1 00:00:05,505 --> 00:00:06,706 GOOD MORNING, EVERYONE. 2 00:00:06,706 --> 00:00:08,308 THANK YOU FOR JOINING US FOR THE 3 00:00:08,308 --> 00:00:11,545 THIRD MEETING OF NATIONAL 4 00:00:11,545 --> 00:00:12,879 COMMISSION ON LYMPHATIC 5 00:00:12,879 --> 00:00:13,380 DISEASES. 6 00:00:13,380 --> 00:00:14,981 THIS IS A VIRTUAL MEETING AND IT 7 00:00:14,981 --> 00:00:20,587 IS THE FIRST MEETING THAT NCLD 8 00:00:20,587 --> 00:00:22,122 IS MEETING WITH STAKEHOLDERS AND 9 00:00:22,122 --> 00:00:23,990 ALL PARTICIPANTS ARE JOINING US 10 00:00:23,990 --> 00:00:26,426 THROUGH THE ZOOM ENVIRONMENT. 11 00:00:26,426 --> 00:00:28,028 WE ALSO WELCOME EVERYONE 12 00:00:28,028 --> 00:00:29,362 LISTENING THROUGH THE NIH 13 00:00:29,362 --> 00:00:31,298 VIDEOCAST. 14 00:00:31,298 --> 00:00:33,166 I'M SELEN CATANIA, A PROGRAM 15 00:00:33,166 --> 00:00:35,702 OFFICER IN NATIONAL HEART, LUNG, 16 00:00:35,702 --> 00:00:37,704 BLOOD INSTITUTE IN THE DIVISION 17 00:00:37,704 --> 00:00:39,005 OF CARDIOVASCULAR SCIENCES. 18 00:00:39,005 --> 00:00:41,074 I'M THE EXECUTIVE SECRETARY OF 19 00:00:41,074 --> 00:00:43,777 THIS COMMISSION, SERVING AS A 20 00:00:43,777 --> 00:00:47,280 LIAISON BETWEEN NCLD AND NHLBI 21 00:00:47,280 --> 00:00:52,652 LEADERSHIP. 22 00:00:52,652 --> 00:00:55,188 SO I'M REPRESENTING HERE A 23 00:00:55,188 --> 00:00:56,556 LARGE -- CONSIDERABLY LARGE 24 00:00:56,556 --> 00:00:59,092 NHLBI SUPPORT STRUCTURE FOR THE 25 00:00:59,092 --> 00:01:01,061 COMMISSION. 26 00:01:01,061 --> 00:01:02,596 I'M GOING TO MAKE A FEW 27 00:01:02,596 --> 00:01:04,164 ADMINISTRATIVE ANNOUNCEMENTS AND 28 00:01:04,164 --> 00:01:04,764 SOME HOUSEKEEPING REMINDERS 29 00:01:04,764 --> 00:01:06,199 BEFORE WE GET STARTED. 30 00:01:06,199 --> 00:01:08,168 FIRST, I WANT TO WELCOME ALL OUR 31 00:01:08,168 --> 00:01:10,804 PUBLIC VISITORS, AS WELL AS THE 32 00:01:10,804 --> 00:01:12,339 STAFF TO THE OPEN SESSION AND WE 33 00:01:12,339 --> 00:01:13,640 ARE LOOKING FORWARD TO YOUR 34 00:01:13,640 --> 00:01:16,176 FEEDBACK. 35 00:01:16,176 --> 00:01:18,678 THE LISTENERS ON THE VIDEOCAST 36 00:01:18,678 --> 00:01:21,514 ENVIRONMENT CAN USE THE "SEND 37 00:01:21,514 --> 00:01:23,950 FEEDBACK" BUTTON RIGHT UNDER THE 38 00:01:23,950 --> 00:01:25,118 WEBCAST SCREEN, AND ALL YOUR 39 00:01:25,118 --> 00:01:27,520 QUESTIONS WILL BE RECORDED AND 40 00:01:27,520 --> 00:01:29,556 TAKEN INTO CONSIDERATION BY THE 41 00:01:29,556 --> 00:01:30,590 COMMISSION AFTER THE MEETING 42 00:01:30,590 --> 00:01:33,793 ENDS. 43 00:01:33,793 --> 00:01:35,095 TODAY'S MEETING IS BEING 44 00:01:35,095 --> 00:01:36,830 WEBCASTED AND RECORDED. 45 00:01:36,830 --> 00:01:38,565 THE VIDEO WILL BE ARCHIVED AND 46 00:01:38,565 --> 00:01:39,933 WILL BE AVAILABLE FOR THE PUBLIC 47 00:01:39,933 --> 00:01:41,868 AND OUR NIH COLLEAGUES FOR AN 48 00:01:41,868 --> 00:01:43,303 INDEFINITE AMOUNT OF TIME. 49 00:01:43,303 --> 00:01:45,271 A BRIEF OVERVIEW OF TODAY'S 50 00:01:45,271 --> 00:01:48,208 AGENDA IS, WE WILL HAVE TWO 51 00:01:48,208 --> 00:01:49,743 PANEL SESSIONS HOSTING 52 00:01:49,743 --> 00:01:51,144 SEPARATELY A GROUP OF 53 00:01:51,144 --> 00:01:52,479 PROFESSIONAL SOCIETIES IN THE 54 00:01:52,479 --> 00:01:54,014 MORNING AND A GROUP OF PATIENT 55 00:01:54,014 --> 00:01:55,048 AND PROFESSIONAL EDUCATORS IN 56 00:01:55,048 --> 00:01:56,316 THE AFTERNOON. 57 00:01:56,316 --> 00:01:57,617 AS THE COMMISSION CONTINUES 58 00:01:57,617 --> 00:01:58,618 THEIR JOURNEY TO BETTER 59 00:01:58,618 --> 00:02:01,688 UNDERSTAND AND ADDRESS LYMPHATIC 60 00:02:01,688 --> 00:02:05,158 DISEASES, TODAY'S PANELS ARE 61 00:02:05,158 --> 00:02:06,026 ESSENTIAL FOR PART OF THEIR 62 00:02:06,026 --> 00:02:06,593 EFFORTS. 63 00:02:06,593 --> 00:02:08,361 WE THANK ALL OUR PANELISTS TO 64 00:02:08,361 --> 00:02:10,196 SUPPORT THIS EFFORT. 65 00:02:10,196 --> 00:02:13,566 DURING LUNCH BREAK AT 11:50 A.M. 66 00:02:13,566 --> 00:02:15,335 EASTERN TIME, WE WILL REQUEST 67 00:02:15,335 --> 00:02:17,337 PANEL A PARTICIPANTS TO EXIT THE 68 00:02:17,337 --> 00:02:19,305 ZOOM MEETING AND JOIN THE 69 00:02:19,305 --> 00:02:20,573 VIDEOCAST LINK THAT WAS SENT IN 70 00:02:20,573 --> 00:02:23,410 THEIR CALENDAR INVITE TO FOLLOW 71 00:02:23,410 --> 00:02:25,178 THE AFTERNOON SESSIONS. 72 00:02:25,178 --> 00:02:26,946 PANEL B WILL BE JOINING AT THIS 73 00:02:26,946 --> 00:02:30,216 TIME FOR THE AFTERNOON SESSION 74 00:02:30,216 --> 00:02:32,886 AT 12:30 P.M. 75 00:02:32,886 --> 00:02:35,155 THE NCLD CO-CHAIR, DR. STANLEY 76 00:02:35,155 --> 00:02:35,989 ROCKSON, WILL BRIEFLY WELCOME 77 00:02:35,989 --> 00:02:38,091 THE PANELS TO INTRODUCE THE 78 00:02:38,091 --> 00:02:39,392 NCLD'S CHARGE AND PROGRESS OF 79 00:02:39,392 --> 00:02:40,960 THE COMMISSION. 80 00:02:40,960 --> 00:02:43,096 EACH SESSION WILL HAVE TWO 81 00:02:43,096 --> 00:02:45,331 PARTS: THE INTRODUCTION AND THE 82 00:02:45,331 --> 00:02:46,700 OPEN PANEL DISCUSSION. 83 00:02:46,700 --> 00:02:48,501 WE REQUEST EVERYONE TO TURN 84 00:02:48,501 --> 00:02:51,971 THEIR CAMERAS ON WHEN SPEAKING 85 00:02:51,971 --> 00:02:53,606 AND USE HAND-RAISE FUNCTION 86 00:02:53,606 --> 00:02:54,474 DURING DISCUSSION. 87 00:02:54,474 --> 00:02:57,010 I'LL BE CALLING YOU TO ENTER IN 88 00:02:57,010 --> 00:02:58,478 TO THE DISCUSSION. 89 00:02:58,478 --> 00:02:59,879 ALL ZOOM CHAT COMMUNICATION WILL 90 00:02:59,879 --> 00:03:03,083 BE SAVED FOR THE RECORD OF THE 91 00:03:03,083 --> 00:03:04,784 COMMISSION. 92 00:03:04,784 --> 00:03:06,086 BEFORE PASSING THE MIC, I WANT 93 00:03:06,086 --> 00:03:07,954 TO MENTION THAT MS. STEPHANIE 94 00:03:07,954 --> 00:03:09,856 DREYER, THE CO-CHAIR OF THE NCLD 95 00:03:09,856 --> 00:03:11,791 WHO IS IN ATTENDANCE, WILL NOT 96 00:03:11,791 --> 00:03:13,326 BE CO-LEADING THE MEETING 97 00:03:13,326 --> 00:03:15,061 ACTIVELY, DUE TO HER 98 00:03:15,061 --> 00:03:16,029 HEALTH-RELATED PROBLEMS. 99 00:03:16,029 --> 00:03:20,633 WITH THAT, IT IS MY GREAT 100 00:03:20,633 --> 00:03:21,901 PLEASURE TO INTRODUCE 101 00:03:21,901 --> 00:03:23,603 DR. STANLEY ROCKSON, THE 102 00:03:23,603 --> 00:03:25,572 CO-CHAIR OF NCLD, FOR HIS 103 00:03:25,572 --> 00:03:31,711 WELCOME REMARKS. 104 00:03:31,711 --> 00:03:33,646 >> SORRY, I'M UNABLE TO START 105 00:03:33,646 --> 00:03:35,849 THE VIDEO BASED ON THE HOST? 106 00:03:35,849 --> 00:03:37,250 OKAY, THERE WE GO. 107 00:03:37,250 --> 00:03:38,017 GOOD MORNING, LADIES AND 108 00:03:38,017 --> 00:03:38,284 GENTLEMEN. 109 00:03:38,284 --> 00:03:42,455 THANK YOU SO MUCH FOR ATTENDING 110 00:03:42,455 --> 00:03:42,856 TODAY'S SESSION. 111 00:03:42,856 --> 00:03:47,293 THANK YOU, SELEN, FOR YOUR 112 00:03:47,293 --> 00:03:47,761 INTRODUCTION. 113 00:03:47,761 --> 00:03:52,132 I AM REPRESENTING MYSELF AND 114 00:03:52,132 --> 00:03:52,799 MYCO-CHAIR, STEPHANIE DREYER, 115 00:03:52,799 --> 00:03:55,101 WHO ACTIVELY PARTICIPATED IN THE 116 00:03:55,101 --> 00:03:58,238 CREATION OF TODAY'S SESSION AND 117 00:03:58,238 --> 00:04:05,578 INVAL INVALUABLE TO WHAT WE'RE G 118 00:04:05,578 --> 00:04:05,912 TODAY. 119 00:04:05,912 --> 00:04:07,647 I WANT TO SAY AS AN INTRODUCTORY 120 00:04:07,647 --> 00:04:09,249 COMMENT THAT THERE IS A WEBPAGE 121 00:04:09,249 --> 00:04:10,016 DEVOTED TO THIS NATIONAL 122 00:04:10,016 --> 00:04:11,718 COMMISSION, SO IF YOU WOULD LIKE 123 00:04:11,718 --> 00:04:13,453 TO REVIEW WHAT THE COMMISSION 124 00:04:13,453 --> 00:04:15,021 REPRESENTS AND WHO ITS MEMBERS 125 00:04:15,021 --> 00:04:18,825 ARE, YOU CAN CONSULT THE URL 126 00:04:18,825 --> 00:04:19,959 THAT IS POSTED AT THE BOTTOM OF 127 00:04:19,959 --> 00:04:22,529 THIS SLIDE. 128 00:04:22,529 --> 00:04:23,997 IF WE CAN MOVE ON TO THE NEXT 129 00:04:23,997 --> 00:04:28,935 SLIDE, PLEASE. 130 00:04:28,935 --> 00:04:30,837 JUST TO BRIEFLY REMIND EVERYBODY 131 00:04:30,837 --> 00:04:31,504 ABOUT THE CHARGE OF THE NATIONAL 132 00:04:31,504 --> 00:04:31,805 COMMISSION. 133 00:04:31,805 --> 00:04:33,206 OF COURSE OUR COMMISSION MEMBERS 134 00:04:33,206 --> 00:04:34,808 ALREADY KNOW THIS, BUT THIS IS 135 00:04:34,808 --> 00:04:37,010 FOR THE PURPOSE OF OUR INVITED 136 00:04:37,010 --> 00:04:38,978 PANELISTS AS WELL AS THE PUBLIC 137 00:04:38,978 --> 00:04:42,482 ATTENDEES THROUGH THE VIDEOCAST. 138 00:04:42,482 --> 00:04:45,752 WE HAVE BEEN ASKED TO 139 00:04:45,752 --> 00:04:47,821 PARTICIPATE IN THIS NATIONAL 140 00:04:47,821 --> 00:04:48,454 COMMISSION ON LYMPHATIC DISEASE 141 00:04:48,454 --> 00:04:50,456 THAT IS INTENDED TO BE 142 00:04:50,456 --> 00:04:53,626 TRANSPARENT, INCLUSIVE AND AN 143 00:04:53,626 --> 00:04:54,527 ACCESSIBLE PUBLIC FORUM. 144 00:04:54,527 --> 00:04:55,728 WE'RE TRYING TO ADDRESS THE 145 00:04:55,728 --> 00:04:57,130 CRITICAL CHALLENGES AND 146 00:04:57,130 --> 00:04:59,566 SCIENTIFIC AND CLINICAL 147 00:04:59,566 --> 00:05:01,067 OPPORTUNITIES THAT SURROUND ALL 148 00:05:01,067 --> 00:05:02,802 OF THE LYMPHATIC DISEASES. 149 00:05:02,802 --> 00:05:04,904 WE ARE GOING TO ACCOMPLISH IN 150 00:05:04,904 --> 00:05:07,440 PART WHAT IS THE SECOND BULLET 151 00:05:07,440 --> 00:05:08,741 POINT HERE TODAY, WHICH IS TO 152 00:05:08,741 --> 00:05:11,244 GATHER INPUT FROM A WIDE AND 153 00:05:11,244 --> 00:05:12,679 DIVERSE SPECTRUM OF STAKEHOLDERS 154 00:05:12,679 --> 00:05:15,181 TO IDENTIFY REMAINING GAPS AND 155 00:05:15,181 --> 00:05:15,582 CHALLENGES. 156 00:05:15,582 --> 00:05:17,183 AND YOU AS PANELISTS WHO ARE 157 00:05:17,183 --> 00:05:18,218 INVITED THIS MORNING WILL HELP 158 00:05:18,218 --> 00:05:21,087 US TO ACCOMPLISH THIS GOAL SO 159 00:05:21,087 --> 00:05:23,523 THAT ULTIMATELY, BULLET POINT 160 00:05:23,523 --> 00:05:25,358 NUMBER THREE, WE CAN PROVIDE 161 00:05:25,358 --> 00:05:26,993 ACTIONABLE PROGRESS UPDATES AND 162 00:05:26,993 --> 00:05:28,294 A FINAL REPORT TO THE NATIONAL 163 00:05:28,294 --> 00:05:30,630 HEART, LUNG AND BLOOD ADVISORY 164 00:05:30,630 --> 00:05:32,365 COUNCIL TO REFLECT THESE 165 00:05:32,365 --> 00:05:34,300 PERSPECTIVES AND TO ALLOW US TO 166 00:05:34,300 --> 00:05:36,803 BEGIN TO COME TO SOME MEANINGFUL 167 00:05:36,803 --> 00:05:38,137 SOLUTIONS FOR THE PROBLEMS THAT 168 00:05:38,137 --> 00:05:44,844 ARE IN FRONT OF US. 169 00:05:44,844 --> 00:05:46,579 JUST AS A WORD OF INTRODUCTION, 170 00:05:46,579 --> 00:05:47,780 OUR COMMISSION HAS BEEN 171 00:05:47,780 --> 00:05:50,483 SUBDIVIDED INTO SIX COMMITTEES 172 00:05:50,483 --> 00:05:52,819 THAT ARE ADDRESSING PARTICULAR 173 00:05:52,819 --> 00:05:54,120 ASPECTS OF THE PROBLEM IN FRONT 174 00:05:54,120 --> 00:05:55,889 OF US, SO WE HAVE A COMMITTEE 175 00:05:55,889 --> 00:05:57,657 FOR SCIENTIFIC ADVANCEMENT, ONE 176 00:05:57,657 --> 00:05:59,659 FOR EDUCATIONAL IMPERATIVES, ONE 177 00:05:59,659 --> 00:06:03,029 FOR MEASURABLE RESULTS, PATIENT 178 00:06:03,029 --> 00:06:04,163 TOOLS, THIRD PARTY COVERAGE, AND 179 00:06:04,163 --> 00:06:04,898 COMMUNITY GROWTH. 