On behalf of the physicians of the Duval County Medical Society, my heart goes out to the family and loved ones of the young father of two whose life was stolen in yesterday’s senseless act of violence, and to the families of those affected by the tragic school shooting in Colorado. Regardless of one’s point of view, political leaning, or affiliation, the killing of a parent, child, student, or teacher is a tragedy that should grieve us all. Behind every headline is a face, a story, a family—and the loss of a parent, child, brother, sister, or spouse leaves an emptiness that no words can ever fill. Tragedies like these remind us that the pain of violence reverberates far beyond the immediate family, touching entire communities.

With yet another school shooting, the reality is stark. Since 2020, firearm-related injuries have been the leading cause of death among children and adolescents in the United States, surpassing motor vehicle crashes for the first time in history (New England Journal of Medicine, 2022). At the same time, the United States continues to endure firearm death rates nearly ten times higher than those of nations with similar resources and values, such as the United Kingdom and Australia. These disparities are not destiny—they are the result of choices we make as a society about how to protect life.

As physicians, our calling is clear: to save lives. Here in Northeast Florida, the Duval County Medical Society, in partnership with the American College of Surgeons, is working to bring Stop the Bleed kits and training into schools, our community, and neighborhoods. In those critical first minutes after an injury, before emergency responders arrive, a bystander with the right tools and knowledge can mean the difference between life and death.

Let us respond to the repeated heartbreak of these tragedies with more than sympathy, with a shared commitment to action. Together, we can turn grief into purpose and ensure fewer families face this unimaginable pain.

And today, as we remember September 11, 2001, we are reminded of another day when our Nation was shaken to its core. Out of that unimaginable loss came a profound sense of unity, resilience, and shared purpose. May we carry forward that same spirit as we face today’s challenges, coming together not in division, but in our common humanity, to protect and to heal.

With deepest sympathy and steadfast hope,

Ali Kasraeian, MD, MHA, FACS
President, Duval County Medical Society

Jacksonville, Florida

September 4, 2025

To our community and policymakers,

Protecting Children, Protecting Florida: The Case for Vaccination

As physicians of the Duval County Medical Society (DCMS), we are deeply concerned by efforts to dismantle longstanding childhood vaccine requirements in Florida. At a time when we should be strengthening the health of our communities, removing these safeguards threatens to reverse decades of progress against preventable disease.

Vaccines are not abstract. They are among medicine’s greatest triumphs, protecting generations of children from polio, measles, whooping cough, and other devastating illnesses. They represent the best of science in service to humanity. When vaccination protections are undermined, the consequences are measured not in rhetoric, but in real illnesses, preventable suffering, and unnecessary deaths.

Already, troubling signs are before us. In 2025 alone, the United States has witnessed more than 1,400 measles cases and over 10,000 pertussis cases. These figures are nearly double those of last year. Tragically, most occurred in individuals who were unvaccinated or whose vaccination status was unknown. Here in Jacksonville, we have seen firsthand the return of diseases once considered controlled. These outbreaks remind us that immunity is not a given; it is a responsibility we share.

We recognize that parents may have concerns about the potential effects of vaccines on their children, and these concerns stem from a natural and well-founded desire to safeguard their child’s health. As physicians, our charge is clear: to protect children and families through evidence-based care, to educate with compassion and knowledge, and to advocate for policies that place community well-being above ideology. We know that the health of one child is inseparable from the health of all.

To our state leaders, we say this: medical freedom must never come at the expense of public safety. True freedom means ensuring that every child can safely attend school, every parent can trust that their community is protected, and every family can thrive without fear of diseases we already know how to prevent.

The Duval County Medical Society stands ready to work with lawmakers, educators, and community leaders to preserve vaccination protections, to educate families, and to strengthen public trust. Together, we can reaffirm Florida’s role as a leader in public health—not by retreating from science, but by embracing it.

At its best, medicine is not about winning arguments. It is about keeping people healthy and saving lives. On behalf of the physicians of Duval County, I urge us all to act with courage, wisdom, and unity. Our children, and our future, deserve nothing less.

Respectfully,

Ali Kasraeian, MD, MHA, FACS
President, Duval County Medical Society

As physicians, we see every day what happens when our neighbors fall through the cracks of our healthcare system. Too often, uninsured patients wait until their conditions worsen, then end up in the emergency room—the most expensive, least efficient, and often too-late point of care. Jacksonville has had a program that helps change this reality: Healthlink JAX.

