F ALL 2010 - Project SEVAK

27 Pages·2010·3.66 MB·English

AAPI
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T H E J O U R N A L O F I N D I A N A M E R I C A N P H Y S I C I A N S
• President’s Message
• Conversation with
Dr. Cecil Wilson
• Indo -U.S. Physician
Exchange Program
• Sevak: A Pilot Project to
Address Health Needs of
Rural India
• AAPI Journal Sentinel Fall
• What is the Secret of
Mr. Frank Spurling’s
Long Survival?
• Health Reform:
My Perspective
• MSR/ YPS Corner
about the cover
Main photo: Union Minister of Health & Family
Welfare, Mr. Ghulam Nabi Azad (left), witnesses
Dr. Vinod Shah (right) pass the AAPI President
gavel to Dr. Ajeet Singhvi (middle).
content
aapi
ExEcutivE OfficErs rEpOrts

President
4 President’s Report – Ajeet R. Singhvi, MD
Ajeet Singhvi, M.D.
7 Editor’s Report – M.P. Ravindra Nathan, MD
8 Secretary’s Report – Jayesh Shah, MD
600 Enterprise Drive, Suite #108
Oakbrook, IL 60523 9 Treasurer’s Report – Ravi Jahagirdar, MD
Phone: [phone] Board of Trustees Chair’s Report – Ashok Fulambarker, MD
Fax: [phone]
www.aapiusa.org
fEaturEd articlEs

AAPI Journal Editor 12 SEVAK: a Pilot Project to Address Health Needs of Rural India –
M. P. Ravindra Nathan,
Abhishek J. Patel, MD, Thakor G. Patel, MD, Hemant Patel, MD,
MD, FACC, FACP, FRCP (Lond & Can)
Padmini Balagopal, PhD, Jivraj Damor, MD, Ranjita Misra, PhD
Hernando Heart Clinic
Brooksville, FL 34613 15 AAPI Clinical Observership Program – Bhoja Reddy Katipally, MD
Phone: [phone] What is the Secret of Mr. Frank Spurling’s Long Survival? –
Fax: [phone]
R. R. Vijaynagar, MD
[email protected]
17 Medical Emergencies on Airline Flights – Bala V. Manyam, MD
19 Health Reform: My Perspective – Aravind Pillai, MD
Marketing Communications
20 AAPI Journal Sentinel Fall 2010 – Sagar Galwankar, MD
& Ad Sales
Sam Fulambarker 22 AAPI Convention 2010 – Vinod Shah, MD & Nayan Shah, MD
[email protected]
Phone: [phone]
spEcial articlEs

Accounts & Membership 30 India & U.S. Physician Exchange Program – Jayesh Shah, MD
Vijaya Kodali 31 India the “Super Bug” Capital – Akshat Jain, MD
[email protected]
32 Can Modern Medicine Learn From Teachings of Religion –
Phone: [phone]
Parveen Kumar Khosla, MD

Designed & Printed by
Msr/Yps cOrnEr
GR Marketing & Graphic Design
Phone: [phone]
34 Report from President, MSRF, AAPI – Mamta Singhvi, MD
Fax: [phone]
35 Through the Eyes of the Young AAPI – Pooja Voria, MD
35 Message from President, YPS – Priya Kundra, MD
Copyright©2010 by
American Association 36 The Time for Change is Now – Nirupama Madduri, MD
of Physicians 37 Pfizer Helpful Answers Partnership – Chirag Parghi
of Indian Origin.
38 AAPI Sponsors Harvard-affiliated Initiative – Neel Shah, MD

All rights reserved.
40 A Glimpse of My Life: La Vie En Rose – Udita Jahagirdar, MD