180 00:06:04,898 --> 00:06:08,134 AND YOU CAN SEE THE COMPOSITION 181 00:06:08,134 --> 00:06:10,203 OF EACH OF THESE SUBCOMMITTEES 182 00:06:10,203 --> 00:06:11,404 LISTED ON THE SLIDE, AND ONCE 183 00:06:11,404 --> 00:06:13,573 AGAIN, IF YOU WANT TO CONSULT 184 00:06:13,573 --> 00:06:15,541 THE NCLD WEBPAGE YOU CAN SEE IN 185 00:06:15,541 --> 00:06:17,310 MORE DETAIL WHO THESE 186 00:06:17,310 --> 00:06:18,611 INDIVIDUALS ARE AND WHAT THEY 187 00:06:18,611 --> 00:06:26,486 REPRESENT. 188 00:06:26,486 --> 00:06:27,787 AT THIS POINT, I'M GOING TO 189 00:06:27,787 --> 00:06:30,223 INTRODUCE AND WELCOME OUR VERY 190 00:06:30,223 --> 00:06:31,758 DISTINGUISHED INVITED PANEL WHO 191 00:06:31,758 --> 00:06:34,494 WILL PROVIDE US WITH SOME 192 00:06:34,494 --> 00:06:36,763 INITIAL INFORMATION AND THEN BE 193 00:06:36,763 --> 00:06:40,700 INVITED TO INTERACT IN, WE HOPE, 194 00:06:40,700 --> 00:06:42,268 A VERY CONSTRUCTIVE AND LIVELY 195 00:06:42,268 --> 00:06:43,102 FASHION WITH THE COMMISSION. 196 00:06:43,102 --> 00:06:44,904 I WILL BE INTRODUCING EACH OF 197 00:06:44,904 --> 00:06:47,407 YOU BY NAME AND ORGANIZATION. 198 00:06:47,407 --> 00:06:49,909 AT THAT POINT, I ASK YOU PLEASE 199 00:06:49,909 --> 00:06:53,012 TO INTRODUCE YOURSELF AND YOUR 200 00:06:53,012 --> 00:06:54,547 BACKGROUND, AND IF RELEVANT, 201 00:06:54,547 --> 00:07:00,853 YOUR RELATIONSHIP TO THE LYM 202 00:07:00,853 --> 00:07:01,521 LYMPHATIC ENVIRONMENT AND TO 203 00:07:01,521 --> 00:07:02,789 SPEAK A LITTLE BIT ABOUT THE 204 00:07:02,789 --> 00:07:04,457 ORGANIZATION THAT YOU REPRESENT 205 00:07:04,457 --> 00:07:05,591 AND WHAT ITS POTENTIAL ROLE MAY 206 00:07:05,591 --> 00:07:08,928 BE IN HELPING THIS COMMISSION TO 207 00:07:08,928 --> 00:07:12,098 ACCOMPLISH ITS GOAL. 208 00:07:12,098 --> 00:07:14,200 EACH SOCIETY OR FOUNDATION WILL 209 00:07:14,200 --> 00:07:15,201 HAVE SEVEN MINUTES IN WHICH TO 210 00:07:15,201 --> 00:07:19,639 MAKE THIS PARTICULAR 211 00:07:19,639 --> 00:07:21,207 INTRODUCTION, AND WE WANT TO 212 00:07:21,207 --> 00:07:22,175 LEAVE PLENTY OF TIME FOR THE 213 00:07:22,175 --> 00:07:24,444 COMMISSION TO INTERACT WITH YOU 214 00:07:24,444 --> 00:07:26,546 BASED UPON WHAT YOU HAVE TO SAY 215 00:07:26,546 --> 00:07:27,647 INDIVIDUALLY AND COLLECTIVELY AS 216 00:07:27,647 --> 00:07:30,516 A PANEL. 217 00:07:30,516 --> 00:07:32,251 SO I'LL START WITH DR. MARK 218 00:07:32,251 --> 00:07:33,820 CREAGER WHO'S REPRESENTING THE 219 00:07:33,820 --> 00:07:40,660 AMERICAN HEART ASSOCIATION. 220 00:07:40,660 --> 00:07:42,395 >> THANK YOU VERY MUCH, STAN, 221 00:07:42,395 --> 00:07:50,103 AND HELLO, EVERYBODY. 222 00:07:50,103 --> 00:07:51,404 >> THERE YOU ARE. 223 00:07:51,404 --> 00:07:53,072 THAT'S GOOD. 224 00:07:53,072 --> 00:07:54,307 WE MAY HAVE A BIT OF A 225 00:07:54,307 --> 00:07:55,475 CONNECTION ISSUE. 226 00:07:55,475 --> 00:07:56,776 >> CAN YOU HEAR ME? 227 00:07:56,776 --> 00:07:58,177 >> YES. 228 00:07:58,177 --> 00:08:03,950 YES, CAN HEAR YOU NOW. 229 00:08:03,950 --> 00:08:06,019 >> MY INTERNET CONNECTION IS 230 00:08:06,019 --> 00:08:08,221 UNSTABLE, SO I'LL DO MY VERY 231 00:08:08,221 --> 00:08:09,555 BEST. 232 00:08:09,555 --> 00:08:13,292 >> THANK YOU. 233 00:08:13,292 --> 00:08:14,460 >> AGAIN, GOOD MORNING, 234 00:08:14,460 --> 00:08:15,194 EVERYONE. 235 00:08:15,194 --> 00:08:16,029 I'M MARK CREAGER. 236 00:08:16,029 --> 00:08:18,731 FOR THIS PANEL, I AM 237 00:08:18,731 --> 00:08:21,434 REPRESENTING THE AMERICAN HEART 238 00:08:21,434 --> 00:08:21,734 ASSOCIATION. 239 00:08:21,734 --> 00:08:24,370 I'M A CARDIOVASCULAR PHYSICIAN. 240 00:08:24,370 --> 00:08:26,706 MY RESEARCH INTERESTS AND MY 241 00:08:26,706 --> 00:08:32,378 CLINICAL INTERESTS -- IN ITS 242 00:08:32,378 --> 00:08:34,013 BROADEST CONTEXT. 243 00:08:34,013 --> 00:08:36,682 SO OBVIOUSLY LYMPHATIC DISEASES 244 00:08:36,682 --> 00:08:41,354 ARE INCLUDED -- TRAINED AT 245 00:08:41,354 --> 00:08:43,556 BOSTON MEDICAL CENTER, MY MENTOR 246 00:08:43,556 --> 00:08:47,627 WAS JAY KAUFMAN, MOVED ON TO 247 00:08:47,627 --> 00:08:51,964 BRIGHAM AND WOMEN'S HOSPITAL -- 248 00:08:51,964 --> 00:08:54,367 FOR 31 YEARS. 249 00:08:54,367 --> 00:09:00,139 APPROXIMATELY EIGHT YEARS AGO -- 250 00:09:00,139 --> 00:09:03,810 KNOWN AS DARTMOUTH HEALTH AND 251 00:09:03,810 --> 00:09:05,211 SCHOOL OF MEDICINE AT DARTMOUTH 252 00:09:05,211 --> 00:09:11,217 AS THE -- AND ABOUT ONE YEAR 253 00:09:11,217 --> 00:09:13,920 AGO, I STEPPED DOWN FROM THAT 254 00:09:13,920 --> 00:09:20,726 POSITION BUT MAINTAIN -- A LARGE 255 00:09:20,726 --> 00:09:21,694 RESEARCH GRANT SPOP SOARED BY 256 00:09:21,694 --> 00:09:28,267 SPONSORED BY THENIH ON THEIR --L 257 00:09:28,267 --> 00:09:31,370 HEALTHCARE DELIVERY SCIENCE, AND 258 00:09:31,370 --> 00:09:39,112 I MENTOR OUR -- MEDICINE CLINIC. 259 00:09:39,112 --> 00:09:40,413 MY BACKGROUND IN VASCULAR 260 00:09:40,413 --> 00:09:42,215 MEDICINE HAS REALLY BEEN QUITE 261 00:09:42,215 --> 00:09:45,551 EXTENSIVE. 262 00:09:45,551 --> 00:09:47,120 -- MEDICINE. 263 00:09:47,120 --> 00:09:49,956 I WAS THE PRESIDENT OF THE 264 00:09:49,956 --> 00:09:55,061 VASCULAR DISEASE FOUNDATION -- 265 00:09:55,061 --> 00:09:56,596 EDITED A TEXTBOOK CALLED 266 00:09:56,596 --> 00:10:04,003 VASCULAR MEDICINE, AND STAN -- 267 00:10:04,003 --> 00:10:06,772 >> DR. CREAGER, WE JUST REMOVED 268 00:10:06,772 --> 00:10:08,141 YOUR CAMERA TO RESERVE BANDWIDTH 269 00:10:08,141 --> 00:10:09,509 SO YOU CAN HAVE A BETTER 270 00:10:09,509 --> 00:10:09,809 CONNECTION. 271 00:10:09,809 --> 00:10:10,610 >> STOP THE CAMERA? 272 00:10:10,610 --> 00:10:13,679 >> NO, WE ALREADY DID IT. 273 00:10:13,679 --> 00:10:15,047 >> CAN YOU HEAR ME BETTER? 274 00:10:15,047 --> 00:10:16,048 >> YES, WE CAN. 275 00:10:16,048 --> 00:10:16,849 >> OH, OKAY. 276 00:10:16,849 --> 00:10:17,717 THANK YOU. 277 00:10:17,717 --> 00:10:18,651 >> NO PROBLEM. 278 00:10:18,651 --> 00:10:20,753 >> I ASSUME I DON'T HAVE TO GO 279 00:10:20,753 --> 00:10:24,090 BACK TO -- 280 00:10:24,090 --> 00:10:25,358 >> NO, YOU'RE ALL SET. 281 00:10:25,358 --> 00:10:26,692 >> OKAY, THANK YOU. 282 00:10:26,692 --> 00:10:27,560 ALL RIGHT. 283 00:10:27,560 --> 00:10:29,529 SO ANYWAY, I'VE HAD LEADERSHIP 284 00:10:29,529 --> 00:10:36,202 POSITIONS IN -- E EDITED TEXTBOK 285 00:10:36,202 --> 00:10:39,372 VASCULAR MEDICINE AND I'M NOW 286 00:10:39,372 --> 00:10:45,378 THE EDITOR -- MEDICINE, WHICH I 287 00:10:45,378 --> 00:10:48,047 EDITED FOR ABOUT 18 YEARS. 288 00:10:48,047 --> 00:10:55,354 ONE OF MY MAJOR -- MY PLACE OF 289 00:10:55,354 --> 00:10:57,089 EMPLOYMENT HAS EVOLVED HERE FOR 290 00:10:57,089 --> 00:11:04,997 THE AMERICAN HEART ASSOCIATION. 291 00:11:04,997 --> 00:11:05,631 -ORGANIZATION PARTICIPATING IN 292 00:11:05,631 --> 00:11:11,404 MANY OF ITS ASPECTS, BUT IN 293 00:11:11,404 --> 00:11:14,006 2015, -- AMERICAN HEART 294 00:11:14,006 --> 00:11:15,741 ASSOCIATION AND I'VE REMAINED A 295 00:11:15,741 --> 00:11:17,543 VERY ENGAGED AND ACTIVE 296 00:11:17,543 --> 00:11:23,115 VOLUNTEER SINCE -- AMERICAN 297 00:11:23,115 --> 00:11:25,651 HEART ASSOCIATION, BUT LET ME 298 00:11:25,651 --> 00:11:33,893 JUST SUMMARIZE SOME OF -- A VERY 299 00:11:33,893 --> 00:11:36,996 LARGE REALLY PATIENT-ORIENTED 300 00:11:36,996 --> 00:11:41,367 ORGANIZATION, BUT IT'S -- ACROSS 301 00:11:41,367 --> 00:11:43,502 THE SPECTRUM FROM CLINICIANS TO 302 00:11:43,502 --> 00:11:44,971 SCIENTISTS AND LAY VOLUNTEERS AS 303 00:11:44,971 --> 00:11:45,905 WELL. 304 00:11:45,905 --> 00:11:53,613 IT HAS -- ITS MISSION CERTAINLY 305 00:11:53,613 --> 00:11:55,381 IS IMPORTANT SCIENCE ASPECT, IT 306 00:11:55,381 --> 00:12:01,754 FUNDS THE RESEARCH -- MORE 307 00:12:01,754 --> 00:12:02,722 CARDIOVASCULAR RESEARCH THAN ANY 308 00:12:02,722 --> 00:12:09,595 OTHER ORGANIZATION. 309 00:12:09,595 --> 00:12:11,564 INFORMING THE PUBLIC AND HELPING 310 00:12:11,564 --> 00:12:14,734 THE PUBLIC IN MANY AREAS OF 311 00:12:14,734 --> 00:12:19,672 CARDIOVASCULAR DISEASE -- 312 00:12:19,672 --> 00:12:21,641 PROGRAM AT CPR BUT IT DOES SO 313 00:12:21,641 --> 00:12:23,342 MUCH MORE THAN THAT IN INFORMING 314 00:12:23,342 --> 00:12:30,283 THE PUBLIC ABOUT THE -- IT'S 315 00:12:30,283 --> 00:12:32,551 ALSO VERY MUCH AT THE SEAT FOR A 316 00:12:32,551 --> 00:12:39,292 NUMBER OF ADVOCACY -- 317 00:12:39,292 --> 00:12:40,026 ORGANIZATION, IT'S STAFFED BY 318 00:12:40,026 --> 00:12:44,397 THOUSANDS OF EMPLOYEES, BUT TENS 319 00:12:44,397 --> 00:12:48,601 OF -- ACTIVITIES OF THE AMERICAN 320 00:12:48,601 --> 00:12:49,902 HEART ASSOCIATION. 321 00:12:49,902 --> 00:12:57,076 WHEN YOU HEAR THE WORD "HEART," 322 00:12:57,076 --> 00:12:58,077 PARTICULAR ORGAN, BUT THAT'S 323 00:12:58,077 --> 00:12:59,145 REALLY NOT THE CASE. 324 00:12:59,145 --> 00:13:00,680 IT'S REALLY AN ORGANIZATION THAT 325 00:13:00,680 --> 00:13:01,881 LOOKS AT HEALTH IN GENERAL BUT 326 00:13:01,881 --> 00:13:08,721 IF WE WANT TO -- THE HEART, 327 00:13:08,721 --> 00:13:11,724 WE'RE TALKING ABOUT BRAIN HEALTH 328 00:13:11,724 --> 00:13:17,763 AND IN CONTEXT -- NOW I WILL 329 00:13:17,763 --> 00:13:19,832 READILY ADMIT, LYMPHATIC 330 00:13:19,832 --> 00:13:21,901 DISEASES HAS NOT BEEN AT THE 331 00:13:21,901 --> 00:13:28,574 FOREFRONT OF THE -- I THINK FOR 332 00:13:28,574 --> 00:13:29,775 THAT REASON THAT MY JOINING THE 333 00:13:29,775 --> 00:13:30,676 PANEL TODAY CREATES AN 334 00:13:30,676 --> 00:13:35,014 OPPORTUNITY NOT ONLY FOR ME T 335 00:13:35,014 --> 00:13:37,283 TO -- AMERICAN HEART ASSOCIATION 336 00:13:37,283 --> 00:13:39,719 CAN BECOME MUCH MORE ENGAGED IN 337 00:13:39,719 --> 00:13:46,492 SUPPORTING ACTIVITIES -- 338 00:13:46,492 --> 00:13:47,727 RESEARCH FRONT -- FUNDING 339 00:13:47,727 --> 00:13:49,762 SCIENCE OR WHETHER THAT HAS TO 340 00:13:49,762 --> 00:13:54,934 DO WITH INFORMING -- AS WELL AS 341 00:13:54,934 --> 00:13:57,436 ADVOCACY EFFORTS, I THINK WE'RE 342 00:13:57,436 --> 00:13:58,604 PREPARED TO DO THAT AND I'M 343 00:13:58,604 --> 00:14:00,940 LOOKING FORWARD TO THE REST OF 344 00:14:00,940 --> 00:14:06,245 THE -- 345 00:14:06,245 --> 00:14:07,880 >> OKAY, THANK YOU, MARK. 346 00:14:07,880 --> 00:14:08,948 THANK YOU VERY MUCH. 347 00:14:08,948 --> 00:14:10,683 IT SOUNDS LIKE WE HAVE WONDERFUL 348 00:14:10,683 --> 00:14:11,784 OPPORTUNITIES TO INTERACT WITH 349 00:14:11,784 --> 00:14:14,920 YOU DURING THE INTERACTIVE 350 00:14:14,920 --> 00:14:15,287 SESSION. 