When I think about healthcare, I often frame it around four simple pillars—Access, Quality, Cost, and Accountability. Healthlink JAX represents all four.

Access means care where it is needed most. Last year alone, Healthlink JAX provided more than 3,100 visits to uninsured residents and helped prevent more than 1,300 unnecessary ER visits. But behind those numbers are people: a mother with diabetes able to have her blood sugar checked before it spiraled out of control, a patient with a heart condition receiving timely follow-up, and a working father spared a crushing medical bill he could not afford.

Quality is about care you can trust. Healthlink JAX is not just a hotline or a website—it is physicians, EMTs, and community partners woven into the fabric of our city. From schools and housing communities to churches and workplaces, the program shows up where people live their lives. Partnerships with Goodwill, Jacksonville Housing, Operation New Hope, and others ensure care reaches those too often left behind. Patients themselves call it “life-saving,” “professional,” and “kind.” That is what quality healthcare looks like.

Cost matters to families and to our city. For less than the price of a cup of coffee per household per month, Jacksonville sustains a program that saves lives while reducing avoidable ER visits and costly hospital stays. The proposed tax cut may save families only a few dollars a year, but eliminating Healthlink JAX will cost our city far more—in human lives, in avoidable suffering, and in preventable expenses. This is an investment that pays for itself many times over.

Accountability means results we can measure and trust. Healthlink JAX delivers healthier neighbors, fewer ER visits, and stronger partnerships across Jacksonville. It is a program our city can point to with pride—an example of physician-led, patient-centric, community-centered innovation that works.

As President of the Duval County Medical Society, I stand with my colleagues in saying: this is not wasteful spending—it is an investment in the health and resilience of our city. It is a proven solution that brings together patients, physicians, and our community to make Jacksonville stronger. We should not be dismantling it—we should be building on its success.

By supporting Healthlink JAX, we can sustain a program that saves lives, strengthens families, and reduces strain on our emergency rooms and hospitals. Eliminating this funding would undermine a proven solution at the very time when access, prevention, and innovation should be our priorities. Jacksonville should be proud to lead with a model that puts patients, physicians, and our community first.

Healthlink JAX is proof that when we work together, we can expand access, improve quality, lower costs, and hold ourselves accountable to the people we serve. Jacksonville has the chance to lead—not by cutting what works, but by building on it.

Let’s keep Healthlink JAX alive—for our patients, for our doctors, and for the community we all call home.

The DCMS is excited to welcome new member Anjali Gupta, MD, an internal medicine physician with Baptist Health.

Originally from India, Dr. Gupta has over 20 years of practice experience. She lived and practiced in India and Thailand before moving to the United States.

Dr. Gupta completed her residency at Howard University in Washington DC, then practiced in Minnesota for several years before moving to sunny Florida!

Dr. Gupta enjoys exploring all that Florida has to offer with her family, and spending time at the beach.

I am one of the pediatric emergency medicine doctors at Wolfson Children’s Hospital. Recently, I saw a post on Facebook about being recruited into a COVID-19 vaccine trial and immediately I thought it sounded like a great idea. I visited the website (https://www.coronaviruspreventionnetwork.org/) and started the process.

While you might be thinking, “that is an altruistic doctor,” in all honesty at the time I was most concerned about how to get the vaccine as quickly as possible in order to also protect my family and loved ones from the disease. Being vaccinated also gives you a sense of peace.

My wife asked me to pray about it to make sure it was the right decision. She was not 100% on board, but she did give me permission to do it. As a man of faith, I felt a peace with the decision to go ahead with the trial.

As a randomized double-blind control trial, I, of course, do not know for certain whether I received the real thing (stay tuned to find out). However, I can share that I did experience some mild side effects after my “vaccine.” More on this in a minute.

A little bit about the trial itself: The trial was run very smoothly with physicians seeing me twice, as I went in for the two doses a month apart. The doctors tell me with unlimited funding and no paucity of volunteers, it has been very easy to complete the study. The study includes several parts: a nose swab, a COVID-19 test, and a blood draw. Then you get your vaccine.

My arm felt a little bit sore, but nowhere near Tdap vaccination. The next day, I felt a little bit like I was experiencing the flu. I felt weak and tired and some generalized muscle aches and pains. However, by the following day I was 90% better and the day after that I was back to normal.