41 AAPI 2010 Mexican Riviera Cruise CME Conference a Big Success
DISCLAIMER: The AAPI Journal is published quarterly by the American Association of Physicians of Indian Origin (AAPI). This publication may not be reproduced in whole or
in part without the express written permission of AAPI. All articles published including editorials, letters and book reviews represent the opinions of the authors and do not
reflect the official policy of AAPI. Please note that the acceptance of advertising in this journal does not constitute or imply endorsement by AAPI of any product or service nor
does AAPI accept any responsibility for any claims made in any advertisement, unless otherwise stated by AAPI. In addition individual advertisers are solely responsible for the
content of their advertising material which they submit to us, including ensuring that it complies with relevant legislation.
www.aapiusa.org 3
president’s report president’s report
with the local AAPI and Alumni chapters in Charleston, Nominations Committee under the leadership of Dr. Vinod
SC, Fresno, CA and San Pedro Island, TX have been very Shah will be active soon and so will be the Alumni Committee
mission successful. Another meeting in Chattanooga, TN is scheduled under the leadership of Dr. Mohan Mallam.
in November.
aaPi 4th indo-uS heaLthCaRe SuMMit
aapi 2010-2011 MeMbeRShiP beneFitS AAPI enjoys tremendous respect and name recognition
The Membership Benefits Committee under the leadership in the Indian American community. AAPI will be organizing
of Dr. Lakhu Rohra, Dr. Hemant Dhingra and Dr. Sanku S. Rao the 4th Indo-US Healthcare Summit and CME in Jaipur India
as the advisor has been working hard. Please take advantage of from January 3-5, 2011 and also be celebrating the New Year in
the new benefits being offered. We are also looking for sponsors Jaisalmer, Rajasthan, (December 29, 2010 to January 2, 2011)
for providing a welcome kit for the Medical Students joining prior to the summit and Pravasi Bharatiya Divas in New Delhi
AAPI as new members. (January 6-9, 2011) immediately following the summit. Please
ajeet r. singhvi, Md
join us for one or more programs.
aaPi ChaRitabLe Foundation
This has been our flagship arm. Dr. Shashi S. Shah is aaPi annuaL Convention
As the President of the American S. Shivangi as advisor are busy streamlining the process. One
helping us not only in Medical Missions, Medical Rotations Dr. Ajay Lodha has been working diligently to give us a
Association of Physicians of Indian Medical Student Dr. Preeti Dangayach from Baylor, Houston
etc., he has been busy raising funds to support various clinics very good convention in New York at the Hilton from June 22-
Origin (AAPI), it is my privilege to is currently in Indore, India. Dr. Swarup Swaminathan from
here in US and in India. Two successful fundraisers were 26, 2011. He already has had several meetings with AAPI staff
present the President’s report. Harvard and Dr. Kinjal Shah from University of Tennessee
hosted one in San Antonio and one in Alabama under the at Hilton to streamline registrations, booths & exhibits and to
are slated to be leaving soon for the rotations in Chennai and
Washington DC Convention was a great success. Please leadership of Dr. Jayesh Shah and Dr. M.S. Arun. Dr. Shashi get adequate space. Please mark your calendar and attend the
three hospitals in Gujarat respectively. My hope is, any Medical
allow me to congratulate Dr. Vinod K. Shah, Dr. Nayan Shah, S. Shah has embarked upon a very ambitious program to convention.
Student or Resident who wants to work, serve and learn in India
the Executive Committee and the entire Convention team. install Automatic External Defibrillators in each and every
should be able to do it and we should not run out of funds. I
I have been regularly attending the Board of Trustees
Indo-American community center in the Country to improve
MSRF/YPS urge you to please sponsor one Medical Student or Resident for meetings and have been impressed with the entire team under the
the survivability of sudden cardiac arrest victims. Please
Our focus has been the younger generation. Residents/ a mere sum of $1,500. leadership of Dr. Ashok Fulambarker. In short period, they have
consider sending your year-end donation to AAPI-CF at our
Fellows and Young Physician membership has been very addressed several important issues including financial stability.
LegiSLative agenda Office in Oak Brook, IL.
successful under the leadership of Dr. Narendra Kumar. Once
We now have a legislative office in Washington, DC with
I have been travelling and have attended several
reluctant to be part of AAPI, these Young Physicians are not aaPi WoMen’S CoMMittee
Dino Teppara, JD, Esq as the Legislative Director. Dr. Krishan
Alumni and regional meetings. I also attended the 16th bi-
only thankful to the parents, uncles and aunts who nominated Dr. Manju Sachdev, Chairperson of the Women Physicians
Aggarwal as Legislative Chair will be working hard to support
annual convention of National Federation of Indo-American
them to be the members, I see a definite interest and pride in Committee is working hard for a very good Women’s Forum at
the legislation to increase the Residency slots, which are
Association (NFIA) in New York. It hosted a joint meeting
them to have become a part of the organization. I see a very the AAPI annual convention.
desperately needed. J1 visa waiver, permanent fix of SGR, loan
of several large associations to address common issues
strong future for the organization in their leadership. I hope we
forgiveness and adjustment for Medical Students and Young
The Women’s Health Forum is scheduled to be held in important to Indo-American community. At annual Diwali
can continue this program at least through the end of the AAPI
Physicians and increased salary of medical Residents are some
Dallas, Texas from March 5th and 6th, 2011. The previously celebrations by Association of Indian Americans (AIA)
calendar year.
of the issues we are committed to address.
held conferences clearly demonstrated the unwavering mission in New York, Hon’ble Congresswoman Carolyn Maloney,
We are hosting four Leadership Development Programs of AAPI to improve women’s healthcare in this country and to at my request, agreed and assured us that we will have a
We are planning the Legislative Day on March 23rd, 2011
in Newport Beach CA, Long Island NY, Detroit MI and Dallas help them live longer and healthier lives. Diwali stamp soon, hopefully before next year’s celebrations.
in Washington, D.C. Before that we will have a Legislative staff
TX for them.
dinner as soon as the new Congress is in place. We plan to aaPi CoMMitteeS
I would like to thank Ms. Vijaya Kodali and Mr. Sam
Medical Missions and Community Service committee apprise them of the issues of concerns to us both in US and in Dr. Sarjit Singh, Liaison Committee Chair, Dr. Radhu
Fulambarker at AAPI office who are a great asset to the
under the able leadership of Dr. Ram Upadhyay as its chair, Dr. India before we meet the legislators. Agrawal as Academic Affairs Committee Chair, Dr. Mahesh
organization. We welcome the new addition Ms. Harshitha
Sudeep Kukreja as Co-chair and Dr. Nitin Shah as its advisor Gupta as Ethics & Grievance Committee Chair, Dr. Pawan
We have started two scholarships for the Capitol Hill Mukunda. The Executive Director Search team will hopefully
along with very dedicated members have done a great job in Rattan as Awards Committee Chair and Dr. Snehal Desai as
Internship for Young Medical Students and Physicians and find a right candidate soon.
motivating young physicians as well as senior AAPI members IT Chair have been working diligently. I sincerely thank Dr.
each year the candidates will have an opportunity to serve and
and volunteers. Several of our members and volunteers are Ravindra Nathan for taking care of AAPI Journal, a difficult I will be happy to receive and respond to your comments.
learn healthcare policy making with senior Legislators, one
working in Alexandria, Egypt and in India as I write this and extremely responsible job. His abilities and work ethics
during Fall and another during Spring.
Respectfully Submitted.
message to you. are unsurpassable. AAPI Bylaws were recently revised after
CMe extensive deliberations. The General Body approved them
Endowment and Medical Rotations to India Committee
Under the leadership of Dr. Sundar Mudaliar as Chair of overwhelmingly (over 97%). Executive Committee felt that
under the leadership of Dr. Vinod Sancheti as its chair along Ajeet R. Singhvi, M.D., F.A.C.G
the Committee and Dr. Kris Vijay and Dr. Jagat Narula as Co- these Bylaws should be in place for at least one year before
with MSRF President Dr. Mamta Singhvi as well as Dr. Shashi [email protected]
Chairs, we have been planning several National, International revisiting them since they have been in effect for only few
S. Shah, Chair AAPI charitable Foundation and Dr. Sampat
and Regional CMEs. Three regional CMEs in conjunction months. The Bylaws were revised earlier in 1998 & 2004. The
4 fall 2010 • AAPI Journal www.aapiusa.org 5
editor’s report

