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The PA pipeline: More trained to fill Georgia’s growing need

Members of the PA program at Georgia Regents University wear blue to raise awareness of diabetes

Members of the PA program at Georgia Regents University, including Timber Wages, wear blue to raise awareness of diabetes

Her 27 months at physician assistant school was an intense experience, says Timber Wages.

“It’s like trying to drink water from a fire hydrant,’’ says Wages, 31, who attended the PA program at Georgia Regents University in Augusta.

A fire hydrant?

“The volume of information is overwhelming,’’ she explains, adding with a chuckle, “but not impossible.’’

Timber Wages

Timber Wages

Wages, originally from Calhoun in northwest Georgia, weighed several job opportunities when she graduated about a year ago. She joined an Augusta urgent care center as a PA in primary care, and also works at a Columbia County detention center.

Over the past decade, both Georgia and the nation have seen a surge of PAs. The higher demand comes from several factors: the growth in outpatient clinics; the shortage of primary care physicians; and the added emphasis on cost-effective, team-based medical care.

A physician assistant is a health care professional who has the training to perform many of the duties that doctors routinely handle. PAs must be licensed and each must work under the direction of a physician.

About 95,000 PAs are practicing across the country, up from 43, 500 in 2003.

The number of PAs in Georgia has increased by 67 percent over the past 10 years, now surpassing 3,000. Still, experts say there’s a shortage of them in the state.

Though she and other PAs are not allowed to prescribe certain medications, Wages says she can do most things a primary care physician can do. That’s why PAs are so valuable in primary care: They can relieve much of the workload of doctors.

A large majority of Georgia PAs, more than 75 percent, are currently practicing in metropolitan areas, according to a state workforce survey.

Wages says an attractive feature of being a PA is lateral career mobility, where she can work in primary care for a while, then transfer into a specialty, such as dermatology or orthopedics.

nccpaMost physician assistants end up going into a specialty, says James Cannon, board chairman for the National Commission on Certification of Physician Assistants.

All are trained in primary care, which can help a PA who moves into specialty medicine, says Cannon. He’s a PA who works in psychiatry, and while he treats substance abuse patients, he also can address their primary care needs.

The NCCPA organization, based in Johns Creek in the northern Atlanta suburbs, is the only certification and licensing exam entity for the PA profession. NCCPA certification (passing a PANCE exam) is required for initial licensure in every state.


A calling that’s relatively new


The PA profession arose in the 1960s, when physicians and educators recognized there was a shortage of primary care physicians.

To help address the need, Dr. Eugene A. Stead Jr. of the Duke Medical Center, formed the first class of physician assistants in 1965. He selected four Navy corpsmen – military medics who treat sailors and Marines – to be the first students.

Now, PAs and nurse practitioners (who also can handle many of the duties frequently left up to doctors), are considered part of the solution to primary care shortages, especially with the coverage expansions from the Affordable Care Act.

Chris Parker, associate project director at the Georgia Health Policy Center, adds that under the ACA, “as more individuals find coverage, an even greater demand will be placed on our primary care system, especially in rural and underserved communities.

A Rand Corp. study published in November said new roles for PAs and nurse practitioners may cut a predicted shortage of physicians by about 50 percent.

“Growing use of new models of care that depend more on non-physicians as primary care providers could do much to reduce the nation’s looming physician shortage,” said David Auerbach, the study’s lead author. “But achieving this goal may require changes in policy, such as laws to expand the scope of practice for nurse practitioners and physician assistants, and changes in acceptance, on the part of providers and patients, of new models of care.”

Using PAs and nurse practitioners in “medical homes” – teams of health professionals working together to coordinate care – can relieve the doctor shortage by serving larger numbers of patients than a single physician can treat, experts say.

Georgia now has four PA schools – at Emory in Atlanta, Mercer in Atlanta, Georgia Regents University in Augusta and South University in Savannah.

USA Today reported last year that according to the American Academy of Physician Assistants, 60 new physician assistant programs were waiting then for accreditation, and 10,000 new PAs were expected by 2020.

Jeff Chambers is one of five PAs on an  Air National Guard special medical team.

Jeff Chambers is one of five PAs on an Air National Guard special medical team.

“There are a lot of jobs available, especially in emergency medicine,’’ says Jeff Chambers, a physician assistant who works in orthopedics in Athens. “More primary care jobs are opening in rural areas.’’