From reading up on the COVID-19 vaccine, what I experienced seems to be the most common side effects. This is why I think (though I obviously do not know for sure), that I received the vaccine and not the placebo.

Regardless of what I got, I trust the science of the vaccine. It has been hard to see this vaccine being weaponized as a political tool. Vaccines work. They save lives. They are safe. They are studied under the scientific method.

I hope and pray that we all are able to get the vaccine soon so we can go back to our normal lives and, more importantly, be protected from the virus. After all, I believe that the keystone tenet of pediatrics is vaccination. Go get the vaccine when it’s available! After all, while I believe and have faith in God, vaccines are not a matter of belief or faith, they are a matter of science. 

Dear Colleagues,

Here’s a quick question for you. Do you own an HDTV made by Gateway Computers? Here’s another: Do you own a digital music player made by Dell?

These questions may seem silly, but they are the subject of an inspirational and evocative TED Talk from Simon Sinek around the concept of “Start with Why”. You can find a link here. I highly suggest that you watch it to empower not only your practice, but also to help me with something that’s deeply important to me.

The Duval County Medical Society has been an important part of the Jacksonville medical community since 1853. It’s personally been important to my practice, providing me with education and opportunities I would not have with DCMS.

Now, as President, I am asking our members to help us ensure that the next 165 years are as valuable to physicians.

I am convening a Task Force called Why DCMS 2020 to really dig into some of those issues and help focus on what matters most to you. I would love to have a broad range of diverse perspectives to really help provide a representation of the “Why” for DCMS moving forward.

I am asking you to volunteer for this Task Force. The commitment should be very light, with a single in-person meeting scheduled for later in the month. If you are interested, please let me know at president@dcmsonline.org no later than Tuesday, May 13^th.

Thank you, and I look forward to hearing from you.

-Ruple Galani, MD
2019 DCMS President

By Mark Dobbertien, MD, FACS
DCMS Treasurer & FMA Surgical Specialty Board Representative

As we approach the halfway point of the 2019 Legislative Session, it has become abundantly clear that the House and Senate have very different healthcare agendas.

In the House, scope of practice issues have dominated, as the healthcare committees have been committed to passing independent practice bills for Nurse Practitioners and Physician Assistants, as well as allowing Pharmacists to diagnose and prescribe. The Senate, on the other hand, has not even considered these issues to date, and instead has focused on promoting Telehealth (with the requirement that Telehealth providers be licensed in Florida) and patient right issues.

Fortunately, a few issues appear to have grabbed the attention of both chambers. Both the House and Senate Health committees have advanced legislation that would allow the Department of Health to regulate not only the physicians who operate in Office Surgery Centers, but also the owners, operators, and facilities themselves. Likewise, both committees have passed proposals that would require hospitals to consult with primary care physicians when one of their patients is admitted.

All of these legislative initiatives have several more legislative stops before final floor action, but the stage has been set for a very eventful April.

By Mark Dobbertien, MD, FACS
DCMS Treasurer & FMA Surgical Specialty Board Representative

“If you work for a living, why do you kill yourself working?” – Tuco the Ugly

This famous line from Clint Eastwood’s The Good, The Bad and the Ugly could aptly describe the plight of physicians today. As we struggle with changing regulations, ever-changing legislation and reimbursement models, it becomes harder and harder to focus on our primary concern, our patients.

That’s why the DCMS and the FMA work diligently for you during Florida Legislative Session to ensure that the government overreach is not negatively impacting your practice. And sometimes, it’s a real struggle.

This year, I have been active in Tallahassee as a member of the DCMS Executive Committee and a Surgical Specialty Representative to the Florida Medical Association (FMA) Board of Governors fighting an onslaught of bills designed specifically to change the scope of practice for thousands in Florida. It’s not all bad, in fact, some of it is very good…

…and some is just downright ugly.

The Good

The Senate Health Policy Committee adopted a comprehensive rewrite of SB 732, which governs office surgery. As originally written, this bill would have required virtually every physician office in the State to become licensed as an ambulatory surgical center. As a result of the amendment, only facilities that provide significant surgical services would be regulated. The degree of regulation would be enhanced, however, in the wake of several abuses, primarily in cosmetic surgery clinics in Southeast Florida. We thank Senator Anitere Flores for working with us closely on this effort to enhance patient safety without over-regulating all physicians.

