Category Archives: Longevity Medicine

In a post-Roe world, Amazons newest series Dead Ringers is unapologetically visceral and poignantly clinical. A gender-flipped, highly divergent remake of David Cronenbergs 1988 film follows the complicated relationship of Elliot and Beverly Mantle (both played by Rachel Weisz), twin obstetrician-gynecologists whose brilliance tests the equilibrium of their bond, the lens through which the disequilibrium between women and their bodies is explored.

Warning: Spoilers for Dead Ringers below!

Channeling the psychosexual thriller qualities of its cinematic progenitor, Dead Ringers rides its science hard at times. At the Mantles holistic birthing center, where babies and bioethical conundrums are very much thematic twins, uber-wealthy women want to use the Mantles intellect to skirt legal regulations around surrogacy and create bespoke services that promise everlasting youth and longevity.

In particular, Elliot Mantle, the more scientifically driven of the pair, boasts that menopause a natural biological process marking the end of an individuals reproductive years with the permanent cessation of menstruation is as easily malleable as a magician bending a spoon.

We can postpone it. We can delay the onset of it, says Elliot at a dinner meeting with potential investors for the new birthing center in the second episode. Its a good example of something that we technically know how to do, but were limited by law, ethics, finances, bodies to experiment on.

Elliot makes an even bolder claim that menopause could be prevented indefinitely through a real-life procedure called ovarian tissue freezing. Such a technique, the twin insists, would have women preserving their own ovarian tissue when theyre brimming with estrogenic youthfulness and re-implanting on the rainy days of hot flashes and unsexy infirmity.

Its a not-so-subtle dig at the booming anti-aging culture so dependent on making us feel bad for sprouting a crows feet or two. But is it really possible to counter menopause really, reproductive aging with a simple tissue implant? The prospect of that feminine fountain of youth is much closer than you think, although it is questionable whether its even worth it.

Also known as ovarian tissue cryopreservation, its a still-experimental procedure where a portion of an individuals ovarian tissue is surgically removed and then placed into cold storage for fertility preservation and future use, Elizabeth Rubin, an obstetrician-gynecologist and reproductive endocrinology fellow at Oregon Health and Science University, tells Inverse.

Typically, [its done] in situations in which people with ovaries are about to undergo an extremely gonadotoxic therapy, such as certain types of chemotherapy, or are known to have a condition, usually genetic, in which they will go through menopause, either around or even before the time of puberty, she explains.

While there are other routes to preserve future fertility, such as egg or embryo freezing, these arent options for individuals who are too young, cant delay their cancer treatment, or recently had chemotherapy.

The ASRM [American Society for Reproductive Medicine] still considers ovarian tissue cryopreservation or freezing experimental, Michelle Roach, assistant professor of obstetrics and gynecology at Vanderbilt University Medical Center, tells Inverse. Its not something routinely done except at a few centers the best way to preserve fertility, its still egg freezing or oocyte preservation.

The magic is in the anti-freeze solution and technologies, explains Kutluk Oktay, professor of obstetrics and gynecology at the Yale School of Medicine and medical director of Innovation Fertility Preservation and IVF.

You cannot just take the tissue and stick it in your fridge or freezer, Oktay tells Inverse. He says that when you freeze a cell this way, ice crystals form and damage the delicate components of the cell. Instead, you prepare very thin slices [of ovarian tissue] that fit into test tubes fitted to specialized machines, and then you mix them with cryoprotectants.

Once locked away like Han Solo in carbonite according to a specific freezing formula, these slices of mostly the ovarian cortex the outer layer of the ovary containing primordial follicles (aka immature eggs) are kept under watchful eyes for several years in specially equipped storage facilities.

When someone is ready to use their iced eggs for pregnancy, the tissue is thawed and then placed back into the body near any remaining ovarian tissue or where it was initially removed. It may also be placed, as suggested by Dead Ringers Elliot Mantle, in the armpit, which is nicely vascularized and rich in blood, but more on that later.

According to Memorial Sloan Kettering Cancer Center, around 200 babies worldwide have so far been born from preserved ovarian tissue, with half of those pregnancies occurring naturally and the other half with help from assisted reproductive technology techniques like in vitro fertilization (or IVF).

