PERF BOARD OF DIRECTORS
|Richard Casaburi, Ph.D., M.D., President Alvin Grancell, Vice President Mary Burns, R.N., B.S., Executive V. P. Jean Hughes, Treasurer Thomas L. Petty, M.D.||Jeanne Rife Alvin Hughes Craig Murga Barbara Jean Borak Brian L. Tiep, M.D. Peter D. Pettler|
New Perspective, Donations,
Travel with Oxygen, Pulmonary Fibrosis, Finding a doctor, New Research opportunity, Upcoming events, Future of Pulmonary Rehabilitation, News
A belated Happy St. Patrick’s Day to all our friends and readers! We may be a few days late, but even if you are not a descendent of the Emerald Isle, we would like to send you an
IRISH FRIENDSHIP WISH
May there always be work for your hands to do;
May your purse always hold a coin or two;
May the sun always shine on your windowpane;
May a rainbow be certain to follow each rain;
May the hand of a friend always be near you;
May God fill your heart with gladness to cheer you.
And who would be better than our half Irish friend, Dr. Thomas O’Petty, to start our newsletter this month discussing
COPD affects 16 million people in the United States today. Probably an equal number of persons have undiagnosed disease. While pharmacologic agents used strategically along with pulmonary rehabilitation and oxygen in selected patients has improved both the length and quality of life, COPD is the only disease in the top 10 killers that continues to increase. In 1997 107,000 people died from COPD. Projections for 2002 are that 115,000 will succumb. COPD costs approximately 30.1 billion dollars in both direct and indirect costs. Oxygen alone is responsible for about three billion dollars annually.
Today we recognize that the natural history of COPD covers 30 years or more. Most patients with early stage disease have no symptoms. One in five smokers develop COPD. Why most smokers do not get COPD is the subject of intense research efforts. Probably genetically based protective factors prevent the inflammatory damage to airways and the destruction of alveoli. About 15% of people with COPD are non-smokers. Accordingly, it is certain that the pathogenesis of COPD is multifactorial.
Early identification is key to changing the course and prognosis of COPD. Simple office spirometry can accurately diagnose and monitor COPD. New office spirometers are inexpensive, easy to use and durable. All primary care physicians should have an office spirometer, just like they have a sphygmomanometer, an EKG, or an ophthalmoscope and scales for patients’ weight.
The National Lung Health Education Program (NLHEP), is a new health care initiative launched in 1997. The NLHEP enjoys a broad base of support from many societies, associations, governmental agencies and foundations. Financial support for the NLHEP comes form annual unrestricted grants from the pharmaceutical and medical equipment industries.
"Test Your Lungs, Know Your Numbers" is the battle cry of the NLHEP. It is a "Call to Arms" for all primary care physicians and many specialists, such as cardiologists, to get involved in the diagnosis and treatment of all stages of COPD.
Why should pulmonologists support the NLHEP? The answer is simple. Pulmonologists do not see asymptotic patients with COPD now. There are only about 10,000 pulmonologists in the USA, but 220,000 primary care physicians. It is the primary care physician that sees the smoker each year in the office for something, that may or may not be a smoking related disease. When primary care physicians identify patients in need of further evaluation, bronchoscopy, surgery, pulmonary rehabilitation and a wide array of specialized consultation, these patients will reach the pulmonologist.
Why should HMOs support the NLHEP? Again, a simple answer. COPD is a very expensive disease to treat in late stages, but not expensive in early incipient stages. Thus, even if patients switch between HMOs, the entire industry will save money if programs for the early diagnosis of COPD are implemented.
Why should industry support the NLHEP? Again an obvious answer. There is a huge market for a growing number of products to serve the newly diagnosed patient.
Why should government support the NLHEP? For one, it is the right thing to do. Secondly, as the health of our nation improves, the quality and length of life will be enhanced.
A final challenge, and a major one, is to increase COPD awareness. We need a nation-wide patient advocacy group. We need the public to understand emphysema/COPD. We also need all stakeholders in COPD to recognize that smokers with airflow obstruction are also at a huge risk of lung cancer, heart attack and stroke, as we learned from the Lung Health Study. Thus, a nationwide COPD effort in early detection of COPD and in smoking cessation is truly a massive broad health care initiative for America.
We have a new perspective on COPD. We are entering a new era!
All of us would like to extend our congratulations to Dr. Petty! The University of Colorado has just announced that the fourth Chair in the Pulmonary Division will be called the Thomas L. Petty Chair in Pulmonology. This Chair will be used to support a research scientist and will be funded in perpetuity. The first occupant of this Chair will be Dr. York Miller, Professor of Medicine at the University of Colorado who is doing his research on lung cancer. This is a very great honor and is certainly well-deserved. Again, congratulations, Dr. Petty!