351 00:14:15,287 --> 00:14:17,123 I NEXT WILL INTRODUCE DR. ROBERT 352 00:14:17,123 --> 00:14:19,425 SMITH, WHO IS HERE REPRESENTING 353 00:14:19,425 --> 00:14:23,662 THE AMERICAN CANCER SOCIETY. 354 00:14:23,662 --> 00:14:24,964 >> THANK YOU, AND GOOD MORNING, 355 00:14:24,964 --> 00:14:25,564 STAN. 356 00:14:25,564 --> 00:14:28,000 I AM A CANCER EPIDEMIOLOGIST, 357 00:14:28,000 --> 00:14:30,369 AND SENIOR VICE PRESIDENT FOR 358 00:14:30,369 --> 00:14:34,073 CANCER SCREENING AND DIRECTOR OF 359 00:14:34,073 --> 00:14:36,175 THE AMERICAN CANCER SOCIETY 360 00:14:36,175 --> 00:14:37,309 CENTER FOR EARLY CANCER 361 00:14:37,309 --> 00:14:40,312 DETECTION SCIENCE. 362 00:14:40,312 --> 00:14:41,480 MY CAREER STARTED IN THE SCHOOL 363 00:14:41,480 --> 00:14:42,982 OF MEDICINE AT BOSTON 364 00:14:42,982 --> 00:14:44,650 UNIVERSITY, AND THEN WENT TO THE 365 00:14:44,650 --> 00:14:45,317 CENTERS FOR DISEASE CONTROL AND 366 00:14:45,317 --> 00:14:46,919 I'VE BEEN AT THE AMERICAN CANCER 367 00:14:46,919 --> 00:14:49,054 SOCIETY FOR 32 YEARS. 368 00:14:49,054 --> 00:14:50,723 I'M MOSTLY FOCUSED ON EARLY 369 00:14:50,723 --> 00:14:52,725 CANCER DETECTION, DEVELOPMENT OF 370 00:14:52,725 --> 00:14:55,227 CANCER SCREENING GUIDELINES, BUT 371 00:14:55,227 --> 00:14:57,963 I'M ALSO PARTICULARLY INTERESTED 372 00:14:57,963 --> 00:14:59,298 IN ORPHAN PROBLEMS IN CANCER 373 00:14:59,298 --> 00:15:00,533 CONTROL. 374 00:15:00,533 --> 00:15:02,868 IN 1997, TH THE AMERICAN CANCER 375 00:15:02,868 --> 00:15:05,704 SOCIETY HAD THE GOOD FORTUNE TO 376 00:15:05,704 --> 00:15:08,841 ESTABLISH PARTNERSHIP WITH THE 377 00:15:08,841 --> 00:15:09,975 LONGABERGER COMPANY, A COMPANY 378 00:15:09,975 --> 00:15:12,812 THAT MADE BASICALLY HOME 379 00:15:12,812 --> 00:15:17,616 PRODUCTS, MAINLY HARDWOOD VENEER 380 00:15:17,616 --> 00:15:19,051 BASKETS, THE HORIZON OF HOPE 381 00:15:19,051 --> 00:15:20,119 CAMPAIGN WAS TO TARGET RESEARCH 382 00:15:20,119 --> 00:15:21,654 AND EDUCATION IN BREAST CANCER. 383 00:15:21,654 --> 00:15:25,724 $2 FROM EVERY SALE OF THE BASKET 384 00:15:25,724 --> 00:15:27,259 WOULD COME TO THE AMERICAN 385 00:15:27,259 --> 00:15:28,461 CANCER SOCIETY AND AMONG THE 386 00:15:28,461 --> 00:15:29,361 MANY CONTRIBUTIONS AND IDEAS 387 00:15:29,361 --> 00:15:30,496 THAT THE COMPANY HAD FOR HOW 388 00:15:30,496 --> 00:15:31,964 THEY COULD MAKE A DIFFERENCE IN 389 00:15:31,964 --> 00:15:38,904 BREAST CANCER, DR. GENE PETRIC, 390 00:15:38,904 --> 00:15:45,845 THE LATE DR -- THE MORE I LEARND 391 00:15:45,845 --> 00:15:50,015 ABOUT LYMPHEDEMA, EARLY 392 00:15:50,015 --> 00:15:51,116 DETECTION AND TREATMENT WAS, THE 393 00:15:51,116 --> 00:15:53,752 MORE I WAS PERSUADED THIS WAS AN 394 00:15:53,752 --> 00:15:54,553 IMPORTANT COMMITMENT FOR THE 395 00:15:54,553 --> 00:15:55,788 AMERICAN CASS 16 SEWER SITE. 396 00:15:55,788 --> 00:15:56,889 OUR FIRST INITIATIVE WAS AN 397 00:15:56,889 --> 00:15:58,123 INTERNATIONAL WORKSHOP HELD IN 398 00:15:58,123 --> 00:15:59,725 NEW YORK CITY IN 1998, TO 399 00:15:59,725 --> 00:16:02,761 IDENTIFY THE HIGHEST PRIORITY 400 00:16:02,761 --> 00:16:05,865 STRATEGIES FOR LYMPHEDEMA 401 00:16:05,865 --> 00:16:06,832 EDUCATION TREATMENT AND 402 00:16:06,832 --> 00:16:08,467 RESEARCH, WHEN I FIRST MET 403 00:16:08,467 --> 00:16:09,268 DR. ROCKSON. 404 00:16:09,268 --> 00:16:10,236 OF PARTICULAR IMPORTANCE, ALL 405 00:16:10,236 --> 00:16:14,273 THE INTERNATIONAL SCHOOLS OF 406 00:16:14,273 --> 00:16:17,076 LYMPHEDEMA THERAPY WERE PRESENT, 407 00:16:17,076 --> 00:16:18,644 THERE WERE APPROACHES THAT WERE 408 00:16:18,644 --> 00:16:19,745 PARTICULARLY THORNY. 409 00:16:19,745 --> 00:16:20,846 THE PRESENTATIONS AND 410 00:16:20,846 --> 00:16:22,481 RECOMMENDATIONS WERE PUBLISHED 411 00:16:22,481 --> 00:16:23,916 IN THE SUPPLEMENT OF CANCER AND 412 00:16:23,916 --> 00:16:26,018 WERE OPEN ACCESS, BUT THE 413 00:16:26,018 --> 00:16:28,387 MEETING HAS BEEN REGARDED AS A 414 00:16:28,387 --> 00:16:30,356 MILESTONE IN RAISING AWARENESS 415 00:16:30,356 --> 00:16:32,892 ABOUT LYMPHEDEMA AND GAINING 416 00:16:32,892 --> 00:16:33,893 SOME MOMENTUM PARTICULARLY IN 417 00:16:33,893 --> 00:16:35,394 THE AREA OF BREAST CANCER. 418 00:16:35,394 --> 00:16:38,230 ONE OF THE WORK GROUP 419 00:16:38,230 --> 00:16:39,031 RECOMMENDATIONS WAS THE 420 00:16:39,031 --> 00:16:40,299 ESTABLISHMENT OF A CERTIFICATION 421 00:16:40,299 --> 00:16:41,433 PROGRAM SO ONE WOULD HAVE A 422 00:16:41,433 --> 00:16:43,802 TRUSTED INDICATOR THAT THEIR 423 00:16:43,802 --> 00:16:45,738 THERAPIST HAD RECEIVED SPECIAL 424 00:16:45,738 --> 00:16:50,943 TRAINING IN LYMPHEDEMA AND PAS 425 00:16:50,943 --> 00:16:52,211 PASSED -- THEY'RE STILL 426 00:16:52,211 --> 00:16:54,113 CERTIFYING THERAPISTS TODAY. 427 00:16:54,113 --> 00:16:56,048 IN 2012, THE ACS SUPPORTED A 428 00:16:56,048 --> 00:16:58,684 WORKSHOP PROPOSING A PROSPECTIVE 429 00:16:58,684 --> 00:16:59,585 SURVEILLANCE MODEL FOR 430 00:16:59,585 --> 00:17:00,586 REHABILITATION FOR WOMEN WITH 431 00:17:00,586 --> 00:17:01,954 BREAST CANCER, WHICH INCLUDED 432 00:17:01,954 --> 00:17:03,389 NUMEROUS PHYSICAL IMPAIRMENTS IN 433 00:17:03,389 --> 00:17:05,124 ADDITION TO LYMPHEDEMA. 434 00:17:05,124 --> 00:17:06,892 THE WORKSHOP EMPHASIZED THE 435 00:17:06,892 --> 00:17:07,993 SERIOUS ENDURING CLINICAL 436 00:17:07,993 --> 00:17:10,829 FAILURE TO IDENTIFY THESE 437 00:17:10,829 --> 00:17:12,197 IMPAIRMENTS WHEN THEY FIRST 438 00:17:12,197 --> 00:17:13,999 MATERIALIZE SO THEY ARE COMMONLY 439 00:17:13,999 --> 00:17:15,334 UNRECOGNIZED, UNTREATED AND 440 00:17:15,334 --> 00:17:17,736 PROGRESS WITHOUT INTERVENTIONS 441 00:17:17,736 --> 00:17:19,772 TO LEVELS THAT NEGATIVELY IMPACT 442 00:17:19,772 --> 00:17:20,239 FUNCTION. 443 00:17:20,239 --> 00:17:24,176 MANY CLIPPINGS BU CLINICS BUT NY 444 00:17:24,176 --> 00:17:26,579 ENOUGH HAVE ADOPTED THIS MODEL. 445 00:17:26,579 --> 00:17:30,916 RESEARCH AND EDUCATION IN 446 00:17:30,916 --> 00:17:32,184 LYMPHEDEMA MA HAVE ADVANCED OVER 447 00:17:32,184 --> 00:17:35,387 THE LAST 25 YEARS, THE ACS, THE 448 00:17:35,387 --> 00:17:36,989 LYMPHOLOGY ASSOCIATION OF NORTH 449 00:17:36,989 --> 00:17:38,924 AMERICA, AND WASHINGTON 450 00:17:38,924 --> 00:17:39,525 UNIVERSITY SCHOOL OF MEDICINE 451 00:17:39,525 --> 00:17:40,793 HOSTED A SUMMIT IN ST. LOUIS, 452 00:17:40,793 --> 00:17:42,328 MISSOURI. 453 00:17:42,328 --> 00:17:46,732 THE LYMPHEDEMA -- PHYSICIANS, 454 00:17:46,732 --> 00:17:47,666 THERAPISTS, RESEARCHERS AND 455 00:17:47,666 --> 00:17:48,701 OTHER THOUGHT LEADERS IN THE 456 00:17:48,701 --> 00:17:50,869 FIELD WITH THE AIM TO ESTABLISH 457 00:17:50,869 --> 00:17:52,304 CURRENT KNOWLEDGE AND PRODUCE 458 00:17:52,304 --> 00:17:53,606 CONSENSUS DOCUMENTS TO ESTABLISH 459 00:17:53,606 --> 00:17:55,074 BASELINE FOR FUTURE PROGRESS IN 460 00:17:55,074 --> 00:17:56,775 THE TOPIC. 461 00:17:56,775 --> 00:17:58,844 THOSE MATERIALS WILL ALSO BE 462 00:17:58,844 --> 00:18:00,346 GATHERED AND IN A SUPPLEMENT 463 00:18:00,346 --> 00:18:02,548 THAT WILL BE OPEN ACCESS AND 464 00:18:02,548 --> 00:18:04,984 PUBLISHED IN ANOTHER JOURNAL. 465 00:18:04,984 --> 00:18:07,286 SECONDARY CANCER TREATMENT 466 00:18:07,286 --> 00:18:09,355 RELATED LYMPHEDEMA REMAINS A 467 00:18:09,355 --> 00:18:10,923 SERIOUS PROBLEM TODAY. 468 00:18:10,923 --> 00:18:12,725 THE PREVALENCE AND INCIDENCE IS 469 00:18:12,725 --> 00:18:14,827 NOT FULLY KNOWN AS WAS 470 00:18:14,827 --> 00:18:16,028 ESTABLISHED IN THESE COMPANY 471 00:18:16,028 --> 00:18:18,530 DOCUMENTS, WHICH IS DUE IN PART 472 00:18:18,530 --> 00:18:19,498 TO THE HETEROGENEITY OF THE 473 00:18:19,498 --> 00:18:21,000 CANCER TYPES, CANCER LOCATIONS, 474 00:18:21,000 --> 00:18:22,935 THE ABSENCE OF SURVEILLANCE 475 00:18:22,935 --> 00:18:24,336 SYSTEMS, AND HOWEVER ESTIMATES 476 00:18:24,336 --> 00:18:28,073 SUGGEST THAT THE INCIDENCE OF 477 00:18:28,073 --> 00:18:29,808 TREATMENT-RELATED LYMPHEDEMA MAY 478 00:18:29,808 --> 00:18:31,977 RANGE BETWEEN 5 -- RANGING FROM 479 00:18:31,977 --> 00:18:34,179 VERY MILD TO QUITE SEVERE AND 480 00:18:34,179 --> 00:18:36,048 DEBILITATING AND ADVERSELY 481 00:18:36,048 --> 00:18:37,783 IMPABTING PHYSICAL FUNCTION, 482 00:18:37,783 --> 00:18:38,751 PSYCHOSOCIAL HEALTH AND 483 00:18:38,751 --> 00:18:41,720 HEALTH-RELATED QUALITY OF LIFE. 484 00:18:41,720 --> 00:18:42,621 LYMPHEDEMA MAY OCCUR SOON OR 485 00:18:42,621 --> 00:18:43,789 VERY LONG AFTER TREATMENT AND 486 00:18:43,789 --> 00:18:45,891 TOO OFTEN WE HEAR CLINICIANS 487 00:18:45,891 --> 00:18:54,099 TELL US THAT LI LYMPHEDEMA IS R, 488 00:18:54,099 --> 00:18:55,300 SOMETHING IN THE PAST, AND 489 00:18:55,300 --> 00:18:56,602 THEY'RE NO LONGER TAKING CARE OF 490 00:18:56,602 --> 00:18:58,137 THESE PATIENTS WHEN SYMPTOMS 491 00:18:58,137 --> 00:18:58,804 FIRST MANIFEST. 492 00:18:58,804 --> 00:19:00,205 AS THE BACKGROUND DOCUMENTS 493 00:19:00,205 --> 00:19:01,507 HIGHLIGHTED, WE HAVE VERY 494 00:19:01,507 --> 00:19:03,175 LIMITED ABILITY TO ESTIMATE THE 495 00:19:03,175 --> 00:19:06,011 INCIDENCE AND PREVALENCE OF 496 00:19:06,011 --> 00:19:07,012 TREATMENT RELATED LYMPHEDEMA BUT 497 00:19:07,012 --> 00:19:08,213 THE NUMBERS ARE QUITE LARGE AND 498 00:19:08,213 --> 00:19:11,150 THE SIZE OF THE POPULATION AT 499 00:19:11,150 --> 00:19:14,420 RISK IS MANY TIMES LARGER. 