In his clinic, Oktay who performed the first reported ovarian tissue autotransplantation (going back into the tissue donor versus someone else) in 1999 says hes seen it work for patients in whom ovarian tissue was harvested when they were teenagers, a decade and one ovarian tissue transplant later were able to have two or three children, either naturally or through IVF.

But as with anything in science, theres always a catch. One impediment to the success of ovarian tissue cryopreservation is that when the tissue is reimplanted, the number of eggs you start with isnt the number of eggs you end with. This is crucial because every individual with ovaries, for the most part, is born with a set number of eggs that slowly dwindle with age.

The one hurdle we have, which were overcoming with time, is that freezing and thawing doesnt kill that many eggs, says Oktay. But when you transplant, theres an ischemic stage by the time the blood vessels are formed, according to animal models, you could lose 60 percent of all the eggs [in the transplanted tissue].

Oktay and his colleagues at Yale are investigating pharmacological ways to stave off primordial follicle death We predict we can reduce those losses to about 20 percent, he says. But even before that, theres the risk this fertility preservation could, ironically, trigger menopause, which brings us to the much-anticipated answer.

When we jump to episode three, Elliot performs ovarian tissue freezing on a young 24-year-old woman named Stacy to a live audience watching behind a glass window amid the dark lighting and eerie red surgical gowns.

When Stacy is on the precipice of the menopause, her frozen ovarian tissue will be thawed out and grafted back into her body thus restoring her declining sex hormones and delaying the menopause for potentially 20 years, says Elliot in the show.

For women experiencing symptoms associated with the transition to menopause, there are hormonal and non-hormonal therapies available.

Oktay says in his own clinic, hes definitely seen ovarian tissue transplantation (OTT) stall menopause in some individuals, but never as long as 20 years. In one small 2020 study where about four healthy menopausal women around 47 years old had their banked ovarian tissue successfully grafted back, the tissue was functional for at least six months.

Theres also a possibility that ovarian tissue freezing can trigger early menopause, rendering efforts to safeguard future reproductive health kind of futile and impractical.

For example, if you were under 18 and we took a whole ovary, you may experience early menopause earlier by seven years, based on some studies looking at people who had their ovaries removed for medical reasons, says Oktay. But as you get older, that number is less and less.

For example, shooting for ovarian tissue freezing between ages 30 and 40 may harken menopause a year or two earlier than expected. However, you have to balance that with the fact nothing trumps younger eggs when it comes to quality and survivability and, in turn, what will be more effective at keeping menopause at bay for longer when youre older.

Were working with mathematicians, and weve put together molecular and clinical information and mathematical formulas in a model, which would be available to patients to enter their age, the desire [time] of delay, and that will tell them whether [going with ovarian tissue freezing] makes sense for them or how much tissue to take out, says Oktay.

(In the show, the character Elliot mentions the possibility of grafting tissue from one individual to another unrelated individual. Oktay and Rubin of OHSU say, just like you need matching between donors, you would run into the same challenge with OTT.)

Rubin and Roach of VUMC feel that ovarian tissue freezing as a means to delay menopause is a bit much. Thanks to modern medicine, individuals experiencing this completely natural life transition have many therapies available to help cope with symptoms like hot flashes, low sex drive, or other mood symptoms. These therapies include exogenous hormone replacement with estrogen or progesterone, whats known as hormone replacement therapy, as well as antidepressants and even cognitive behavioral therapy.

Whether the future holds a cure for reproductive aging, the researchers say thats hard to determine. Aging is inevitable, and so too could be our attitude of whole-hearted self-acceptance if we so choose.

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The Trippiest Psychological Thriller on Amazon Showcases a ... - Inverse

Stem cells taking out the trash. This illustration is from Emma Vidal of DrawImpacts. Credit: Emma Vidal

Scientists at UC San Diego have discovered that stem cells unique method of discarding misfolded proteins could hold the key to preserving long-term health and avoiding illness.

As humans continue their search for the fountain of youth, stem cells keep emerging as a key player in the quest for longevity. Studies increasingly suggest that preserving the fitness of stem cells leads to a longer healthspan, and new research highlights the importance of keeping stem cells clean and tidy.

According to a study recently published in the journal Cell Stem Cell, scientists at the University of California San Diego School of Medicine discovered that blood stem cells employ a surprising technique to eliminate their misfolded proteins. The researchers found that this process decreases with age and believe that boosting this specialized garbage disposal system could help fend off age-related illnesses.

