health care – Page 3 – Go Retire Psychiatrist

University of Iowa Physician Wins Lasker Award!

How about some good news? This just in, University of Iowa Physician-Scientist, Dr. Michael Welsh, wins the 2025 Lasker Award for his research on cystic fibrosis.

His work and the work of two other researchers with whom he’ll share the award set the stage for the development of new drugs which saves the lives of those who suffer from cystic fibrosis.

I learned from the article that the cystic fibrosis gene was discovered in 1989; I was a second-year medical student then. Since then, the development of new treatments has meant that many people who died in early adulthood now can live into their 80s.

Congratulations to Dr. Welsh and colleagues!

Rounding@Iowa Podcast: “When to Suspect Atypical Recreational Substances”

There’s a new podcast in town from The University of Iowa Health Care and the title is “When to Suspect Atypical Recreational Substances.”

86: Cancer Rates in Iowa – Rounding@IOWA

Iowa's cancer rates are among the highest in the country, and they are rising. In this episode of Rounding@Iowa, Dr. Gerry Clancy and guest experts Dr. Mary Charlton and Dr. Mark Burkard discuss the data, risk factors, and prevention strategies clinicians can use to make a difference. CME Credit Available: https://uiowa.cloud-cme.com/course/courseoverview?P=0&EID=81274 Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Mark E. Burkard, MD, PhD Professor of Internal Medicine-Hematology, Oncology, and Blood and Marrow Transplantation University of Iowa Carver College of Medicine Director, University of Iowa Health Care Holden Comprehensive Cancer Center Mary Charlton, PhD Professor of Epidemiology Director, Iowa Cancer Registry Iowa College of Public Health Financial Disclosures: Dr. Clancy, Dr. Burkard, Dr. Charlton, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 0.75 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 0.75 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. UAN: JA0000310-0000-25-090-H99 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.) References/Resources: Iowa Cancer Plan

This is a fascinating topic and the discussion ran for close to an hour, which is longer than usual because there’s a lot to say about it. The substances include a lot of chemicals that are not illegal and, in some cases, easily available in convenience stores and gas stations. In fact, the name for one of them is gas station heroin, which is tianeptine, approved in other countries as an antidepressant.

The discussion also included substantial information (or maybe better said, lack of enough information) about bath salts (usually cathinones), kratom, and something I’ve never even heard of: diamond shruumz (chocolate bars which can contain various substances not limited to psilocin). Remember that guy who chewed the face off of somebody in Miami in 2012? That was attributed to intoxication with bath salts.

This is way beyond the 1970s stuff like window pane or blotter (LSD) and pot. Many people end up in emergency rooms for evaluation of what looks like poisoning from multiple drugs. The stickler is the possibility that they got poisoned from something bought at a convenience store. Often it’s difficult to tell what the person ingested.

One of the takeaways from this podcast is that, whenever possible, try to get a history from the patient. They might just tell you what you need to know.

Got Vaccines Today!

Sena and I got our latest updated seasonal Covid-19 and flu vaccines today. Manpower was low at Walgreens so we ended up sitting for about an hour, but otherwise this was a routine trip. We’re thankful.

We noticed there were a few people waiting—mostly our age. No word up yet on the CDC ACIP site about the Sept. 18-19 meeting as far as an agenda, speakers, or slides.

Upcoming CDC Advisory Committee Meeting in September 2025-Or Not?

I’ve been checking the Centers for Advisory Committee schedule on their website for weeks and the only way I found out there is an upcoming meeting is on the Federal Register schedule. Sena found it in a news outlet story. As of this morning around 9 a.m., there was no announcement on the CDC website yet. That may change later today.

According to the Federal Register, the CDC ACIP will hold a meeting on September 18, 2025, from 10 a.m. to 5 p.m., EDT, and September 19, 2025, from 8 a.m. to 4 p.m., EDT.