The House Civil Justice Committee passed a Committee Bill that would reinstate the caps on non-economic damages that had been stricken by the Supreme Court. The hope is that, with the replacement of three judges on the Supreme Court by Governor DeSantis, these caps may now be upheld by the new court.

The Bad

HB 833, which would allow Consultant Pharmacists to perform patient assessments and initiate drug therapies, was the subject of intense negotiation over the last two weeks. Unfortunately, those discussions did not produce an acceptable amendment, and we must continue to oppose the bill.

Another pharmacist bill, HB 111 would allow pharmacists to enter into collaborative pharmacy practice agreements with physicians, which would allow them to initiate or discontinue medications without the consent of the treating physician. This Bill has passed the Health Appropriations Committee and will be heard in the Health and Human Services Subcommittee Thursday. We will continue to oppose the bill. 

The Ugly

The House Health Quality Committee not only passed HB 821, which would grant independent practice to Advanced Practice Registered Nurses, but also amended the bill to create “autonomous physician assistants” that also could practice independently. We spoke vigorously against the bill, as did the FMA, but the bill was passed on a 10-3 vote.

As you can see, we have had an eventful two weeks, but nothing has yet been finalized, and we will redouble our efforts over the next few weeks. 

Dear Colleague,

The Centers for Medicare and Medicaid Services (CMS) has proposed changes to the E/M services billed under Medicare which will result in dramatically reduced reimbursements for many physicians. In particular, physician payment for the cognitive process of caring for complex, chronically ill, and elderly patients will be adversely impacted. The proposed rule, as with many Medicare policies, will pit procedural based physicians vs non procedural physicians. This rule will not only impact your Medicare patients, it will ultimately open the door for further reimbursement cuts for E/M services from private payors. Physicians, employed and private, have to be leery of any associated RVU modifications that reduce productivity and deserved payment for complex patients. Finally, in the reality of medical practice, the proposed change is unlikely to lead to simplification or reduction in paperwork, mouse clicks, or time spent “justifying” the new E/M codes.

With the tremendous help of our Duval County Medical Society CEO and staff, we have highlighted some of key analysis and explanation of this proposed rule below. Take the time to talk to your colleagues and read more about the CMS rule from your county, state, and national medical societies.

Most importantly, take 5 minutes and officially register your opinion with CMS on how this new E/M rule will hurt our patients and practices.

Sincerely,
Dr. Ruple Galani
2018 DCMS President

Summary of the Proposed Changes:
-It is important to understand the proposed changes to the E/M Services billed under Medicare. Please click here to read a summary from the American Medical Association, as well as comments from Florida Medical Association President Dr. Corey Howard.

Estimated Impact of Proposed Rule:
-Click here to access the estimated impact of the proposed codes on your practice.

Submit a Formal Comment:
-Click here and hit the Green Button to Submit a Formal Comment. However, you need to hurry. Public comment closes on September 10

Should you have any questions, feel free to reach out to me at ruplegalani@gmail.com or to our CEO Bryan Campbell at bcampbell@dcmsonline.org.

Nearly one week after the tragedy in Parkland, many of us remain devastated in its aftermath. It is quite impossible to imagine what the families and loved ones are going through at this time. In the last week, there has been even more discussion about gun violence in our communities. Most of the discussion has been on political lines and quite bitter, as well. There must be common ground and there is no reason that we need to wait for elected officials in Washington to help improve the conditions in our hometown and neighborhoods. Since 2016, our community has lost 17 children in Northeast Florida due to gun violence. This is unacceptable and has become a public health concern.

We must start a discussion that will lead to local public policy that eventually pumps the brakes on this horrible epidemic. The DCMS Foundation’s Future of Healthcare Conference will focus on gun violence as a public health issue! We have local and national speakers to help us address the issue and offer potential common-sense solutions. If you love this community and its children, you will want to be a part of our second annual FOHC at the Prime Osborn Convention Center on May 21 and 22, 2018. 

Dear Colleagues,

I am writing again today to express my deep concern about physician burnout and associated suicides in Northeast Florida. Recent studies suggest that 46% of all physicians suffer with symptoms of burnout. We all know the reasons which include electronic medical records, government regulations, malpractice and lower reimbursements just to name a few. Most of you are aware that we have had two physician suicides in the last 3 months and a death from drug overdose as well. Our rate of suicide is now over 5 times higher than the age adjusted suicide rate. We have a problem.

