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    Dr Martin Makary Chosen to Head the FDA

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    President-elect Donald J. Trump announced on Friday that he would nominate Dr. Martin A. Makary, a Johns Hopkins University surgeon with a contrarian streak, to be commissioner of the Food and Drug Administration.In a post on social media, Mr. Trump said: “F.D.A. has lost the trust of Americans and lost sight of its primary goal as a regulator.” He said that Dr. Makary would work under Robert F. Kennedy Jr., the president-elect’s choice for the cabinet-level role as health secretary, to “properly evaluate harmful chemicals poisoning our nation’s food supply and drugs.”“I am confident that Dr. Makary, having dedicated his career to high-quality, lower-cost care will restore the F.D.A. to the gold standard of scientific research and cut the bureaucratic red tape at the agency to make sure Americans get the medical cures and treatments they deserve,” Mr. Trump said in a statement.Mr. Trump announced two other top health picks on Friday evening as well. He chose Dr. Dave Weldon, a physician and former congressman from Florida, to lead the Centers for Disease Control and Prevention.For years, Dr. Weldon championed the notion that thimerosal, a preservative once used widely in vaccines, caused an explosion of autism cases around the world. In 2007, he backed a bill proposing to take vaccine safety research out of the hands of the C.D.C. Health officials reject the idea that research shows any link between thimerosal and autism.Mr. Trump also put forward Dr. Janette Nesheiwat, a physician and Fox News contributor, to be surgeon general. She worked caring for patients after Hurricane Katrina, an announcement from Mr. Trump said, and on the front lines of the Covid pandemic in New York City. She also markets vitamin B and vitamin C dietary supplements.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Urologist Who Sexually Abused Patients Is Sentenced to Life in Prison

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      Darius A. Paduch, a fertility specialist, assaulted men and boys for years at prominent New York hospitals, prosecutors said.A urologist convicted of sexually abusing seven patients, including five who were minors, was sentenced to life in prison on Wednesday, prosecutors said.The doctor, Darius A. Paduch, a fertility specialist, molested boys and young men for years at two prominent New York hospitals, prosecutors said. Hundreds of other young men and boys have also accused Dr. Paduch, 57, of abuse spanning more than 15 years in scores of civil suits.Dr. Paduch “was a sexual predator who preyed on patients seeking treatment for sensitive medical issues,” Damian Williams, the U.S. attorney in Manhattan, said in a statement on Wednesday. “He used his position as a renowned urologist at prestigious hospitals to sexually assault vulnerable patients, including children, to gratify his own sexual desires.”In May, a jury found him guilty of five counts of inducing a minor to engage in unlawful sexual activity and six counts of enticing people to travel to engage in unlawful sexual activity. The trial lasted just two weeks.On Wednesday, his sentence was handed down by Judge Ronnie Abrams in federal court in Manhattan.Dr. Paduch, of North Bergen, N.J., was arrested last April. He has been barred from practicing in New York. Through the trial, he maintained his innocence. A lawyer who represented him, Michael Baldassare, said on Wednesday that “we are confident that one day he will be vindicated.”Once a urologist who specialized in treating patients with a genetic condition, Dr. Paduch worked at hospitals including NewYork-Presbyterian Hospital and Weill-Cornell Medical Center in Manhattan and Northwell Health on Long Island. According to prosecutors, he used his position at prominent hospitals “to make the victims believe that the sexual abuse he inflicted on them was medically necessary and appropriate, when, in fact, it was not.”The abuse continued over several years in some cases, as Dr. Paduch instructed the patients to return for follow-up appointments, where he continued to assault them. During appointments, the indictment said, Dr. Paduch told patients to masturbate in front of him, sometimes groping them or showing them pornography.During the course of the trial, 11 victims testified about abuse they had suffered under Dr. Paduch’s care, and dozens more wrote impact statements before he was sentenced Wednesday.Mallory Allen, a lawyer for a firm that represents 140 former patients who have filed civil suits against him, said in a statement that the sentence affirms that “heinous sexual abuse will not be overlooked.”Survivors of the abuse have also sued the hospitals where he worked under the Adult Survivors Act, which opened a yearlong window between 2022 and 2023 during which adult victims of abuse could file claims even after the statute of limitations had passed.“While no sentence can ever undo the pain and suffering endured by each and every survivor who experienced abuse at the hands of Dr. Darius Paduch, the sentencing closes an important chapter for these survivors,” Ms. Allen said in the statement. More