The study focused on hematopoietic stem cells (HSCs), the cells in our bone marrow that produce new blood and immune cells throughout our lives. When their function is weakened or lost, this can lead to blood and immune disorders, such as anemia, blood clotting, and cancer.

UC San Diego researcher Robert Signer, Ph.D., describes how stem cells contribute to aging and age-related diseases. Credit: UC San Diego Health Sciences

Stem cells are in it for the long haul, said senior study author Robert Signer, Ph.D., associate professor at UC San Diego School of Medicine. Their need for longevity requires them to be wired differently than all the short-lived cells in the body.

A key to keeping stem cells happy is maintaining protein homeostasis. Previous work showed that stem cells, including HSCs, synthesize proteins much slower than other cell types, prioritizing quality over quantity. This helps them make fewer mistakes in the process, as misfolded proteins can become toxic to cells if allowed to build up.

Still, some mistakes or protein damage are inevitable, so the researchers set out to understand how stem cells ensure these proteins are properly discarded.

In most cells, damaged or misfolded proteins get individually tagged for disposal. A mobile protein destroyer called the proteasome then finds the labeled proteins and breaks them down into their original amino acid components. But in the new study, the researchers found proteasome activity was especially low in HSCs. This left the team puzzled: if getting rid of damaged proteins is so important to stem cells, why is the proteasome less active?

UC San Diego scientists found misfolded proteins were aggregated and caged into a single area (green) within stem cells before being disposed of. Credit: UC San Diego Health Sciences

Through a series of subsequent experiments, the team discovered that HSCs use a different system entirely. Here, damaged and misfolded proteins are collected and trafficked into clusters called aggresomes. Once corralled into a single location, they can be collectively destroyed by the lysosome (a cell organelle containing digestive enzymes) in a process called aggrephagy.

Whats very unusual here is this pathway was thought to only be triggered as an extreme stress response, but its actually the normal physiological pathway thats used by stem cells, said Signer. This emphasizes how critical it is for stem cells to prevent stress so they can preserve their health and longevity.

So why this different system? A main advantage of the proteasome method is that it breaks proteins down immediately, producing amino acids that the cell can reuse to build new proteins. But stem cells are less interested in building new proteins. Thus the authors suggest that by storing a collection of damaged proteins in one place, stem cells may be creating their own cache of resources that can be used at a later time when they are actually needed, such as after an injury or when it is time to regenerate.

The body really cant risk losing its stem cells, so having this stockpile of raw materials makes them more protected against rainy days, said Signer. Stem cells are marathon runners, but they also need to be world-class sprinters when the circumstances call for it.

When the researchers genetically disabled the aggrephagy pathway, the stem cells started to accumulate aggregated protein, which impaired their fitness, longevity and regenerative activity.

The team then discovered that while almost all young stem cells had aggresomes, at a certain point in aging, they were almost completely gone. The authors suggest that stem cells inability to efficiently destroy misfolded proteins during aging is likely a key contributing factor to their declining function and the resulting age-related disorders.

Our hope is that if we can improve stem cells ability to maintain the aggrephagy pathway, we will preserve better stem cell fitness during aging and mitigate blood and immune disorders, said Signer.

The authors suspect that other types of stem cells and long-lived cells like neurons have a similar requirement for strict regulation of protein homeostasis, suggesting therapeutics to boost this pathway may be beneficial across multiple organs and pathologies.

Enter your journal: Reference: Hematopoietic stem cells preferentially traffic misfolded proteins to aggresomes and depend on aggrephagy to maintain protein homeostasis by Bernadette A. Chua, Connor J. Lennan, Mary Jean Sunshine, Daniela Dreifke, Ashu Chawla, Eric J. Bennett and Robert A.J. Signer, 21 March 2023, Cell Stem Cell.DOI: 10.1016/j.stem.2023.02.010

Co-authors of this study include: Bernadette A. Chua, Connor J. Lennan, Mary Jean Sunshine, Daniela Dreifke and Eric J. Bennett at UC San Diego and Ashu Chawla at La Jolla Institute for Immunology.

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Clearing Out the Trash Stem Cells' Battle Against Aging - SciTechDaily

A 102-year-old doctor who still works has shared her tips for living a long and fulfilling life as she continues to focus on the future with her 10-year plan.