As a PA in orthopedics, he says, “I can put bones and joints back in place,’’ plus assist in surgery.

It’s cheaper and quicker to train a PA than a doctor, says Chambers, a past president of the PA association.

Nationally, the median salary for a PA is about $97,000.

Wages says she wanted to practice in Georgia because it’s her home state.

“I’m very proud to be a PA,’’ she says. “And I enjoy general practice much more than I anticipated.”


Hospitalists: The specialists whose patients all have beds

Nurse practitioner George Mackel (right) is one of the first hospitalists at Morgan Memorial Hospital

Nurse practitioner George Mackel (right) is a member of the hospitalist team at Morgan Memorial.

Morgan Memorial Hospital in Madison got tired of having so many patients who were just passing through.

Too often in the past, the hospital has stabilized newly arrived patients, only to see them quickly bundled off to Athens for further treatment.

Ralph Castillo, the administrator for the 25-bed hospital in one of the most famously beautiful communities in Georgia, thinks he has the solution to this stopover problem.  He has launched a program that he says will save lives and keep more patients in Morgan County, closer to home and family.

Castillo introduced a team of hospitalists – mainly physicians who specialize in the care of patients who are admitted to a hospital.

Morgan Memorial has brought in a hospitalist group of nine physicians and five nurse practitioners/physician assistants who manage and coordinate all aspects of a hospitalized patients stay while working closely with a patient’s primary care physician– from admission until discharge.

The idea, Castillo says, is to increase patient and physician satisfaction. Every day, a hospitalist comes in very early, catches up with the nursing staff on any overnight developments, and tends to about 10 patients in an eight-hour shift.  That’s about 60 percent of Morgan Memorial’s inpatients on an average day.

Previously, all six of Madison’s primary care doctors came to the hospital to see patients who had been admitted.  Castillo said having hospitalists at Morgan Memorial enables doctors in the community to see more patients in their offices, while inpatients have a hospital-based doctor to respond quickly and expedite their recovery.

A new idea for a small town

Most people around Madison don’t even know what a hospitalist is.  But that’s probably true of most people around the country.

“Hospitalist” is a relatively new medical specialty, one rooted in a California experiment that began in 1992.  The term “hospitalist” was coined four years later in a New England Journal of Medicine study.

Morgan Memorial Hospital

Morgan Memorial Hospital

Studies conducted in Minneapolis, Long Island, N.Y., Los Angeles and other urban areas indicate that hospitalist programs can decrease the average length of hospital stays by up to 35 percent.  In Georgia, hospitalists have been around for a while in larger, regional hospitals.

But almost no data are available anywhere about hospitalist programs in small or rural facilities.

Because the service in Madison is only a few months old, its impact on patient care remains unclear.  And there are skeptics.  Not every local doctor has agreed to cooperate, and pharmacists are worried that working with hospitalists could make their job harder.

Morgan Memorial does not directly pay the salaries of hospitalists.  They are part of an Integrated Care Program (ICP), a bundle of inpatient and emergency department services that cost the hospital $800,000 to $900,000 annually.

Since the hospitalists went to work at Morgan Memorial about four months ago, the average number of  inpatients is higher by one to two per day.

“There were more patients leaving our ER room than they needed to,” Castillo said, “and having a hospitalist here enabled us to keep more patients here for the routine medicine rather than automatically shipping them to Athens.’’

Castillo said the hospitalist program also makes life better for primary care doctors in the community, giving them more free time.  “I’ve got one physician in particular – he’s been able to travel outside the state of Georgia more often than he had in the past,” Castillo said, “and he’s also been able to actively participate in both of his children’s extracurricular activity.”

Benefits vs. drawbacks

Four of Madison’s six primary care doctors have agreed to hand off acute care patients to the new specialists at Morgan Memorial.

One is Dr. Dan Zant, a family practice physician who’s also chief of staff at the hospital.

“It helps me be free to tend to my patients in the office,’’ Zant says. “It’s helped me expand my hours to see more patients.’’ And after hours, he says, the hospitalist program allows him “to turn it off and enjoy some family time.’’

Dr. Miguel Cossio – known as “Dr. Mickey” to his patients – is one of two who have not.  He says he feels strongly obligated to continue seeing his patients when they are hospitalized.

“It’s like you have a friend,” he said of the patient-doctor relationship.  “When times are good, everyone’s your friend…but a true friend is there in the good times and the bad.”