aapi
ExEcutivE OfficErs
Back at my desk, again!
M. p. ravindra nathan, Md*

IAMA NEWSLETTER
I feel truly honored, of the established sections. It is your story, your
September 2010 being called back from experience – professional, social or personal and the
Indian American Medical AssociationA j(eIeLt) R . Singhvi, Sunita Kanumury, MD Narendra Kumar, MD Jayesh B. Shah, MD Ravindra R. Jahagirdar, MD the Emeritus status to way you say it especially with an autobiographical
MD, FACG President-Elect Vice President Secretary Treasurer serve as your new Editor flavor- that will make it interesting to read; so
President
–in- Chief of AAPI share your experiences with us. A new item this
President’s Report
Journal for the year 2010 -2011. As soon as I took year is journal watch, ‘AAPI Journal Sentinel Fall
charge, I found out there were way too many things 2010’, an overview of recently published research
Thus far, 2010 has been a great year for IAMA. We started the year with the slogan “Year of Membership,” and I am happy
to report that 142 new members including medical students, residents and physicals were added this year. Among our in my ‘to-do-list.’ My first job was to put together an work relevant to current day medical practice.
efforts to boost membership has been the creation of an ad-hoc committee of young physicians, our new website,
editorial team to oversee all aspects of the Journal.
www.iamaill.org, and our increased electronic communications with members. We’ve continued to strengthen our mem-
bership through monthly Educational Seminars. The Executive Committee (EC) continues be actively involved in the activi- A few of the members selected have served in this During the teleconference of the Editorial Board
ties of our organization. The monthly meetings of the EC were attended by the majority of the EC members. We have seen committee before. We have added some young on August 12, 2010 in which AAPI President and
renewed enthusiasm to grow our organization. We are thankful to our sponsors for their support of these events!
blood too, well versed in Information Technology Chair of BOT participated, there was considerable
Thank you for being a part of a year of change and productivity - I am proud to share the following accomplishments: and, they will develop a proper customized internet discussion on whether it is time for AAPI to launch
IAMA-Charitable Foundation Vinod K. Shah, MD Ashok M. Fulambarker, Priya Kundra, MD Mamta Singhvi, MD edition. Sam Fulambarker from the AAPI Executive a separate peer-reviewed scientific journal. And the
Past President Dr. AsMhoDk, F FulCamCbParker YPS President MSRF President Office will coordinate our efforts, a welcome change current AAPI Journal, essentially a medico-social
The IAMA-CF free clinic is our flagship. It has made a difference in so many needy lives and continues to be an important part
Chair, BOT this time. The printing will be done by the same magazine, can remain unchanged. Opinions were
of the work of IAMA and to the community. Dr. Usha Nimmagadda, Chair of IAMA-CF, has provided great leadership to the
Charitable Foundation. We are proud to report that the semi-annual meeting held on May 15th raised $154,000 for the important work of the Charitable group as before, ‘G.R. Graphics (Galal Ramadan)’ divided on this issue and an alternative suggestion
Foundation. Thank you for your continued support! since they have done a superb job in the past. was that part of the journal could be devoted to
Community Health Awareness Seminars: scientific papers. However, many members felt this
Next, I sent an e-mail blast to all the members would not get the attention they deserve. I would
There were two excellent community Health Awareness Seminars arPranged uunder tthe le adyershipo of Dr. uHemlatra Bak ance, Chaiar, Healtrh Awdareness Ctommoit- work for you.
tee. The first seminar covered “911 Medical Emergencies and Community Response” at the Hindu temple of Greater Chicago on April 28, 2010. Dr Vemuri requesting their submissions for publication. The like to know your opinion in the coming days.
Murthy, joined us as the course director and we welcomed our chief guest, Mr. Ashok Kumar Attri, Consulate General of India, Chicago. Our second seminar response was indeed overwhelming. Since many
was an exclusive educational seminar held at Jain Society of Metropolitan Chicago on August 1, 2010. The topics were “Live Long with Strong Bones” and
articles were not submitted in the proper format, Medicine is at cross roads now. The recent
“Tired of Being Tired?” A free Bone Mineral Density measurement screening was made available to the attendees. Dr. Anjali Kale, Dr. Kailash Sharma, and
Anjali Padhye presented excellent educational information to over 100 guests who attended! may I give you a few helpful hints? Please keep economic slump has been quite challenging. Doctors
From breakfast on the run to a night at the movies,
your manuscript brief and succinct, edit it yourself now face further challenges of EHR implementation,
Golf Outing
use your American Association of Physicians of Indian
one last time before sending it. Only electronic ICD coding deadline conversions, and dwindling
A fun event for our member golf enthusiasts was our Annual Golf OuOtirnigg iant SPelvaetnin Burimdg ePsl uGso®lf MCluabs tine rWCoaordd®ri dcgree, dILi to nc aJrudly w11it, h2 0W10o. rFldorPtyo-itnwtos ®g orlefewrsa rds. You’ll earn submissions – properly formatted and sent as e-mail insurance reimbursements. Obamacare is here to
enjoyed a memorable round of golf at this picturesque course. There was an award ceremony and dinner following golf. Dr. Ashok Fulambarker hosted the
19th hole. The golf outing was organized by the IAMA Charitable Foupnodiantitosn o. Tnh apnukrsc thoa Ksieshso troe Crehdugehe,m D rf. oDre ceapsakh ,M tirtaalv, eDlr,. Amsehrockh Faunladmisbea,r keevr,e Dnr .u Unsihqau e adventures.(cid:31) attachment in Microsoft Word with full author stay but is it a bitter pill or good medicine? Drop
Nimmagadda for the great work organizing this event. details including the e-mail id and other contact me a line; let us hear your personal experiences and
Rewards for the things you buy anyway. You also have the chance to show your support for
information, on the title page of the article- will use this journal to vent your thoughts. You may
IAMA Goes Electronic!
American Association of Physicians of Indian Origin every time you present your card.
be considered. All manuscripts will be reviewed contact me at any time at [email protected]
This year, we saved significant amount money and trees by reducing our regular mailings and instead using our professional email system “icontact .com”
for appropriateness and edited for clarity and or through my personal e-mail id.
and our beautiful new website “iamaill.org.” Aside from invitations for the semiannual and annual event and a newsletter, the decision was made that elec-
tronic communication is easy, user-friendly, and saves cost. Our data b2as4e h/as 7ma nSy mEemRbeVrs IwCithEou t a n e mSail EaddCreUss. R PleIaTse Yens uPre tRhaOt yoTu ErecCeivTe oIuOr N O N L I N E A C C O U N T M A N A G E M E N T content. Because of the numerous submissions and
important email communications by sending your email address to [email protected]. 1.866.438.6262 limited space, it may not be possible to publish We hope you find the reports, articles,
Golden Stethoscope Award To apply, call toll-free every one of them. Occasionally, you may get an information and resources in this journal interesting
Mention Priority Code VAAGXQ. You can also visit www.newcardonline.com and e-mail alert from me regarding your manuscript; as well as valuable and we sincerely thank all the
The IAMA Golden Stethoscope Award ceremony held on August 28, 2010 at the Gaylord Restaurant was a huge success. There were over 110 guests in
attendance including residents, fellows, medical students and young physicians. There were e1n9t eqru Parliitoyr iptyo sCtoerdse p VreAsAeGnXteQd.. please respond to that quickly. Please visit AAPI contributors to this issue. Please meet our new
Website for ‘policies and guidelines for writers.’ Editorial Board, a mix of seniority, experience, youth
Thanks to Dr. Ankit Mehta, Chair, Resident committee, and the judges Drs. Manoj Duggal, Rajinder Arora, and Ashok Fulambarker.
and vibrancy (see page 8 for Editorial Committee).
I look forward to the year finishing with even greater success than it has began. I look forward to your joining us for a great scintillating Annual Meeting You can write feature articles of your choice
and Banquet on Saturday, November 20th at the Oak Brook Doubletree Hotel.
For information about the rates, fees, other costs and benefits associated with the use of this Rewards Card, or to apply, call the toll free number above, visit the Web site listed above or write to P.O. relevant to our readership or contribute to any
Box 15020, Wilmington, DE 19850.
Thank you,