The Duval County Medical Society Foundation launched a physician wellness program in 2017. This completely CONFIDENTIAL program refers physicians to a mental health counselor for up to six sessions at no cost. There is a 24 hour wellness line (904-631-1446). There are four certified counselors to choose from with appointment times that can be convenient for a busy physician. There are also emergency sessions available.

It is also very important to note that there is not a medical record created by this program and it is approved by the Florida Board of Medicine. The 2017 Physicians Foundation Annual Report showed that more than 50% of physicians indicated concern about impact on licensure and ability to practice medicine as factors for not seeking professional treatment. We have ensured that you will not be impacted by using the DCMS Foundation Physician Wellness Program.

This program has received over 20 calls and has paid for 15 sessions in the last few months. It is clearly helping to open up conversations for physicians who need guidance. We want to desperately expand this program, but we need your help. Please forward this letter to your friends or colleagues so that they are aware of this potential benefit.

The DCMSF pays for up to six sessions at $100/session. Please consider donating to this worthy cause. Any gift would be welcomed, but we would truly appreciate a gift of $1000 as this would provide 10 sessions to those who desperately need our help. You may donate online at www.dcmsonline.org/pwpdonation.

I personally ask that you strongly consider supporting this worthy cause which helps support our colleagues in need. Once again thank you for your service to our community and your passion for our profession!  

Dear Colleagues:

Influenza season this year is one of the worst in years and we have not even reached the peak of the season in Florida and north Florida. The current predominant circulating virus strain is H3N2, which is known to cause more severe illness. In addition, the current season vaccine may not be as effective, although still very beneficial.

As we face this developing epidemic we wanted to share with you the following:

1.  INFLUENZA VACCINE:  Influenza vaccine remains the most important tool in our toolbox to address influenza infection in individuals and populations. IF not already vaccinated, all individuals eligible for influenza vaccine CAN STILL GET THE VACCINE. Everyone six months of age and older who does not have a contraindication to the vaccine should be vaccinated. However, highest risk patients are most important. This includes the elderly, pregnant women, individuals with chronic healthcare conditions, and children. They are especially at high risk for complications from getting influenza infection. The Centers for Disease Control and Prevention (CDC) offers more details on the populations at higher risk for complications: https://www.cdc.gov/flu/about/disease/high_risk.htm

2.  INFLUENZA TESTING:  In addition, the following CDC website has the algorithm for diagnostic evaluation: https://www.cdc.gov/flu/professionals/diagnosis/consider-influenza-testing.htm

3.  SIMPLE PATIENT ADVICE:  Certain simple practices of good hand hygiene and cough etiquette can be very effective in preventing transmission of influenza infection.

4.  LABORATORY TESTING FOR INFLUENZA: There is currently a shortage of reagents to test for influenza. If your clinical suspicion for influenza is high, it may not be necessary to perform laboratory testing if you are going to treat for influenza regardless. More information on diagnosing influenza is available at this CDC website: https://www.cdc.gov/flu/professionals/diagnosis/index.htm.

5.  INFLUENZA TREATMENT:  Oseltamivir (generic or brand) is effective in treating influenza and works best if used within the first 48 hours of symptoms. There may still be clinical benefit if treatment is started after the first 48 hours. More information about influenza antiviral drugs is available at this CDC website: https://www.cdc.gov/flu/antivirals/whatyoushould.htm

     We are not aware of shortage of Oseltamivir, although there may be challenges of finding it at retail pharmacies because of increased demands. Liquid Oseltamivir availability may even be a more significant issue. We are working of trying to resolve this issue.

6.  SICK AT WORK:  Individuals with influenza can transmit the infection to others around them. Working while sick - “Presenteeism” - with influenza can continue the spread of influenza outbreak. 

Please keep yourselves updated by visiting the CDC and Florida Department of Health websites!                                                                     

Mobeen H. Rathore, MD
DCMS Past President

Physician burnout is not just a national epidemic, it has become a concerning issue right here on the First Coast. We must take some time to recognize that we, as medical professionals, are indeed human beings and have many stressors that are beyond our control. Sometimes, talking to someone in a truly confidential manner can make a difference.

