told ABC.

Last March, as the number of hospitalizations was rising quickly and the country was heading to a shutdown, Dr. Mona Masood, a psychiatrist, began enlisting other psychiatrists to provide mental health support for doctors and medical students.

“It was very clear that physicians did not know how to reassure themselves or take care of their mental health,” Masood said.

Since last year, the free confidential support service has fielded thousands of calls from physicians and students.

“Almost all of them start off with ‘I’m so sorry for taking your time. I’m so sorry taking this resource.’ And that speaks to that implicitness of others should be taken care of before me,” Masood said in an interview just a few months after the hotline launched.

One reason more doctors, nurses and other frontline healthcare workers don’t seek help is worries over losing their license to practice.

ABC News said many medical licensing applications probe deeply into the applicant’s mental health, even going beyond what is allowed by law. The Journal of the American Academy of Psychiatry and the Law found that in 2018 only 18 states complied with the law about mental health questioning on physician licensing applications.

Last year, the American Medical Women’s Association (ANWA) launched the Humans Before Heroes initiative to reform licensing questions to remove the fear that by getting mental health help a professional might be denied or lose a license.

Says the AMWA, “It is critical that we remove all barriers to care-seeking so no frontline hero is left sacrificing themselves for others. Mental health treatment must be normalized and encouraged.”

Image by Darko Stojanovic

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Green Key
Jun 6, 2023

Healthcare Dominates ‘Best Jobs’ List

Did you miss the newest release of the annual list of “Best Healthcare Jobs” by U.S. News & World Report?

Coming out just after the start of the new year when so much other news made the headlines, the list of all the “Best Jobs,” which includes healthcare, didn’t make its usual splash. Too bad, because the U.S. News methodology makes it more than a popularity contest, taking into account hiring demand, projected growth, occupational unemployment, pay, and measures like stress levels and work-life balance.

We singled out healthcare jobs, even though the list covers all sorts of industries and occupations because of its dominance. Of the top 10 jobs on the list of 100, 7 are in healthcare. Software developer, as is so frequently the case, ranks first, but right behind are dentist, physician assistant, orthodontist and nurse practitioner.

Registered nurse, often among the top 10 on previous lists, came in 13th. That’s only because the demand for several specialties with higher pay and fewer qualified professionals has grown even larger. Far more nurses are needed by 2028 (371,500) than speech-language pathologists (41,900).

As in-demand as these jobs are, Green Key Resources can help you fill vacancies fast. We know where the best people are and how to reach them. So if you are looking to fill a nursing job or have an opening for a physical therapist or other professional, one call to 212.683.1988 will put you in touch with a recruiting specialist who knows the industry and will work with you to get just the talent you want.

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Green Key
Jun 6, 2023

COVID-19 Puts Spotlight On Adaptive Clinical Trials

One of the lasting effects of the COVID-19 pandemic is likely to be the accelerated acceptance of adaptive clinical trials.

Dr. Anthony Fauci endorsed adaptive trials when he announced the effectiveness of redelivering in treating COVID-19 patients.

“The data shows that remdesivir has a clear-cut, significant positive effect in diminishing the time to recover,” Fauci said in a White House briefing April 29.

The data came from a unique type of clinical trial launched in February and sponsored by the National Institute of Allergy and Infectious Diseases where Fauci is director. The Adaptive COVID-19 Treatment Trial (ACTT) is different from classical clinical trials in that researchers can make changes in dosing, patients and other parts of the study as the data accumulates.

That’s why, not quite two months into the study, Fauci was able to declare remdesivir effective in reducing recovery time for COVID-19 patients. Discussing the trial findings up to that point, Fauci said, “What [the trial] has proven is that a drug can block this virus.”

Adaptive clinical trial design is common in testing medical devices, but much less so in testing drugs and new therapies. Those tests are almost exclusively designed as randomized clinical trials (RCT) in which subjects are divided into at least two groups, with one receiving the new drug and a second a placebo. It’s a double-blind test meaning neither the patient nor the clinical researchers know who is getting what. Once underway, only in the rarest of situations can the process depart from the trial’s original design.

Though considered the gold standard for testing the efficacy and safety of new drugs, the RCT design has been criticized for its cost, duration and inflexibility. As long ago as 2004 the Food and Drug Administration announced a Critical Path Initiative to accelerate drug development. “Modernizing Clinical Trial Designs and Strategies” was one of the programs.

At the end of last year, the FDA issued an industry guidance for pharmaceutical and bioscience firms “on the appropriate use of adaptive designs for clinical trials.”

The guidance notes,

“Adaptive designs can provide a variety of advantages over non-adaptive designs. These advantages arise from the fundamental property of clinical trials with an adaptive design: they allow the trial to adjust to information that was not available when the trial began.

While the ACTT, first launched at the University of Nebraska Medical Center and now involving 68 sites, and other adaptive COVID-19 trials now underway are showing they can deliver results, adaptive trials are unlikely to any time soon – or ever — become the new standard for drug testing.

Dr. Adams Dudley, a drug safety expert at UC San Francisco, told the Los Angeles Times, it’s risky to allow companies with a financial stake in the outcome to change study rules during a trial. However, in a crisis like the current COVID-19 pandemic, Dudley said randomized clinical trials take too long.

Noted the Times, “With thousands of people dying every day of COVID-19, the deliberate pace of this gold standard research may not be the best way to end the crisis quickly.”

Photo by Viki Mohamad on Unsplash

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