(cid:31) Terms apply to program features and credit card account benefits. For more information about the program, visit bankofamerica.com/worldpoints. Details accompany new account materials.
Sincerely, This credit card program is issued and administered by FIA Card Services, N.A. The WorldPoints program is managed in part by independent third parties, including a travel agency registered to do business in California (Reg. No.2036509-50); Ohio (Reg. No.
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registered trademarks of FIA Card Services, N.A. Bank of America and the Bank of America logo are registered trademarks of Bank of America Corporation. All other company product names and logos are the property of others and their use does not imply
Ashok Fulambarker, MD, FCCP endorsement of, or an association with, the WorldPoints program. WP.MCV.0908
President, IAMA © 2010 Bank of America Corporation AR96896-110909 AD-01-09-0012.C.WP.NT.0109
www.aapiusa.org 7
special report
secretary’s report
interview with the president of aMa
Cecil Wilson, MD
Jayesh B. shah, Md
It has been a distinct honor to This year our first leadership conference is in October in
work as your secretary under the Newport Beach, California. ravi Jahagirdar, Md, AAPI Treasurer 2010-2011
able leadership of our President, • Worked actively with YPS and developed plans for scholarship
Dr. Ajeet Singhvi. As the for legislative internship and for community service.
Secretary, I have tried to fulfill 2. Develop and expand Observership program in the US-
my duties to the best of my • As the AAPI liaison officer for the Observership
ability in keeping the AAPI office and its records in proper Committee, I am working diligently with the Committee
order. Dr. Singhvi and all the committee members are kept Chair to expand this program in this country. Dr. Cecil Wilson is the President of the American Medical Association. He has a distinguished career in solo practice in Internal
appraised of all issues related to AAPI on a daily basis. 3. Strengthen base of AAPI by empowering local chapters- Medicine in Central Florida, and has had an equal passion for service in Organized Medicine. He has visited India twice, and
Our office staff has been doing a phenomenal job. We have • As your representative, I attended multiple local chapter is well versed in issues relating to current medical challenges, and with AAPI. He shares his thoughts in a candid interview.
hired 3rd Employee at AAPI office, Please welcome Harsha meetings. We organized successful 2nd AAPI Family Cruise
Mothikunda. We have started doing weekly conference calls in collaboration with IMASC and IMA Chicago. 3rd AAPI Q : Where does AMA stand on the issue of Q: AMA and AAPI both have strong Q: What about Tort Reform? Physicians are
with office staff to ensure all office work is done in a timely CME Program was organized in South Padre Island, Texas. increased GME slots for Residency Positions? Legislative connections. Is this beneficial? very unhappy with AMA for not addressing
manner. We have worked diligently with our membership 4. Further the goal to improve quality of health care in India- A: AMA strongly supports increasing the A: There are two ways to be helpful this important aspect of Health Care Reform?
drive. All sponsored patron members are posted on the •With the help of TIPS SW chapter leadership, 2nd fund number of slots. The state of Massachusetts : 1 –each continues to increase their A: The dialogue between the AMA and
website. Website is updated on a weekly basis. AAPI Raiser event for the AAPI Charitable Foundation event was
is finding out now what the country will strength in numbers ; 2- there is an the Government has just begun.
resource directory is almost completed. Employee Manual successful organized in San Antonio on Sept.18,2010. . I got
find out soon – that we have a workforce advantage in different organizations
and Convention Manual have also been updated. opportunity to represent AAPI at Indo US EM Summit in
shortage. Providing insurance coverage presenting a common viewpoint. Trouble Q: What about the future of Primary Care ?
Vadodara, India and I was successfully able to procure grant
Governing body and general body in Washington alone will not suffice. The surplus of arises when different organizations A: There is a concern of the inadequate
for this program in india.. I also got opportunity to address,
DC has approved funds for Executive Director. Dr. Ravi physicians projected in 2000 never arrived start going down different pathways. number of Primary Care physicians. In
Indian Medical Association, Bombay on Oct. 4,2010 during
Jahagirdar and his search team are working diligently to find this visit. – and now we will have about 32 million USA, they are only 33 %, as compared
an appropriate Executive Director for our organization. 5. Closely work with organized medicine at state, national more persons carrying insurance with the Q: Scope of Practice: a lot of healthcare to over 50 % in the world. Due to
and subspeciality level- Health Care Reform act in 2010. We have facilities currently replace their doctors disproportions in income, students will
Besides keeping AAPI office functioning well, I have
actively worked to- • I will continue to remain the AAPI liason to AMA as a to continue expanding the workforce at the with non-physicians. This may be more prefer to turn to specialties.
Past Chair of IMG section and I will continue to advocate on same time that we struggle to provide more pronounced in the rural and underserved
1. Increase involvement of young physicians and enhance behalf of IMG’s and other physicians.
people with insurance and medical care. areas. Comment? Q: What do you think of the HealthCare
their participation at all levels of AAPI-
It is definitely a humbling and learning experience to work A: The worst thing in the world is to Reform Act of 2010?
• Planned for 4 leadership conferences this year similar to the
with all AAPI leaders and to serve as your Secretary. Q: Overseas Medical School recognition resolve this issue by utilizing persons who A: In my perspective, this Act is historic,
one that was held in Washington DC in April of last year.
and de-selection, including the ones in the are not properly trained. In addition, there and a milestone for this country. It
Caribbean and in India. Currently the rules is a looming shortage of nurses which provides Health Insurance to a larger
EditOrial cOMMittEE for these decisions are poorly known and leads Washington will run up against if they number of citizens, and addresses issues
to exploitation of the hapless Medical student/ believe they can expand the role of nurses. like pre-existing conditions as a reason
M P Ravindra Nathan MD, Cardiology Nirupama Madduri MD, resident. Medical Students assume large debts, for denial of care.
Chair – [email protected] Developmental Pediatrics and are left in limbo. Since AAPI has delegates Q: Why is AMA not active in supporting
[email protected]
within AMA. can we expect AMA to engage IMG’s in Licensing issues? Q: Do you have a message for the AAPI
Shivprasad Madduri MD, Urology Mamta Singhvi, MD, MSR in discussion and tutorials with them for all to A: As we all know, Licensing is a State members and delegates?
Vice Chair – [email protected] President, MSR – [email protected]
understand the process? issue. AMA has no say in the matter. A: We are most appreciative of the
A: I believe the rules for recognition are support AAPI gives AMA and also the
Sagar Galwankar MD, Emergency Medicine Snehal Desai, MD, Radiation Oncology
Vice Chair – [email protected] Chair, IT Section AAPI not laid down by the AMA. We will look Q: Is the AMA Board composed of support it provides for its members and
[email protected]
into this issue. AMA role in inspecting and institutional physicians who do not by extension, to the patients they care
SagarGalwankar N a r e s h P a r i k h M D , C a r diology Pooja Voria Borde, MD, M.B.A. certifying will be a challenge, considering comprehend matters affecting a private for. That is what we are here about as
MBBS, DNB, MD, MPH, Diplomat ABEM
Chief of Academics [email protected] Chair, MSR Publications
INDO-US Emergency & Trauma Collaborative they do not have jurisdiction, and the medical practitioner? members of this profession and, working
[email protected]
Institutions may not favor such an action. In A: The Board has 21 members, of which together, we can make a difference. And
Radha Menon MD, Internal Medicine Anil K Gupta, MD, FACC, Cardiology
addition, setting up mechanisms will not be one each represents the students, residents we look forward to be doing just that.
[email protected] [email protected]
easy. It will be good to be protective to the and others. Of the others, only two are
Medical students however. from institutions. The Board is clinically
Priya Kundra MD, Endocrinology Sam Fulambarker, Ex officio
Diabetes Mellitus [email protected] oriented, drawn from Orthopedics, Ob-
[email protected]
Gyn, Psychiatry, Anesthesia and others.

