Custom wheels get special-needs tots moving
Chevel Johnson Rodrigue and Stephen Smith
Associated Press
NEW ORLEANS — At 19 months old, Elijah Jack, born with no femur bone in one leg and a short femur in the other, is unable to walk on his own like most toddlers his age. Another 19-month-old, Freya Baudoin, born prematurely at 28 weeks and delayed in her mobility, has finally taken her first step.
Special needs children like these often take longer than most to become independently mobile, which can be a hardship for parents and others who care for them. Elijah is often carried because of his limb difference and clubfeet, meaning that instead of being straight, his feet are twisted inward and his toes point downward.
As a result, getting around on his own is a challenge.
That was until this past spring. Elijah was one of the first recipients of a specially designed rolling chair built by a team of biomedical engineering students at Tulane University. Today, Elijah has mastered getting around on wheels — turning, stopping and steering all on his own.
“He loves his chair,” said Crystal Jack, Elijah’s mom. “So, I get a lot of things done because I know in his chair, he’s safe. He know how to go around the house with it and everything, so I get a lot of things done now.”
Before the chair, Jack said her son was able to scoot on the floor to get where he needed to go but the chair offers a whole new level of independence.
“Like I said we come a long way, but I’m blessed to have him,” Jack said, smiling warmly as he moved back and forth around the living room of her mother’s home in Ventress, Louisiana.
The Tulane students partnered with the nonprofit MakeGood in 2022 to design and produce the chairs to help toddlers (roughly ages 1-4) build independence and strength, and for some, prepare for a real wheelchair. While it remains difficult to access precise numbers for total wheelchair use among children, there were about 2.8 million wheelchair users in the U.S. in 2002, of whom 121,000 were under 15 years of age, according to the U.S. Census Bureau.
MakeGood is the New Orleans area coordinator for TOM Global, an Israeli nonprofit that combines modern design and digital manufacturing to fulfill neglected needs of people with disabilities and limitations. TOM stands for Tikkun Olam, which is Hebrew for “repairing the world.”
The students partnered with the nonprofits as part of a service-learning project — a graduation requirement at Tulane. But many say they had no idea when the project started the depth of impact their chairs would make in the lives of children in the community.
Dylan Lucia, a graduate student at Tulane from the San Diego, California area, said he chose the field of biomedical engineering to help people, and this project has manifested that.
The chairs are particularly helpful for families whose children will eventually need wheelchairs. Noam Platt, director of MakeGood, said insurance companies typically don’t cover the cost of a wheelchair for a child unless there is sufficient evidence that the child can use it effectively.
“These devices are used to create that evidence that their quality of life will be improved so they can get maybe a more durable assistive technology,” Platt said.
Freya’s chair was one of five made throughout several weekends early this fall at Tulane’s Scot Ackerman MakerSpace, an enormous workshop with laser cutters, 3D printers and drilling and sewing equipment.
Students applied padding and safety straps to the chairs, and some required modifications to accommodate the needs of the children receiving them. For instance, Freya’s chair needed a wider strap to help secure her torso, and another patient needed a space behind the chair big enough to hold his breathing vent. Freya’s chair also had a bar added to the back, so that she could push it like a stroller. She took her first steps in early December after working with her physical therapist and her chair.
There’s no word on how long Freya will have to use the chair but her mother said it has been more than a blessing.
“At first, we thought the muscle tone in her ankles wasn’t strong enough for her to walk at all, but the neurologists recently told us everything is looking good and she should be walking on her own or with limited assistance soon,” said her mom, Heather Hampton, of Metairie, Louisiana.
Elijah has had his chair since the end of March. It was made in the first batch of about 10 chairs delivered to pediatric patients for use in occupational and physical therapy sessions.
“His chair shows him that, like, ‘I could be up like other children.’ You know, he don’t let his (being) disabled get in the way,” said Jack, who added Elijah will likely need some type of mobility assistance for the rest of his life.
Platt said there have been two rounds, so far, of chair building and 15 chairs have been given away. But, he said they’re aiming for at least 10 to 15 more by spring 2024. Platt said the chairs cost less than $200 each to make, and even though these chairs were donated to patients at no cost, the price is still much lower than most pediatric wheelchairs on the market and electric-powered wheelchairs can run into the thousands.
