542. The primary care physician, an endangered species? (1:02:15)

Date:
2012-09-19
Main contributors:
University of Virginia. School of Medicine
Summary:
With the aging of our nation's practicing physicians and the recent, steep decline in medical graduates choosing careers in primary care for adults, U.S. patients today are hard pressed to find a primary care doctor. And the already impressive gap between supply and demand of primary care physicians will likely widen once more than 30 million people gain access to health insurance under the Affordable Care Act. The urgent shortage of primary care physicians compounds this country's already significant health care challenges regarding access, delivery, and cost of care. In an era when all of health care is undergoing potentially transformative change, what will be the role of primary care doctors? For patients, what will be the "value added" of having a primary care M.D.? What roles will other primary providers (physician assistants, nurse practitioners) play? Is the primary care physician an endangered species, or a key participant in a newly configured primary care team? How can we devise, model, deploy, and teach new ways of delivering primary care that are team based, interprofessionally collaborative, effective, and satisfying to patients and practitioners alike? In this Medical Center Hour, family doctor and medical journalist Susan Okie draws on her recent Perspective article in the New England Journal of Medicine to explore the prospects ahead for the primary care physician. Two of UVA's primary care physicians: one a mid career family medicine physician and teacher, the other a medical student planning a primary care career offer their perspectives as well. Co-presented with the Generalist Scholars Program in observance at UVA of Primary Care Week

549. The surprising collapse of marijuana prohibition, what now? (1:02:05)

Date:
2015-02-25
Main contributors:
University of Virginia. School of Medicine
Summary:
Marijuana has had a rocky and peculiar history in the United States. The early history of marijuana prohibition is fairly well known, thanks in part to a classic work on the subject, The Marijuana Conviction, co-authored by Richard J. Bonnie while he was associate director of a commission apppointed by Richard Nixon. In 1972, to the surprise of many, the commission recommended decriminalizing marijuana use, but it also rejected the idea of legalization, expressing major concerns about the public health consequences of doing so. While loosening marijuana laws became a mainstream policy idea through the Ford and Carter admisistrations, in the Reagan White House, a policy of "zero tolerance" took hold and evolved into a new and costly war on all illegal drugs. Millions of marijuana arrests ensued. As the drug war's costs accumulated in the early 21st century, support for decriminalizing marijuana returned. Some states defied the federal government by legalizing medical use. Then, suddenly, in 2012, voter initiatives in Colorado and Washington legalized marijuana for recreational use and, in 2014, voters in Washington DC did the same, with legalization in the District due to take effect 26 February 2015. The worries raised by the commission in 1972 are back, complicated by the challenges of implementing the law. This Medical center hour's principal speaker, who has both chronicled this story and been a player in it for more than four decades, will reflect on why marijuana prohibition suddenly collapsed and on what should happen next. Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library