Dr. Gladys McGarey, from Scottsdale, Arizona, is known as the mother of holistic medicine, a form of healing that takes the patient's mind, body, and spirit into account during treatment.

She co-founded the American Board of Holistic Medicine and had a family practice for more than 60 years. The mother of six continues to work as a consulting doctor and writer.

McGarey was 100when she started penning her new book,The Well-Lived Life: A 102-Year-Old Doctors Six Secrets to Health and Happiness at Every Age, which was published last week.

She makes an effort to move daily, including reaching her daily step count and riding her tricycle. In her free time, she knits, listens to audiobooks, and talks with friends.

As she lifts the lid on her keys to longevity while promoting her latest book,FEMAIL has highlighted her best advice below.

Discover your life's purpose

McGarey believes that one of the most important things you can do to live life to the fullest is to find your 'juice' your purpose for living.

In her book, she wrote about how she discovered she was meant to be a doctor when she was just eight years old.

She grew up in India with her parents, who were medical missionaries, and spent years thinking she was 'stupid' because she struggled with dyslexia.

McGareyrecalled how her father took her older brothers hunting one fateful day, leaving her and her younger siblings to help their mother in the medical tent.

A young man brought over a wounded elephant for treatment. Even though her mother wasn't a veterinarian, she removed a splinter of bamboo from the animal's foot and irrigated the infection.

Assisting her mother that day made her realize that she was meant to be a doctor.

'Each of us is here to connect with your unique gifts, this is what activates our desire to be alive,' she wrote. 'Achieving this connection isn't necessarily the point. The search counts for far more. The process of "finding our juice" keeps us vital.'

McGarey is also an advocate for having a 10-year plan and looking to the future.

She told Insider that her current plan involves creating a village for 'living medicine' where people of all ages can care for each other and practice wellness.

'A 10-year plan makes space for everything,' she explained in her book. 'It's a far enough reach that it keeps our life force activated. Yet it's close enough that we can achieve it, dust ourselves off, and plan anew.'

Know there is a lesson in everything

McGarey has had her fair share of struggles over the years, including surviving cancer and grieving the death of her daughter.

She was almost 70 when her husband of 46 years and clinic partner, William McGarey, left her for another woman.

The authortold Today that the painful experience was 'a huge teacher' that helped her find her own voice and led her to start anew holistic medical practice with her daughter.

'Up to that point, I had depended on [his] support in the things that I was saying. After that, I had to believe that what I was saying had strength and was important,' she explained.

'Once I could actually find my own voice, I wrote him a letter and thanked him for giving me my freedom. Because up until that time, I did not feel that my voice was strong enough.'

McGarey also takes cues from her dreams because she believes they are the key to the unconscious and advises others to do the same.

In her interview with Today, she explained that when she is wrestling with a decision, she asks for a dream before going to bed. She immediately writes down the dream after waking up and searches for messages from her unconscious.

Let go of anything that doesn't serve you

McGarey combats unnecessary stress in her life by letting go of things or experiences that no longer serve her.

She explained in an interview with CNBC Make Itthat the happiest and healthiest people she knows understand the importance of releasing whatever isn't working in their lives.

'My mom taught me an easy way to release things that dont matter. She would raise her hand gently in front of us, fingers held loosely, palm up. Then swoop it down and back and say, "It doesnt matter,"' she told the outlet.

McGarey adopted the same practice and has grown to understand the significance of the symbolic gesture.

'I realize that theres great empowerment in knowing that whenever I notice something coming toward me, I can choose whether to take it in,' she said. 'And if its something I dont want, I consciously give the energy back to wherever it came from.'

Keep moving

McGarey makes sure she keeps moving, both literally and figuratively.

She is consistent with her daily fitness goals, which include walking 3,800 steps a day with the help of her walker.

The doctor also rides an adult tricycle around her yard and neighborhood. She recently shared footage of herself riding the bike on her Instagram page.

'I do things that I can do, that I want to do,' she told Fortune.

When it comes to moving through life, she follows her mother's motto: make do.

'Look for what you can do, not what you cant do,' she said. 'Our bodies are our teachers if we pay attention to it, we learn lessons.'

Find what works for you

McGarey follows a daily routine, but she doesn't believe there is a one-size-fits-all approach to living.

She told Insider that on most days she wakes up and does a morning prayer before heading downstairs and starting her day.