500 00:19:14,420 --> 00:19:18,023 -- COMPARED TO LOWER EXTREMITY 501 00:19:18,023 --> 00:19:19,658 GENITAL GYNECOLOGICAL AND HEAD 502 00:19:19,658 --> 00:19:21,860 AND NECK LYMPHEDEMA AND IN THE 503 00:19:21,860 --> 00:19:23,829 UNITED STATES THERE ARE OVER 504 00:19:23,829 --> 00:19:24,830 3.8 MILLION BREAST CANCER 505 00:19:24,830 --> 00:19:26,432 SURVIVORS OF WHOM 10 TO 50% ARE 506 00:19:26,432 --> 00:19:28,834 AT RISK FOR MANIFESTING BREAST 507 00:19:28,834 --> 00:19:30,636 CANCER RELATED LYMPHEDEMA. 508 00:19:30,636 --> 00:19:32,271 ALTHOUGH MUCH HAS BEEN LEARNED, 509 00:19:32,271 --> 00:19:33,639 THERE IS MUCH MORE WE NEED TO 510 00:19:33,639 --> 00:19:34,573 KNOW AND MANY OF THE QUESTIONS 511 00:19:34,573 --> 00:19:36,008 THAT WERE WITH US AT THE TURN OF 512 00:19:36,008 --> 00:19:37,276 CENTURY ARE STILL WITH US TODAY. 513 00:19:37,276 --> 00:19:40,145 AND THAT MEANS THAT MILLIONS OF 514 00:19:40,145 --> 00:19:41,213 PATIENTS WITH LYMPHEDEMA 515 00:19:41,213 --> 00:19:42,314 SECONDARY TO CANCER TREATMENT IS 516 00:19:42,314 --> 00:19:43,882 STILL A MAJOR PROBLEM. 517 00:19:43,882 --> 00:19:44,850 RISK COMMUNICATION IS POOR, 518 00:19:44,850 --> 00:19:46,385 THERE IS COMMONLY NO SYSTEM FOR 519 00:19:46,385 --> 00:19:48,887 POST TREATMENT SURVEILLANCE 520 00:19:48,887 --> 00:19:50,189 WHICH WE KNOW WILL HAVE TO LAST 521 00:19:50,189 --> 00:19:51,490 FOR MANY YEARS AFTER TREATMENT, 522 00:19:51,490 --> 00:19:53,058 PROVIDER AWARENESS IS LOW, AND 523 00:19:53,058 --> 00:19:55,461 TREATMENT QUALITY IS HIGHLY 524 00:19:55,461 --> 00:19:57,463 VARIABLE. 525 00:19:57,463 --> 00:20:02,334 I WANT TO THANK THE LONGABERGER 526 00:20:02,334 --> 00:20:03,202 COMPANY TO THEIR COMMITMENT TO 527 00:20:03,202 --> 00:20:06,371 THIS AND JUST AS AN ANTIDOTE, 528 00:20:06,371 --> 00:20:09,475 THE COMPANY WOULD HOST A 529 00:20:09,475 --> 00:20:10,876 LUNCHEON EVERY YEAR FOR BREAST 530 00:20:10,876 --> 00:20:13,479 CANCER SURVIVORS WHO ARE FRIENDS 531 00:20:13,479 --> 00:20:15,781 OF THEIR SALES ASSOCIATES. 532 00:20:15,781 --> 00:20:17,783 IT WAS A LOVE LOW DAY, KEEP IN 533 00:20:17,783 --> 00:20:19,184 MIND ALL THE WOMEN IN THE ROOM 534 00:20:19,184 --> 00:20:20,519 ARE BREAST CANCER SURVIVORS AND 535 00:20:20,519 --> 00:20:22,020 THERE WOULD BE SORT OF A 536 00:20:22,020 --> 00:20:23,122 RECEIVING LINE AFTERWARDS WITH A 537 00:20:23,122 --> 00:20:25,424 HANDFUL OF SPEAKERS, MYSELF AND 538 00:20:25,424 --> 00:20:27,860 SOME OTHERS FROM THE AMERICAN 539 00:20:27,860 --> 00:20:29,561 CANCER SOCIETY WOULD HAVE AN 540 00:20:29,561 --> 00:20:29,895 OPPORTUNITY -- 541 00:20:29,895 --> 00:20:30,996 >> YOU HAVE ONE MINUTE 542 00:20:30,996 --> 00:20:31,263 REMAINING. 543 00:20:31,263 --> 00:20:33,165 >> I'M GOOD, THOUGH. 544 00:20:33,165 --> 00:20:34,366 WILL HAVE AN OPPORTUNITY TO SAY 545 00:20:34,366 --> 00:20:34,700 HELLO. 546 00:20:34,700 --> 00:20:37,436 MANY OF THESE WOMEN HAD VERY 547 00:20:37,436 --> 00:20:38,103 SWOLLEN ARMS. 548 00:20:38,103 --> 00:20:39,972 BUT THEY WERE QUITE EXCITED TO 549 00:20:39,972 --> 00:20:41,140 FINALLY HEAR SOMEBODY TALK ABOUT 550 00:20:41,140 --> 00:20:42,574 THEIR PROBLEM, BECAUSE UP TO 551 00:20:42,574 --> 00:20:46,278 DATE, THEY HAD HAD NO CONFIDENCE 552 00:20:46,278 --> 00:20:48,413 AND NO HELP IN DEALING WITH THE 553 00:20:48,413 --> 00:20:49,248 CONDITION THEY'D BEEN LIVING 554 00:20:49,248 --> 00:20:49,948 WITH FOR MANY YEARS. 555 00:20:49,948 --> 00:20:52,751 SO I'D LIKE TO CONGRATULATE THE 556 00:20:52,751 --> 00:20:53,752 NATIONAL COMMISSION ON LYMPHATIC 557 00:20:53,752 --> 00:20:55,487 DISEASES FOR ORGANIZING THIS 558 00:20:55,487 --> 00:20:55,754 WORKSHOP. 559 00:20:55,754 --> 00:20:57,055 IT'S MY HOPE THAT MORE MEETINGS 560 00:20:57,055 --> 00:20:58,357 LIKE THIS WILL OCCUR WITH 561 00:20:58,357 --> 00:20:59,758 GREATER FREQUENCY AND WE WILL 562 00:20:59,758 --> 00:21:02,161 BUILD ON RESEARCH PROJECTS MORE 563 00:21:02,161 --> 00:21:04,563 RAPIDLY AND MAKE REAL INRHODES 564 00:21:04,563 --> 00:21:06,999 INTO REDUCING THE DAILY 565 00:21:06,999 --> 00:21:08,233 SUFFERING EXPERIENCE BY MILLIONS 566 00:21:08,233 --> 00:21:10,569 OF INDIVIDUALS WHO HAVE BEEN 567 00:21:10,569 --> 00:21:11,603 SUCCESSFULLY TREATED FOR THEIR 568 00:21:11,603 --> 00:21:13,005 CANCER BUT LEFT WITH A 569 00:21:13,005 --> 00:21:13,639 DEBILITATING TREATMENT 570 00:21:13,639 --> 00:21:14,006 CONDITION. 571 00:21:14,006 --> 00:21:15,507 THE ACS IS COMMITTED TO 572 00:21:15,507 --> 00:21:16,375 COLLABORATION IN THIS AREA. 573 00:21:16,375 --> 00:21:17,709 THANK YOU VERY MUCH AND I LOOK 574 00:21:17,709 --> 00:21:20,779 FORWARD TO THE REST OF THE DAY. 575 00:21:20,779 --> 00:21:22,948 >> THANK YOU, DR. SMITH. 576 00:21:22,948 --> 00:21:24,583 I KNOW OUR PANEL IS GOING TO BE 577 00:21:24,583 --> 00:21:25,684 ANXIOUS TO INTERACT WITH YOU TO 578 00:21:25,684 --> 00:21:27,219 DETERMINE HOW WE CAN PARTNER 579 00:21:27,219 --> 00:21:29,521 TOGETHER TO COME UP WITH MORE 580 00:21:29,521 --> 00:21:31,156 BROAD RANGING SOLUTIONS. 581 00:21:31,156 --> 00:21:34,827 MY NEXT INTRODUCTION IS OF TWO 582 00:21:34,827 --> 00:21:37,196 INVITED PANELISTS WHO 583 00:21:37,196 --> 00:21:39,364 COLLECTIVELY REPRESENT NAVBO, 584 00:21:39,364 --> 00:21:41,333 NORTH AMERICAN VASCULAR BIOLOGY 585 00:21:41,333 --> 00:21:43,402 ORGANIZATION, AND I WILL LEAVE 586 00:21:43,402 --> 00:21:46,939 TO THE TWO OF YOU TO DECIDE HOW 587 00:21:46,939 --> 00:21:48,774 TO DIVIDE UP YOUR TIME ALLOTTED. 588 00:21:48,774 --> 00:21:53,378 I'M PLEASED TO INTRODUCE DR. JAN 589 00:21:53,378 --> 00:21:55,647 KITAJEWSKI AND DR. CARRIE 590 00:21:55,647 --> 00:22:00,018 SHAWBER REPRESENTING NAVBO. 591 00:22:00,018 --> 00:22:01,386 >> THANKS, STAN. 592 00:22:01,386 --> 00:22:03,422 I'LL START OFF AND JAN WILL JOIN 593 00:22:03,422 --> 00:22:04,389 AFTERWARDS AND HE CAN INTRODUCE 594 00:22:04,389 --> 00:22:05,591 HIS BACKGROUND. 595 00:22:05,591 --> 00:22:07,426 I'M A LYMPHATIC VASCULAR 596 00:22:07,426 --> 00:22:07,993 BIOLOGIST. 597 00:22:07,993 --> 00:22:11,296 I STUDY USING MOUSE MODELS, 598 00:22:11,296 --> 00:22:14,266 STUDY BOTH LYMPHATIC DEVELOPMENT 599 00:22:14,266 --> 00:22:16,001 AND THE ROLE OF GENES IN 600 00:22:16,001 --> 00:22:17,569 REGULATING LYMPHATIC HOMEOSTASIS 601 00:22:17,569 --> 00:22:19,171 AND IT RELATES TO THE DISEASES 602 00:22:19,171 --> 00:22:20,372 AND I ALSO HAVE A RESEARCH 603 00:22:20,372 --> 00:22:21,306 PROGRAM LOOKING INTO THE 604 00:22:21,306 --> 00:22:23,742 GENETICS OF CONGENITAL LYMPHATIC 605 00:22:23,742 --> 00:22:26,612 ANOMALIES AND THE TREATMENT 606 00:22:26,612 --> 00:22:28,146 THERE. 607 00:22:28,146 --> 00:22:29,648 I WANT TO THANK THE ORGANIZERS 608 00:22:29,648 --> 00:22:31,617 FOR INVITING BOTH JAN AND MYSELF 609 00:22:31,617 --> 00:22:34,019 TO REPRESENT NAVBO TODAY. 610 00:22:34,019 --> 00:22:36,321 JAN SERVED ON NAVBO COUNCIL AND 611 00:22:36,321 --> 00:22:40,459 WAS PRESIDENT OF NAVBO FROM 2016 612 00:22:40,459 --> 00:22:40,826 TO 2017. 613 00:22:40,826 --> 00:22:42,828 AND I AM CURRENTLY THE CHAIRMAN 614 00:22:42,828 --> 00:22:45,230 OF THE NAVBO EDUCATION 615 00:22:45,230 --> 00:22:45,864 COMMITTEE. 616 00:22:45,864 --> 00:22:47,699 AND WE BOTH, AS I WAS SAYING, WE 617 00:22:47,699 --> 00:22:50,535 BOTH HAVE DISCOVERY AND 618 00:22:50,535 --> 00:22:51,803 TRANSLATIONAL RESEARCH PROGRAMS 619 00:22:51,803 --> 00:22:53,305 IN LYMPHATIC BIOLOGY. 620 00:22:53,305 --> 00:22:54,172 NAVBO IS AN ORGANIZATION THAT 621 00:22:54,172 --> 00:22:58,110 WAS ESTABLISHED 29 YEARS AGO 622 00:22:58,110 --> 00:22:59,845 THAT CONSISTS OF VASCULAR 623 00:22:59,845 --> 00:23:01,146 BIOLOGISTS WITH DIVERSE 624 00:23:01,146 --> 00:23:02,814 BACKGROUNDS, AND IT INCLUDES 625 00:23:02,814 --> 00:23:03,882 FACULTY, POSTDOCTORAL 626 00:23:03,882 --> 00:23:05,083 RESEARCHERS AND GRADUATE 627 00:23:05,083 --> 00:23:06,385 STUDENTS. 628 00:23:06,385 --> 00:23:07,786 A MAJOR GOAL OF NAVBO IS TO 629 00:23:07,786 --> 00:23:11,089 MENTOR THE FUTURE GENERATION OF 630 00:23:11,089 --> 00:23:14,192 SCIENTISTS. 631 00:23:14,192 --> 00:23:18,497 CURRENTLY, 14% OF NAVBO MEMBERS 632 00:23:18,497 --> 00:23:25,003 RECOGNIZE IT AS A RESEARCH 633 00:23:25,003 --> 00:23:25,570 INTEREST. 634 00:23:25,570 --> 00:23:26,872 -- THIS ACTUALLY STATES HOW 635 00:23:26,872 --> 00:23:29,474 INTERESTED US AS A COMMUNITY OF 636 00:23:29,474 --> 00:23:31,310 RESEARCHERS ARE IN COMMUNICATING 637 00:23:31,310 --> 00:23:34,179 AND BEING INVOLVED IN THE NIH. 638 00:23:34,179 --> 00:23:36,481 NAVBO HAS BEEN A LEADER IN 639 00:23:36,481 --> 00:23:37,816 RECOGNIZING LYMPHATIC BIOLOGY AS 640 00:23:37,816 --> 00:23:39,551 A SIGNIFICANT FOCUS IN VAR 641 00:23:39,551 --> 00:23:42,521 COLLAR BIOLOGY, THE TOPIC OF 642 00:23:42,521 --> 00:23:44,256 LYMPHATICS AT NAVBO'S ANNUAL 643 00:23:44,256 --> 00:23:46,491 VASCULAR BIOLOGY MEETING BEGAN 644 00:23:46,491 --> 00:23:48,393 WITH TWO TALKS IN 2010, AND BY 645 00:23:48,393 --> 00:23:50,162 2012, THERE WERE TWO SESSIONS 646 00:23:50,162 --> 00:23:51,730 RELATED TO LYMPHATICS. 647 00:23:51,730 --> 00:23:52,965 AND OVERTHE YEARS, THERE HAS 648 00:23:52,965 --> 00:23:55,434 BEEN AT LEAST ONE OR MORE 649 00:23:55,434 --> 00:23:59,571 SESSIONS ON LYMPHATICS OR IN 650 00:23:59,571 --> 00:24:01,974 OTHER SESSIONS HAVE INCORPORATED 651 00:24:01,974 --> 00:24:03,175 PRESENTATIONS OF LYMPHATICS. 652 00:24:03,175 --> 00:24:04,609 AND THERE'S ALSO BEEN POSTER 653 00:24:04,609 --> 00:24:07,279 SESSIONS. 654 00:24:07,279 --> 00:24:10,716 SINCE 2018, WHEN NAVBO BEGAN 655 00:24:10,716 --> 00:24:12,351 ONLINE PROGRAMMING, THERE'S BEEN 656 00:24:12,351 --> 00:24:13,685 14 EVENTS, WEBINARS, JOURNAL 657 00:24:13,685 --> 00:24:15,554 CLUBS AND IN-FOCUS PRESENTATIONS 658 00:24:15,554 --> 00:24:19,257 ON LYMPHATICS AND FIVE MID 659 00:24:19,257 --> 00:24:21,026 CAREER AND EMERITUS AWARDS IMIFN 660 00:24:21,026 --> 00:24:22,861 TO LYMPHATICS RESEARCHERS. 661 00:24:22,861 --> 00:24:25,797 WHILE OUR FLORENCE SAVINE AWARD 662 00:24:25,797 --> 00:24:28,667 NAMED BY THE ORIGINAL PIONEER IN 663 00:24:28,667 --> 00:24:32,838 LYMPHATICS BIOLOGY RECOGNIZES 664 00:24:32,838 --> 00:24:33,872 INDIVIDUALS WITH DIVERSITY, 665 00:24:33,872 --> 00:24:34,573 EQUITY AND INCLUSION IN SOCIAL 666 00:24:34,573 --> 00:24:35,207 ISSUES. 