Though Cossio says he has “no opinion one way or the other” about the hospitalist program, he made clear that has no intention of switching over to it.

Local pharmacist Elise Lang, who practices at Thrifty Mac, worries that the hospitalist program will make it harder for pharmacists to stay in the patient care loop.

The Affordable Care Act, she said, has already increased paperwork for folks in her profession, especially when ventilators or other medical equipment are needed.  In such situations, pharmacists need more information from the treating physician.

But hospitalists, who see only inpatients, don’t necessarily have every patient’s complete medical records on hand when the pharmacist calls, Lang said.

And sometimes these physicians are harder to reach than office-based doctors.  “They don’t keep regular business hours,” Lang said.

Other area pharmacists say they’ve faced the same issue when trying to fill orders for patients hospitalized at larger facilities with hospitalist practices, including Athens Regional Medical Center.

The full costs and benefits of Morgan Memorial’s hospitalist program remain to be seen.  Most hospitals don’t see the positive effects until at least a year of services, experts say.

“At the end of the day,” said Castillo, “we want the patient well and on their way, just like the primary care physician wants the patient well and on their way.”


Lee Adcock is a first-year health and medical journalism student at the University of Georgia. She is also a music critic for various media outlets.


A test is a useful tool, but can lead to ‘premature’ diagnosis

What happened to Alex Halstead demonstrates that sometimes a quick diagnosis isn't always correct.

Alex Halstead’s appendicitis wasn’t diagnosed during an initial ER visit.

It was finals week in December 2009 and Alex Halstead, a 19-year-old undergraduate at the University of Georgia, was doing some late-night studying for an exam the next day when she felt a stinging pain in her lower right abdomen.

The pain was severe, and she was worried that she might have appendicitis.

By midnight, thanks to her roommate, Halstead was at the emergency room of Athens Regional Medical Center. The doctor on duty felt the problem was serious enough to admit her.

“At this point, I’m pretty much keeled over in pain,” recalls Halstead today.

After recording her vital signs and hooking up an IV of painkillers, the doctor gave Halstead what she remembers as a “metal-flavored milkshake.” This was a contrast agent that makes it possible to view abdominal structures –- such as a swollen and inflamed appendix –- using a CT scan.

The CT scan, surprisingly, showed nothing out of the ordinary.

Based on that scan, the doctor ruled out appendicitis. He concluded instead that Halstead had an ovarian cyst, a much less threatening condition. She’d had one before, and women in her family were plagued by endometriosis, which can sometimes cause intense abdominal pain.

As it turned out, the doctor was wrong.

Looking back, the emergency room doctor appears to have made a type of medical error known as “premature closure,” said family practice expert Mark Ebell, a member of the U.S. Preventive Services Task Force and a professor in UGA’s College of Public Health. This type of mistake happens when a doctor reviews the patient’s symptoms and makes an initial diagnosis without adequately considering other possibilities.

In this case, the doctor jumped to a conclusion based on Halstead’s medical history and the CT scan results.

The doctor at Athens Regional sent Halstead home with pain medication and recommended that she contact her gynecologist in the morning. Her alarmed mother rushed to Athens that morning and drove her to the office of gynecologist Frank Lake, who practices in Gainesville at Northeast Georgia Physicians Group, which is affiliated with Northeast Georgia Medical Center (NGMC).

When Halstead described her symptoms to Lake, he said it sounded like “textbook appendicitis.” He didn’t put much stock in the CT scan, because such tests inevitably miss a certain percentage of appendicitis cases.

“The mistake that can be made is that we rely too much on our diagnostics,” said Lake.

Lake immediately called a colleague at NGMC for a surgical consultation. When Halstead arrived at the hospital, it didn’t take long for the surgeon to identify the cause of her pain.

YouTube Preview Image“He hit the bottom of my heel, and I started immediately vomiting and crying,” Halstead remembers. What she had was appendicitis, just as she had initially feared, and she was rushed into surgery.

Even a slight jolt can cause someone with acute appendicitis to vomit. Knowing that, the surgeon had used a simple physical maneuver –- not fancy equipment –- to identify a potentially life-threatening problem.

In this instance, one doctor’s educated guess and another’s basic exam technique yielded a better diagnosis than did a complex test. But in fairness, Lake readily acknowledges that he and the surgeon may have benefited from the passage of time in Halstead’s case. When they saw the young student, her condition was surely much worse and more obvious than when she was examined in the emergency room.