“For the students that I work with, I tell them this is just the beginning,” Platt said. “I’m trying to open their eyes to kind of a lifelong passion that they’ll have to solving these problems because once you see the problems, you see the scope of the problems and you can’t really ignore them.”
More med students going after business degrees
Samantha Liss
KFF Health News
Jasen Gundersen never considered a career in business when he entered medical school nearly three decades ago to become a rural primary care doctor.
But, today, he isn’t working in rural America and he doesn’t do primary care. In fact, he no longer practices medicine at all.
As CEO of CardioOne, which provides back-office support to cardiologists, Gundersen is part of a growing trend: physicians and medical school students earning advanced business degrees to work the business side of the booming health care industry.
Just over 60% of medical schools now offer dual MD-MBA programs, more than twice the number two decades ago, a recent study shows. And researchers estimate the number of dual-degree graduates has nearly tripled. Still, it’s difficult to know exactly how many physicians now have business degrees. While the medical school students who simultaneously earned both a medical and business degree represent almost 1% of the roughly 28,000 medical school students who graduate each year, that doesn’t include physicians, like Gundersen, who later go back to school to pursue an executive MBA.
For years, some doctors have sought auxiliary degrees, including master’s degrees in public health and law degrees. But more and more, doctors want to pair their clinical expertise with management skills and financial literacy as the American health system focuses on maximizing profits. Often that’s so they can become business executives, especially as lucrative health tech startups proliferate and hospital systems, pharmacy benefit managers, and insurers have swelled into formidable companies.
However, this pursuit of advanced business degrees begs the question: Whom will these doctors end up serving more, patients or shareholders?
Long gone are the days when nuns ran many local hospitals. Now, many hospitals are part of multibillion-dollar systems, some of which, such as HCA Healthcare Inc. and Tenet Healthcare Corp., outrank some of America’s most recognizable brands on the Fortune 500 list.
Still, it’s one of the few sectors of the economy where the people who know the most about what’s going on in their companies aren’t the ones running them, said J.B. Silvers, a management professor at Case Western Reserve University who has been teaching business fundamentals to medical students and physicians for decades.
In the past, doctors rarely left medicine to join the ranks of management because they tended to earn more as practicing physicians. But that’s changing, Silvers said, especially as new career paths emerge. The MBA can serve as the doorway to those new opportunities — and the potentially lucrative ownership stakes that can come from leading successful medical technology companies.
Physicians earn, on average, $350,000 a year, making them among the highest-paid workers in the U.S. Doctors in primary care tend to make less than that, while the top 1% of physicians can make more than $1.7 million annually.
“There’s a lot of other ways to make more money now,” said Rich Joseph, who, as an MDMBA graduate from Stanford, is an example of the trend. Joseph, an outspoken critic of how U.S. doctors are trained, is chief medical officer for Restore Hyper Wellness, which offers cryotherapy and IV drips at locations across the country.
Doctors are considered the face of the health care system, but a lot of big decisions are made in the boardroom, said Folawiyo Laditi, a recent graduate of Yale’s MDMBA program and a urology resident at the University of Pittsburgh.
Laditi wants to leverage his business degree to tackle systemic issues in health care that sometimes don’t always feel “fixable” as a doctor treating a single patient at a time. He hopes “to make changes that can affect a lot of patients and a lot of people at once.”
Medical schools are selling the power that comes from the dual degree. “Ready to pair your clinical expertise with business best practices to transform your organization? Hone your business acumen to assume a greater scope of leadership,” touts the website of the University of Tennessee’s physician executive MBA program.
Harvard University says on its website that its dual-degree program is intended to “develop outstanding physician leaders, skilled in both medicine and management, to take positions of influence through which they will contribute substantially to the health and well-being of individuals and society.”
Gundersen, the CardioOne CEO, who attended the University of Tennessee program and now lives outside of Denver, found it useful to practice medicine for years after he got his business degree, juggling executive and clinical work. He stopped treating patients nearly four years ago.
It helps to speak the language of physicians, Gundersen said while in Florida during a summer business trip to sell cardiologists on using his company’s platform. He pitches alleviating a pain point for most doctors — the nondoctoring work — so they can focus on patient care. It’s something he felt as a practicing physician.
Gundersen said the nation needs more doctors, especially ones who remain independent from sprawling health care companies. As he promotes that message to prospective cardiac doctors, Gundersen recognizes the irony. “We need more doctors, and here I am the doctor who doesn’t doctor anymore,” he said.
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