667 00:24:35,207 --> 00:24:36,575 NAVBO IS BOTH COMMITTED TO 668 00:24:36,575 --> 00:24:38,143 EDUCATING THE CURRENT AND FUTURE 669 00:24:38,143 --> 00:24:39,077 LYMPHATIC BIOLOGISTS THROUGH 670 00:24:39,077 --> 00:24:40,112 MULTIPLE AVENUES AND WE HAVE 671 00:24:40,112 --> 00:24:41,880 DONE THIS IN CLOSE TIES AND WITH 672 00:24:41,880 --> 00:24:43,882 THE SUPPORT OF THE NIH. 673 00:24:43,882 --> 00:24:45,984 BEFORE I TURN THIS OVER TO JAN, 674 00:24:45,984 --> 00:24:47,152 I'D LIKE TO POINT OUT A CONCERN 675 00:24:47,152 --> 00:24:48,687 I HAVE ABOUT THE FUTURE OF 676 00:24:48,687 --> 00:24:49,988 LYMPHATIC RESEARCH. 677 00:24:49,988 --> 00:24:51,890 AS AN EDUCATION CHAIR, I'VE 678 00:24:51,890 --> 00:24:53,091 BECOME VERY AWARE OF THE NEED TO 679 00:24:53,091 --> 00:24:54,593 SUPPORT THE FUTURE GENERATIONS 680 00:24:54,593 --> 00:24:55,894 OF SCIENTISTS, WHETHER IT BE 681 00:24:55,894 --> 00:24:57,429 HIGH SCHOOL STUDENTS OR 682 00:24:57,429 --> 00:24:59,064 POSTDOCTORAL FELLOWS. 683 00:24:59,064 --> 00:25:00,932 PREPARING FOR THIS MEETING, I 684 00:25:00,932 --> 00:25:03,235 USED THE NIH REPORTER TO 685 00:25:03,235 --> 00:25:04,970 EVALUATE NIH INVESTMENT IN THE 686 00:25:04,970 --> 00:25:07,372 FUTURE GENERATION OF LYMPHATIC 687 00:25:07,372 --> 00:25:08,273 RESEARCHERS AND WAS CONCERNED BY 688 00:25:08,273 --> 00:25:09,975 WHAT I FOUND. 689 00:25:09,975 --> 00:25:12,644 SEARCHING FOR K AWARDS AND 690 00:25:12,644 --> 00:25:15,380 LYMPHATICS AS TWO KEYWORDS, ONLY 691 00:25:15,380 --> 00:25:16,448 TWO ACTIVE K AWARDS CAME UP IN 692 00:25:16,448 --> 00:25:16,982 THE SEARCH. 693 00:25:16,982 --> 00:25:18,884 WHEN I CHANGED TO THE SEARCH 694 00:25:18,884 --> 00:25:23,321 WORD VASCULATURE, 293 ACTIVE K 695 00:25:23,321 --> 00:25:25,524 AWARDS WERE CURRENTLY FUNDED. 696 00:25:25,524 --> 00:25:29,027 THAT MEANS ONLY .6% OF K AWARDS 697 00:25:29,027 --> 00:25:30,462 FOR VASCULAR BIOLOGY ARE 698 00:25:30,462 --> 00:25:32,964 CURRENTLY GOING TO SCIENTISTS 699 00:25:32,964 --> 00:25:34,933 FOR LYMPHATIC RESEARCH. 700 00:25:34,933 --> 00:25:37,335 YET WE SEE THAT 14% OF NAVBO 701 00:25:37,335 --> 00:25:38,870 MEMBERS ARE LYMPHATIC 702 00:25:38,870 --> 00:25:40,672 RESEARCHERS. 703 00:25:40,672 --> 00:25:42,474 IF WE WANT TO SUPPORT FUTURE 704 00:25:42,474 --> 00:25:43,909 SCIENTISTS IN LYMPHATICS, WE 705 00:25:43,909 --> 00:25:47,212 NEED RFAs AND PROGRAM 706 00:25:47,212 --> 00:25:48,146 ANNOUNCEMENTS FOR TRAINING 707 00:25:48,146 --> 00:25:50,482 GRANTS IN K AWARDS FOCUSED 708 00:25:50,482 --> 00:25:51,450 SPECIFICALLY ON THE LYMPHATICS. 709 00:25:51,450 --> 00:25:53,552 I KNOW FROM EXPERIENCE, I HAVE 710 00:25:53,552 --> 00:25:55,854 RECEIVED SUPPORT FROM AN NCI 711 00:25:55,854 --> 00:25:57,122 POSTDOCTORAL TRAINING GRANT, I 712 00:25:57,122 --> 00:26:01,393 RECEIVED AN NIDDK K01 AWARD 713 00:26:01,393 --> 00:26:02,294 SUPPORTED BY DEVELOPMENT AND 714 00:26:02,294 --> 00:26:04,796 I'VE HAD TWO R01s THAT HAVE 715 00:26:04,796 --> 00:26:06,198 BEEN AWARRED THROUGH THE PROGRAM 716 00:26:06,198 --> 00:26:07,199 ANNOUNCEMENT PROGRAM ON 717 00:26:07,199 --> 00:26:07,866 LYMPHATICS. 718 00:26:07,866 --> 00:26:09,734 WE SHOULD BE BUILDING MORE 719 00:26:09,734 --> 00:26:10,702 OPPORTUNITIES FOR YOUNG 720 00:26:10,702 --> 00:26:12,270 SCIENTISTS TO ENTER THE FIELD. 721 00:26:12,270 --> 00:26:15,140 AND I WILL PASS IT OVER TO JAN. 722 00:26:15,140 --> 00:26:17,843 >> THANK YOU, CARRIE. 723 00:26:17,843 --> 00:26:19,277 MY NAME IS JAN KITAJEWSKI. 724 00:26:19,277 --> 00:26:21,680 I'M THE DIRECTOR OF THE 725 00:26:21,680 --> 00:26:23,415 UNIVERSITY OF ILLINOIS CANCER 726 00:26:23,415 --> 00:26:23,982 CENTER. 727 00:26:23,982 --> 00:26:26,885 THE HEAD OF PHYSIOLOGY AT THE 728 00:26:26,885 --> 00:26:28,019 UNIVERSITY OF ILLINOIS CHICAGO 729 00:26:28,019 --> 00:26:28,920 CAMPUS. 730 00:26:28,920 --> 00:26:32,390 PRIOR TO THAT, I SPENT 24 YEARS 731 00:26:32,390 --> 00:26:33,391 AT COLUMBIA UNIVERSITY IN THE 732 00:26:33,391 --> 00:26:35,894 DEPARTMENTS OF PATHOLOGY AND 733 00:26:35,894 --> 00:26:39,831 OB-GYN, AND MY RESEARCH 734 00:26:39,831 --> 00:26:42,200 STRADDLES THE WORK FROM 735 00:26:42,200 --> 00:26:43,335 DEVELOPMENTAL, VASCULAR BIOLOGY 736 00:26:43,335 --> 00:26:45,437 IN THE CASE OF LYMPHATICS, 737 00:26:45,437 --> 00:26:48,206 DEVELOPMENT OF THE LYMPHATIC 738 00:26:48,206 --> 00:26:49,241 SYSTEM, LARGELY WORK THAT I DID 739 00:26:49,241 --> 00:26:51,743 IN COLLABORATION WITH CARRIE. 740 00:26:51,743 --> 00:26:59,084 AND MORE RECENTLY, TUMOR LYMPH 741 00:26:59,084 --> 00:27:00,051 ANGIOGENESIS AND METASTATIC 742 00:27:00,051 --> 00:27:01,153 SPREAD TO THE LYMPH NODE AND 743 00:27:01,153 --> 00:27:01,586 BEYOND. 744 00:27:01,586 --> 00:27:04,256 I ALSO SERVE ON THE AMERICAN 745 00:27:04,256 --> 00:27:07,659 ASSOCIATION OF CANCER RESEARCH, 746 00:27:07,659 --> 00:27:09,728 CANCER CENTER DIRECTORS ADVISORY 747 00:27:09,728 --> 00:27:11,029 GROUP, AND ONE OF MY ROLES THERE 748 00:27:11,029 --> 00:27:15,100 IS TO DETERMINE WAYS THAT NIH 749 00:27:15,100 --> 00:27:16,168 INSTITUTES CAN BRIDGE THEIR 750 00:27:16,168 --> 00:27:17,969 ACTIVITIES TO ATTACK THE PROBLEM 751 00:27:17,969 --> 00:27:21,473 OF CAM SER AND I VIEW THE ROLE 752 00:27:21,473 --> 00:27:23,141 OF THE LYMPHATIC SYSTEM IN 753 00:27:23,141 --> 00:27:25,977 CANCER AS A KEY AREA TO EXPAND 754 00:27:25,977 --> 00:27:29,481 THAT TYPE OF WORK. 755 00:27:29,481 --> 00:27:30,882 JUST TO BUILD ON WHAT CARRIE 756 00:27:30,882 --> 00:27:34,519 SPOKE ABOUT, I WANTED TO TALK 757 00:27:34,519 --> 00:27:35,921 ABOUT THE LYMPHATIC FORUM 758 00:27:35,921 --> 00:27:36,154 BRIEFLY. 759 00:27:36,154 --> 00:27:38,990 THIS WAS A MEETING THAT WAS 760 00:27:38,990 --> 00:27:41,426 INITIATED IN A PROPOSAL I MADE 761 00:27:41,426 --> 00:27:42,594 AS COUNSELOR AND THEN SUPPORTED 762 00:27:42,594 --> 00:27:46,031 WHILE I WAS PRESIDENT OF NAVBO 763 00:27:46,031 --> 00:27:47,399 WITH THE IDEA OF CREATING A 764 00:27:47,399 --> 00:27:50,802 NATIONAL MEETING THAT BRINGS 765 00:27:50,802 --> 00:27:51,803 TOGETHER DISCOVERY, 766 00:27:51,803 --> 00:27:54,272 TRANSLATIONAL AND CLINICAL 767 00:27:54,272 --> 00:27:56,942 RESEARCHERS TO EXCHANGE 768 00:27:56,942 --> 00:27:59,444 INFORMATION AND ADVANCE TRAINING 769 00:27:59,444 --> 00:28:01,413 DEVELOPMENT IN THE FIELD OF 770 00:28:01,413 --> 00:28:02,180 LYMPHATIC BIOLOGY. 771 00:28:02,180 --> 00:28:03,949 IT'S BEEN QUITE SUCCESSFUL, 772 00:28:03,949 --> 00:28:07,118 HAVING RUN FOR -- 773 00:28:07,118 --> 00:28:09,521 >> EXCUSE ME, ONE MINUTE 774 00:28:09,521 --> 00:28:09,788 REMAINING. 775 00:28:09,788 --> 00:28:11,690 >> -- THANK YOU, A DECADE AND A 776 00:28:11,690 --> 00:28:11,990 HALF. 777 00:28:11,990 --> 00:28:14,125 I SHOULD SAY THAT NAVBO'S ROLE 778 00:28:14,125 --> 00:28:15,627 IN THIS MEETING IS TO ASSURE 779 00:28:15,627 --> 00:28:17,295 THAT BASIC TIS COVER REIN 780 00:28:17,295 --> 00:28:18,363 TRANSLATIONAL RESEARCHERS ARE 781 00:28:18,363 --> 00:28:19,998 BROUGHT TO A NATIONAL MEETING 782 00:28:19,998 --> 00:28:22,734 AND HAVE THE OPPORTUNITY TO 783 00:28:22,734 --> 00:28:24,703 INTERACT WITH PATIENT, PATIENT 784 00:28:24,703 --> 00:28:27,239 ADVOCATES, AND CLINICIANS, AND 785 00:28:27,239 --> 00:28:28,873 THIS IS FACILITATED LARGELY 786 00:28:28,873 --> 00:28:34,012 THROUGH A COLLABORATION WITH 787 00:28:34,012 --> 00:28:34,679 LEARN. 788 00:28:34,679 --> 00:28:36,848 SO WE LOOK FORWARD TO UTILIZE 789 00:28:36,848 --> 00:28:38,183 THE LYMPHATIC FORUM TO ADVANCE 790 00:28:38,183 --> 00:28:38,817 THIS PARTICULAR EFFORT. 791 00:28:38,817 --> 00:28:41,553 I ALSO HOPE THAT AACR WILL TAKE 792 00:28:41,553 --> 00:28:44,956 A GREATER INTEREST IN THE 793 00:28:44,956 --> 00:28:47,025 PROBLEM OF UTILIZING AND 794 00:28:47,025 --> 00:28:48,126 UNDERSTANDING THE LYMPHATIC 795 00:28:48,126 --> 00:28:49,961 SYSTEM TO ADVANCE IMMUNE 796 00:28:49,961 --> 00:28:53,798 ONCOLOGY IN A VARIETY OF OTHER 797 00:28:53,798 --> 00:28:55,767 ENTITIES, AND I'M GLAD TO KIND 798 00:28:55,767 --> 00:28:56,935 OF PARTICIPATE IN THE FUTURE AS 799 00:28:56,935 --> 00:29:01,139 A REPRESENTATIVE FROM AACR AS 800 00:29:01,139 --> 00:29:04,342 WELL. 801 00:29:04,342 --> 00:29:05,510 I LOOK FORWARD VERY MUCH TO THIS 802 00:29:05,510 --> 00:29:06,745 MEETING AND CARRIE AND I ARE 803 00:29:06,745 --> 00:29:08,380 REALLY DELIGHTED TO BE 804 00:29:08,380 --> 00:29:10,215 REPRESENTING NAVBO, AS SHE'S 805 00:29:10,215 --> 00:29:11,549 MENTIONED, IT'S HAD A RICH AND 806 00:29:11,549 --> 00:29:13,218 DEEP HISTORY IN PROMOTING 807 00:29:13,218 --> 00:29:14,586 SCIENCE AND SCIENTIFIC EXCHANGE 808 00:29:14,586 --> 00:29:16,021 IN THE FIELD OF LYMPHATIC 809 00:29:16,021 --> 00:29:17,389 BIOLOGY AND DISEASE. 810 00:29:17,389 --> 00:29:19,257 THANK YOU. 811 00:29:19,257 --> 00:29:21,059 >> THANKS SO MUCH, CARRIE AND 812 00:29:21,059 --> 00:29:21,626 JAN. 813 00:29:21,626 --> 00:29:22,927 WONDERFUL TO HAVE YOU HERE, AND 814 00:29:22,927 --> 00:29:24,496 WE LOOK FORWARD TO HEARING ABOUT 815 00:29:24,496 --> 00:29:26,331 WAYS IN WHICH WE CAN PARTNER 816 00:29:26,331 --> 00:29:28,066 WITH NAVBO, WHO'S ALREADY TAKEN 817 00:29:28,066 --> 00:29:30,602 QUITE A LEADERSHIP ROLE IN THIS 818 00:29:30,602 --> 00:29:31,136 AREA. 819 00:29:31,136 --> 00:29:33,238 OUR NEXT INVITED PANELIST 820 00:29:33,238 --> 00:29:35,206 ACTUALLY REPRESENTS A SPECIFIC 821 00:29:35,206 --> 00:29:37,409 CATEGORY THAT WAS REQUESTED BY 822 00:29:37,409 --> 00:29:37,909 THE COMMISSION. 823 00:29:37,909 --> 00:29:40,345 WE HAVE TWO SUCH INDIVIDUALS 824 00:29:40,345 --> 00:29:42,714 INVITED TODAY, NAMELY 825 00:29:42,714 --> 00:29:44,282 CLINICIAN-SCIENTISTS WHO HAVE 826 00:29:44,282 --> 00:29:46,584 DEVOTED THEIR CAREERS TO 827 00:29:46,584 --> 00:29:49,087 INVESTIGATING THE LYMPHATIC 828 00:29:49,087 --> 00:29:52,057 SYSTEM IN THE ROLE OF 829 00:29:52,057 --> 00:29:52,490 CLINICIAN-SCIENTIST. 830 00:29:52,490 --> 00:29:57,595 OUR NEXT INVITED PANELIST IS 831 00:29:57,595 --> 00:30:00,899 PROFESSOR MIIKKA VIKKULA WHO 832 00:30:00,899 --> 00:30:04,569 REPRESENTS THE INTERNATI INTERNL 833 00:30:04,569 --> 00:30:05,603 SOCIETY FOR THE STUDY OF 834 00:30:05,603 --> 00:30:06,504 VASCULAR ANOMALIES. 835 00:30:06,504 --> 00:30:12,477 SO MIIKKA, WELCOME. 836 00:30:12,477 --> 00:30:18,550 >> WE CAN'T HEAR YOU, MIIKKA. 