Thinking is a subtle thing


Many hospitals now use checklists and other protocols to prevent “procedural” errors, the kinds of mix-ups that can potentially cause a patient to get the wrong medicine or the wrong surgery. But systematic efforts to reduce errors in judgment –- such as misdiagnosing Halstead’s appendicitis –- have lagged behind, said Dr. Scott Richardson, campus associate dean for curriculum at the GRU-UGA Medical Partnership in Athens.

Diagnosis happens in the mind of the physician, not in a public, documented setting. This complicates the challenge of developing regulations or policies that prevent errors. But Richardson sees two areas that policy shifts can target.

The first is noise.

Emergency rooms and intensive care units are often noisy places, making it difficult for doctors to detect subtle clinical symptoms. For example, a quiet but dangerous heart murmur can be drowned out by the cacophonous environment of the ER.

Last November, CBS News reported that a hospital in the Canadian province of Ontario tackled noise pollution by installing sound-absorbing ceiling tiles, creating more private rooms and moving overhead loudspeakers to the hallways instead of over patients’ beds.

Richardson also believes the reimbursement system needs an overhaul.

Sometimes a doctor cannot make an accurate diagnosis after the first meeting with a patient. But under the current system, doctors can be reimbursed only for time and procedures linked to a specific billing code, which reflects a diagnosis. This puts pressure on physicians to label a condition before they really know what it is, Richardson said.

“Some label has to be applied,” said Richardson. “That label develops a kind of momentum, a life of its own, and that tends to narrow further thought.”

In the same way, relying solely on imperfect technology, as the initial doctor did in Halstead’s case, can prevent physicians from using their clinical skills and common sense to figure out what’s troubling their patients.

“If it walks like a duck, and it quacks like a duck, it’s probably a duck,” said Lake.

Nearly 7 percent of people are afflicted with appendicitis at some point in their lives, and the ailment is misdiagnosed between 20 percent and 40 percent of the time, according to the Agency for Healthcare Research and Quality.


Ian Branam is a second-year master’s student in health and medical journalism at the University of Georgia. He is interested in developing health and medical content for the web and spent the summer developing a social media campaign for smoke-free workplaces. He particularly enjoys writing about health policy, health disparities and chronic diseases. Follow him on twitter at @ianbranam or visit his website at

Wearing two hats (or two white coats): The rise of researcher-doctors

Sam Dolezal is is one of five future doctors who are also doing Ph.D. research at the University of Georgia.

Sam Dolezal is one of five future doctors who are also doing Ph.D. research at UGA.

Moving new discoveries from the science lab to the doctor’s office can take decades and cost hundreds of millions of dollars. And although it is not possible to eliminate this process, people who straddle the worlds of science and medicine may be able to speed it up.

Consider the task of translating laboratory findings about a deadly cancer into a simple blood test.

Right now, no such test exists for pancreatic cancer, and by the time most cases are detected, it’s too late for effective treatment. As a result, about three-quarters of pancreatic cancer patients die within a year.

Sam Dolezal wants to change this. Dolezal is an M.D.–Ph.D. student who has already spent two years in medical school. When he finishes his doctoral work three years from now, he will have the credentials of both a physician and a lab scientist. Although the number of physician-scientists is growing, only about 500 people in the United States graduate with both degrees each year.

As their ranks increase, so does the potential for speeding the development of better tests and treatments.

People with both degrees “tend to be very focused on what it’s going to take to get from the [lab] bench to the bed,” said Margaret Wagner Dahl, who heads the Georgia BioBusiness Center and helps University of Georgia scientists turn new findings into products.

Physician-scientists, she says, “have had the training to be able to go through that whole continuum.”

Dolezal is one of five future doctors who are also doing Ph.D. research at the University of Georgia. As Athens’ new medical school campus – the Georgia Regents University-University of Georgia (GRU-UGA) medical partnership – enters its fourth year of operation, possibilities exist for more dual-degree students.

They’ve embarked on a long journey, not only in terms of their own education but also their contributions to patient-ready tests and treatments. A new drug, for example, requires about 10 to 15 years to move from lab to doctor’s office. A diagnostic test, like the one Dolezal is working on, takes around three to five years.