The DCMS Foundation’s Physician Wellness Program is a completely free and completely confidential resource for DCMS Members. Simply call our hotline at (904) 631-1446 and the DCMS Foundation will pay for up to six visits with a counselor. DCMS has worked with the Florida Board of Medicine to ensure these visits are not reportable to your medical license and will not have any impact on relicensure.

If stress or burnout is affecting you, I personally ask that you call today. For yourself and for your patients.

-Sunil Joshi, M.D.
President, DCMS Foundation

Dear Fellow DCMS Members,

Awesome weather, gorgeous beaches, numerous nature trails and a mighty river whose wide track flows right through the middle of a rapidly growing urban core all contribute to the wonderful quality of life in Northeast Florida. We also have a strong economy and workforce with large corporations moving headquarters to Jacksonville while creating hundreds of thousands of jobs. Yes, we have a lot to be proud of.

However, there remain troubling concerns that our community must improve on so that every citizen in Northeast Florida can benefit from living here. The Robert Wood Johnson Foundation’s annual county health rankings were just released and Duval has fallen even further than in past years. Our county is now ranked as 55^thout of 67 Florida counties in overall health. This is down from a ranking of 48^thjust last year. There are indeed many factors that have contributed to this low ranking including infant mortality, obesity, physical inactivity, food deserts and gun violence just to name a few. Of course, these are not unique or new issues to Northeast Florida. How can a city with so many good things happening continue to suffer with poor overall health outcomes year after year? There really is no good answer to this rhetorical question, but we must stop complaining about our health outcomes and start making a positive impact. There is no better group to lead these efforts than the physicians of the Duval County Medical Society!

Over the last year, Mayor Lenny Curry’s office has developed an all-encompassing, holistic approach to improving the region’s health with the Journey To One plan. In order to shed light on this initiative and on the many issues that must be addressed to improve our community’s well-being, the Duval County Medical Society Foundation (DCMSF) will be hosting the inaugural Future of Healthcare Conference (FOHC) on May 22^nd and 23^rdat the University of North Florida. This conference will focus on some of the region’s biggest areas of concern including health care disparities, food deserts, infant mortality, obesity, physical inactivity, poor mental wellness and how each of these affect our region’s health.

We will hear from many knowledgeable and well-respected speakers on these topics including Dr. Celeste Philip (Florida Surgeon General), Dr. David Barbe (President-elect, American Medical Association), Dr. David Becker (President, Florida Medical Association), Aaron Bean (Florida Senator), Lori Boyer (City Council President) and Jacksonville Mayor Lenny Curry just to name a few. The goal of the discussion is not to simply identify areas of need but to actually develop action items in order to formulate public policy. We will enlist the assistance of Richard Mullaney of the Jacksonville University Public Policy Institute and expect to make a long-term impact in at least one of the issues that adversely affect our community’s health.

This conference is open to all interested parties and in particular those who care about the health of Northeast Florida. Continuing education credit is available for all physicians and other health care professionals as well.

Our corner of Florida is a wonderful place to live, work and play. The Future of Healthcare Conference is a way for us to begin the process of making Jacksonville a healthy city for all of its citizens. If you love this town and its people, please attend the Future of Healthcare Conference and help Duval County succeed on its Journey To One.

Sincerely,

Sunil Joshi, MD FACAAI
President, Duval County Medical Society Foundation

Drs. Sunil Joshi, Tra'Chella Johnson Foy and Alan Harmon contributed to an article for The Florida Times-Union entitled, "Physicians suggest sensible reforms to Obamacare."

Sunil Joshi is president of the Duval County Medical Society. Tra’Chella Johnson-Foy is president-elect of the Duval County Medical Society and Alan Harmon is a DCMS delegate to the American Medical Association.

Read the article by clicking here.

Did you know both real AND fake Christmas trees can trigger allergies?

In today's article for The Florida Times-Union, Duval County Medical Society President Dr. Sunil Joshi explains the allergens associated with both types of trees and how to reduce those allergens.

Click here to read the article.

In this week's DCMS column for The Florida Times-Union, Dr. Arveen Bhasin explains the symptoms of penicillin allergy and recent research on the topic.

To read the full article, visit The Florida Times-Union website.

It seems that there is a new emerging or re-emerging infectious disease every year. Healthcare professionals hear about it and scurry around trying to learn as much as possible, as soon as possible. For most of these infections, physicians in the United States have no firsthand experience. Public health authorities make efforts to escalate their response, falling on their meager resources and experiences with previous emerging infectious diseases (no two diseases are alike). The Centers for Disease Control and Prevention (CDC) also does an exceptional job of quickly responding. However, despite best efforts, the public gets alarmed and confused and no one in particular is to blame.