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      Doctors, A.I. and Empathy for Patients

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      More from our inbox:Breast Cancer ScreeningWalz’s MisstepsMental Health Support for SchoolchildrenTo the Editor:Re “ChatGPT’s Bedside Manner Is Better Than Mine,” by Jonathan Reisman (Opinion guest essay, Oct. 9):Dr. Reisman notes that ChatGPT’s answers to patient questions have been rated as more empathetic than those written by actual doctors. This should not be a call for doctors to surrender our human role to A.I. To the contrary, we need to continue to improve our communication skills.For the past 25 years, I have been facilitating seminars in doctor-patient communication. The skills to communicate bad news listed by Dr. Reisman are exactly the techniques that we suggest to our medical students. However, doctors can avoid the temptation to surrender their “humanity to a script” as if it were “just another day at work.”Techniques are a valuable guide, but the real work consists of carefully listening to the responses and their emotional content, and crafting new words and phrases that speak to the unique patient’s confusion, fear and distress.In my experience, patients know when we are reciting a script, and when we are paying attention to their thoughts and feelings. Unlike A.I., and especially when conversations are matters of life and death, we can reach into the depths of our humanity to feel and communicate empathy and compassion toward our patients.Neil S. ProseDurham, N.C.To the Editor:Mention the words “A.I.” and “doctoring” to most physicians in the same sentence, and the immediate reaction is often skepticism or fear.As Dr. Jonathan Reisman noted in his essay, A.I. has shown a remarkable ability to mimic human empathy in encounters with patients. This is one reason many practicing physicians worry that A.I. may replace doctors eventually.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      A Blood Test Accurately Diagnosed Alzheimer’s 90% of the Time, Study Finds

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      It was much more accurate than primary care doctors using cognitive tests and CT scans. The findings could speed the quest for an affordable and accessible way to diagnose patients with memory problems.Scientists have made another major stride toward the long-sought goal of diagnosing Alzheimer’s disease with a simple blood test. On Sunday, a team of researchers reported that a blood test was significantly more accurate than doctors’ interpretation of cognitive tests and CT scans in signaling the condition.The study, published Sunday in the journal JAMA, found that about 90 percent of the time the blood test correctly identified whether patients with memory problems had Alzheimer’s. Dementia specialists using standard methods that did not include expensive PET scans or invasive spinal taps were accurate 73 percent of the time, while primary care doctors using those methods got it right only 61 percent of the time.“Not too long ago measuring pathology in the brain of a living human was considered just impossible,” said Dr. Jason Karlawish, a co-director of the Penn Memory Center at the University of Pennsylvania who was not involved in the research. “This study adds to the revolution that has occurred in our ability to measure what’s going on in the brain of living humans.”The results, presented Sunday at the Alzheimer’s Association International Conference in Philadelphia, are the latest milestone in the search for affordable and accessible ways to diagnose Alzheimer’s, a disease that afflicts nearly seven million Americans and over 32 million people worldwide. Medical experts say the findings bring the field closer to a day when people might receive routine blood tests for cognitive impairment as part of primary care checkups, similar to the way they receive cholesterol tests.“Now, we screen people with mammograms and PSA or prostate exams and other things to look for very early signs of cancer,” said Dr. Adam Boxer, a neurologist at the University of California, San Francisco, who was not involved in the study. “And I think we’re going to be doing the same thing for Alzheimer’s disease and hopefully other forms of neurodegeneration.”In recent years, several blood tests have been developed for Alzheimer’s. They are currently used mostly to screen participants in clinical trials and by some specialists like Dr. Boxer to help pinpoint if a patient’s dementia is caused by Alzheimer’s or another condition.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      I Was a White House Doctor. Presidents Should Have to Take Cognitive Tests.