McGareylikes to havea bowl of Raisin Bran and a glass of prune juice for breakfast, while lunch is typically a salad and soup.

However, she explained in her interview with Today that she eats whatever she wants to eat, including the occasional hamburger.

She doesn't smoke or drink alcohol, but she isn't opposed to the latter.

'I think wine for some people is a lovely thing. Its what works for you,' she said.

'The individual person has to live their own individual life, so as you find what works for you, bless it and use it and work with it.'

Excerpt from:
102-year-old doctor shares her secrets to longevity as she looks to the future with her 10-year plan - Daily Mail

Alzheimers disease is the most common form of dementia, causing up to 70% of dementia cases. According to the Alzheimers Association, it affects some 6 million people in the United States, and around two-thirds of those affected are women.

Increasing age is the greatest risk factor for Alzheimers disease, and women, on average, live longer than men. According to the Centers for Disease Control and Prevention (CDC), in 2021, womens life expectancy at birth in the United States was 79.1 years, compared with 73.2 for men.

Dr. Emer MacSweeney, CEO and consultant neuroradiologist at Re:Cognition Health, told Medical News Today that the risk of developing Alzheimers disease is multifactorial, with a higher incidence in women than men, even when adjusted for the longer average life span for women.

Those extra life years alone cannot fully explain the difference in Alzheimers disease risk between women and men. Recent research has suggested that hormonal changes after menopause may contribute to risk.

And women may have a greater genetic risk, too the APOE e4 gene variant, which increases dementia risk and is carried by around 15% to 25% of people, seems to have more effect in women than men.

Also under investigation are societal and lifestyle factors. The Alzheimers Association recently reported that women who undertook paid employment had slower memory decline in late life than those who did not.

Recent research has focused on whether stress is a contributing factor. It has been shown that stress can accelerate symptoms of Alzheimers, but how might it increase the risk of developing Alzheimers disease?

A new study has found that stress leads to a rise in beta-amyloid in female mice, and not in males. Beta-amyloid forms plaques in the brain that interfere with nerve impulses and trigger inflammation and are widely thought to be responsible for many of the symptoms of Alzheimers disease.

The study, from Washington University School of Medicine, St. Louis, is published in Brain.

Stress can have a profound effect on the body and we are understanding more about the implications it can have to our mental and physical health both positive and negative, explained Sebnem Unluisler, genetic engineer and chief longevity officer at the London Regenerative Institute in the United Kingdom, not involved in the study.

Stress triggers the release of hormones such as cortisol and adrenaline, which, if produced excessively or over a prolonged period of time, can have a hugely negative effect on the body, causing inflammation, damage to DNA and cells, and accelerating the aging process, which of course can affect the brain and cognition, she added.

Dr. John Cirrito, co-lead study author, and a professor in the Department of Neurology at Washington University School of Medicine in St. Louis, also told us why stress might play a role in Alzheimers risk in women:

Many other studies have demonstrated that women are more likely to be stressed, that stress is linked to increased risk of Alzheimers disease, and that women are at higher risk of Alzheimers disease. We are not the first to put together this possible link. However, there could many possible reasons that link stress, women and Alzheimers disease, including correlational, comorbidities, and lifestyle.

Our study demonstrates a direct link between stress and Alzheimers disease in women at a cellular level, he told MNT.

Whilst stress has been accepted as a significant risk factor, Edwards et al have provided new data from studies on mice to explain why a different response to stress may account for the higher incidence of Alzheimers disease in women, compared to men, said Dr. MacSweeney.

Using mice, the researchers in the current study investigated the effect of stress on levels of beta-amyloid in the interstitial fluid of the hippocampus. The hippocampus is an area of the brain that is affected in the early stages of Alzheimers disease and continues to deteriorate as the disease progresses.

They exposed mice to one of two stressors restraint stress or olfactory stress for 3 hours.

Restraint stress involved placing the mouse in a small, clear, plastic container with air holes that restricted their movement.

For olfactory stress, a small tube containing 0.1 milliliters (ml) of urine from a predator (fox, bobcat, or coyote) was placed in their normal cage. The urine was swapped every 30 minutes so the mice did not become accustomed to the scent of one predator.

Beta-amyloid levels were measured before, during, and after stress, for a total of 22 hours.

The researchers measured levels of stress hormones in the blood of the mice, and found that males and females were experiencing similar levels of stress. But there was a significant difference in beta-amyloid levels.

