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Here are some public information that GloalMD would like to present and share with its members. Hopefully these information will be useful for your practice and study.

Medical Journals:

PubMed : NCBI's search service, providing over 11million citations in MEDLINE and other related databases . PubCrawler : In addition to describing some of the graduate student activities, PubCrawler is also the name of a very useful publication-tracking site. It monitors peer-reviewed journals for publications matching a user's description, & email alerts.

PubMed Central An archive of free online life sciences journal literature that is managed by the NCBI.

Public Library of Science (PLoS) A nonprofit organization of scientists and physicians committed to making the world's scientific and medical literature a free public resource. Some free online journals of particular interest include: PLoS Biology , PLoS Genetics , PLoS Computational Biology and PLoS Pathogens .

BioMedCentral An independent publishing house committed to providing immediate open access to peer-reviewed biomedical research.

Cell The premiere journal of cellular and molecular biology.

EMBO Journal The journal of the European Molecular Biology Organization.

Morbidity and Mortality Weekly Report Published by the CDC , this journal catalogs the current trends in public health in the United States.

Nature The internationally-renowned journal was a latecomer to the online publication game, but is rapidly making up for lost time.

Proceedings of the National Academy of Sciences (PNAS) The official journal of the National Academy of Sciences of the United States.

Science One of the best science sites online.

Gene Regulation

Mol. Cell. Biol. The online version of the journal Molecular and Cellular Biology.

J. Cell Biol. The Journal of Cell Biology, with articles available online.

J. Mol. Biol. The Journal of Molecular Biology.

J. Immunology Read the Journal of Immunology and search its contents online.

CCID The Center for Complex Infectious Disease studies the interactions of the immune system with pathogens.

J. Virol. The Journal of Virology online.

All the Virology on the WWW A meta-site of links to virology-related sites. It is not quite as complete as its title claims, but it is pretty good.

An Electronic Introduction To Molecular Virology A Web-based textbook with some interesting features.

Bock Laboratories at UW-Madison This site provides a tremendous amount of information for molecular virology. Among other things, you can download crystallography data or link to journals from here.

Herpes Zone Aimed at a more general audience, this page focuses on medical aspects of herpesviruses.

Herpesviruses Another medically-oriented herpes page.

The Polio Information Center Online (PICO) General information on the molecular biology and medical aspects of poliovirus, with extensive links to outside resources.

Virology Weblog A weblog about viruses and viral disease, maintained by Vincent Racaniello

Virus Particle Explorer A collection of structural images of icosahedral viruses, consistently oriented to make comparison straightforward.

Parasitology

The American Society of Parasitologists The web site for the American Society of Parasitologists, including a free archive of the Journal of Parasitology.

Virology

J. Virol. The Journal of Virology online.

All the Virology on the WWW A meta-site of links to virology-related sites. It is not quite as complete as its title claims, but it is pretty good.

An Electronic Introduction To Molecular Virology A Web-based textbook with some interesting features.

Bock Laboratories at UW-Madison This site provides a tremendous amount of information for molecular virology. Among other things, you can download crystallography data or link to journals from here.

Herpes Zone Aimed at a more general audience, this page focuses on medical aspects of herpesviruses.

Herpesviruses Another medically-oriented herpes page.

The Polio Information Center Online (PICO) General information on the molecular biology and medical aspects of poliovirus, with extensive links to outside resources.

Virology Weblog A weblog about viruses and viral disease, maintained by Vincent Racaniello

Virus Particle Explorer A collection of structural images of icosahedral viruses, consistently oriented to make comparison straightforward.

Microbiology Resources

Bugs on the Web Index Many links to microbiology-related sites.

BioChemNet Information about biochemistry research and education, including current news stories.

Community of Science Web Server Based at Johns Hopkins, this resource aims to bring scientists across different disciplines and geographies together.

Glossary of Microbiology Can't figure out a term? This is a good place to start searching for an explanation.

HHMI Beyond Bio 101: Table of Contents An interesting idea that brings science to the public and updates information currently taught at the secondary and college levels. Sponsored by the Howard Hughes Medical Institute

United Kingdom National Culture Collection The online database of the UKNCC, which has a collection of over 70,000 microorganism and cell line strains.

Cells Alive! Photos, drawings, and movies of microbial interactions with cells of the immune system.