Under Supplementary Information:

“The agenda will include discussions on COVID-19 vaccines; Hepatitis B vaccine; measles, mumps, rubella, varicella (MMRV) vaccine; and Respiratory Syncytial Virus (RSV). The agenda will include updates on ACIP Workgroups. Recommendation votes may be scheduled for COVID-19 vaccines, Hepatitis B vaccine, MMRV vaccine, and RSV. Vaccines for Children (VFC) may be scheduled for COVID-19 vaccines, Hepatitis B vaccine, MMRV vaccine, and RSV. Agenda items are subject to change as priorities dictate. For more information on the meeting agenda, visit https://www.cdc.gov/acip/meetings/index.html.”

However, I also noticed a news article posted by the Center for Infectious Disease Research and Policy (CIDRAP) indicating that the meeting might be postponed because of the recent upheaval around vaccine policy and personnel.

This meeting’s actual timing and schedule items could be moving targets.

Community Psychiatry Podcast: Shelter House Iowa City, Iowa

I just discovered this Community Psychiatry Podcast site today. A couple of days ago Dr. Emily Morse, DO, of The University of Iowa Health Care gave a 20-minute interview that outlines how the psychiatry department leverages community psychiatry outreach to address the challenges those experiencing homelessness face.

Introduction: “Emily Morse, DO, is a Clinical Associate Professor of Psychiatry at the University of Iowa where she was first drawn to community-based care during her residency training. Her current clinical work spans a variety of settings which include outreach clinics embedded within local permanent supportive housing programs in partnership with Shelter House in Iowa City—an organization that provides comprehensive support services to help individuals move beyond homelessness. She also works as part of interdisciplinary teams that reach patients across Iowa, including one focused on individuals with intellectual and developmental disabilities, and another providing reproductive and perinatal mental health care. Along with her clinical work, she is active in medical education as a psychiatry clerkship co-director, and she enjoys working alongside residents and fellows while aiming to provide accessible, collaborative, and relationship-centered care.”

Dr. Morse provides a view of psychiatry that goes beyond the idea of scheduled appointments in the psychiatry clinic.

This is also a great way to get beyond the politicization of this issue we typically hear about in the national and local news almost every day.

In Memory of Leonard Tow, Founder of the Tow Foundation and Humanism in Medicine

I just found out that Leonard Tow died on August 10, 2025. In humility, I express my gratitude and respect for his creation of the Tow Foundation, a big part of that being the Humanism in Medicine Award, of which I am one of the many recipients over the years. I hope this great tradition goes on forever, a reminder to doctors, patients, and families of the great rewards and greater responsibilities in medicine.

I thank Dr. Jeanne M. Lackamp, now Chair of the Department of Psychiatry, Psychiatrist in Chief for University Hospitals and Director of the University Hospital Behavioral Health Institute for nominating me and Dr. Jerold Woodhead, Professor Emeritus in Pediatrics at University of Iowa Health Care for placing the pin in my lapel. That was in 2007.

Leonard Tow established the Humanism in Medicine award to foster the development of humanistic doctors. They exemplify compassion and respect for others, humility and empathy.

That is how I will remember Leonard Tow.

Success of Johnson County Civil Mental Health Court in its First Year

I’ve been looking for other ways that Iowa addresses mental illness and its impact on homelessness and other adverse outcomes since my last post on the issue.

It turns out that, despite Iowa ranking 51^st out of all U.S. states for the low number of psychiatric beds according to the Treatment Advocacy Center statistics (in 2023, it had just two beds per 100,000 patients in need), a new mental health court established in in May of 2023 has made substantial progress in reducing the number of crisis contacts, psychiatric hospitalizations, and days in the hospital. Arrests, jailings, and days in jail were also reduced.

Participants in the new program include the University of Iowa Health Care, Iowa City VA Hospital, the Abbe Center, Guidelink Center, National Alliance for the Mentally Ill (NAMI), Shelter House, and several other mental health service agencies in Johnson County.

The Johnson Mental Health Court continues to operate since June of this year when the pilot program’s funding from the East Central Iowa Mental Health Region was supposed to have ended on June 30, 2025, due to the change in mental health regions. This is a program for patients under involuntary mental health commitment that avoids incarceration and placement in a state psychiatric hospital.