Dolezal works in a spacious lab on the top floor of the Complex Carbohydrate Research Center, a brick and wood building nestled among trees like a mountain lodge.

There, he’s part of a team searching for a cancer marker, a molecule that when found in the bloodstream alerts doctors that pancreatic cancer is present.

The lab where Dolezal works is led by Michael Pierce, a professor of biochemistry and molecular biology who directs the UGA Cancer Center. If the researchers can identify such a marker, the next step will be developing a blood test that can be licensed to a pharmaceutical or biotechnology company. After experiments to confirm its accuracy and safety, such a test could enable doctors to diagnose pancreatic cancer at a point when treatment will be more effective.

YouTube Preview ImageDolezal’s research is shaped by his experiences during medical school. He completed his first two years of med school at GRU’s Medical College of Georgia in Augusta, the parent of the new medical campus in Athens. During his first year, Dolezal met a woman with the type of cancer he now studies in the lab.

“I learned not only how pancreatic cancer was affecting her physically, but also how it was affecting her mentally and emotionally,” Dolezal said. The woman’s only wish was to live six more weeks so she could attend her son’s high school graduation. She met that goal, Dolezal later learned, but died a few weeks later.

“When I’m in the lab, that makes me lean my questions more towards what’s important” for patients, Dolezal said. “Pancreatic cancer doesn’t have a [currently recognized] detection marker, so my project involves trying to find these detection markers.”

While a basic science researcher focuses closely on the biology of the disease, Dolezal’s approach is different.

“He’s looking at it really as a clinician would,” Pierce said. “I can tell he always has in the back of his mind how he can develop his discovery into a treatment or a diagnostic blood test.”


The human factor


In a lab less than two miles away, Joseph Burch is completing the research portion of his two degrees under UGA microbiologist Harry Dailey. He’s also using his two years of medical training to think about how his research could affect patients.

Burch is studying a protein involved the making of heme – an essential part of the oxygen-carrying blood protein hemoglobin. If the protein is defective, toxic levels of chemicals build up in the body and cause one of several diseases commonly known as porphyria. These diseases can cause patients a variety of problems – from seizures to abdominal pain.

“He’s interested in the bigger picture: How this is going to translate into clinical medicine,” Dailey said.

Currently in his second year of doctoral study, Burch is already thinking how what he’s learned in the lab could help design a treatment for porphyria.

After graduation, students like Dolezal and Burch hope to be able to see human maladies from two different perspectives, and to turn laboratory work into relief of human suffering.

“If you got just a Ph.D. and you do biomedical research, you can work in a lab, you can work on animals, but you can’t work on people,” Dailey said. “With a Ph.D. and an M.D., it allows you to do the basic work and to translate it into the clinics.”

Burch is optimistic about his broad education.

“I hope it will make the transition from lab research to drug discovery or treatments more efficient and faster.”


Julianne Wyrick is a freelance science and health writer currently completing the health and medical journalism graduate program at the University of Georgia.

Mistakes are every doctor’s nightmare, but what to do about them?

Dr. Howard Cohen spent nearly 30 years as an infectious disease physician in Atlanta.

He treated people with everything from the flu to malaria.

He was a highly respected doctor, recognized in his field. But about a decade ago, Cohen made a mistake that he has never forgotten. And he doesn’t want to forget.

At the time it happened, he was far from a rookie. He was a seasoned professional at the top of his game.

As Atul Gawande — a Boston surgeon and bestselling author — put forth in a 1999 article in the New Yorker magazine, “When Doctors Make Mistakes,” many medical mistakes are made by good, highly regarded doctors, not by the habitually negligent.

And critical mistakes occur often. A recent study in the Journal of Patient Safety said that  210,000 to 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death.

YouTube Preview ImageCohen’s mistake was simply a mix-up, but a troubling one. It all started when two of his patients, whom he calls A. Jones and B. Jones, visited his private practice office at about the same time.

The two women had the same last name, but different first names and very different prognoses.

A. Jones was a patient of Cohen’s with a known blood abnormality, and Cohen ordered laboratory tests to determine whether her condition had worsened.

B. Jones, on the other hand, was a healthy woman who had come in for a periodic check-up. Cohen found nothing out of the ordinary during an examination, but as matter of routine, he had a sample of her blood drawn and sent to a lab for testing.

In the rush of a busy practice, mix-ups can happen.