837 00:30:18,550 --> 00:30:19,718 >> CAN YOU HEAR ME NOW? 838 00:30:19,718 --> 00:30:20,151 >> YES. 839 00:30:20,151 --> 00:30:20,919 >> PERFECT. 840 00:30:20,919 --> 00:30:22,120 THANK YOU FOR THE INTRODUCTION 841 00:30:22,120 --> 00:30:27,258 AND FOR THIS INVITATION FROM THE 842 00:30:27,258 --> 00:30:31,863 COMMITTEE, FOR THE ORGANIZERS. 843 00:30:31,863 --> 00:30:36,034 I'M CURRENTLY CO-DIRECTOR OF THE 844 00:30:36,034 --> 00:30:37,569 INSTITUTE IN BRUSSELS, BELGIUM, 845 00:30:37,569 --> 00:30:40,271 VERY STRONGLY AFFILIATED WITH 846 00:30:40,271 --> 00:30:41,506 THE UNIVERSITY, THE MEDICAL 847 00:30:41,506 --> 00:30:43,141 FACULTY HERE IN BRUSSELS, 848 00:30:43,141 --> 00:30:43,575 BELGIUM. 849 00:30:43,575 --> 00:30:47,412 I'M ALSO A MEMBER OF THE BELGIAN 850 00:30:47,412 --> 00:30:51,549 ACADEMY OF MEDICINE, AND A 851 00:30:51,549 --> 00:30:59,357 MEMBER NOW VICE PRESIDE VICE PRH 852 00:30:59,357 --> 00:31:01,626 IS WHY I'M HERE TODAY. 853 00:31:01,626 --> 00:31:04,596 I'M AN M.D. PH.D., THEN IN 1993, 854 00:31:04,596 --> 00:31:07,532 I FLEW TO BOSTON, I WAS THERE 855 00:31:07,532 --> 00:31:10,201 FROM '93 TO '97 AS A POSTDOC, 856 00:31:10,201 --> 00:31:11,603 THAT IS WHEN I WAS INTRODUCED TO 857 00:31:11,603 --> 00:31:18,343 THE FIELD OF VASCULAR ANOMALIES, 858 00:31:18,343 --> 00:31:19,811 IT INCLUDES ALL THE LYMPHATIC 859 00:31:19,811 --> 00:31:21,312 PROBLEMS AS WELL. 860 00:31:21,312 --> 00:31:22,514 SO EVER SINCE I'VE BEEN WORKING 861 00:31:22,514 --> 00:31:27,652 FOR THE PAST 30 YEARS IN THIS 862 00:31:27,652 --> 00:31:29,721 FIELD, AND MAINLY LOOKING FOR 863 00:31:29,721 --> 00:31:31,489 THE GENETIC ASPECTS, TRYING TO 864 00:31:31,489 --> 00:31:36,161 UNDERSTAND WHY PEOPLE HAVE THESE 865 00:31:36,161 --> 00:31:37,629 LYMPHATIC MALFORMATIONS OR 866 00:31:37,629 --> 00:31:47,038 VASCULAR MALFORMATIONS OR 867 00:31:47,038 --> 00:31:51,176 LYMPHEDEMA, BASICALLY FUNDED BY 868 00:31:51,176 --> 00:31:53,711 NIH, EUROPEAN UNION, 869 00:31:53,711 --> 00:31:55,847 COLLABORATIVE NETWORKS AS WELL, 870 00:31:55,847 --> 00:31:57,849 AND CENTER OF EXCELLENCE FROM 871 00:31:57,849 --> 00:31:59,384 THE BELGIAN SIDE ALSO FUNDING 872 00:31:59,384 --> 00:32:04,989 THESE STUDIES. 873 00:32:04,989 --> 00:32:07,392 I HAVE ALSO FOLLOWED THE LEARN 874 00:32:07,392 --> 00:32:09,160 FROM THE VERY INITIATION, WHICH 875 00:32:09,160 --> 00:32:11,763 I THINK HAS BEEN MAKING A GREAT 876 00:32:11,763 --> 00:32:15,400 WORK IN MAKING AWARENESS OF 877 00:32:15,400 --> 00:32:16,468 LYMPHEDEMA AND LYMPHATIC 878 00:32:16,468 --> 00:32:17,268 DISEASES, WHICH AT THE BEGINNING 879 00:32:17,268 --> 00:32:19,204 WHEN I STARTED MY WORK 30 YEARS 880 00:32:19,204 --> 00:32:24,876 AGO, I THINK THAT WE HAVE VERY 881 00:32:24,876 --> 00:32:25,844 MUCH BETTER WAY FROM WHERE WE 882 00:32:25,844 --> 00:32:26,544 ARE NOW. 883 00:32:26,544 --> 00:32:27,745 EVEN IF THERE'S STILL A LOT TO 884 00:32:27,745 --> 00:32:28,213 BE DONE. 885 00:32:28,213 --> 00:32:30,949 SO WE SEE THESE PATIENT 886 00:32:30,949 --> 00:32:35,220 FREQUENTLY WEEKLY, DAILY, 887 00:32:35,220 --> 00:32:36,721 THERE'S A LOT OF CONCERNS, LOTS 888 00:32:36,721 --> 00:32:40,258 OF CLINICAL PROBLEMS, ALSO 889 00:32:40,258 --> 00:32:41,893 REIMBURSEMENTS FOR TAKING CARE 890 00:32:41,893 --> 00:32:43,428 OF THEIR PROBLEMS. 891 00:32:43,428 --> 00:32:46,731 WE DO HAVE SURGERY, WE DO HAVE 892 00:32:46,731 --> 00:32:49,200 LIPOSUCTION, WE HAVE BANDAGES, 893 00:32:49,200 --> 00:32:52,270 WE HAVE THE LYMPHATIC DRAINAGE 894 00:32:52,270 --> 00:32:53,605 THERAPY BY MASSAGE, BUT NOTHING 895 00:32:53,605 --> 00:32:55,273 IS REALLY CURATIVE. 896 00:32:55,273 --> 00:32:59,177 SO THIS IS KIND OF A LIFELONG 897 00:32:59,177 --> 00:33:00,612 MANAGEMENT COPING WITH THE 898 00:33:00,612 --> 00:33:01,479 DISEASE. 899 00:33:01,479 --> 00:33:03,047 AND THAT, OF COURSE, IS VERY 900 00:33:03,047 --> 00:33:04,782 HEAVY AND CAN CAUSE LOTS OF 901 00:33:04,782 --> 00:33:08,186 PROBLEMS IN DAILY LIFE, IN WORK, 902 00:33:08,186 --> 00:33:14,859 AND SO VERY IMPORTANT ASPECTS. 903 00:33:14,859 --> 00:33:20,532 SO I AM HERE FOR ISSVA, AND WE 904 00:33:20,532 --> 00:33:21,966 ACTUALLY RECENTLY REVISED THE 905 00:33:21,966 --> 00:33:26,037 MISSION STATEMENT, SO ISSVA IS A 906 00:33:26,037 --> 00:33:26,671 MULTIDISCIPLINARY INTERNATIONAL 907 00:33:26,671 --> 00:33:28,573 SOCIETY OF PHYSICIANS, 908 00:33:28,573 --> 00:33:30,542 SCIENTISTS AND HEALTHCARE 909 00:33:30,542 --> 00:33:33,645 PROVIDERS UNITED BY AN INTEREST 910 00:33:33,645 --> 00:33:35,680 IN VASCULAR ANOMALIES, MEANING 911 00:33:35,680 --> 00:33:39,617 ALSO LYMPHATIC PROBLEMS. 912 00:33:39,617 --> 00:33:40,685 THE SOCIETY AIMS TO PROMOTE THE 913 00:33:40,685 --> 00:33:42,220 HIGH ETION STANDARDS OF CARE FOR 914 00:33:42,220 --> 00:33:45,490 PATIENTS WITH VASCULAR ANOMALIES 915 00:33:45,490 --> 00:33:47,358 BY ADVANCING CLINICAL AND 916 00:33:47,358 --> 00:33:48,226 SCIENTIFIC KNOWLEDGE CONCERNING 917 00:33:48,226 --> 00:33:49,894 CAUSES, DIAGNOSES AND TREATMENT, 918 00:33:49,894 --> 00:33:52,430 AND BY EDUCATION OF PHYSICIANS, 919 00:33:52,430 --> 00:33:55,500 HEALTHCARE PROVIDERS, PATIENTS, 920 00:33:55,500 --> 00:33:56,367 AND THE COMMUNITY. 921 00:33:56,367 --> 00:33:58,202 THE SOCIETY ENCOURAGES THE FREE 922 00:33:58,202 --> 00:33:59,938 FLOW OF INFORMATION BETWEEN ITS 923 00:33:59,938 --> 00:34:03,908 MEMBERS AND INDUSTRY GROUPS 924 00:34:03,908 --> 00:34:05,343 THROUGH WORKSHOPS, MEETINGS, AND 925 00:34:05,343 --> 00:34:06,945 TEACHING PROGRAMS AND BY THE 926 00:34:06,945 --> 00:34:08,279 DISSEMINATION OF A 927 00:34:08,279 --> 00:34:09,847 CLASSIFICATION SCHEME AND 928 00:34:09,847 --> 00:34:12,116 PERTINENT SCIENTIFIC -- IT'S 929 00:34:12,116 --> 00:34:13,351 TRUE THAT -- CLASSIFICATION 930 00:34:13,351 --> 00:34:15,720 SHOULD BE SOON PUBLISHED, AND 931 00:34:15,720 --> 00:34:17,956 THE INTEREST IN THE -- CAN BE 932 00:34:17,956 --> 00:34:19,924 ALSO SEEN IN THE INCREASE OF THE 933 00:34:19,924 --> 00:34:22,260 NUMBER OF PARTICIPANTS AT THE 934 00:34:22,260 --> 00:34:22,794 ISSVA MEETINGS. 935 00:34:22,794 --> 00:34:24,629 WE USED TO BE A SMALL GROUP 30 936 00:34:24,629 --> 00:34:26,831 YEARS AGO, ABOUT 200 PEOPLE. 937 00:34:26,831 --> 00:34:30,935 NOW IT'S OVER 900 PEOPLE AT 938 00:34:30,935 --> 00:34:31,869 EVERY SECOND YEAR MEETING THAT 939 00:34:31,869 --> 00:34:33,204 WE HAVE, WHICH IS NOW A WORLD 940 00:34:33,204 --> 00:34:34,505 CONGRESS, AND THERE'S A LOT OF 941 00:34:34,505 --> 00:34:36,608 THOUGHT HOW TO ORGANIZE THIS IN 942 00:34:36,608 --> 00:34:39,410 THE FUTURE BECAUSE CLEARLY THERE 943 00:34:39,410 --> 00:34:41,412 ARE MORE AND MORE PHYSICIANS AND 944 00:34:41,412 --> 00:34:42,814 BASIC SCIENTISTS INTERESTED IN 945 00:34:42,814 --> 00:34:45,550 THE FIELD, AND WE ALSO WANT TO 946 00:34:45,550 --> 00:34:47,752 BRING THE PATIENT ASSOCIATIONS 947 00:34:47,752 --> 00:34:49,220 ACTUALLY INTO THIS FIELD AS 948 00:34:49,220 --> 00:34:52,590 WELL. 949 00:34:52,590 --> 00:34:55,326 SO THAT'S ALL FOR ME, I HOPE. 950 00:34:55,326 --> 00:34:55,827 THANK YOU VERY MUCH. 951 00:34:55,827 --> 00:34:56,961 >> THANK YOU, MIIKKA. 952 00:34:56,961 --> 00:34:57,829 THAT'S GREAT. 953 00:34:57,829 --> 00:35:00,665 WE'LL BE DISCUSSING MORE ONCE WE 954 00:35:00,665 --> 00:35:02,433 GET TO THE END OF ALL THE 955 00:35:02,433 --> 00:35:03,635 INTRODUCTIONS. 956 00:35:03,635 --> 00:35:06,704 MY NEXT INTRODUCTION IS FOR 957 00:35:06,704 --> 00:35:08,573 REPRESENTATIVES OF THE 958 00:35:08,573 --> 00:35:09,540 MICROCIRCULATORY SOCIETY, SO 959 00:35:09,540 --> 00:35:10,908 AGAIN, I'LL LEAVE TO THE TWO OF 960 00:35:10,908 --> 00:35:12,844 YOU TO DIVIDE YOUR TIME. 961 00:35:12,844 --> 00:35:20,318 I HAVE DR. POONEH BAGHER AND DR. 962 00:35:20,318 --> 00:35:21,853 >> THANK YOU SO MUCH, AND THANK 963 00:35:21,853 --> 00:35:23,454 YOU FOR INVITING UTS TO 964 00:35:23,454 --> 00:35:25,990 PARTICIPATE IN THIS IMPORTANT 965 00:35:25,990 --> 00:35:26,958 MEETING. 966 00:35:26,958 --> 00:35:28,126 I'M POONEH BAGHER, ASSOCIATE 967 00:35:28,126 --> 00:35:29,093 PROFESSOR IN THE DEPARTMENT OF 968 00:35:29,093 --> 00:35:31,396 CELLULAR AND INTEGRATED 969 00:35:31,396 --> 00:35:32,730 PHYSIOLOGY AT THE UNIVERSITY OF 970 00:35:32,730 --> 00:35:33,464 NEBRASKA MEDICAL CENTER. 971 00:35:33,464 --> 00:35:35,433 MY RESEARCH IS IN THE FIELD OF 972 00:35:35,433 --> 00:35:36,067 VASCULAR PHYSIOLOGY. 973 00:35:36,067 --> 00:35:37,735 I'M JOINING TODAY AS I'M THE 974 00:35:37,735 --> 00:35:39,804 CURRENT PRESIDENT OF THE 975 00:35:39,804 --> 00:35:40,338 MICROCIRCULATORY SOCIETY. 976 00:35:40,338 --> 00:35:42,440 WE CALL IT THE MCS FOR SHORT, 977 00:35:42,440 --> 00:35:44,742 AND I'M HERE WITH OUR IMMEDIATE 978 00:35:44,742 --> 00:35:47,445 PAST PRESIDENT, JERRY BRESLIN. 979 00:35:47,445 --> 00:35:48,546 WE REPRESENT ONE OF THE 980 00:35:48,546 --> 00:35:49,681 SOCIETIES THAT SERVES AS A 981 00:35:49,681 --> 00:35:51,115 NETWORKING HOME FOR NUMEROUS 982 00:35:51,115 --> 00:35:53,351 LYMPHATIC RESEARCHERS. 983 00:35:53,351 --> 00:35:55,553 OUR SOCIETY'S MISSION IS TO 984 00:35:55,553 --> 00:35:57,422 ACTIVELY ENGAGE AND PROMOTE 985 00:35:57,422 --> 00:35:59,057 INNOVATIVE RESEARCH PERTAINING 986 00:35:59,057 --> 00:36:01,926 TO MICROCIRCULATORY AND 987 00:36:01,926 --> 00:36:03,594 LYMPHATIC FUNCTION IN HEALTH AND 988 00:36:03,594 --> 00:36:04,095 DISEASE. 989 00:36:04,095 --> 00:36:05,897 WE ORGANIZE SCIENTIFIC MEETINGS 990 00:36:05,897 --> 00:36:07,298 TO FACILITATE INTERACTIONS AND 991 00:36:07,298 --> 00:36:08,466 NETWORKING BETWEEN SCIENTISTS TO 992 00:36:08,466 --> 00:36:09,901 SPARK NEW IDEAS, OFTEN 993 00:36:09,901 --> 00:36:11,803 PARTNERING WITH OTHER SCIENTIFIC 994 00:36:11,803 --> 00:36:12,336 SOCIETIES. 995 00:36:12,336 --> 00:36:15,173 WE ALSO FEATURE AN ANNUAL AWARD 996 00:36:15,173 --> 00:36:16,174 HIGHLIGHTING INNOVATIVE WORK 997 00:36:16,174 --> 00:36:17,909 FROM A JUNIOR INVESTIGATOR IN 998 00:36:17,909 --> 00:36:19,911 THE LYMPHATIC FIELD. 999 00:36:19,911 --> 00:36:22,046 I'LL NOW LET JERRY SPEAK, AS 1000 00:36:22,046 --> 00:36:26,751 HE'S AN ACTIVE LYMPHATIC 1001 00:36:26,751 --> 00:36:27,051 RESEARCHER. 1002 00:36:27,051 --> 00:36:29,387 >> THANK YOU, POONEH. 