Microbes Info The Microbiology Information Portal.

AKA Robert C. Davidson, MD, MPH Area Peace Corps Medical Officer for Eastern Africa

Robert Davidson, MD, MPH,
is Professor in the Department of Family and Community Medicine at University of California, Davis, where his interests include both rural health and the organization and financing of health care systems. In the past few years, he has served as both the Director of Rural Health and earlier as the Medical Director of Managed Care for the UC Davis Health System. What follows is an on-line journal of his odyssey in the U.S. Peace Corps as the area Medical Officer in Eastern Africa.

Physician Profiles in Africa
Robert C. Davidson MD, MPH

When I came to Eastern Africa, I was not sure what to expect regarding my colleague physicians. I have been pleasantly surprised by most of the physicians I have met in Eastern Africa. Since some of you may be contemplating a career or experience in international work, I have decided to profile several of the physicians I have met.

Dr. S., an American, is an important medical consultant to Peace Corps Kenya. He went to medical school in Chicago and completed both his residency in Internal Medicine and a fellowship in Cardiology in Seattle. Now in his fifties, Dr. S. has spent most of his career practicing in Nairobi. He has developed a well-respected group of Kenyan physicians. Dr. S. seems genuinely happy with his practice and his life. Observing him in his consultations, I noted that he uses less confirmatory testing than is customary in the US, which may be a blessing since most people do not have insurance and pay out-of-pocket for their health care. Dr. S. is well known throughout the country as "the President's personal physician," a position that has embroiled him in some messy politics in the country. My impression is that he would enjoy less prestige and demand for his services were he to return to a practice in the US.

Dr. K. is a Kenyan who went to medical school at Nairobi University. He did six years of surgical training at the Medical College of Wisconsin and holds both General and Cardiothoracic Board Certifications in the US. He met his wife during his surgery training when she worked as an ICU nurse at the University hospital. She now manages his office as well as raising their children. He could return to the US to practice but prefers to stay in Kenya. The volunteers who see him are initially taken aback by this obviously Kenyan male who speaks English with a mid-western American accent. He is trying to develop a cardiac surgery program in Nairobi, but is frustrated by the lack of skilled nurses and technicians. Most people here think of South Africa as the place to go for cardiac surgery. He reminds me of some of the well-trained surgeons I met in small communities in rural northern California. They wanted to use the advanced skills they had received in their training and often resented the implication that you get better care for major surgery in the large urban hospitals.

Drs. D. and M. represent the best of the United States contribution to international health through the Centers for Disease Control. I have been surprised by the large CDC presence in Eastern Africa. These two physicians typify the epidemiologist- researcher in international health. Their predominate focus now is on HIV / AIDS. Dr. M is a pediatrician-epidemiologist whose area of interest is maternal-child transmission of HIV. His wife is a social worker, well known for her leadership in several programs in Eastern Africa targeting HIV prevention. They have two children who have been raised around the world and are now in high school in Nairobi. Both have spent their entire careers, except for some obligatory time in Bethesda, in overseas countries, seem very happy with their career choice, and feel a sense of accomplishment from their professional lives.

Dr. H. at 64 heads a major project on reproductive health in Kenya and devotes much effort to marketing his dream to various funding agencies. He envisions an Africa-wide initiative to develop leadership in HIV / AIDS programs based on the US Peace Corps model where African volunteers would be trained, supported in their work for two years in another African country, and then returned to their own country. His enthusiasm when describing his proposal is infectious. I understand his rationale for selecting the Peace Corps model, since I am witness to the tremendous impact the US Peace Corps has had on the development of leadership. Many current employees in the State Dept. and US Agency for International Development are former Peace Corps volunteers, including three of the five US ambassadors in the countries I cover. Dr. H's wife heads a major US program in Pakistan, so the couple maintains a long-distance marriage. He has training in pediatrics, has taught international health in a US medical school, and has worked all over the world in both government positions and with many of the non-governmental agencies (NGOs) involved in health projects. I again sense a happy person who believes he has made a difference through his work, and is still excited about international health projects.