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      The job of president is physically and mentally demanding. I witnessed this firsthand as a White House physician for three presidents, including as the designated physician to the president for Barack Obama during his first term. My presidential patients often worked 12-hour days seven days a week. The leader of the free world travels constantly, and participates in or leads briefings in which he must retain huge amounts of information.Health scares can happen at any moment. My role as White House physician was to keep the president healthy and performing optimally, and to provide the public with a candid medical assessment of his ability to carry out the duties of his office.I participated in tabletop exercises in the Situation Room to go over how to follow Section 3 of the 25th Amendment, which deals with succession in the event the president is disabled or incapacitated. Typically, the 25th Amendment came into play when a president was going under general anesthesia for a colonoscopy or scheduled surgical procedure.It is widely assumed that the physician to the president will gather and provide pertinent medical information to those contemplating whether the amendment needs to be invoked. This is not stipulated, but most in the medical community agree that the appropriate role for a physician is to offer a medical opinion, based on facts, that is then weighed by the patient — in this case the president — and those around him.The debates around the fitness of Joe Biden and Donald Trump in the last several weeks have created new pressure to start having serious conversations about exactly how the White House medical team should evaluate presidents and determine their fitness for duty — cognitively as well as physically. This has been the subject of decades of discussion within the White House medical team as well as with the broader medical community.Many Americans may want the White House medical team to take a more active role in declaring the president fit for duty. Many would probably like to see the same standard apply to candidates running for president as well. For those things to happen, these medical teams will need access to more data about these individuals than they now collect. And perhaps even more important, we should seriously consider the need for an age limit for those running for president, given the high stakes of the office and the realities of cognitive decline with aging.Many cognitive abilities decrease with ageWhile we retain much of our vocabulary as we get older, cognitive abilities such as speed and reasoning tend to decline more rapidly after age 60. More

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      White House Doctor Kevin O’Connor Discussed Business With James Biden

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      Before Dr. Kevin O’Connor was appointed White House physician at the beginning of the Biden administration, he discussed a business venture with the president’s brother James Biden, but the doctor ultimately received no compensation, Mr. Biden’s lawyer said.The discussions revolved around James Biden’s involvement with a health care company called Americore, which was looking to expand a network of hospitals in underserved rural areas of the United States.Republicans have seized on the episode to suggest that Dr. O’Connor might have had incentive to minimize issues related to President Biden’s health. The White House rejected the speculation, with a spokesman calling it “ridiculous and insulting.”In his current role, Dr. O’Connor produced letters each of the three years following Mr. Biden’s physicals that attested the president was healthy and “fit to successfully execute the duties of the presidency.” The assessments have come under renewed scrutiny in recent weeks as Mr. Biden’s decline has become more apparent, particularly after his feeble performance in last month’s debate against former President Donald J. Trump, the presumptive Republican nominee.Representative James R. Comer, a Kentucky Republican who is chairman of the House Oversight Committee, sent a letter this week asking Dr. O’Connor to turn over documents related to James Biden and Americore, and to submit to a transcribed interview with committee staff.The White House dismissed Mr. Comer’s effort to draw a link between Dr. O’Connor’s statements about the president and his consultation with James Biden.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Your Hologram Doctor Will See You Now

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      A Texas hospital is experimenting with hologram technology for doctors to see patients. Some health care experts wonder if it’s beneficial.A patient walks into a hospital room, sits down and starts talking to a doctor. Only in this case, the doctor is a hologram.It might sound like science fiction, but it is the reality for some patients at Crescent Regional Hospital in Lancaster, Texas.In May, the hospital group began offering patients the ability to see their doctor remotely as a hologram through a partnership with Holoconnects, a digital technology firm based in the Netherlands.Each Holobox — the company’s name for its 440-pound, 7-foot-tall device that displays on a screen a highly realistic, 3-D live video of a person — costs $42,000, with an additional annual service fee of $1,900.The high-quality image gives the patient the feeling that a doctor is sitting inside the box, when in reality the doctor is miles away looking into cameras and displays showing the patient.The system allows the patient and doctor to have a telehealth visit in real time that feels more like an in-person conversation. For now, the service is used mostly for pre- and postoperative visits.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Some States Say They Can’t Afford Ozempic and Other Weight Loss Drugs