In female mice, beta-amyloid levels in the interstitial fluid rose by around 50% within the first 2 hours of stress, and stayed elevated for the rest of the monitoring period. Only about 20% of male mice exhibited a small, delayed increase in beta-amyloid.

Dr. Cirrito explained the importance of raised beta-amyloid in the interstitial fluid: In mice there is a tight correlation between the concentration of [interstitial fluid] beta-amyloid within a brain region and if/ how much that region develops beta-amyloid plaques. Elevated [interstitial fluid] beta-amyloid also drives plaque formation (vice versa with suppressed [interstitial fluid] beta-amyloid).

However, he added that it is difficult to make that direct comparison in humans since we cannot measure [interstitial fluid] as readily in people.

Key to the difference between males and females was the cellular response to the stress hormone, corticotropin-releasing factor (CRF).

In female mice, nerve cells take up this hormone. The cascade of events that follows increases levels of beta-amyloid in the brain. The nerve cells of male mice do not take up the hormone.

The researchers suggest that this is due to the CRF receptor acting differently in males and females.

Whilst the study strongly suggests stress is one potential factor that may influence risk, quite significantly, it is still only one of many factors. However, the authors are the first to determine, at the cell signaling level, why stress differentially affects disease-related proteins in males and females.

Dr. Emer MacSweeney

While this finding in mice is important, the researchers recognize that the mechanism may not be the same in people. However, their findings may help show directions for further research and treatment, as Dr. MacSweeney explained.

It is not possible to extrapolate, with confidence, that this differential response to stress in mice translates precisely to humans, she told us. However, the physiological explanation in mice is interesting, and could provide, at least in part, the explanation for the gender differences between men and women for risk of Alzheimers.

The finding is, in turn, important in guiding future pharmaceutical research towards new treatment options, that may differ between males and females, she added.

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Alzheimer's disease: Stress may increase risk in females - Medical News Today

Network Television is no stranger to medical dramas, from the cynical genius offered by Fox's House to the more humorous approach of NBC's Scrubs and everything in between. As much as the police procedural has been a staple of television, viewers have long since proven themselves to be engaged in the happenings of hospital life too. Perhaps the most successful instances of audience captivation are seen in ER and Grey's Anatomy, which boast high ratings of over 38 million viewers for their top episodes. However, despite their similarities in the rankings department, ER takes the crown for the best rendition of a medical show.

Currently sitting at 416 episodes, Grey's Anatomy officially surpassed ER as the longest-running medical drama on television in 2019 with its 332nd episode. Although both shows are their own entities and have carved out distinctive spaces within the evolution of network television over the last twenty years, ER remains the superior medical drama to this day.

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While Grey's Anatomy offers a wide scope in the halls of the hospital, often providing viewers with moments for an intersection between different departments, ER widened the net to provide a larger worldview on medicine. From the backstory painted by Dr. Luka Kovac of life in Croatia to John Carter's trips to Africa, ER allowed viewers to see the struggles of medicine in other parts of the world. On the other hand, Grey's Anatomy remains insular in this field by rarely leaving Seattle, let alone America. Even when Meredith and Amelia spent time in Minnesota for a small stint of research work, the set is not wildly different from Seattle Grace's white walls and state-of-the-art technology.

Additionally, the medical jargon spewed out by characters in ER left little room for doubt that the characters knew exactly what they were talking about and subsequently doing in moments of trauma. Faith was bestowed upon the actors in ER that they could handle themselves in a real emergency. This faith was furthered by the broader perspective shifts when the episodes showcased traumas and medical emergencies outside Chicago.

Furthering the parochialism, Grey's Anatomy heightens the drama by utilizing major disasters. Viewers are encouraged to become entangled in plane crashes, hospital explosions, ferry crashes, shootings, and natural disasters regularly, often overriding the stories of the patients and the doctors. Conversely, ER took a more localized approach and highlighted the chaos of every day in an emergency room setting; the world around County General did not need to be on fire for the episodes to feel high-stakes. The personable storylines allowed viewers to entrust their attention to the show while remaining enveloped in reality. Every patient brought their own catastrophe, which grounded ER in this respect as it mirrored the conflict and emotionally fraught moments of humanity.