8 fall 2010 • AAPI Journal www.aapiusa.org 9
board of trustee report
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report of 
Chairman, Board of Trustees 

ashok fulambarker, Md 
At the historic AAPI Convention in Washington DC in 
June of 2010, the new Board of Trustees took office and took
on the challenge to make a difference in AAPI. This Board 
of Trustees is committed to maintaining the prestige and
functionality of AAPI and its committees have been working


hard. The Finance Committee is acting as good stewards of
 
the financial welfare of AAPI; the patron fund of AAPI is
up 10 per cent this year, despite difficult financial times. Further, the Audit Committee
recently completed their internal audit and look forward to presenting the findings in the 
Fall Governing Body meeting. Finally, the Long Range Planning Committee is working

on a cohesive plan that will create goals that are in the best interest of the future of AAPI.

I firmly believe AAPI’s success depends on the cooperation and teamwork of both the

Executive Committee and the Board of Trustees. I am confident that with our membership’s
AAPI Executive Committee AAPI Board of Trustees
collective talent, wisdom and experience our organization will continue to reach new

heights. Below are the members of your Board for 2010 -2011, please feel free to contact us Ashok Fulambarker, MD
Ajeet R. Singhvi, MD
as we value and appreciate your input.
Chairman
President
M.P. Ravindra Nathan, MD
Sunita Kanumury, MD
Trustee
President Elect
BOard Of trustEEs
IAMA NEWSLETTER Seema Jain, MD
September 2010 Narendra Kumar, MD
Indian American Medical Association (IL)
Trustee
President’s Report Ashok M. Fulambarker, MD, FCCP Shobha Gupta, MD Vice President
Thus far, 2010 has been a great year for IAMA. We started the year with the slogan “Year of Membership,” and I am happy Shobha Gupta, MD
teoff orerptso trot tbhoaot s1t 4m2e nmebwe rmsheimp bhearss binecelnu dthineg c mreeadtiiocna l osft uadne andts-h, roecs icdoemntms iattnede pohf yysoicuanlsg wpheryes iacidadnesd, o tuhris n yeewar w. Aebmsoiten,g our Trustee Trustee Jayesh Shah, MD
www.iamaill.org, and our increased electronic communications with members. We’ve continued to strengthen our mem-
tbieesr sohfi po uthr rooruggahn imzaotinotnh.l yT hEed umcoantitohnlya lm Seemetiinnagrss .o Tf hthee E ExeCc wuteivree aCtotemnmdeitdte bey ( EthCe) cmoanjtoinriutye os fb teh aec EtiCv emlye imnvboelrvse. dW ine hthaev ea csteivein- Trustee
renewed enthusiasm to grow our organization. We are thankful to our sponsors for their support of these events! Secretary
Thank you for being a part of a year of change and productivity - I am proud to share the following accomplishments:
IAMA-Charitable Foundation Muttathil P. Ravindra Nathan Durgesh P. Mankikar, MD Satish Anand, MD
Tohf eth IeA wMoAr-kC Fo ff rIeAeM cAlin ainc dis toou trh fela cgosmhimp. uItn hitays. mDra.d Ues ah ad iNffiemremnacge aind dsoa, mChanaiyr noef eIAdMy lAiv-eCsF ,a hnads c pornotvinidueeds gtore baet laena dimerpsohripta tnot tphaer t Dr. Ashok Fulambarker Trustee Trustee Ravi Jahagirdar, MD
CFohuanridtaabtiloe nF.o Tuhnadnakti oyno.u Wfoer yaoreu rp croonudtin tuoe rde psourptp tohratt! the semi-annual meeting held on May 15th raised $154,000 for the important work of the Charitable Trustee
Community Health Awareness Seminars: Treasurer
TtMwehaeues.r r t eaTh nhyw ,ee ej oxfriceirnls utte wssdievo ume es ei xnadcasue rtlc hlceaeont ivcote ocnruoearmdl ss em“e9 mdu1inri1nei tacMytr o eHhrdee aicladnalt dlah E t w AmJeawe iwnrag reSeeolnnccoceieimsestsy eS daoen mfo dMui nCre aoctrrhmso iaepmrfo ruglaintunaiegtnyse t CRd, hMe usicrnp.a doAgensorsh eotoh”nk ea AK tl euuthamgdeuae Hsrrt siA nh1td,it p2ru i0,o tC1fe o0Dmn.r pT.s luhHele eao mttfeo Gl paGrticeeasan Btweearerka arCle noh e“fiL c,I ianCvgdehoi aaL i,oor C,nn Hh gAie cwpaarligtitlhho 2 .AS 8 tOw,r 2oua0nrr1 egs0ne B.ce o osDnsn reCd Vso ”sem eammnmudiinrt i-a r Seema Jain, MD Naresh Parikh, MD Vinod K. Shah, MD Anil Khosla, MD
“ATnirjeadli Poaf dBheyineg p Treirseedn?t”e Ad efrxecee Blleonnte e Mduinceartaiol nDaeln insiftoyr mmeaatisounr etom oevnet rs c1r0e0e ngiunegs tws awsh moa adtete anvdaeilda!b le to the attendees. Dr. Anjali Kale, Dr. Kailash Sharma, and Trustee Trustee Trustee
Golf Outing Past President
A fun event for our member golf enthusiasts was our Annual Golf Outing at Seven Bridges Golf Club in Woodridge, IL on July 11, 2010. Forty-two golfers
e1n9jtho yheodle a. Tmheem goorlfa obulet irnogu nwda so fo grgoalfn aizte tdh ibs yp itchteu rIeAsMquAe C choaurritsaeb. Tleh Feoreu nwdaast aionn a. wThaarndk cse troe mKioshnoyr aen Cdh duignhn,e Dr rfo. Dlloewepinagk Mgoitlaf.l ,D Dr.r .A Ashshookk F Fuulalammbbaarkrkeer rh, oDsrt.e Uds thhae Naresh Parikh, MD
NIAiMmAm aGgoaedsd Eale fcotrr othneic g! reat work organizing this event. Satish K. Anand, MBBS Suresh C. Gupta, MD
taTrhnoidns ioyceu caro rbm, ewmaeuu stniafiuvcela ndtie oswnig inwsi feeicabassynit,t e ua “smiearom-furaineiltln. omdrlogy,n. ”ae nAyd sa indsadev fterrsoe mecos sibnty.v Oirteaudtriu odcnaisnt afgo b ora utshre er h esgaesum mlaiaran mnnyau mialilne agmnsbd ae narnds n winuistahtle oeauvdet nuastn ian engmd oa auil r na pedrwdorsfeelesstsst.ie o rPn,l eathal eese md eeancilis ssuiyorsent e twmhaa “tsi cymooanudt raeec ctth e.ciavote me ol”eu cr- Trustee Trustee Ashok Fulambarker, MD Trustee
important email communications by sending your email address to [email protected].
Golden Stethoscope Award Suresh C. Gupta, MD
The IAMA Golden Stethoscope Award ceremony held on August 28, 2010 at the Gaylord Restaurant was a huge success. There were over 110 guests in Chair BOT
a Thttaennkdsa tnoc eD rin. Aclnukdiitn Mg erehstiad, eCnhtas,i rf,e Rlleoswidse, nmte cdoimcaml sittutedee, natnsd a nthde y jouudngge sp Dhryss.i cMiaannso. jT Dheurgeg wale, rRea 1jin9d qeur aAlirtoy rpao, astnedrs A psrheosekn Ftuedla.m barker. Anil Khosla, MD Sanku Surender Rao, MD Trustee
aI lnodo kB afonrqwuaertd o tno Sthateu yrdeaayr ,f iNnoisvheinmgb weri t2h0 ethve ant gthreea Oteark s Burcocoesks D thoaunb liet threaes bHeogtaenl. . I look forward to your joining us for a great scintillating Annual Meeting Trustee Trustee (Past President) Priya Kundra, MD
Thank you, Durgesh Mankikar, MD
Sincerely, YPS President
Ashok Fulambarker, MD, FCCP
President, IAMA Trustee
Mamta Singhvi, MD
Sanku S. Rao, MD

