When Eudora Brown Elmond founded the first National Doctor’s Day in a small Georgia town in 1933, no one could have predicted the significance it holds today for all of us.

She simply wanted to celebrate her husband’s career.

Today, we celebrate the heroic work of doctors who risked their health and their very life to treat those infected by the SARS-CoV-2 virus.

Most nations honor the work of medical doctors with a special day of recognition. In the US, we celebrate National Doctor’s Day on March 30, chosen because it marks the day in 1842 that anesthesia was first used. 68 years after Elmond’s first doctor’s day, Congress made it an official day of recognition.

The red carnation doctors may wear today was a tradition Elmond started.

We at Green Key Resources join with all Americans to say “Thank you” to doctors everywhere. Thank you for being there when your country needed you most. Thank you for your courage, your long hours and your caring.

Thank you for being a doctor!

Photo by JAFAR AHMED on Unsplash

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Green Key
Jun 6, 2023

How COVID Is Changing Clinical Trials

Amidst all the uncertainty about a COVID vaccine, at least this one thing is certain: it is changing how clinical trials are conducted.

Instead of taking years to move apotential vaccine from laboratory to trial, the US’s Operation Warp Speed has moved two of six prospective COVID vaccines into Phase 3 recruitment in under six months. Two more are expected to begin Phase 3 recruitment this month.

In the United Kingdom, a different type of clinical trial showed it is possible to enroll 12,000 patients, test several different existing treatment candidates and have the first significant results in fewer than 100 days.

Even given the substantial differences between the government-run health care system of the UK and the private, decentralized US system, there are lessons – “ideas,” Nicole Mather calls them in an article for the journal Nature – researchers here can apply to accelerate trials.

Describing how the UK’s RECOVERY trial went from concept to first, actionable results in such a short time, Mather identifies five differences with traditional trials:

  1. The trial protocol took only 20 pages to detail the design, and data and regulatory requirements. It was flexible enough to allow trial arms to be stopped or added.
  2. It got approvals in 9 days, versus the typical 30-60.
  3. Recruitment paperwork was simplified.
  4. Data collection and processing was accelerated through the UK’s DigiTrials hub, which provides centralized support for clinical trials.
  5. Results were quickly made public.

Though the RECOVERY program has its critics – objections center on releasing results without first being peer-reviewed and structural issues – Mather says it shows how a centralized health data system and a streamlined design and approval process can accelerate the timeline.

“We’ve gone so far towards managing risk that we’ve created layers of bureaucracy that absorb time and money, and, paradoxically, increase the risk that beneficial treatments are not tested,” she writes.

That view is echoed by Martin Landray, deputy chief investigator of RECOVERY, who said the way the National Institute for Health Research cut red tape was “fabulous.” “Many academic and commercial trials have accumulated so much extra baggage over the years, such as long case report forms and 10 page patient consent forms,” he said in an interview with The BMJ.

Digital entry for the RECOVERY trial made consent and subsequent data collection quick and simple, The BMJ article reports.

Leveraging data systems is an important lesson, says Mather, who is life-sciences lead at IBM Services in London, which was a partner in the DigiTrials project. Because of the UK’s National Health System, much information was already available for trial study patients, simplifying the participation process.

That would be a much greater challenge in the US because of its private medical system, although the strong push over the last decade to digitize medical records is making the portability of patient data easier.

The UK RECOVERY program has given momentum to accelerating clinical trial processes. To build on it, says Landray, “We now need to apply the lessons from this approach to other major health challenges such as heart disease, cancer, arthritis, and mental health.”

Photo by JC Gellidon on Unsplash


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Green Key
Jun 6, 2023

Family Doctors Are In Demand Everywhere

Family physicians are the most recruited of all doctors. The demand for these family practitioners is expected to grow by 10%, second only to psychiatrists. Yet those who practice family medicine have seen their average pay decrease, making these doctors among the lowest paid of all medical specialties.

To 10 states highest doctor pay - blog.jpg

These aren’t new revelations, but they stand out starkly in the just-released Physician Compensation Report from Physicians Thrive, a financial advisory firm for doctors. The report is a compilation of data from multiple sources. It covers pay and bonuses by physician specialty and practice, and drills down into regional and state differences, hiring demand, and gender gap issues.

The report tells us that in 2020 specialists earned an average $346,000 per year, up from $341,000 in 2019. But female physicians earn 28% less on average than their male counterparts in the same specialty.

Primary care physicians, including family medicine practitioners, earn an average of $243,000 per year, up from $237,000 in 2019. But half of all family medicine doctors earn less than $205,000. And they’ve seen their pay decrease by 8.3%, the largest of all medical specialties, according to the report.

Why isn’t clear.

It’s not a matter of a significant gender imbalance the way it is in pediatrics where almost two-thirds of the doctors are women. Or in obstetrics/gynecology, which is 59% female. The Association of American Medical Colleges says 59% of the family medicine doctors are male.

For whatever reason, the Physicians Thrive report says that, “Since 2014, the number of physicians choosing to work in family medicine has decreased, leaving family practices understaffed throughout the country.”

Picking up at least some of the slack are nurse practitioners and physician assistants. The report says 78% of NPs and 33% of PAs provide primary care, according to the report. Though they do much of the same work as a physician, nurse practitioners on average earned $124,000 in 2019.

The highest-paid specialists, according to the report, are neurosurgeons earning a median of $645,000. In the Midwest, these specialists earn an average of $760,000 annually, making them the highest-paid specialists anywhere.

Photo by CDC on Unsplash


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Green Key