For too long, we have neglected these orphan diseases that were causing disasters in “far off exotic lands.” No more. These diseases are now only a short flight away.

Zika is the recent in a series of diseases that have come to our backyard. In recent years, it started with SARS and continued with bird flu, West Nile virus, pandemic novel flu, Dengue, Chikungunya, MERS and Ebola, among others.

While the previous recent emerging disease outbreaks did not occur in the U.S., although Florida did see its share, Zika virus is different. First, it follows Dengue and Chikungunya in the pattern in which it is spread, being that all three are transmitted primarily by the Aedes mosquitoes and we have a naïve susceptible population. The disease itself is mostly asymptomatic (80 percent) and when symptomatic patients experience symptoms similar to a mild “flu” with pink eye. Transmission of the virus to a fetus by a mother who gets infected during pregnancy, and the dreaded consequences of congenital infection, has gotten everyone’s attention.

Although Zika virus infection is known to cause other neurologic problems, including Guillain Barre Syndrome, the microcephaly and other neurological problems in the newborn are of great concern. Zika virus infection is the first significant congenital infection recognized in over 50 years. We still need to learn a lot more about it.

Although, many experts believe, based on the experience with Dengue and Chikungunya infections, that we may not have the explosive outbreak that was seen in Brazil and other parts of South America, we must be prepared. This is a fast moving disease with new information coming to our attention almost daily. The CDC has done a wonderful job and is constantly updating its advice to healthcare professionals and the public via their “Interim Guidance” documents and information on the CDC website. The Florida Department of Health is also providing regularly updated information to healthcare providers and citizens of Florida.

It is important that we review the CDC and Florida Department of Health (FDOH) websites (listed below) routinely and, especially, if we suspect one of our patients may be infected by the Zika virus.

CDC: https://www.cdc.gov/zika/

FDOH: http://www.floridahealth.gov/diseases-and-conditions/zika-virus/

Dear Colleagues,

This is a special day on the calendar. In 1990, the United States Congress passed a resolution that the President signed to make March 30^th Doctors’ Day. It is a day for us, as physicians, to take a few minutes to recognize what each of us does on a day-to-day basis. I know that there are many who feel that doctors don’t really need any extra attention or recognition. Well, these people are wrong! 

Physicians go into medicine with the altruistic ideal of not only benefiting each individual patient, but also improving the health of the larger community in which they live. After years of undergraduate education, medical school and residency training, the young physician is well prepared to communicate, evaluate, diagnose and manage many medical conditions. He/she does this while sacrificing the young adult years in medical training whereas his/her non-medical friends are starting families and earning a solid living.

Even after training, the burden of practicing medicine in the ever-changing health care environment is also challenging. It is the increased demand from insurance companies, changing government regulations, malpractice concerns and the hardship of medical school debt that generally makes it more difficult for the physician to enjoy doing his/her job.

Many doctors graduate with an average of $160,000 in medical school debt. They have to pay back their student loans at a time in their lives when they are usually starting families and getting their first job. So they are working to provide for their loved ones and to pay off tremendous debt at the same time they are in the office for 60 hours a week, if not more.

Despite all of this, medical schools receive more and more applications every year. Doctors come out of residency programs ready and excited to practice medicine. Physicians go to work every day and provide selfless, evidence-based, cost-effective, high-quality, patient-centric care to help improve the health of communities all across the great metropolitan Jacksonville area.

The greatest profession of mankind will continue to heal because of the men and women who choose to join it. This is why, my friends, I feel it is important for all of us to take a few minutes to recognize your accomplishments and those of your medical colleagues as well.

It is indeed a well-deserved day of recognition.

Happy Doctors’ Day!

Sunil Joshi, MD
President, Duval County Medical Society

So, how much should they be getting? DCMS member Dr. Mariam Louis discusses in this article for The Florida Times-Union.

Click here to read the entire article.

In this week's column for The Florida Times-Union, DCMS Member Dr. Megan Deacon-Casey explains the link between exercise and vein health.

Read the entire article here.

In this week's column for The Florida Times-Union, DCMS member Dr. Robert Harmon explains options and availability of these types of contraceptives.

Click here to read the entire article.