This civil mental health program didn’t exist until well after I retired and I hope for its continued success.

Luett, T. (2024, April 24). Civil Mental Health Court in Johnson County finds success in first year. The Daily Iowan. https://dailyiowan.com/2024/04/24/civil-mental-health-court-in-johnson-county-finds-success-in-first-year/ Accessed July 30, 2025

Mehaffey, T. (2024, April 14). News Track: ‘Challenging, rewarding’ first year of Johnson County mental health court. The Gazette – Local Iowa News, Sports, Obituaries, and Headlines – Cedar Rapids, Iowa City. https://www.thegazette.com/crime-courts/news-track-challenging-rewarding-first-year-of-johnson-county-mental-health-court/ Accessed July 30, 2025.

It Takes a Village to Tackle Homelessness: What’s Iowa Doing?

After I read Dr. Dawson’s post today “More on homelessness and violence as a public health problem,” it got me thinking about what the situation on homelessness of people with mental illness and substance use disorder is here in Iowa.

First, I looked at the 2024 Iowa Homelessness Needs Assessment, which is a thorough report you can download if you need it. It’s a 23-page pdf document which doesn’t mention the intersection with the homeless mentally ill until almost the very last page. It gets mentioned in the section subtitled “Improve Coordination With Adjacent Systems”:

To end or substantially reduce homelessness, a coordinated response is needed that aligns the resources in adjacent systems with CoC resources and housing. Homelessness is often caused by and/or exacerbated by the inability of public support systems to address the complex needs of people in extreme poverty experiencing housing crises. These systems include education, hospitals, behavioral health, criminal justice, and child welfare. Engagement and service delivery approaches need to be responsive to the particular needs of people at imminent risk or experiencing literal homelessness. More responsive adjacent systems will provide specialized engagement, enrollment supports, discharge planning, and coordination with CoCs in each region.

Typically, this kind of document makes me thirsty for a more granular, human connected account of what kind of person actually becomes homeless. Are they always dangerous? The answer is “no.”

Actually, there’s this human-interest Iowa’s News Now story published December 27, 2024, “A Closer Look: U.S. and Iowa homelessness reach record highs” (accessed July 28, 2025). It’s about a real person who became homeless despite being a University of Iowa graduate.

People become homeless for many reasons. I just want to mention resources that are available in Iowa that could be helpful. The website Homeless or At-Risk of Homelessness presents the idea that “Sometimes, life takes an unexpected turn. People face hardships and turn toward their communities for support.”

There are some people who struggle with mental illness and substance abuse and as a consequence of those challenges become homeless, as the Iowa Homelessness Needs Assessment above points out.

One resource I think is important is The University of Iowa’s Integrated Multidisciplinary Program of Assertive Community Treatment or PACT program. It’s an evidence-based treatment model that’s been around for decades in many locations in the U.S.

There’s also an Iowa Health and Human Services program called PATH (Projects for Assistance in Transition from Homelessness) to help homeless adults with mental illness, substance abuse and trauma.

This was just a quick and admittedly superficial summary of what Iowans have been doing about the homelessness crisis. It really takes a village.

Extreme Heat Warning for I-80 Corridor

There’s an extreme heat warning from the National Weather Service for much of the I-80 corridor today and tomorrow. Heat indices of 95-110+ are expected.

Cooling Centers in Iowa City, IA

Cooling Centers in Coralville, IA

Consider donating to the Iowa City Shelter House Beat the Heat drive!

Shout Out to Dr. George Dawson for Post “The Autocratic Approach to Homelessness”

I want to give a shout out to Dr. George Dawson for his post today “The Autocratic Approach to Homelessness” in reference to President Trump’s most recent executive order, “Ending Crime and Disorder on America’s Streets.” As a retired psychiatrist, I look back and remember seeing the problem of the homeless mentally ill a lot. You can read my take on it from last summer’s posts: