Get out of that tanning bed!

When summer comes along, many people just can’t resist lying out in the sun to develop a deep, golden tan. Now, the summer tan is no longer limited to the summertime. The rise of the tanning bed, coupled with the idealization of tanned bodies from shows like the Jersey Shore, has led people—mostly women—to tan year round. Tanning, whether out in the sun or in an indoor tanning bed, can have harmful consequences. Here are the top seven reasons for you to quit tanning once and for all.

1.      Tanning—especially in tanning beds—can actually be habit forming and at worst, addictive. Research has shown that tanning is often habit forming, and some people show behaviors similar to drug and alcohol addicts. In a study reported by ABC News back in April, researchers found that between 30 and 40 percent of individuals who used tanning beds demonstrated the psychiatric diagnostic indicators for addiction.  Some “tanorexics” just can’t stop tanning no matter what they try, while others miss social opportunities just to tan.

1. Melanoma, the most dangerous type of skin cancer, is highly linked to exposure to UV rays. Both tanning beds and the sun produce UVA and UVB rays, and overexposure to UV rays can cause cancer. In particular, melanoma is one of the most common cancers affecting young people, according to the American Academy of Dermatology.

3.      Ultraviolet rays also cause premature aging of the skin. Yes, that means wrinkles.  UV rays break down the collagen in your skin. Collagen keeps your face smooth and wrinkle-free. Do you really want to risk turning your skin into leather just to keep up a Snooki-esque tan?

4.      Proponents of tanning have argued that exposure to sunlight and tanning bed light generates Vitamin D, which may be able to reduce the risk of certain cancers.  However, a recent study showed that high levels of vitamin D weren’t necessarily linked to reduced risk in cancer.

5.      Overexposure to the sun can also damage the DNA in your skin, leading to increased risk of skin cancer.  Tanning bulbs also prevent your body from repairing the damaged DNA, another factor that may increase cancer risks.

6.      Anyways, soaking up the sun is not the only way to increase Vitamin D intake.  Alternative sources include fish, cheese, and fortified foods like milk, as well as vitamin D supplements. Limited exposure to the sun is a good thing, but baking in tanning beds and burning in sunlight is not a good way to obtain Vitamin D.

7.      Not only does tanning hurt your health, but it can also hurt your wallet.  If you choose to tan in a tanning salon, by default you must pay for services. Add in expensive tanning lotions meant to enhance your tan. By the time you factor in the 10% tanning tax that starts July 1^st 2010, you’ve made a sizeable dent in your wallet.

The Situation with tanning does not look promising. “Fake-n-bake” tanning and sunbathing alike can be very harmful to your wallet, and most importantly, your health. If you’re not willing to cut down on your tanning habits, consider at least reducing your time under the heat lamps. If you prefer to brown outside, wear sunscreen to protect your skin. Follow Lindsay Lohan’s lead—this is probably the only time you’ll ever be told to listen to Lohan—and use sunless tanning products. Self-tanners and spray tans can give you that golden glow without harming your health.

In another one of my blogs, I outlined the reasons why you should quit tanning once and for all. I mainly focused on the health risks associated with tanning, including skin cancer and premature aging. One important new tax to know about is the tan tax, a tax on indoor tanning services that began on July 1 2010.

A tax on indoor tanning will help pay for healthcare reform

To fund the 2010 Affordable Care act, the federal government will now levy a 10 percent tax on indoor tanning, which started on July 1^st.  Spray tans and other sunless tanning products will not be taxed under the new legislation.  The tanning tax is expected to generate 2.7 billion dollars towards health care reform.  Dermatologists and other advocates hope that the tanning tax will dissuade people from baking their skin in indoor tanning beds.

Why tax tanning?

To begin with, countless dermatological studies have shown that tanning has a negative impact on the body. Exposure to UV rays damages the skin’s DNA, leaving people more than three times more likely to develop skin cancers like melanoma.  Although many skin cancers can be treatable, melanoma is the most deadly skin cancer—as well as the most common type of skin cancer found in young people. Indoor tanning beds can also contribute to premature aging of the skin, causing younger people to develop wrinkly or leathery looking skin. A young survivor of skin cancer who tanned in his youth even wants to ban tanning for minors because of health risks.

Initially, cosmetic surgery procedures were the victims of the tax—known as the “Botax” for the popular Botox procedure, until dermatologists successfully lobbied Congress to hit indoor tanning beds instead.

Still, tanning businesses fear that the new tax will put a damper on their fun in the sun. Before the 10% tax went into effect, many small businesses expressed their concern over the tax’s impact on business. Although tanning packages purchased at tanning salons will be exposed to the tax, health clubs that also feature tanning beds are exempt from the new legislation. One famous tanning salon patron, the Jersey Shore’s majestically orange Snooki, claimed that she would stop using tanning beds for good because of the tax, and use spray tan services instead. Other tanners said that the tax wouldn’t affect their tanning habits.

Other businesses claim that they have already noticed a drop off in sales. According to an article in the Washington Post, one tanning salon in Arlington, Virginia noticed a 20 to 30 percent drop off in business since the recession, and anticipated worse since the tanning tax went into effect July.  Then again, it is July, the height of beach season, when indoor fake n’ bake tanning really isn’t necessary, which could factor into that sales decline.

While time will tell how hard the tax will hit the tanning industry, I feel tanning salons should not be the only establishments subject to the tax.  By exempting fitness centers from taxation, the government is really squeezing the tanning industry. Still, the tax may serve as an additional incentive—including health—for people to stop tanning once and for all.

When I think of the emergency room, I think of the crowded waiting area, chock full of people who have been waiting a long time to see a doctor.  The Center for Disease Control confirms that image. Studies have shown that the average wait to receive care is around one hour. A 2006 report by Press Ganey Associates found that the average stay in an American emergency room clocks in at around 3.7 hours. Patients filled out satisfaction surveys, and Arizona clocked in with the highest average wait time at 297.3 minutes—close to five hours!  Iowa led the way with a wait time of 138.3 minutes, a little over two hours worth of time spent in the hard plastic waiting room chairs.

Healthcare providers working to reduce Emergency Room waits

Some feel that the health care reforms will put the squeeze on emergency rooms. After Massachusetts implemented universal health care, emergency rooms reported a boost in people. Even though the health insurance would theoretically give them more access to preventative care, the primary care physician shortage may actually make it more difficult to seek preventative services, consequently making ER care ever more critical.

It’s no surprise that hospitals throughout the United States are working to increase patient satisfaction by decreasing hospital wait time. According to the Baltimore Sun, in 2006, 120 million patients went to an emergency room, a sizeable increase from ten years earlier. More and more people are using the ER to receive care. By using innovative, inexpensive new technology, emergency rooms are cutting down unnecessary services.  Hospitals in some states use texts and emails to communicate with patients, marketing their services.

A recent article in the Baltimore Sun details the efforts of area emergency rooms.  At St. Joseph Medical Center in Towson, the hospital advertises its emergency room wait time online. This initiative has raised patient satisfaction, increasing the likelihood that patients will choose St. Joseph’s. St. Joseph’s cuts out unnecessary, bulky procedures to streamline care.  At the University of Maryland Medical Center, staff moves patients in need of urgent care to beds instead of housing them in the ER.  Many other Maryland hospitals have added staff to deal with emergencies.

In Arizona, the state that the third longest wait time in 2009, hospitals are also marketing their wares. Gilbert Hospital in Phoenix ran an ad touting its ER services, highlighting the fact that most patients saw a doctor in 31 minutes or less. Other area hospitals used billboards and other media to promote speedy service. By marketing their superior service, hospitals can increase their business, unless their actions don’t back up their words.

All in all, the fact that emergency rooms are working to become more efficient is promising.  Ultimately, however, I feel that increased ER waiting times are a symptom of the primary care physician shortage. On top of all the slimming and trimming of ER procedures, emphasizing preventative care is crucial to reducing ER wait times.  Building a strong supply of primary care physicians can increase access to preventative care as more and more people are insured.

Medical residencies are notorious for their excruciatingly long shifts.  Doctors fresh out of medical schools use their residencies to gain on the job experience in their desired specialty. Although residencies allow these young doctors to develop expertise, the long work hours can take a toll on their minds and bodies. Residents practice under the supervision of licensed doctors and continue their training as physicians.

In the past, a medical resident could expect to work more than 100 hours a week, with minimal rest in between. Things changed in 2003, when the Accreditation Council for Graduate Medical Education (also known as ACGME), cut down the hours to 80 weekly, although this ruling was not strictly enforced. Still, many shifts can last over a day, up to 30 hours with limited time to sleep.

A new proposal set by ACGME will cut down on mistakes and ensure that patients are safe.   Maximum shift lengths would be reduced hopefully reduce harmful medical from 24 hours to 16 hours for first year residents and to 24 hours for all other physicians. Additionally, attending physicians would be required to make patients aware that they are under the charge of a resident.  The new guidelines will require attending physicians to supervise residents more closely in an effort to improve patient safety. Still, these regulations would only affect first year residents. All other physicians would limited to 24-hour shifts.

Studies have shown that sleep-deprived residents are more prone to making medical mistakes.  A Mayo Clinic study revealed that fatigued, distressed medical residents were more likely to make preventable medical mistakes. Yet another study found that residents were three times as likely to say that they’d made an error during months when they worked one 24 hour long shift.  In 2004, a report discovered that medical residents who worked all night shifts were ultimately accountable for over half of medical errors.

Overworked Medical Residents May Be Catching a Break

Ultimately, some medical mistakes prove fatal. One famous medical malpractice case is that of Libby Zion, an 18 year old college student who died when her overworked, fatigued medical residents prescribed her medication that reacted dangerously with her antidepressants.

Grueling shifts can compromise the health of the doctors themselves. Dr. Shannon Gulliver recently wrote a piece for the New York Times in which she detailed her own weakened immune system, a result of the long hours and high stress of her position. She developed esophagitis, while her colleagues themselves developed shingles, fungal infections, C. difficile diarrhea, and more.

While education is undoubtedly a priority during residency, maintaining the health of both doctors and patients is equally important.  As long as these regulations can cut down life threatening mistakes, I feel that cutting back these hours can be a good thing. Medical residents will still be able to gain the experience they need to practice, and after they complete their first year of residency, young doctors will only be restricted to 24 hour shifts. Ultimately, these guidelines will improve quality of care for patients and better health for doctors and patients alike.

Decided in 1973, the Roe v. Wade case forbade states from establishing laws that banned abortion.  It gave women the right to have an abortion in any US state up until their third trimester.  The ruling of this case has led to an ongoing abortion debate throughout the nation.  Anthony Kennedy, a Justice of the Supreme Court, is known for having a “swing vote” in many Supreme Court decisions.  However, people fear that a Republican President may choose to replace Kennedy.  Kennedy’s vote has always been important in the abortion cases.  If he were replaced, there is fear that Roe v. Wade may be overturned. This would allow states to enact laws against abortion at any point in the pregnancy if they so desire.

Supreme Court Nomination May Overturn on Roe v. Wade

If Roe v. Wade was overturned, the likelihood that we would see any variation in the amount of abortions in the US would be slim.  More problems may arise than would be solved in the event that Roe v. Wade was overturned.  If it was, there are about 20-25 states that would immediately enact laws against abortion.  This would make it more difficult for females to find a doctor offering abortion services.  However, it would not stop them from having abortions.  Females will either go to the states offering abortion services or find other means that are less safe and healthy than finding an available doctor.  Overturning Roe v. Wade would theoretically eliminate 170 doctors providing abortion services, which is less than 10% of all services available in the US.

Overturning Roe v. Wade will pose serious health and financial burdens.  As mentioned before, females will take more risky measures to have an abortion.  Those who decide to keep their baby are immediately faced with the high hospital costs and medical costs associated with having a baby.  Consequently, more women may consider taking contraceptives to prevent pregnancy in the first place.  However, this too can be expensive because many health insurance plans do not cover contraceptives.  If they do offer coverage, there is often a high out-of-pocket charge for the contraceptive prescription.  Also, there are very few health insurance companies that offer abortion coverage (most are private insurance companies).  It is likely that these health insurance companies will establish much higher costs in the states that would choose to allow abortion after overturning Roe v. Wade.

The replacement of Anthony Kennedy is not an immediate concern, but it is a possibility in the near future.  Kennedy’s retirement should not be in question because he is not likely to retire soon.  The only imminent threat to his position would be a Republican president, who may choose to replace Kennedy with a candidate who opposes abortion.  This decision, however, would have many repercussions and may not solve any abortion issues.