1003 00:36:29,387 --> 00:36:31,456 I'D JUST LIKE TO HIGHLIGHT THE 1004 00:36:31,456 --> 00:36:32,890 WORK THAT SEVERAL OF OUR MEMBERS 1005 00:36:32,890 --> 00:36:37,862 HAVE ENGAGED IN THAT'S DIRECTLY 1006 00:36:37,862 --> 00:36:39,163 RELEVANT TO LYMPHATIC DISEASE. 1007 00:36:39,163 --> 00:36:40,998 SO MEMBERS OF THE MCS HAVE BEEN 1008 00:36:40,998 --> 00:36:41,999 INVESTIGATING LYMPHATIC VESSELS 1009 00:36:41,999 --> 00:36:45,336 FOR THE PAST 70 YEARS. 1010 00:36:45,336 --> 00:36:48,206 IN FACT ONE OF OUR FOUNDERS AND 1011 00:36:48,206 --> 00:36:51,876 OUR TRAINEES -- OR HIS TRAINEES 1012 00:36:51,876 --> 00:36:56,047 INCLUDING ARTHUR GIDEN AND G 1013 00:36:56,047 --> 00:36:58,116 ERSHMAN STUDY THE MECHANICS OF 1014 00:36:58,116 --> 00:36:58,816 LYMPH TRANSPORT. 1015 00:36:58,816 --> 00:37:00,017 FOLLOWED BY ANOTHER GENERATION 1016 00:37:00,017 --> 00:37:02,019 OF RESEARCHES INCLUDING MIKE 1017 00:37:02,019 --> 00:37:04,956 DAVIS AND DAVID ZAVEA WHO 1018 00:37:04,956 --> 00:37:06,357 DESIGNED PROTOCOLS TO ISOLATE 1019 00:37:06,357 --> 00:37:07,825 AND CANNULATE LYMPHATIC VESSELS 1020 00:37:07,825 --> 00:37:11,195 TO BE ABLE TO UNDERSTAND THEIR 1021 00:37:11,195 --> 00:37:14,899 MECHANISMS OF PUMP FUNCTION. 1022 00:37:14,899 --> 00:37:16,367 SO SINCE THEN THE SLIGHTLY 1023 00:37:16,367 --> 00:37:18,436 YOUNGER GENERATION HAVE STARTED 1024 00:37:18,436 --> 00:37:21,172 TO' PLY THIS TO DISEASES SUCH AS 1025 00:37:21,172 --> 00:37:22,607 METABOLIC SYNDROME, AGING AND 1026 00:37:22,607 --> 00:37:25,243 BOTH PRIMARY AND SECONDARY 1027 00:37:25,243 --> 00:37:28,312 LYMPHEDEMA SO THIS INCLUDES 1028 00:37:28,312 --> 00:37:34,952 PEOPLE AND ALSO I SHOULD MENTION 1029 00:37:34,952 --> 00:37:38,022 MARI WHO IS ABOUT TO LEAD THE 1030 00:37:38,022 --> 00:37:40,024 FIRST EVER LYMPHATIC ORIENTED 1031 00:37:40,024 --> 00:37:41,759 NIH T32 TRAINING GRANT IN THE 1032 00:37:41,759 --> 00:37:44,729 NATION. 1033 00:37:44,729 --> 00:37:46,063 IN ADDITION, THE GENERATION 1034 00:37:46,063 --> 00:37:48,499 WHO'S AFTER US WHO ARE NOW 1035 00:37:48,499 --> 00:37:49,267 BECOMING ESTABLISHED 1036 00:37:49,267 --> 00:37:50,568 INVESTIGATORS INCLUDING PEOPLE 1037 00:37:50,568 --> 00:37:56,040 LIKE JOSH SCALLEN, ING YUNG, TO 1038 00:37:56,040 --> 00:37:59,710 NAME A FEW, ARE STUDYING A WIDE 1039 00:37:59,710 --> 00:38:01,412 RANGE OF NEW MERCK NISMS 1040 00:38:01,412 --> 00:38:03,514 RELATIVE TO LYMPHATIC PUMPING, 1041 00:38:03,514 --> 00:38:05,950 MALFORMATION AND MATURATION IN 1042 00:38:05,950 --> 00:38:07,618 INTRACELLULAR SIGNALING IN 1043 00:38:07,618 --> 00:38:08,553 LYMPHATIC VESSELS IN BOTH THE 1044 00:38:08,553 --> 00:38:10,321 CONTEXT OF HEALTH AND DISEASE. 1045 00:38:10,321 --> 00:38:12,723 SO AS A SCIENTIFIC SOCIETY, WE 1046 00:38:12,723 --> 00:38:14,625 AIM TO HIGHLIGHT THE ADVANCES 1047 00:38:14,625 --> 00:38:16,561 MADE BY THESE MEMBERS AT 1048 00:38:16,561 --> 00:38:20,598 MULTIPLE MEETINGSAGE SCIENTISTS 1049 00:38:20,598 --> 00:38:21,699 EACH YEAR TO SPARK NEW 1050 00:38:21,699 --> 00:38:23,167 INNOVATIONS AND ENCOURAGE MORE 1051 00:38:23,167 --> 00:38:24,702 RESEARCH THAT WILL ADVANCE OUR 1052 00:38:24,702 --> 00:38:28,439 KNOWLEDGE OF THE LYMPHATIC 1053 00:38:28,439 --> 00:38:29,740 SYSTEM AND ULTIMATELY TRANSLATE 1054 00:38:29,740 --> 00:38:31,943 INTO MORE POSITIVE OUTCOMES FOR 1055 00:38:31,943 --> 00:38:33,911 PATIENTS WITH LYMPHATIC 1056 00:38:33,911 --> 00:38:34,579 DISEASES. 1057 00:38:34,579 --> 00:38:36,747 SO I'D LIKE TO HAND IT BACK TO 1058 00:38:36,747 --> 00:38:37,748 POONEH, WHO CAN TALK A LITTLE 1059 00:38:37,748 --> 00:38:41,853 BIT MORE ABOUT THAT. 1060 00:38:41,853 --> 00:38:42,887 >> THANKS, JERRY. 1061 00:38:42,887 --> 00:38:44,355 JUST TO EXPAND ON WHAT JERRY 1062 00:38:44,355 --> 00:38:46,324 SAID, IN RECENT YEARS, WE HAVE 1063 00:38:46,324 --> 00:38:47,425 COLLABORATED WITH THE NORTH 1064 00:38:47,425 --> 00:38:49,493 AMERICAN VASCULAR BIOLOGY 1065 00:38:49,493 --> 00:38:50,294 ORGANIZATION, WHICH WE'VE 1066 00:38:50,294 --> 00:38:52,663 ALREADY HEARD FROM THEM A LITTLE 1067 00:38:52,663 --> 00:38:54,966 BIT EARLIER, AND WE'VE SPONSORED 1068 00:38:54,966 --> 00:38:56,500 SYMPOSIA HIGHLIGHTING LYMPHATIC 1069 00:38:56,500 --> 00:38:57,735 RESEARCH AT THEIR ANNUAL 1070 00:38:57,735 --> 00:39:01,005 MEETING, PLUS WE'VE ALSO HAD 1071 00:39:01,005 --> 00:39:02,006 SYMPOSIA AT THE LYMPHATIC FORUM, 1072 00:39:02,006 --> 00:39:03,140 WHICH WAS ALSO MENTIONED EARLIER 1073 00:39:03,140 --> 00:39:03,741 WHY. 1074 00:39:03,741 --> 00:39:05,509 WE ALSO HAVE WORKED WITH THE 1075 00:39:05,509 --> 00:39:06,878 AMERICAN PHYSIOLOGICAL SOCIETY 1076 00:39:06,878 --> 00:39:09,647 TO MAKE SURE THAT LYMPHATIC 1077 00:39:09,647 --> 00:39:11,215 RESEARCH IS REPRESENTED IN THEIR 1078 00:39:11,215 --> 00:39:12,750 ANNUAL MEETING PROGRAM. 1079 00:39:12,750 --> 00:39:13,851 IF YOU'D LIKE TO LEARN MORE 1080 00:39:13,851 --> 00:39:15,586 ABOUT OUR SOCIETY, PLEASE FEEL 1081 00:39:15,586 --> 00:39:17,722 FREE TO CONTACT MYSELF OR JERRY 1082 00:39:17,722 --> 00:39:20,524 OR YOU CAN VISIT OUR WEBSITE. 1083 00:39:20,524 --> 00:39:22,927 IT'S MICROCIRC.ORG. 1084 00:39:22,927 --> 00:39:24,695 WE'RE HIGHLY INTERESTED IN 1085 00:39:24,695 --> 00:39:25,796 FACILITATING ADVANCES IN 1086 00:39:25,796 --> 00:39:26,898 LYMPHATIC RESEARCH AND ARE HAPPY 1087 00:39:26,898 --> 00:39:28,866 TO BE HERE AND TO OUR SUPPORT. 1088 00:39:28,866 --> 00:39:31,302 SO THANK YOU VERY MUCH. 1089 00:39:31,302 --> 00:39:34,138 >> THANK YOU SO MUCH, POONEH AND 1090 00:39:34,138 --> 00:39:34,505 JERRY. 1091 00:39:34,505 --> 00:39:36,140 AND I'M SORRY ABOUT THE 1092 00:39:36,140 --> 00:39:38,209 MISPRONUNCIATION OF YOUR LAST 1093 00:39:38,209 --> 00:39:39,810 NAME, DR. BAGHER. 1094 00:39:39,810 --> 00:39:41,112 >> NO PROBLEM. 1095 00:39:41,112 --> 00:39:44,882 >> OUR NEXT INVITED SPEAKER IS 1096 00:39:44,882 --> 00:39:46,417 DR. MICHAEL KELLY, WHO 1097 00:39:46,417 --> 00:39:49,186 REPRESENTS LGDA, THE 1098 00:39:49,186 --> 00:39:50,154 LYMPHANGIOMATOSIS AND GORHAM'S 1099 00:39:50,154 --> 00:39:52,890 DISEASE ALLIANCE. 1100 00:39:52,890 --> 00:39:54,792 >> THANK YOU, DR. ROCKSON, AND 1101 00:39:54,792 --> 00:39:57,295 THANK YOU TO THE NATIONAL 1102 00:39:57,295 --> 00:39:58,195 COMMISSION ON LYMPHATIC DISEASES 1103 00:39:58,195 --> 00:40:00,698 FOR THE INVITATION. 1104 00:40:00,698 --> 00:40:02,333 I'M MIKE KELLY. 1105 00:40:02,333 --> 00:40:05,569 I'M A PHYSICIAN SCIENTIST AT 1106 00:40:05,569 --> 00:40:07,505 CLEVELAND CLINIC, AND HEAD OUR 1107 00:40:07,505 --> 00:40:09,373 VASCULAR ANOMALY PROGRAM THERE. 1108 00:40:09,373 --> 00:40:14,078 ALSO THE EXECUTIVE DIRECTOR OF 1109 00:40:14,078 --> 00:40:19,350 DIRECTOR OFLGDA. 1110 00:40:19,350 --> 00:40:20,584 THIS IS A PATIENT ADVOCACY 1111 00:40:20,584 --> 00:40:24,088 ORGANIZATION FORMED IN 2007 BY 1112 00:40:24,088 --> 00:40:25,489 JANA, A PATIENT WHO WANTED 1113 00:40:25,489 --> 00:40:27,224 REALLY TO PROVIDE A SUPPORTIVE 1114 00:40:27,224 --> 00:40:28,426 COMMUNITY TO THOSE WITH SIMILAR 1115 00:40:28,426 --> 00:40:30,761 DISEASES AND THEIR FAMILIES. 1116 00:40:30,761 --> 00:40:33,064 THE LGDA HAS EVOLVED OVER THAT 1117 00:40:33,064 --> 00:40:35,166 TIME, AND EXISTS TO ADVANCE THE 1118 00:40:35,166 --> 00:40:38,869 CARE OF PATIENTS WITH RARE 1119 00:40:38,869 --> 00:40:40,204 COMPLEX LYMPHATIC ANOMALIES 1120 00:40:40,204 --> 00:40:44,475 THROUGH PATIENT SUPPORT, MEDICAL 1121 00:40:44,475 --> 00:40:46,110 EDUCATION AND ADVANCEMENT OF 1122 00:40:46,110 --> 00:40:47,244 RESEARCH. 1123 00:40:47,244 --> 00:40:49,013 COMPLEX LYMPHATIC ANOMALIES 1124 00:40:49,013 --> 00:40:53,451 INCLUDE DISEASES SUCH AS GORHAM 1125 00:40:53,451 --> 00:40:56,087 STOUT DISEASE, GENERALIZED 1126 00:40:56,087 --> 00:41:00,458 LYMPHATIC ANOMALY, AND CENTRAL 1127 00:41:00,458 --> 00:41:02,693 CONDUCTING LYMPHATIC ANOMALY. 1128 00:41:02,693 --> 00:41:05,963 THESE DISEASES RESULT IN 1129 00:41:05,963 --> 00:41:07,298 ABNORMAL LYMPHATIC PROLIFERATION 1130 00:41:07,298 --> 00:41:09,233 AND FUNCTION INVOLVING MULTIPLE 1131 00:41:09,233 --> 00:41:10,868 ORGANS INCLUDING BOTH SOFT 1132 00:41:10,868 --> 00:41:14,271 TISSUES AND BONES. 1133 00:41:14,271 --> 00:41:15,373 THEY'RE DEVELOPMENTAL DISEASES 1134 00:41:15,373 --> 00:41:16,907 CAUSED BY SOMATIC AND LESS 1135 00:41:16,907 --> 00:41:19,210 COMMONLY GERMLINE VARIANTS AND 1136 00:41:19,210 --> 00:41:20,745 GENES RESULTING IN 1137 00:41:20,745 --> 00:41:23,614 HYPERACTIVATION OF THE 1138 00:41:23,614 --> 00:41:25,149 PI3 KINASE AS WELL AS RAS 1139 00:41:25,149 --> 00:41:26,017 SIGNALING PATHWAYS. 1140 00:41:26,017 --> 00:41:28,753 TO RAISE AWARENESS AND IMPROVE 1141 00:41:28,753 --> 00:41:31,622 GLOBAL IMPACT, THE LGDA HAS 1142 00:41:31,622 --> 00:41:32,490 ESTABLISHED FORMAL 1143 00:41:32,490 --> 00:41:35,559 COLLABORATIONS WITH TWO LIKE 1144 00:41:35,559 --> 00:41:36,494 ORGANIZATIONS. 1145 00:41:36,494 --> 00:41:38,229 THE LYMPHATIC MALFORMATION 1146 00:41:38,229 --> 00:41:40,831 INSTITUTE, OR LMI, AND LGDA 1147 00:41:40,831 --> 00:41:41,866 EUROPE. 1148 00:41:41,866 --> 00:41:44,468 THESE ORGANIZATIONS SHARE 1149 00:41:44,468 --> 00:41:46,771 PRIORITIES, ADVISORY COUNCILS 1150 00:41:46,771 --> 00:41:48,105 INCLUDING THE MEDICAL AND 1151 00:41:48,105 --> 00:41:50,508 SCIENTIFIC ADVISORY COUNCIL, AND 1152 00:41:50,508 --> 00:41:53,077 A PATIENT COMMUNITY ADVISORY 1153 00:41:53,077 --> 00:41:55,646 COUNCIL, AND FUNDS TO RAISE 1154 00:41:55,646 --> 00:41:57,681 GLOBAL AWARENESS OF AND SUPPORT 1155 00:41:57,681 --> 00:41:59,283 FOR CLAs. 1156 00:41:59,283 --> 00:42:03,020 OVER THE PAST 10 YEARS, THIS 1157 00:42:03,020 --> 00:42:06,457 CONSORTIUM OF ORGANIZATIONS HAS 1158 00:42:06,457 --> 00:42:07,758 PROMOTED RESEARCH ADVANCEMENT 1159 00:42:07,758 --> 00:42:09,360 THROUGH SPONSORING A SCIENTIFIC 1160 00:42:09,360 --> 00:42:11,028 CONFERENCE EVERY OTHER YEAR, 1161 00:42:11,028 --> 00:42:12,363 BRINGING TOGETHER INTERNATIONAL 1162 00:42:12,363 --> 00:42:14,532 EXPERTS IN THE STUDY AND CARE OF 1163 00:42:14,532 --> 00:42:16,734 CLAs. 1164 00:42:16,734 --> 00:42:18,369 DEVELOPING CLA RESEARCH NETWORK 1165 00:42:18,369 --> 00:42:21,705 THAT'S NOW INCLUSIVE OF OVER 200 1166 00:42:21,705 --> 00:42:24,075 INTERNATIONAL INVESTIGATORS WITH 1167 00:42:24,075 --> 00:42:27,578 A MONTHLY SEMINAR SERIES. 