Drs. M, G, and S. are colleagues of mine working for the Peace Corps in Africa. Drs. M. and G. came to Peace Corps from the Indian Health Service. The commitment they have for under-served populations is met by both their previous and current jobs. Dr. S.'s story is a bit different. Following medical school and Internal Medicine and gastroenterology training in the US, she had a private practice for a while and then moved into increasing responsibilities in a managed care company. Becoming disillusioned with this, she came to Africa. She has some wonderful stories about her experience as a black American woman in a position of responsibility in Africa. She is married to an African man whom she met in the US, and they are raising their children in both cultures.

Drs. G. and H. are American physicians working in Kenya as part of religious missions. Dr. G. is an opthalmologist who divides his time between a practice in Oregon and directing an eye institute near Nairobi. He is fascinated by the pathology he treats in Kenya. He plans to return full time to the US sometime in the future. Dr. H. is here on a two-year mission commitment. He is an orthopedic surgeon who acts as Chief of Surgery in a mission hospital that serves a rural, poor population. Both of these physicians receive much personal satisfaction from using their skills in service to humanity.

The conclusion I come to is that all the physicians I have described are happy with their lives and find gratification in what they are doing. In the US, I became tired of belly aching by physicians. I too often heard comments like, "I am just putting in my time until I can get out of practice." Many seemed to look for a villain for their unhappiness and managed care seemed an easy target. They seemed to dwell on their loss of income when they were still in the top five percent of wage earners in the US. Most disturbing to me personally were comments that they did not want their sons or daughters to go into medicine.

Now my advice. If you find yourself sharing that level of frustration, do something about it. There are opportunities throughout the world where your skills are needed. Working overseas may not be the answer for everyone, but it works for the physicians I have profiled.

Daktari Bob

http://peacecorpsonline.org/messages/messages/467/1011501.html

One of Volunteers in Health Care’s (VIH) technical assistance clients recently contacted us to find out if we had any sample "contracts" the organization could look at as a basis for approaching local hospitals for ancillary services for their referral network patients. VIH staff surveyed several similar programs about the process they use in securing ancillary services and their comments and recommendations are below. All of the programs surveyed stressed the importance of relationship building, periodically re-establishing the relationship and flexibility in service delivery versus formal, written contracts. Feel free to contact VIH at 877-844-8442should you have any questions.

HOW DID YOU FIRST APPROACH THE HOSPITALS?

We developed relationships with members of the hospital Board of Directors, and the VP for Marketing and Public Relations as well as the billing office staff.

When you are approaching hospitals for the first time, it may be wise to involve one of their employees, staff physicians etc.

To get started in building relationships with each of the hospitals we work with, I simply called the administrative offices and scheduled an appointment. One hospital took several months to develop a good relationship with as I had to meet with several tiers of management, but now everyone at the hospital knows who we are and we work very well together. Other hospitals merely took a one-time phone call to the CEO followed with a personal presentation to join our efforts!

I've been most surprised to find out that some of our for-profit hospitals have been willing to work with us - for those hospitals I started out talking with the marketing and PR staff.

In my experience, hospitals have already devised plans for dealing with indigent patients and requests for donations - discovering what each individual hospital's preferences and policies would be a great starting point.

HOW DO YOU MAINTAIN THESE RELATIONSHIPS?

Anytime there is a change in leadership or a facility is sold we always go to the new CEO and introduce ourselves and confirm that the relationship still exists. The same goes for the physician groups (i.e. radiologists) that provide donated services

HOW DO THESE ARRANGEMENTS WORK?

We use a voucher form (very simple) that goes with the requisition or to the business office that identifies that particular service as being covered by our agreement and the hospital writes it off.

With some of our hospitals we have a letter that summarizes a verbal conversation.

You need to have a smooth system in place though, so that patients are not turned away when they show up.

We have a special fund set up for urgent surgeries where the hospital is paid at a discount rate and the physicians volunteer their services. Authorizations are sent out ahead of time so that there is communication with someone at the top and we have a written agreement in the event the business office isn't notified of the arrangements.

Some hospitals prefer to have me or my staff call the CEO of the hospital and ask on a case by case basis. Other hospitals have given me carte blanche on labs, x-rays and hospitalizations - we just send the patient with information that identifies them as one of our patients and they are not billed.

Another scenario is that at one hospital I send the patients to the patient billing department to talk with a specialist who will review the family finances with the family and then offer a sliding scale fee (which goes to $0).

I have a verbal arrangement for 8-10 surgeries a year - to access those I make a call to the Utilization Management Department and talk with them on a case by case basis.