Numerous lab reports arrived at the office every day and were stuffed into patients’ charts, where doctors read them and acted on them. In the hurried atmosphere, most doctors never questioned whether a particular lab report was in the right folder.

When Cohen looked at the test results in B. Jones’ folder, they showed significant abnormalities suggesting leukemia, even though she had seemed healthy a few days earlier. He immediately reached out to her and asked her to come in for a face-to-face consultation.

B. Jones came in the next day and got the totally unexpected news that she appeared to have a serious illness.

“I feel fine,” she said, but she was also stunned and frightened.

But then her gaze focused on the chart in Cohen’s hand, and she saw that something was amiss on the lab paperwork. The birth date was not hers.

As it happened, the worrisome test result actually belonged to A. Jones, the patient with a history of blood abnormalities. The result had mistakenly been put into B. Jones’ folder.

A wave of relief swept over B. Jones as she realized she was healthy after all and that her doctor had mistaken her for another patient. Cohen was quick to apologize for the blunder.

“I said, ‘I’m so sorry. I’m so sorry I made you feel so stressed for 24 hours,’ ” Cohen recalls. “I said we made a mistake.”

Within 24 hours, Cohen notified A. Jones of her test result. It signaled a turn for the worse in her condition. But given her previous problems, she was disturbed by the news but not overwhelmed by it.


Apologizing may go a long way

Cohen felt horrible for the false alarm he had given B. Jones.

“For a night there, I’m sure this lady didn’t sleep,” he says today.

To his surprise, the woman was so relieved when she was told about the mix-up that she gave him a big hug.

This is not as surprising as it seems. A 2010 study from researchers at the University of Michigan and Brigham and Women’s Hospital showed that when doctors apologize for their mistakes, it can actually prevent malpractice lawsuits.

In fact, there are entire organizations devoted to this philosophy.

Sorry Works! Consulting, a company in Glen Carbon, Ill., provides training and resources to health care professionals to teach them to disclose when they have committed an error and apologize to patients and their families.

The company was started in 2005 by consultant Doug Wojcieszak. He had lost a brother to medical errors in 1998, and his goal was to reduce malpractice lawsuits as well as medical errors.

“It’s often not bad individuals, it’s poor systems that get in the way,” says Dr. Scott Richardson, campus associate dean for curriculum at the GRU-UGA Medical Partnership in Athens.

Richardson mentions systems redesign, an approach to health care championed by the Agency for Healthcare Research and Quality (AHRQ), as an important factor in reducing medical errors.

It includes mechanisms like electronic health records and checklists to limit the potential for human error. This strategy has been used to reduce medication errors, delays in performing surgery, and paperwork mix-ups like Cohen’s, says Richardson.

In the New Yorker piece, Gawande described an error he made as a surgical resident in an emergency room. A car crash victim came into the ER with a blockage in her airway, and after Gawande and his medical team made repeated attempts at intubating her, she was no closer to breathing on her own.

She needed a tracheotomy to have the breathing tube inserted through her windpipe rather than orally.

Gawande, who blamed himself for the mistake, said he should have been preparing the patient for a tracheotomy, and instead let the emergency medicine attending physician continue attempting to intubate the patient.

This made her vocal cords swell, and her airway shut down. Eventually, the intubation was successful, but the long period of time she went without oxygen made it unclear how much brain function she would have when she regained consciousness.

In August 2012, Cohen put down his stethoscope to become a full-time medical school professor in Athens at the GRU-UGA Medical Partnership.

Immediately after the mix-up in his office a few years ago, he met with the office manager and the staff to go over their policy for handling abnormal test results and verifying information before calling patients. A clearly defined procedure for notifying patients of lab results can prevent patients from being alarmed unnecessarily.

And ever since that day, says Cohen, he has been more careful himself. He always double-checks in any situation where an error might occur.

He believes that electronic health records — which are increasingly being used in the United States and will become even more widespread under the Affordable Care Act — will reduce the likelihood of medical mistakes. But they will not eliminate them completely.

There is still the human factor.

“Computers may be infallible, but the data put into the computer may not be,” he says.


Ian Branam is a second-year master’s student in health and medical journalism at the University of Georgia. He is interested in developing health and medical content for the web and spent the summer developing a social media campaign for smoke-free workplaces. He particularly enjoys writing about health policy, health disparities and chronic diseases. Follow him on twitter at @ianbranam or visit his website at


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