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Romance is another element that remained parallel with reality in ER as they adhered to the notion of not letting relationships get in the way of the medicine, which juxtaposes with Grey's Anatomy, where they try not to let the medicine get in the way of romance. In the show's fifteen-season run, ER had little more than a handful of relationships between co-workers within the halls of County General -- with Dr. Doug Ross and Nurse Carol Hathaway quickly setting the tone for a slow-burn progression. However, Grey's Anatomy has submitted to the idea that medical professionals spend more time hooking up in on-call rooms than they do treating patients. It's hard to keep track of who is with whom from one week to the next at Grey Sloane Memorial, with the romance on the show losing its appeal due to its frequency.

This is not to say that Grey's Anatomy has not blazed several trails in its own right -- the show is popular and long-standing for a reason -- but it progresses on a path forged by ER. Ultimately, for viewers, ER offered a glimpse into the life of an emergency room, striking an enjoyable balance between the severity of medical emergencies and the more light-hearted elements. Grey's Anatomy relies on its soap operatic tendencies and romantic entanglements too much, whereas ER favored the complexities that impair the fabric of life.

Originally posted here:
The Grey's Anatomy and ER Parallels are Obvious But One Is ... - CBR - Comic Book Resources

Despite a push toward work-life balance in the medical field, physicians continue to dedicate more time to work and less time to themselves, their loved ones, and their outside interests. On average, physicians reported in the Medscape Physician Compensation Report 2023 that they worked 50 hours per week. Five specialties, including critical care, cardiology, and general surgery reported working 55 or more hours weekly.

But there's a small segment of physicians that has bucked the norm. They've scaled back their hours to part-time, clocking in only 25-30 hours a week.

In 2011, The New England Journal of Medicine reported that part-time physician careers were rising. At the time, part-time doctors made up 21% of the physician workforce, up from 13% in 2005.

In a more recent survey from the California Health Care Foundation, only 12% of California physicians said they devoted 20-29 hours a week to patient care.

Amy Knoup, a senior recruitment advisor with Provider Solutions & Development (PS&D), has been helping doctors find jobs for over a decade, and she's noticed a trend.

"Not only are more physicians seeking part-time roles than they were 10 years ago, but more large healthcare systems are also offering part-time or per diem as well," says Knoup.

Ten years ago, the fastest growing segment of part-timers were men nearing retirement and early-to-mid-career women.

Pediatricians led the part-time pack in 2002, according to an American Academy of Pediatrics study. At the time, 15% of pediatricians reported their hours as part-time. However, the numbers may have increased over the years. For example, a 2021 study by the Department of Pediatrics, Boston Medical Center, and the School of Medicine, Boston University, found that almost 30% of graduating pediatricians sought part-time work at the end of their training.

At PS&D, Knoup says she has noticed a trend toward part-timers among primary care, behavioral health, and outpatient specialties such as endocrinology. "We're also seeing it with the inpatient side in roles that are more shift-based like hospitalists, radiologists, and critical care and ER doctors," she said.

Another trend Knoup has noticed is with early-career doctors. "They have a different mindset," she said. "Younger generations are acutely aware of burnout. They may have experienced it in residency or during the pandemic. They've had a taste of that and don't want to go down that road again, so they're seeking part-time roles. It's an intentional choice."

Tracey O'Connell, MD, a radiologist, always knew that she wanted to work part-time. "I had a baby as a resident, and I was pregnant with my second child as a fellow," she said. "I was already feeling overwhelmed with medical training and having a family."

O'Connell worked in private practice for 16 years on Mondays, Wednesdays, and Fridays, with no nights or weekends.

"I still found it completely overwhelming," she said. "Even though I had more days not working than working, I felt like the demands of medical life had advanced faster than human beings could adapt, and I still feel that way."

Today she runs a part-time teleradiology practice from home but spends more time on her second career as a life coach. "Most of my clients are physicians looking for more fulfillment and sustainable ways of practicing medicine while maintaining their own identity as human beings, not just the all-consuming identity of doctor,'" she said.

On the other end of the career spectrum is Lois Goodman, MD, an ob/gyn in her late 70s. After 42 years in a group practice,she started her solo practice at 72, seeing patients three days per week. "I'm just happy to be working. That's a tremendous payoff for me. I need to keep working for my mental health."

