Lung Infections: Common Types and How to Treat Them

Zelenskyy Replaces Commander Of Medical Forces Of Ukraine

Volodymyr Zelenskyy, President of Ukraine, has dismissed Tetiana Ostashchenko from the office of the Commander of the Medical Forces of the Armed Forces of Ukraine and appointed Anatoliy Kazmirchuk, head of a military hospital in Kyiv, as the new commander.

Source: evening address of the President

Quote: "Today there is an important staff decision. Following the request of the Minister of Defence, I have changed the Commander of the Medical Forces of the Armed Forces of Ukraine.

I have appointed General Major of Medical Service Anatoliy Kazmirchuk, head of the (...) Main Military Clinical Hospital in the city of Kyiv, as the Commander – instead of Tetiana Ostashchenko, General Major of Medical Service."

Details: Zelenskyy explained that in the society, specifically in the community of combat medics, there have been many statements that a "fundamentally new level of medical supply for our soldiers is needed".

"From high-quality tourniquets to full digitalisation and transparency in the supplies, from high-quality training to sincere communication with combat medics in those units where the medicine functions properly and efficiently. The experience of efficiency of specific units must be spread on all the defence forces," Zelenskyy remarked.

Background:

On 13 November, Ukrainska Pravda reported that Defence Minister Rustem Umierov was preparing to dismiss Tetiana Ostashchenko, Commander of Medical Forces of the Armed Forces of Ukraine, Oleksandr Tarnavskyi, Commander of the Tavriia Operational Strategic Group of Forces, and Serhii Naiev, Commander of Joint Forces of the Armed Forces of Ukraine.

Paramedics and volunteers involved in medical support for Ukraine's Defence Forces have reportedly been insisting on Ostashchenko's dismissal.

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Some Mass. General Brigham Locations Forced To Turn Away New Primary Care Patients

Leah Charofson remembers the good old days of medicine — back when a doctor's appointment was a cut-and-dried affair.

"If you had a problem, you'd call up and make an appointment in a day or two... Sometimes the same day," the Framingham resident said.

Then came COVID-19.

"All of a sudden, no matter how sick you are, it's almost impossible to get an appointment with your primary care physician," Charofson said. "I just had to wait four months to get an annual Medicare examination and I could not, before that, get an appointment to see my doctor when I was sick."

Many more will not be able to get primary care appointments in the short term after the state's largest healthcare system announced it is not accepting new patients at its Boston locations, not the entire system.

Massachusetts General Brigham tells Boston 25 News it continues to see what it calls "historic and unrelenting" capacity issues — with some primary care physicians so backed up that six-month appointment times are not unusual. The hospital said it would not be responsible to add more patients to primary care waiting lists — as they could be waiting up to a year to see a doctor.

"It is very difficult, even for physicians today, to find a primary care doctor," said Massachusetts Medical Society President, Barbara Spivak, MD, a primary care doctor in Watertown.

Spivak, too, says the pandemic had an effect on this.

"We saw with the pandemic many more physicians retire than we would have normally expected," she said. "And the pipeline is less these days to hire primary care doctors."

Primary care has become a hard sell to new medical graduates because, Spivak said, it offers more work at less money — given all the administrative tasks now required of PCPs.

"The EHR, the electronic health record, is complicated and takes longer for people to work through the number of messages that they get in their inbox," Spivak said. "It's very hard for someone coming out of residency training and interested in appropriately having a work-life balance who has hundreds of thousands of dollars in loans to decide to do primary care."

Spivak said those who do will see that it offers rewards beyond money. She cherishes the relationships she has with patients — and the fact she's taken care, in some cases, of entire familial generations.

"I love being a primary care doctor," she said.

At present, the U.S. Has about half a million practicing primary care doctors. By some estimates, close to 50,000 additional PCPs will be needed in the next ten years. But there is a foreboding sign for primary care. A recent survey of medical students by Elsevier Health found that 1/4 of them are thinking about quitting altogether — and 58% planning to pursue medical careers that do not involve direct patient care.

Spivak said the U.S. Might think about following the model in other countries in which medical school loans are paid for in return for a term of primary care service.

Mass General Brigham said it is trying to alleviate the immediate problem by hiring more staff and making use of virtual options and alternative provider appointments — such as nurse practitioners and physician's assistants.

But in the short term, Spivak worries that MGB not accepting new patients could have serious health ramifications.

"The fewer primary care doctors that are geographically close to where patients live will affect patients to get the care they need," she said. "And unfortunately, it's the patients with disabilities, it's the patients of color who lack transportation who will be most affected and will end up in the emergency room more often than not for care."

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Ukraine's Zelensky Calls For Rapid Operations Changes For Soldiers, Sacks Medical Commander

Ukraine's President Volodymyr Zelensky on Sunday demanded rapid changes in the operations of Ukraine's military and announced the dismissal of the commander of the military's medical forces.

Zelensky's move was announced as he met Defence Minister Rustem Umerov, and coincided with debate over the conduct of the 20-month-long war against Russia, with questions over how quickly a counteroffensive in the east and south is proceeding.

"In today's meeting with Defence Minister Umerov, priorities were set," Zelensky said in his nightly video address. "There is little time left to wait for results. Quick action is needed for forthcoming changes."

Zelensky said he had replaced Major-General Tetiana Ostashchenko as commander of the Armed Forces Medical Forces.

Russia attacks Kyiv with drones for second night in a row, Ukraine says

"The task is clear, as has been repeatedly stressed in society, particularly among combat medics, we need a fundamentally new level of medical support for our soldiers," he said.

This, he said, included a range of issues – better tourniquets, digitalisation and better communication.

Umerov acknowledged the change on the Telegram messaging app and set as top priorities digitalisation, "tactical medicine" and rotation of servicemen.

Ukraine's military reports on what it describes as advances in recapturing occupied areas in the east and south and last week acknowledged that troops had taken control of areas on the eastern bank of the Dnipro River in southern Kherson region. Russian general critical of army found dead, with his wife

Ukrainian commander in chief General Valery Zaluzhny, in an essay published this month, said the war was entering a new stage of attrition and Ukraine needed more sophisticated technology to counter the Russian military.

While repeatedly saying advances will take time, Zelensky has denied the war is headed into a stalemate and has called on Kyiv's Western partners, mainly the United States, to maintain levels of military support.

Ostashchenko was replaced by Major-General Anatoly Kazmirchuk, head of a military clinic in Kyiv.

Her dismissal came a week after a Ukrainian news outlet suggested her removal, as well as that of others, was imminent following consultations with paramedics and other officials responsible for providing support to the military.

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