Saturday, October 25, 2014

Wednesday Roundup: Medicine No-Shows

06/06/2012

medicine show huntingdon, TN New York Public Library/via New York Times Medicine show in Huntingdon, Tennessee, 1935: a photograph taken by Ben Shahn for the Farm Security Administration and recently discovered in the New York Public Library collection.

Vermont’s food assistance program is “drowning,” says a state economic services official. Andrew Stein reports for the Addison County Independent that a perfect storm has saturated 3SquaresVT (formerly known as the food stamp program) with need and dimished staff to meet that need.
 
In 2009, just as eligibility standards for food assistance were broadened, the recession hit. Many more applicants asked for state food services: statewide, the caseloads are nearly 2 ½ times higher than they were ten years ago, but the number of caseworks has been cut back.
 
Managers of the 3SquaresVT program are experimenting with new intake systems and procedures to meet the food need.
 
• A luminous group of small ag supporters has signed onto a petition to the U.S. Congress with objections to the U.S. Senate’s recommendations for the next Farm Bill.
 
“We strongly object to any cuts in food assistance during such dire times for so many Americans,” wrote Dan Imhoff, Anna Lappé, & Kari Hamerschlag.
 
The letter also protests proposed allocations, claiming they favor large-scale agribusiness at the expense of small farms and sustainable practices. “We are deeply concerned that [the proposed Farm Bill] would continue to give away subsidies worth tens of billions of taxpayer dollars to the largest commodity crop growers, insurance companies, and agribusinesses even as it drastically underfunds programs to promote the health and food security of all Americans, invest in beginning and disadvantaged farmers, revitalize local food economies and protect natural resources.” Wendell Berry, Alice Waters, Wes Jackson, and Michael Pollan are among the many who signed the open letter.
 
• “I’d say running a solo, primary care practice in rural America is impossible,” Dr. Marc Shiffman told the Washington Post. Shiffman is closing the clinic the founded five years ago in Summit County, Colorado.
 
Shiffman opened his practice 70 miles west of Denver in 2007, after discovering there was no other internist working in Summit County. In only a few months, he had registered 2650 patients, people who otherwise would have driven 40 miles to see a doctor.
 
Sarah Kliff reports, “Shiffman enjoys the work he does, mostly because of the relationships that he has built with the patients he sees. But last fall, right around Thanksgiving, he started thinking that running the practice was becoming untenable for a number of reasons,” primarily the heavy load of paperwork. Forty percent of his patients are Medicare enrollees.

“When Shiffman looked forward, he didn’t see things getting easier. Many of the hospitals around him, especially in Denver, were forming Accountable Care Organizations, large partnerships of doctors and hospitals that are meant to coordinate a patient’s entire course of care.

"Shiffman is one doctor; he cannot manage a patient population in that way. He said that the bigger, nearby hospitals were not keen in having a rural doctor, relatively far away and with few patients, participate. ‘They have made it very clear that they’re not interested.’”
 
Vertical integration has come to medicine.
 
• At a legendary railroad crossing in Poplar Bluff, Missouri, a true tragedy killed two teenagers June 5.
 
On Tuesday, “Five teenage girls were parked on the tracks when a real Amtrak train approached about 12:30 a.m. It's unclear if the driver's Jeep stalled, or if she couldn't get it to restart. Three of the teens were able to jump out, but one, Haley Whitmer, whose family owned the Jeep, returned to free her two friends who couldn't unbuckle their seat belts. The train struck as Whitmer tried to get them out. Whitmer, 17, and Victoria E. Swanson, 15, died at the scene.”

According to local lore, a train derailment at this spot killed nearly all the passengers aboard in 1900. There’s no official record of such an accident but the story has given this spot an aura of mystery and danger.

Butler County Coroner Jim Akers said he hoped the accident “would not fuel more legend." He called "Ghost Train" daredevil antics near the crossing  "a very silly game."
 
• After devastating fires last year across Texas, and this year in New Mexico, the Department of Natural Resources is making strong recommendations to homeowners whose dream is a house in the woods.
 
Paul Kollmeyer of the DNR advocates “Firewise landscaping.”

Within 30 feet of a structure (at a minimum), homeowners should:

- Reduce and/or eliminate hazardous evergreen trees, such as pines and spruce, that have limbs hanging to the ground
- Remove small trees, household debris, brush and ground fuels (such as leaves and pine needles)
- Store firewood away from the house and clear vegetation at least 10 feet away from LP tanks
- Plant short green grass and keep it watered and mowed (grass lawns act as a first-rate fuel break)
- Prune lower tree limbs to a height of 6 to 10 feet, and space trees so crowns are 10 to 16 feet apart (prevents fire from jumping through the crowns and encourages trees to grow larger, faster)
- Remove small shrubs, scrub growth, ground litter and dead trees
- Store gasoline, paint, solvents and other highly flammable items in a cool, well-ventilated area away from other structures.

 
For more Firewise tips, look here.

• Some 1000 photographs taken under the auspices of the Farm Security Administration during the 1930 and ‘40s – pictures by the likes of Dorothea Lange and Ben Shan and Russell Lee -- have turned up in the New York Public Library.
 
As the Library of Congress amassed its FSA collection, Roy Stryker, who directed the photo project, sent these photos off to Ramona Javitz at the New York library to ensure that copies of the photographs would be available. Many of the NYPL images duplicate the holdings of the Library of Congress but nearly 1000 more are not represented in the national collection’s online catalogue. The images will soon be online through NYPL’s site.