April 6, 2021
Members of the Tuscaloosa community have the opportunity to learn about trends in medicine and health and advances in medicine and research as part of the Mini Medical School program. Mini Medical School is a lecture series for The University of Alabama’s OLLI program provided by University Medical Center physicians. Eight lectures are presented each fall semester and eight during the spring semester. The lecture series is usually held at the Bryant Conference Center, but this semester is being held virtually because of COVID-19. OLLI, short for Osher Lifelong Learning Institute is a member-led program catering to those age 50 and older. Mini Medical School is open to OLLI registrants and the public.
In March, OLLI members heard presentations about:
You read about the results of a medical research study but aren’t quite sure how to evaluate the information.
Dr. Gregg Bell said it’s important to read reports of medical findings with a critical eye. He said asking questions, including about the sample used and who funded the research, can help you assess the findings.
Bell said while a larger sample size is always better, “you need the right sample.” He cited a poll done by the now-defunct Literary Digest. The magazine’s poll had correctly predicted every presidential election beginning in 1916, but in 1936, based on a poll with a sample size of 10 million, predicted that Alf Landon would overwhelmingly win the presidential race.
“The sample size was huge, but it was the way they sampled,” Bell said. The magazine polled its own subscribers, more affluent Americans, because during the Great Depression it was likely that only those with means could afford magazine subscriptions.
George Gallup, meanwhile, also conducted a poll about the 1936 presidential election. He surveyed 50,000 people but across gender, geographic and demographic lines. His poll showed Franklin Delano Roosevelt winning and obtaining 56% of the popular vote (FDR won 60.8%). While significantly smaller than the Literary Digest sample, Gallup’s sample “was a smart sample,” Bell said.
He added: “If I want to study heart disease, I don’t necessarily want to sample 20-year-olds.”
The so-called Wakefield paper chronicles a study in the prestigious British medical journal, Lancet, that linked autism to the measles, mumps and rubella (MMR) vaccine. The study by Dr. Andrew Wakefield was published by Lancet in 1998, but 12 years later, the journal retracted the article stating that “several elements are incorrect, contrary to the findings of an earlier investigation.”
The study sampled 12 children and claimed eight lost acquired skills, including language, as a result of the MMR vaccine, implying a link to autism, Bell said. He said the children had been carefully selected and that funding for the study had come from attorneys representing parents suing vaccine manufacturers.
“This was one of the most egregious violations of research ethics and the implications of it are still going on,” Bell said. After the study was published, and still today, thousands of parents around the world choose not to have their children vaccinated against MMR because of an implied link between vaccinations and autism.
Doctors who specialize in family medicine are well prepared to provide care for routine, acute and chronic conditions for patients of all ages, said Dr. Tamer Elsayed.
Elsayed is a family medicine at University Medical Center, which is operated by The University of Alabama College of Community Health Sciences, and he directs the UA Tuscaloosa Family Medicine Residency, a three-year training program for medical school graduates seeking to specialize in family medicine. The residency is also operated by CCHS.
Family medicine is defined as the medical specialty that provides continuing and comprehensive health care for individuals and families, and that encompasses all ages, sexes, organ systems and disease entities, Elsayed said
“Family medicine best meets the definition of primary care,” he said. “Healthcare systems with a primary care foundation have better quality of care, population health, greater equity and lower cost.”
Family medicine physicians offer continuity of care to patients throughout their lifetime, Elsayed said. He said care is provided to patients in the context of their families, community-level factors and social determinants of health.
In addition to routine, chronic and acute care, family medicine physicians provide annual wellness visits, health screenings, immunizations and sports physicals. They can cast broken bones, conduct endoscopies and perform procedures for musculoskeletal, skin and gynecological issues. They also help their patients navigate the healthcare system, including care with other specialists and hospital coordination and follow-up.
“They care for patients regardless of age and health condition and serve as patients’ first point of contact for the healthcare system,” Elsayed said.
As director of the Tuscaloosa Family Medicine Residency, Elsayed is responsible for the education and training of its residents. The program offers residents continuity of care for patients during the three years residents are in the program. Residents practice in community settings at UMC locations in Tuscaloosa, Northport and Demopolis. They receive in-patient hospital training at DCH Regional Medical Center in Tuscaloosa in emergency medicine, surgery, cardiology, radiology, orthopedics, pediatrics and ob/gyn, delivering babies and performing C-sections.
On the academic side, residents hear from prominent speakers in the field, participate in morbidity and mortality rounds where patient care and safety is discussed, and are taught practice management skills, including how to start and operate a medical practice.
The Tuscaloosa Family Medicine Residency also provides seven fellowships for post-residency and more immersive training in emergency medicine, geriatrics, hospital medicine, ob/gyn, pediatrics, psychiatry and sports medicine. “Rural areas in Alabama are lacking prenatal care so residents learn to deliver babies and do C-sections. Psychiatry is also in great need in rural areas,” Elsayed said.
To date, the residency has graduated more than 500 family medicine physicians, and 1 in 7 family medicine physicians practicing in Alabama are graduates. More than 50 residency graduates are members of the DCH physician staff.