MSRF President
Trustee

10 fall 2010 • AAPI Journal
feature sevak: a pilot project to address health needs of rural india
sEvak:
a pilot project to address
Health needs of rural india
abhishek J. patel, Md • thakor G. patel, Md
Hemant patel, Md • padmini Balagopal, phd
Jivraj damor, Md • ranjita Misra, phd
India is currently on pace to become the most populous of heart attack, stroke, trauma triage, infectious diseases, kidney
country in the world within the next two decades and three-fourths diseases, pain and its causes, diarrhea, immunization, sanitation,
of its population currently resides in rural areas. Do they have water purification, efficient chulas (stoves), and how to deliver
proper access to healthcare and more importantly knowledge of lifestyle modification education. They will screen the village
diseases that are preventable with the right lifestyle modification? population for diabetes, hypertension, and monitor for various
diseases and patients with chronic disease who are on treatment,
In 2007, with the help of American Association of Physicians
in addition to providing healthy lifestyle education and preventive
of Indian Origin (AAPI) President, Dr. Hemant Patel, the
care. The goal of this project is to create standardized delivery
Chairman of the Public Health Committee of AAPI, Dr. Thakor
of diabetes and hypertension screening and care in the villages
G. Patel, with Drs. Ranjita Misra and Padmini Balagopal set out
by the Sevak who live there. The Sevaks will help ensure that
to find the prevalence of diabetes, dyslipidemia, and hypertension
patients on TB, HIV, and malaria treatment take their medicines
in a rural village located in Gujarat by the name of Karakhdi. Their
and that patients with diabetes and hypertension come for regular
research led them to conclude that in addition to the prevalence
checkups and attend health classes. Pregnant women will be
of diabetes and hypertension, the access to care and preventive
screened for diabetes, hypertension and encouraged to deliver in
care was a critical problem. With the facts at hand they decided
a hospital. Sevaks are also trained in efficient Chula (clay stove)
that large-scale efforts to improve general awareness through and sanitary toilet construction as an immediate measure of Dr. Thakor Patel and Project Manager Kirti Patel recruiting a Sevak from a remote village in Dang, which is located in southeastern Gujarat.
education and to promote healthy lifestyles must be undertaken.
improving village resident health infrastructure.
Dr. Thakor Patel was bothered by the inability to get chronic
A data base of the population as per defined parameters access to care responsibilities criteria
disease care in the village and came up with the concept of Sevak,
such as demographics, chronic conditions, B.P., weights, blood
IN RURAL INDIA OF SEVAK FOR A SEVAK
which he based on his experience serving in the US Navy. A rural
sugar and immunizations both for adults and children will be
Having a Sevak in the village Sevaks are in essence An aspiring Sevak should
village can be compared to a naval ship in a lot of ways where a
maintained.
to look after the health complimentary to health care meet the following criteria:
large number of people live in close proximity far from any health
needs of its inhabitants will providers and should not He/she must live in the
care center. This project is modeled after the role of Independent
create a healthier and more be treated as a competitor. village; have a graduate
Duty Corpsman (IDC) in the US Navy who are given 12 months
efficient India. The Sevak Sevaks will make the health degree if possible, but high
of training and then assigned to Marine Corps units or naval
concept falls within the care providers more efficient school diploma is fine. They
ships. To become an IDC all you need is a high school diploma
Gandhian principles of “Gram in dealing with diseases that can continue to work in the
and an interest in health care. The Sevak Project is a pilot project
Swarajya.” Glucometers and require their expertise. The farms but must have the
to address the shortfalls in the healthcare needs of villages similar
blood pressure machines access to care project may be willingness to work in t heir
to that of an IDC on a fleet ship.
for the pilot project will be one of the solutions to screen own community.
One village in each of the 26 districts in Gujarat was provided by AAPI. Continuous and control the high rates
chosen for the pilot. The project involves coordinating monitoring of this project of diabetes, hypertension,
with the villages and identifying interested individuals will be carried out by the and CAD. This project will
with medical and or non-medical backgrounds, basically coordinators of the project. be conducted as a pilot in
it was one person per village of 1000-2500 population. Gujarat before widespread
implementation.
The 3- month Sevak training was based in the city of
Vadodara; M.S. University and Baroda Medical College play a

key role in educating the trainees. Prominent lecturers from the Basic disease awareness and education can dramatically impact
incidence and prevalence of communicable diseases.
preventive medicine department help train the Sevaks to diagnose
diabetes and hypertension, and develop knowledge of the symptoms
12 fall 2010 • AAPI Journal www.aapiusa.org 13
1. Sevaks getting acquainted with digital blood pressure machines. 2.
Sevaks are practicing taking blood glucose readings with digital glucometers.
3. Dr. Abhishek Patel is familiarizing the Sevaks with the EMR software— American Association of Physicians of India Origin (AAPI)
created by Dr. Ashish Joshi of the University of Maryland—which they will
use. 4. Sevaks are able to educate villagers on the construction of energy Clinical
 Observership
 Program
efficient Chulas with proper ventilation. 5. Dr. Mrinalini Paur, Chancellor

1. of MS University, who is an advocate for rural health care visits the Sevaks

during their graduation on May 2nd, 2010.

It’s my distinct pleasure and honor to serve as the chair
for AAPI Clinical Observership Program for this year. This program
enables young Indian Medical Graduates to obtain US clinical
experience which, in this competitive era of residency search, has
become a difference making factor in applicants’ CV. AAPI,
through a centralized screening and recruitment process, delivers
this service via volunteer proctors who are well experienced
2. 3.
physicians in their respective fields of medical practice from all
Bhoja reddy katipally, Md, MpH
around America.
This centralized program was launched a few years ago with the support and hard
work of leading members of AAPI and volunteer proctors from its various regional chapters
This program is expanding its wings with flying colors. And, now is the time to identify
those potential local programs that have been serving the young Indian Medical Graduates
and integrate them as parts of AAPI Clinical Observership Program. I cordially thank my
predecessors, and as the new chair of the committee, I would like to take it to the next level
by creating more regional chapters by recruiting new proctors and improving the screening,
4. 5.
recruitment, evaluation, and certification process further, while enhancing the
communication among chapters.
We all remember the times we started our personal journeys after stepping on this
The performance of the Sevaks will be based on the number of

land of opportunity to begin our careers. Days are changed, influx of International Medical
screenings, follow-ups, and the increase in the number of toilets,
Graduates has increased exponentially over time, and the cut-throat competition to get into a
stoves ventilated to the outside and educational classes. residency program is only getting worse.
We should identify the high-yield chapters across AAPI regions based on location
of IMG friendly residency programs and also location of observers. If we combine more
The pilot program will be for stoves ventilated to the outside and (Chair); Hemant Patel, MD(Co-
heads of knowledge, hearts of passion, and hands of service together, AAPI can expand this
three years with a maximum of five educational classes. The Sevaks will Chair); Ranjita Misra, PhD (Co-Chair);
program and thus become capable of serving more applicants and also gives them a choice of
years. The program will be managed provide a resource for a healthy, clean Padmini Balagopal, PhD; Ashish Joshi,
by Texas A & M University with the village with ready availability to provide MD(US); Dean (Ret) of Baroda Medical pursuing the program in geographically feasible chapters. You as a dear member of AAPI are
American Association of Physicians advice. Mahatma Gandhi aspired for College Kamal Pathak, MD; Current already a part of this mission, and now can support this program by signing up as a proctor,
of Indian Origin, Baroda Medical such a village and hopefully the need Dean of Baroda Medical College, local chapter coordinator, regional director, and / or national committee member.
College, and AAPI (NY-NJ). The is being met by the Sevaks. This is a Amrit Leuva, MD; Mr. Kirti D. Patel;