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      Public employees in West Virginia who took the drugs lost weight and were healthier, and some are despondent that the state is canceling a program to help pay for them.Joanna Bailey, a family physician and obesity specialist, doesn’t want to tell her patients that they can’t take Wegovy, but she has gotten used to it.Around a quarter of the people she sees in her small clinic in Wyoming County would benefit from the weight-loss medications known as GLP-1s, which also include Ozempic, Zepbound and Mounjaro, she says. The drugs have helped some of them lose 15 to 20 percent of their weight. But most people in the area she serves don’t have insurance that covers the cost, and virtually no one can afford sticker prices of $1,000 to $1,400 a month.“Even my richest patients can’t afford it,” Dr. Bailey said. She then mentioned something that many doctors in West Virginia — among the poorest states in the country, with the highest prevalence of obesity, at 41 percent — say: “We’ve separated between the haves and the have-nots.”Such disparities sharpened in March when West Virginia’s Public Employees Insurance Agency, which pays most of the cost of prescription drugs for more than 75,000 teachers, municipal workers and other public employees and their families, canceled a pilot program to cover weight-loss drugs.Some private insurers help pay for medications to treat obesity, but most Medicaid programs do so only to manage diabetes, and Medicare covers Wegovy and Zepbound only when they are prescribed for heart problems.Over the past year, states have been trying, amid rising demand, to determine how far to extend coverage for public employees. Connecticut is on track to spend more than $35 million this year through a limited weight-loss coverage initiative. In January, North Carolina announced that it would stop paying for weight-loss medications after forking out $100 million for them in 2023 — 10 percent of its spending on prescription drugs.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Abortion Pills May Become Controlled Substances in Louisiana

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      A bill that is expected to pass would impose prison time and thousands of dollars in fines on people possessing the pills without a prescription.Louisiana could become the first state to classify abortion pills as dangerous controlled substances, making possession of the pills without a prescription a crime subject to jail time and fines.A bill that would designate the abortion pills mifepristone and misoprostol as Schedule IV drugs — a category of medicines with the potential for abuse or dependence — passed the state’s Republican-controlled House of Representatives on Tuesday by a vote of 63 to 29. Should the Senate follow suit, Gov. Jeff Landry, a Republican and a vocal opponent of abortion, is likely to sign the legislation into law.The measure — which would put abortion pills in the same category as Xanax, Ambien and Valium — contradicts the way the federal government classifies mifepristone and misoprostol. The federal Food and Drug Administration does not consider abortion pills to be drugs with the potential for dependence or abuse, and decades of medical studies have found both to be overwhelmingly safe.Under the legislation, possession of mifepristone or misoprostol without a prescription in Louisiana could be punishable with thousands of dollars in fines and up to five years in jail. Pregnant women would be exempt from those penalties; most abortion bans and restrictions do not punish pregnant women because most voters oppose doing so.“These drugs are increasingly being shipped from outside our state and country to women and girls in our state,” Attorney General Liz Murrill, a Republican, said in a statement on social media. “This legislation does NOT prohibit these drugs from being prescribed and dispensed in Louisiana for legal and legitimate reasons.”Louisiana already bans most abortions, except when women’s lives or health are in danger or fetuses have some fatal conditions. As a result, abortion rights advocates and legal scholars said that in practice, the measure might not prevent many abortions among Louisiana women. Since the state imposed its strict abortion ban after the Supreme Court overturned Roe v. Wade, many patients have traveled to states where abortion is legal or have obtained pills under shield laws from doctors or nurses in other states who prescribe and mail the medications to Louisiana. Such circumstances would not be affected by the new bill, experts say.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More