Reducing clinical effort is one of the strategies physicians use to scale down overload. Still, it's not viable as a long-term solution, says Christine Sinsky, MD, AMA's vice president of professional satisfaction and a nationally regarded researcher on physician burnout.

"If all the physicians in a community went from working 100% FTE clinical to 50% FTE clinical, then the people in that community would have half the access to care that they had," said Sinsky. "There's less capacity in the system to care for patients."

Some could argue, then, that part-time physician work may contribute to physician shortage predictions. An Association of American Medical Colleges report estimates there will be a shortage of 37,800 to 124,000 physicians by 2034.

But physicians working part-time express a contrasting point of view. "I don't believe that part-time workers are responsible for the healthcare shortage but rather, a great solution," says O'Connell. "Because in order to continue working for a long time rather than quitting when the demands exceed human capacity, working part-time is a great compromise to offer a life of more sustainable well-being and longevity as a physician, and still live a wholehearted life."

Rachel Miller, MD, an ob/gyn, agrees. "Instead of quitting and coming up with something else to do, it [working part time] increases my longevity to practice medicine."

Pros and Cons of Being a Part-Time Physician

Pros

Less Burnout: The American Medical Association has tracked burnout rates for 22 years. By the end of 2021, nearly 63% of physicians reported burnout symptoms compared with 38% the year before. Going part-time appears to reduce burnout, suggests a study published in Mayo Clinic Proceedings.

Better Work-Life Balance: Rachel Miller, MD, an ob/gyn, worked 60-70 hours weekly for 9 years. In 2022, she went to work as an OB hospitalist for a healthcare system that welcomes part-time clinicians. Since then, she has achieved a better work-life balance, putting in 26-28 hours a week. Miller now spends more time with her kids and in her additional role as an executive coach to leaders in the medical field.

More Focus: "When I'm at work, I'm 100% mentally in and focused," said Miller. "My interactions with patients are different because I'm not burned out. My demeanor and my willingness to connect are stronger."

Better Health: Mehmet Cilingiroglu, MD, with CardioSolution, traded full-time work for part-time when health issues and a kidney transplant sidelined his 30-year career in 2018. "Despite my significant health issues, I've been able to continue working at a pace that suits me rather than having to retire," he said. "Part-time physicians can still enjoy patient care, research, innovation, education, and training while balancing that with other areas of life."

Errin Weisman, a DO who gave up full-time work in 2016, said cutting back makes her feel healthier, happier, and more energized. "Part-time work helps me to bring my A-game each day I work and deliver the best care," she said. She's also a life coach encouraging other physicians to find balance in their professional and personal lives.

Cons

Cut in Pay: Obviously, the number one con is you'll make less working part-time, so adjusting to a salary decrease can be a huge issue, especially if you don't have other sources of income. Physicians paying off student loans, those caring for children or elderly parents, or those in their prime earning years needing to save for retirement may not be able to go part-time.

Diminished Career: The chance for promotions or being well known in your field can be diminished, as well as a loss of proficiency if you're only performing surgery or procedures part-time. In some specialties, working part-time and not keeping up with (or being able to practice) newer technology developments can harm your career or reputation in the long run.

Missing Out: While working part-time has many benefits, physicians also experience a wide range of drawbacks. Goodman, for example, says she misses delivering babies and doing surgeries.Miller said she gave up some aspects of her specialty, like performing hysterectomies, participating in complex cases, and no longer having an office like she did as a full-time ob/gyn.

Loss of Fellowship: O'Connell says she missed the camaraderie and sense of belonging when she scaled back her hours. "I felt like a fish out of water, that my values didn't align with the group's values," she said. This led to self-doubt, frustrated colleagues, and a reduction in benefits.

Lost Esteem: O'Connell also felt she was expected to work overtime without additional pay and was no longer eligible for bonuses. "I was treated as a team player when I was needed, but not when it came to perks and benefits and insider privilege," she said. There may be a loss of esteem among colleagues and supervisors.

Overcoming Stigma: Because part-time physician work is still not prevalent among colleagues, some may resist the idea, have less respect for it, perceive it as not being serious about your career as a physician, or associate it with being lazy or entitled.

Summing it Up

Every physician must weigh the value and drawbacks of part-time work, but the more physicians who go this route, the more part-time medicine gains traction and the more physicians can learn about its values vs its drawbacks.

The rest is here:
Part-Time Physician: Is It a Viable Career Choice? - Medscape