program will be reviewed each pilot project for India and can be used Bhartiya Seva Samaj; and Bina Sengar,
Please visit ‘Education/Clinical Observership Program’ page of AAPI website for
month to ensure compliance with the anywhere in the world where there are PhD, Sudarshan Foundation Trust.
further details about the program and also how to become a proctor or a leader at various
standard of care and that the villagers’ with minimal resources available. The
health care needs are being met. Sevaks can train people from anywhere This project was supported by a grant levels of the program. With Warm Wishes & Cheers,
in India or other countries, and the from Pfizer Inc., Federation of AAPI of
The Sevaks were chosen without program can be replicated as many times Greater NY-NJ and J&J Co provided the
Bhoja Reddy Katipally MD MPH
regards to their caste, religion, beliefs, as required until the needs of a local glucometers, strips, stylets and pens for
Chair, AAPI Clinical Observership Program
or gender. The performance of the area, district, state or country are met. the project.
Sevaks will be based on the number
of screenings, follow-ups, and the The principal coordinators for
increase in the number of toilets, the project are Thakor G. Patel, MD,
14 fall 2010 • AAPI Journal www.aapiusa.org 15
feature feature
What is the secret of Medical Emergencies on airline flights
Mr. frank spurling’s long survival?
Bala v. Manyam, Md*
“Is there a doctor on the flight?” Another case of vasovagal attack! The patient came out of it. I felt
r. r. vijaynagar, Md*
The voice coming at 35,000 feet and told the lead cabin crew that the patient will be all right and
above ground is an occasional the flight can continue. But, the captain decided to disembark the
It was bad enough that Frank in 1985. This first patient lived for eleven years. Frank Spurling is occurrence on any airline flight. You passenger, his family members and their luggage by returning to
are a doctor - possibly the only one the gate and the flight was delayed by over an hour. This was OK
Spurling developed osteogenic our second cardiac transplant.
on that particular flight. Should with me as the captain has full and final responsibility and authority
sarcoma of the tibia at the young age
of 25 for which he had to undergo A few precautions are necessary for a successful outcome. you respond? To my karma, it has for the safety of all passengers, staff and the aircraft.
happened to me, too many times. I usually wait to see if any one
above knee amputation followed by Close communication and coordination between the recipient I have made it a habit to include a stethoscope, Ace
else responds before I press the call button. If none, I respond. Years
chemotherapy with Adriamycin. and donor hospital is a must. Confirm donor patient is free of bandages, sterile gauze, Band-Aids of different sizes, basic
back, I was returning to US by Air India. I responded to the call.
Later, when he was admitted with hepatitis, HIV and any other infections. Blood group and body A child had developed urticaria, an allergic reaction causing severe analgesics, antibiotic cream, anti-diarrheal and anti-emetic
drugs. I also carry insect repellent of 30% deet (depending on the
progressive heart failure, it became clear that he had developed the weight should be a proper match too between donor and recipient. itching. I always carry a first aid kit. I took out Benadryl capsules
country of visit). Years earlier, I also used to include sterile, one
much feared complication ‘adriamycin induced cardiomyopathy.’ Once the heart has been extracted, cardiac chambers are explored and treated the child. The family thanked me immensely as the
ml. syringes with needle, adrenaline ampules, one vial of 50%
Frank was extremely ill and needed numerous intravenous medications. to rule out any evidence for endocarditis. Initially we had to work child stopped crying and went to sleep. The crew moved me to first 50 ml glucose ampule and meperidine tablets. I no longer carry
class for rest of the flight and before I disembarked, presented me
Fortunately, on June 21, 1985, a donor heart was located in Myrtle within the window of four hours between the time the donor heart the last mentioned items, as once on landing at New York’s JFK
with an expensive Champagne bottle. This was a generous gesture
Beach, South Carolina and he underwent a successful cardiac transplant. is harvested and placed in the recipient in a beating condition. airport when I went through customs, the officer checked my
for responding as a physician. It was nice of them to do so. On the
Now fast forward to 2010 and Frank Spurling was celebrated recently Beyond five hours of ischemia there will be cause for concern. other hand, while on a Continental flight from Newark to Houston, carry-on luggage that had my first aid kit. I identified the drugs
in the kit I carried including two 50 mg tablets of meperidine. I
in Tampa as Florida’s longest surviving cardiac transplant patient. Postoperative course is the most important aspect with anti- the familiar voice came. I responded. The lead cabin crew, even
also showed my wallet copy of my medical license. He let me go.
rejection medication. Aggressively suppressing the immune system before taking me to the patient (who had collapsed in his seat), said
When I walked about 20 feet, another officer flashed his badge
There has been an interest in organ transplantation dating for the protection of the donor organ is secondary infections and a “I need to verify your medical license” in a not so friendly voice. I
and indicated he needed to check my luggage again. He did.
back to perhaps a century ago. Credit should be given to Alexis was shocked. I pulled my pocket copy of medical license and gave
balance needs to be achieved between rejection and infection. When he looked at meperidine tablets, I indicated that I am a
Carrell and Vladimir Demikhov at the University of Moscow, it to her and rushed to the patient. This time I had my stethoscope,
physician and I carry a first aid kit which includes meperidine in
Russia, the first to demonstrate that an intrathoracic cardiac So, what is the secret of the long survival of Mr. Frank Spurling? BP cuff and in fact my entire medical bag. case I need to treat someone who has severe pain in an emergency,
transplant was possible in warm blooded animals. Subsequently the The world’s longest living heart transplant recipient recently died The patient was on his way for post-op follow-up of his such as during a heart attack. He responded by saying he could
actual technique was described by Dr. Richard Lower and Norman of cancer, after surviving for thirty one years. Frank, currently the cardiac surgery and appeared to have had a vasovagal attack. As arrest me for possessing narcotics. I showed him my copy of my
Shumway in the animal laboratory. Many years’ of research took longest survivor in the State of Florida, has completed twenty five the patient regained his consciousness and his blood pressure had medical license. He was rough with me, but ultimately let me go.
returned to a near-normal level with near-normal cardiac rate, That was the end of my carrying meperidine tablets and syringes
place between the first primate to human heart transplantation years. He dotes over his four grandchildren and enjoys his life in full.
I had the patient lying flat on the aisle for rest of the flight, told fitted with needles as I don’t want to be put into prison!
by Dr. Hardy at the University of Mississippi in 1964 to the first Yes, he has had a few episodes of rejection and some infections. He
the captain that there was no need for an emergency landing,
human to human heart transplantation by Dr. Christian Barnard in did develop coronary arteriopathy induced by Cyclosporine and was but to have paramedics and an ambulance near the gate on Most on-flight medical emergencies are fever, cough, running
nose, nausea and vomiting, chest pain, headache, backache,
South Africa in 1967. However, because of medical-legal problems successfully treated with stents. landing. As we were about 45 minutes from landing, he agreed.
motion sickness, confusion from jet lag, dehydration or excess
human to human heart transplantation was not performed in the The lead cabin crew member came back to me and asked me to
The real question is “why don’t these patients have a very long alcoholic drinks, dyspnea from whatever the cause including acute
describe what I did (my diagnosis, management etc.) over their
United States at that time. I had the opportunity to do a research bronchospasm, and rare urinary retention. Strokes or actual acute
survival rate since donor hearts are young and healthy with a potential phone system to the airline physician who was stationed in a
fellowship in heart transplantation, experimenting with techniques myocardial infarction may need emergency landing. Childbirth is
for long life span?” In the case of Frank and other patients, the answer different city. As this was for their liability protection, I did not
in mongrel dogs, from 1970-1971 at Montefiore Hospital, N.Y. a rarity, as most mothers do not fly in late third trimester. Injuries
lies in the fact that long term survival is a matter of acceptance of feel obligated and refused. Over this, I felt the lead cabin crew
on board during a normal flight are rare. Even more so now, as
was more concerned about the airline liability than the safety of
Early enthusiasm in cardiac transplantation waned because the transplanted organ by their immune system. Since there is a very we cannot carry any sharp objects. Occasional death on board
a sick passenger. The take-home lesson is, you may be rewarded
of high mortality from severe rejection episodes and infections. short window of time for heart transplantation, HLA matching has occurred. Injuries resulting from aircraft crash landing are
for your services or rarely treated roughly as my rare experience,
The discovery of Cyclosporine-A in the early 1980’s along with (human leukocyte antigen) is not possible before the procedure. but, most often airlines appreciate your services. In any case, beyond the scope of this article.
development of the endo-myocardial biopsies for early detection of Fortunately HLA matching turned out to be optimal in the case you won’t be sued for malpractice if something goes wrong due In summary, it is worth responding to help on humanitarian
cardiac rejection generated new enthusiasm. of Frank Spurling and other long-term survivors. I believe that it to limited resources as it is covered under a Good Samaritan act grounds. Most airline crew members are nice to you and appreciate
is ultimately these biological factors and the patient’s own immune by the courts. In any case, I do not give out a prescription, my your help and even more by passengers. If you are a resident
In Tampa General Hospital where I worked, numerous cases name, phone number etc., to patients or their relatives. physician, disclose your status first to cabin crew members and
system accepting the donor organ, are the critical determinants of
of end stage cardiomyopathy of different etiologies suitable for heart patient or relatives and get permission to help. Upon returning to
long survival of the transplanted organ. Airline flights on board carry emergency medical items that
your place of work, inform your Residency Program director also,
transplantation, were either left to die or referred out. Considering include basic medications such as for motion sickness, pain, etc.,
in case some inquires come later as you may be on a limited medical
these factors and my experience as a transplant fellow, I decided * Dr. R. R. Vijaynagar, MD, FACS, FACC, is the recipient of Ellis and even defibrillators. The flight crew members are trained to
license. It is also useful to carry some basic first aid items as who
to establish the cardiac transplant program at Tampa General Island Medal of Honor and numerous other distinctions for his outstanding handle some emergency procedures in the absence of a qualified
knows you may need to use it for yourself or someone close to you!
Hospital in early 1983. This culminated in the performance of the contributions in cardiovascular surgery and to the local community. Emeritus professional. They first ask for a doctor. In the absence of any, they
first successful cardiac transplantation by me in the State of Florida Cardiac Transplant Surgeon, Tampa General Hospital, Tampa, FL. may step in. On one occasion, our flight from Tel Aviv to Atlanta * Clinical Professor, Dept. of Neurology, Penn State University.
was taxiing. Before take off, the call came for a doctor. I responded. [email protected]
16 fall 2010 • AAPI Journal www.aapiusa.org 17
feature
AKMG Alumni Chapter Meeting during the Annual Convention
of AAPI 2010 at Gaylord Resort and Convention Center.
Book Review...
HEaltH rEfOrM: My perspective
continued
Continued from page 28 word is ‘adaptation.’ In the case of patients, it means aravind pillai, Md facp *