DO YOU HAVE ANY OTHER ADVICE?

Relationships are key, and I get the impression that facilities prefer to stay away from written contracts, utilizing their own policies/procedures for indigent care to shape the verbal agreements instead.

What hospitals want to know is that their resources are considered precious and will be used wisely and the use monitored. When it comes down to cost, the marginal cost of a x-ray is very little and they get a much larger charity write-off.

Referral Network
3/02

Volunteer clinician referral networks are medical or dental service systems in which eligible patients receive care in private practice settings at no or low out-of-pocket cost. Provider recruitment, client eligibility determination, ancillary service arrangements, scope-of-service, etc. are coordinated by an organization which is either a clinic for the uninsured OR a free-standing program to refer uninsured patients to providers. Networks focus on specialists, primary care physicians, general dentists or a combination of these practitioners.

A SUCCESSFUL REFERRAL NETWORK REQUIRES:

a thorough knowledge of practice settings within the target area
the ability to respect individual practice settings
a reliable communication system for making referrals
the ability to balance patient demand with provider availability and geographic proximity
the ability to leverage sufficient ancillary providers (lab, x-ray, etc.)
the ability to be able to offer a pharmaceutical component accessible to all patients
the ability to create a user-friendly system for service related feed-back from providers
a willingness to seek input from providers and partner organizations
a trusted method of patient eligibility determination
upbeat, flexible, personable staff
sources willing to fund mostly administrative functions

STEPS TO CONSIDER IN CREATING A NETWORK:

Look for partners and program champions:

Define the need and get the data

Define

Determine the source of patients

Determine the patient application process

Determine how volunteers will be recruited

Determine how services are verified

Determine how the network will be marketed

Determine the referral process

A well conceived referral network can be satisfying to both providers and patients. It offers patients the opportunity to receive care in the same setting as insured and paying patients. It offers altruistic providers the opportunity to provide care within their own practices.

For customized assistance with your questions about volunteer clinician networks, please call our toll free number 1-877-844-8442or submit a query at http://www.volunteersinhealthcare.org/requests.htm

health departments, community service organizations, medical and dental societies, hospitals, schools, pharmacy organizations, and private practitioners : Know the number of uninsured - age, location and what services are in short supply. Know the number of physicians or dentists within the proposed service area including their specialties and practice locations. : your target population, eligibility criteria, scope-of-service, volunteer responsibilities, and patient responsibilities : (health departments, clinics, physicians, dentists, pharmacists, hospitals, community service organizations, self-referral) : Will it be program staff, community agency, hospital, health department? : Will it be staff, medical or dental society, independent peer-to-peer? Will you ask for signed agreements? : (It's important to know if patients have been served and the value of services rendered). Will providers report by phone, on paper, by fax or electronically? : Will it be by participating providers, referring organizations, word-of-mouth, advertisements? : Will you piggyback onto an existing telephone referral system or develop your own? Will you track patients and providers by computer or on paper?

VIH ON-LINE RESOURCES Field Reports - Referral Networks The Vermont Coalition of Clinics for the Uninsured, Middlebury, VT
The Free Clinic of the New Rove Valley, Christianburg, VA
http://www.volunteersinhealthcare.org/Reports/Referralnet.htm

Institutes

Columbia University The academic and research institution where the Department of Microbiology is based.

Columbia University Medical Center The medical campus of Columbia University where the Department of Microbiology is based.

Centers for Disease Control and Prevention (CDC) The center in Atlanta responsible for monitoring and preventing diseases ranging from cancer to avian influenza virus.

World Health Organization (WHO) The WHO is the branch of the United Nations responsible for monitoring and improving public health around the world.

Johns Hopkins University Department of Infectious Disease A university department with a very informative website.

Rockefeller University Right across town from Columbia University's Medical Center campus , Rockefeller is one of the other major research centers in the city.

National Institutes of Health (NIH) Much of the research you have been reading about here at Columbia is funded by the NIH. Their site offers a wealth of information on related resources.

The National Center for Biotechnology Information (NCBI) The NCBI is the branch of the NIH responsible for creating and maintaining biomedical databases and online tools for biological research, including PubMed , NCBI BLAST and GenBank .

Medical doctors or social health workers who are interested in our similar projects, free to download and get the initial resources.