buying time to reduce body’s oxygen demands which
them in ‘suspended animation’- a sort of hibernation- in turn will reduce organ injury during the recovery
Over the next decade, as per expert healthy life style. Adopting these lifestyle changes at an early
which reduces the metabolic and energy demands. process. Hypothermia using a variety of methods
opinion, we will spend close to 30 age will eliminate most obesity related illness which costs the
seems to be very beneficial. trillion dollars to provide acceptable health care industry billions of dollars. Similar to the federal laws
We learned about ‘suspended animation and health care to all Americans prohibiting underage purchase of alcohol and cigarettes, there has
including more than 30 million to be a nation-wide initiative to promote healthy living.
hibernation’ as two approaches that can save human Dr. Gupta’s book teaches us, that the power of
uninsured persons.
lives from animal models. Many animals go into modern medicine continues to unfold revealing an 3. obeSitY: The dangers of obesity are well known and yet the
hibernation in winter to conserve energy demands amazing array of new treatment modalities and Every American agrees that the existing health care incidence is going up, affecting almost 60 million or more in USA.
system must change! Our current health care cost exceeds 12% And what is worse, obesity is about to take over from smoking as
that aid in their long term survival. The painted innovations which are helping us to cheat death and
of the gross domestic product. Raising this amount of money is the number one cause of ill health in this county. We all know what
turtles often burrow in the mud, without breathing live longer.Thanks to these major breakthroughs,the
daunting and may, in fact, propel our great nation into financial to do, eat less calories and exercise more, right? But how many of
foArb oaus tl o5n0 gm aesm fboeurrs mofo Anstshosc,iadtiuorni nogf Kae rroaluag Mhe wdiicnatle Gr.raAdnuates attemndyesdte trhieo uAslu mlinnie C hbaepttwere Mene etliinfge. Dainscdu sdsieoant hce nitse rebde ing collapse. On the other hand, we have a young, dynamic president us really practice this? I definitely think health care reform should
uanr-oaucncdl imhoawt iztoe dd of ircsotl latibmorea tcivliem pbroejre cotfs Mbeotwuneet nE AvAePreI satnd AKMGs hsiof ttehda ti nb oothu ra fsasvoocria.tAiosn sW woioll dbye Amluletuna sllayy bs e(nqeufiotetedd. by who is ready to right all that is wrong with our health care system. address this issue without delay.
I congratulate President Obama and his team for showing courage
isE flfiokretlsy a troe agloso i nutnod epruwlamy oton aprroym eodteem mao rwe hpiacthro cno mueldm bbeerships froGmu tphtea )ra “nIk ds oonf ’At KwMaGn.t to achieve immortality through
4. neW tax FoR SugaR PRoduCtS, inCR eaSe
to propose a comprehensive health care plan, which they think will
fatal, and yet a seasoned, well trained climber can my work. I want to achieve it through not dying.” tax FoR CigaRette and gaS: The government
spur an economic recovery. This is the first positive step.
scale high altitudes without much difficulty.The key Don’t we all? Read this book and you will know how. should immediately implement a huge tax on high calorie-
Currently, after passing the health care reform bill, public sweetened sodas, chips, fried foods, and cigarettes. Introduce
opinion and support for the reform are ambivalent at best. a minimum ten cents health tax per gallon of Gas. If smoking
Legislators and the public alike are confused about the vast could be banned, 50% of the cancers and a significant percentage
content of this bill. The Government hopes to reduce the deficit of heart disease could be eliminated! Think about that.
by cutting pay to doctors and increasing tax on wealthy and
5. oFFeR PaLLiative CaRe FoR the teRMinaLLY
small business. We must realize that most of the health care
iLL, avoid duPLiCation oF SeRviCeS and StoP
expenses go to pay hospital bills, medicines and sophisticated
PaYing FoR FRauduLent equiPMentS: The
tests. How do we raise trillions of dollars to balance the budget?
terminally ill and elderly patients with the poorest quality of
Republican and democratic leaders may never find an acceptable
life should be referred to the appropriate palliative and hospice
CALL FOR Safari Ventures organized a most financial resource to fund the proposed health care plan.
services in a timely fashion. Many families are not given these
YOUR FREE
unforgettable trip to south and East
TOURIST Here are some practical suggestions: options until it’s far too late for their loved ones to die with dignity
Africa for three couples which included
GUIDE and peace. Duplication of services at the private health care and
my husband and me”. We are taking 1. eLiMinate deFenSive MediCine: Practice VA systems should be eliminated.
another trip with Safari Ventures to see the Tiger of defensive medicine evolved from the fear evoked by blatantly
unfounded malpractice suits. This can be corrected if we implement 6. eMR: Government must help to make Electronic Medical
sanctuary in India. It promises to be as memorable
a federal law which caps non-economic damages. Recent study Records software affordable and thus make it acceptable to all
as the tour we took seven years ago.
showed that close to 30% hospital admissions and 35% of expensive providers. EMR will keep track of all medical services being
tests are done to defend the physician from malpractice suits. This given to the patient, and thus become a national repository.
Nalini Juthani, MD
is a huge waste and clearly not essential for patient care by any Medicare should enforce strict rules to stop fraud like when
Life Member, AAPI
standards. The billion dollar question is “Why Republican and they pay for motorized wheel chairs, hospital beds, home
Democratic law makers do not want to pass Tort reform?” We oxygen, and diabetic supplies.
physicians demand to legally cap non-economic damages, or give
These are some of the measures that will make our nation
4 us similar malpractice protection as is offered to doctors working in
5
2 the true leader of a healthy world! We can only wish that our
5 government institutions (such as: Veterans Administration doctors).
3
T- Government could implement these corrective steps to eliminate
S
2. PRoMote heaLthY Living: Local and federal waste, increase revenue, close the budget gap and build a nation of
Governments should take lead to implement healthy living in the healthy people!
home and school environment at an early age. School physical
Ask about our 2010 special
exercise for one hour a day must be made universal. “Healthy *Dr. Aravind Pillai is the President-elect of Association of Kerala
AAPI departures
living” has to be included in the school syllabus. Encourage health Medical Graduates and practices Internal Medicine. Orlando, FL -
Call now TOLL FREE 1 888 341 7771 insurance discount (25% or more) to people who show proof of [email protected]
Visit www.safariventures.com The Wild Of Africa – Within Your Reach…
www.aapiusa.org 19
AAPI Journal Winter 2010 www.aapiusa.org 29