1168 00:42:27,578 --> 00:42:29,146 WE'VE PROVIDE OVER $8 MILLION IN 1169 00:42:29,146 --> 00:42:30,614 RESEARCH FUNDING OVER THAT 1170 00:42:30,614 --> 00:42:32,650 PERIOD OF TIME, AND AWARDS HAVE 1171 00:42:32,650 --> 00:42:34,151 FUNDED OVER 50 NEW AND 1172 00:42:34,151 --> 00:42:35,786 ESTABLISHED INVESTIGATORS IN THE 1173 00:42:35,786 --> 00:42:38,489 FIELD OF CLAs REPRESENTING 11 1174 00:42:38,489 --> 00:42:42,293 DIFFERENT COUNTRIES AND FOUR 1175 00:42:42,293 --> 00:42:42,593 CONTINENTS. 1176 00:42:42,593 --> 00:42:44,428 FUNDING HAS BEEN INSTRUMENTAL IN 1177 00:42:44,428 --> 00:42:46,897 SUPPORTING CLA INVESTIGATORS WHO 1178 00:42:46,897 --> 00:42:50,401 HAVE DEVELOPED NEW PRE-CLINICAL 1179 00:42:50,401 --> 00:42:54,572 MODELS OF DISEASES, INNOVATIVE 1180 00:42:54,572 --> 00:42:55,606 IMAGING TECHNOLOGIES THAT ARE 1181 00:42:55,606 --> 00:42:58,342 NOW STANDARD OF CARE, REGISTRIES 1182 00:42:58,342 --> 00:42:59,376 AND BIOREPOSITORIES IMPORTANT 1183 00:42:59,376 --> 00:43:04,281 FOR NATURAL HISTORY STUDIES, AS 1184 00:43:04,281 --> 00:43:06,016 WELL AS ANNOTATED PATIENT 1185 00:43:06,016 --> 00:43:06,884 SAMPLES. 1186 00:43:06,884 --> 00:43:08,419 NEW MEDICAL THERAPIES TARGETING 1187 00:43:08,419 --> 00:43:10,988 GENETIC VARIANTS CAUSING CLAs, 1188 00:43:10,988 --> 00:43:12,289 AS WELL AS STUDIES TO BETTER 1189 00:43:12,289 --> 00:43:14,725 UNDERSTAND THE CHALLENGES AND 1190 00:43:14,725 --> 00:43:16,427 BARRIERS FACED BY OUR PATIENTS 1191 00:43:16,427 --> 00:43:20,764 WITH CLAs AND THEIR FAMILIES. 1192 00:43:20,764 --> 00:43:22,266 OUR ORGANIZATION'S WORK TO RAISE 1193 00:43:22,266 --> 00:43:24,401 AWARENESS OF CLAs THROUGH 1194 00:43:24,401 --> 00:43:25,503 PARTNERING WITH LIFE SCIENCE 1195 00:43:25,503 --> 00:43:27,538 COMPANIES AND PARTNERING AS A 1196 00:43:27,538 --> 00:43:30,007 GUEST ORGANIZATION IN THE 1197 00:43:30,007 --> 00:43:33,577 TRANS-NIH LYMPHATIC COORDINATING 1198 00:43:33,577 --> 00:43:34,745 COMMITTEE, PARTICIPATING IN THE 1199 00:43:34,745 --> 00:43:35,346 INTERNATIONAL SOCIETY FOR THE 1200 00:43:35,346 --> 00:43:39,150 STUDY OF VASCULAR ANOMALIES OR 1201 00:43:39,150 --> 00:43:40,384 ISSVA, CONSORTIUM OF 1202 00:43:40,384 --> 00:43:41,852 INTERNATIONAL INVESTIGATORS FOR 1203 00:43:41,852 --> 00:43:48,425 VASCULAR ANOMALIES, OR CI IVA. 1204 00:43:48,425 --> 00:43:49,627 THIS YEAR WE HAVE SEVERAL 1205 00:43:49,627 --> 00:43:51,295 PLANNED INITIATIVES INCLUDING 1206 00:43:51,295 --> 00:43:53,164 DEVELOPMENT OF CONSENSUS OF CARE 1207 00:43:53,164 --> 00:43:55,466 GUIDELINES FOR CLAs. 1208 00:43:55,466 --> 00:43:58,536 WE PLAN TO INITIATE A CLA 1209 00:43:58,536 --> 00:44:00,738 EDUCATION SERIES TARGETING 1210 00:44:00,738 --> 00:44:02,373 NON-EXPERT MEDICAL PROFESSIONALS 1211 00:44:02,373 --> 00:44:05,976 AND TRAINEES, AND WE'RE 1212 00:44:05,976 --> 00:44:07,878 REORGANIZING OUR GLOBAL PATIENT 1213 00:44:07,878 --> 00:44:11,182 REGISTRY TO MAKE IT MORE 1214 00:44:11,182 --> 00:44:11,916 RESEARCH-RELEVANT. 1215 00:44:11,916 --> 00:44:14,218 I REALLY APPRECIATE THE 1216 00:44:14,218 --> 00:44:17,054 OPPORTUNITY TO BRING THE PATIENT 1217 00:44:17,054 --> 00:44:18,889 VOICE TO THESE ACTIVITIES. 1218 00:44:18,889 --> 00:44:22,059 I THINK THAT REPRESENTING VERY 1219 00:44:22,059 --> 00:44:25,429 RARE OR ULTRA-RARE LYMPHATIC 1220 00:44:25,429 --> 00:44:27,264 DISEASES AND THE PATIENT 1221 00:44:27,264 --> 00:44:30,668 EXPERIENCE IS PARAMOUNT, AND 1222 00:44:30,668 --> 00:44:31,902 HOPEFULLY -- AND I LOOK FORWARD 1223 00:44:31,902 --> 00:44:34,505 TO PARTICIPATING IN THE 1224 00:44:34,505 --> 00:44:35,973 WORKSHOP, AND BRINGING THAT 1225 00:44:35,973 --> 00:44:37,308 PERSPECTIVE AS WE MOVE FORWARD. 1226 00:44:37,308 --> 00:44:39,510 THANK YOU. 1227 00:44:39,510 --> 00:44:42,813 >> THANKS SO MUCH, MIKE. 1228 00:44:42,813 --> 00:44:46,717 NEXT UP, WE'RE GOING TO HEAR 1229 00:44:46,717 --> 00:44:47,718 FROM THE GORDON RESEARCH 1230 00:44:47,718 --> 00:44:48,252 CONFERENCE SERIES. 1231 00:44:48,252 --> 00:44:49,687 MANY OF YOU KNOW THAT THIS IS A 1232 00:44:49,687 --> 00:44:51,589 SERIES OF OVER 200 MEETINGS THAT 1233 00:44:51,589 --> 00:44:54,558 ARE EITHER ANNUAL OR BIENNIAL, 1234 00:44:54,558 --> 00:44:56,260 AND REPRESENT WIDE 1235 00:44:56,260 --> 00:44:57,861 MULTIDISCIPLINARY AREAS OF 1236 00:44:57,861 --> 00:44:59,063 BIOMEDICAL RESEARCH. 1237 00:44:59,063 --> 00:45:01,498 IN THIS CASE, THE GRC HAS 1238 00:45:01,498 --> 00:45:04,768 SUPPORTED A LYMPHATICS MEETING 1239 00:45:04,768 --> 00:45:07,538 SINCE 2004, AND I'M PLEASED TO 1240 00:45:07,538 --> 00:45:08,772 INTRODUCE THE INDIVIDUAL WHO 1241 00:45:08,772 --> 00:45:10,908 JUST COMPLETED HIS TENURE AS 1242 00:45:10,908 --> 00:45:12,509 CHAIR OF THAT SESSION, DR. BEN 1243 00:45:12,509 --> 00:45:17,748 HOGAN. 1244 00:45:17,748 --> 00:45:20,017 >> THANKS, DR. ROCKSON, FOR THAT 1245 00:45:20,017 --> 00:45:21,252 INTRODUCTION, AND GOOD EVENING 1246 00:45:21,252 --> 00:45:23,821 FROM MELBOURNE, AUSTRALIA, TO 1247 00:45:23,821 --> 00:45:24,421 ALL OF YOU. 1248 00:45:24,421 --> 00:45:26,390 I'M REALLY GRATEFUL FOR THE 1249 00:45:26,390 --> 00:45:29,260 OPPORTUNITY TO BE INVOLVED IN 1250 00:45:29,260 --> 00:45:30,961 THIS COMMISSION, WHICH I'D SAY 1251 00:45:30,961 --> 00:45:33,464 IS A PROCESS THAT IS INCREDIBLY 1252 00:45:33,464 --> 00:45:34,531 IMPORTANT ALL AROUND THE WORLD 1253 00:45:34,531 --> 00:45:38,269 FOR RESEARCHERS, CLINICIANS AND 1254 00:45:38,269 --> 00:45:39,603 PATIENTS WITH LYMPHATIC DISEASE. 1255 00:45:39,603 --> 00:45:42,206 SO BY WAY OF INTRODUCTION, I'M A 1256 00:45:42,206 --> 00:45:45,976 SCIENTIST, I'M A PH.D.-TRAINED 1257 00:45:45,976 --> 00:45:47,711 SCIENTIST IN DEVELOPMENTAL 1258 00:45:47,711 --> 00:45:48,612 GENETICS AND SELL BIOLOGY. 1259 00:45:48,612 --> 00:45:53,751 -- AND CELLBIOLOGY. 1260 00:45:53,751 --> 00:45:57,621 I RECEIVED MY PH.D. BACK IN 1261 00:45:57,621 --> 00:45:57,821 2005. 1262 00:45:57,821 --> 00:45:59,623 BEFORE I MOVED TO THE 1263 00:45:59,623 --> 00:46:02,092 NETHERLANDS AND REALLY BECAME A 1264 00:46:02,092 --> 00:46:03,761 LYMPHATIC VASCULAR BIOLOGIST FOR 1265 00:46:03,761 --> 00:46:06,830 THE FIRST TIME, STUDYING 1266 00:46:06,830 --> 00:46:08,399 ZEBRAFISH TO TRY -- AND ALSO 1267 00:46:08,399 --> 00:46:10,567 MOUSE MODELS TO TRY AND DISCOVER 1268 00:46:10,567 --> 00:46:12,336 GENES AND MOLECULAR PATHWAYS 1269 00:46:12,336 --> 00:46:14,038 INVOLVED IN THE FORMATION OF 1270 00:46:14,038 --> 00:46:17,941 LYMPHATIC VESSELS AND TISSUES. 1271 00:46:17,941 --> 00:46:22,579 REALLY, THAT WORK LED TO 1272 00:46:22,579 --> 00:46:31,622 DISCOVERIES IN INHERITED LYMPH 1273 00:46:31,622 --> 00:46:32,456 DEMA. 1274 00:46:32,456 --> 00:46:33,991 I'M CURRENTLY ASSOCIATE DIRECTOR 1275 00:46:33,991 --> 00:46:35,592 OF RESEARCH AT THE KENT CENTER 1276 00:46:35,592 --> 00:46:36,460 HERE IN MELBOURNE. 1277 00:46:36,460 --> 00:46:39,129 THIS IS AUSTRALIA'S LARGEST KENT 1278 00:46:39,129 --> 00:46:41,098 HOSPITAL IN CANCER RESEARCH 1279 00:46:41,098 --> 00:46:43,167 CENTER, AND IN THAT ROLE, I 1280 00:46:43,167 --> 00:46:45,135 OVERSEE 34 RESEARCH LABS AND 1281 00:46:45,135 --> 00:46:49,340 FIVE CORE FACILITIES, ABOUT 750 1282 00:46:49,340 --> 00:46:50,741 SCIENTISTS AND SUPPORT STAFF. 1283 00:46:50,741 --> 00:46:53,177 SO IN THAT ROLE, I HAVE A GOOD 1284 00:46:53,177 --> 00:46:55,713 GRASP, I GUESS, OF DISCOVERY 1285 00:46:55,713 --> 00:46:57,715 SCIENCE PRE-CLINICAL AND EVEN 1286 00:46:57,715 --> 00:46:59,249 CLINICAL RESEARCH IN CANCER. 1287 00:46:59,249 --> 00:47:02,119 AND WE HAVE A GROWING INTEREST 1288 00:47:02,119 --> 00:47:09,727 IN DISEASES OF SURVIVORSHIP AND 1289 00:47:09,727 --> 00:47:11,428 LYMPHEDEMA IN CANCER PATIENTS. 1290 00:47:11,428 --> 00:47:13,197 SO I'M HERE TODAY REPRESENTING 1291 00:47:13,197 --> 00:47:19,636 THE GOLDEN RESEARCH COMMUNITY IN 1292 00:47:19,636 --> 00:47:20,971 LYMPHATICS, IT'S BEEN RUNNING 1293 00:47:20,971 --> 00:47:23,273 SINCE 2004, AND THE LAST FEW 1294 00:47:23,273 --> 00:47:24,575 GORDON RESEARCH LYMPHATIC 1295 00:47:24,575 --> 00:47:26,443 CONFERENCES HAVE BEEN 1296 00:47:26,443 --> 00:47:28,078 OVERSUBSCRIBED, AND IT'S REALLY 1297 00:47:28,078 --> 00:47:31,181 BECOME, I THINK, A KEY MEETING 1298 00:47:31,181 --> 00:47:32,583 FOR LYMPHATIC RESEARCHERS ALL 1299 00:47:32,583 --> 00:47:34,451 AROUND THE WORLD. 1300 00:47:34,451 --> 00:47:37,354 WE'VE SEEN AN EXPLOSION IN THE 1301 00:47:37,354 --> 00:47:38,756 TOPICS THAT ARE COVERED AT 1302 00:47:38,756 --> 00:47:40,924 GORDON RESEARCH LYMPHATIC 1303 00:47:40,924 --> 00:47:42,092 CONFERENCES OVER RECENT YEARS, 1304 00:47:42,092 --> 00:47:44,395 AND REALLY LYMPHATIC BIOLOGY AT 1305 00:47:44,395 --> 00:47:46,997 A FUNDAMENTAL LEVEL REACHING 1306 00:47:46,997 --> 00:47:48,432 INTO MANY DIFFERENT TYPES OF 1307 00:47:48,432 --> 00:47:52,169 DISEASES AND DISEASE OUTCOMES, 1308 00:47:52,169 --> 00:47:54,138 AND WE REALLY HAVE SEEN I THINK 1309 00:47:54,138 --> 00:47:59,777 THAT THAT MEETING HAS BEEN -- 1310 00:47:59,777 --> 00:48:00,878 SCIENTISTS, PRE-CLINICAL AND 1311 00:48:00,878 --> 00:48:05,849 CLINICAL RESEARCHERS AS WELL. 1312 00:48:05,849 --> 00:48:08,051 I THINK IT'S EXCITING TIMES FOR 1313 00:48:08,051 --> 00:48:08,919 FUNDAMENTAL LYMPHATIC RESEARCH, 1314 00:48:08,919 --> 00:48:10,421 SO I'M VERY, VERY PLEASED TO BE 1315 00:48:10,421 --> 00:48:11,588 HERE, AND I THANK YOU AGAIN, 1316 00:48:11,588 --> 00:48:19,096 STAN, FOR THE OPPORTUNITY. 1317 00:48:19,096 --> 00:48:20,330 >> THANKS SO MUCH, BEN. 1318 00:48:20,330 --> 00:48:21,732 WE LOOK FORWARD TO INTERACTING 1319 00:48:21,732 --> 00:48:23,901 WITH YOU ABOUT HOW THE GRC CAN 1320 00:48:23,901 --> 00:48:24,802 HELP. 1321 00:48:24,802 --> 00:48:27,671 IT'S NEXT MY GREAT PLEASURE TO 1322 00:48:27,671 --> 00:48:28,672 INTRODUCE THE CURRENT PRESIDENT 1323 00:48:28,672 --> 00:48:31,308 OF THE INTERNATIONAL SOCIETY OF 1324 00:48:31,308 --> 00:48:37,481 LYMPHOLOGY, DR. EE ADVAN EVANGES 1325 00:48:37,481 --> 00:48:38,248 DIMAKAKOS. 1326 00:48:38,248 --> 00:48:42,386 >> HELLO TO EVERYBODY. 1327 00:48:42,386 --> 00:48:49,259 THANK YOU VERY MUCH FOR THE KIND 1328 00:48:49,259 --> 00:48:49,560 INVITATION. 1329 00:48:49,560 --> 00:48:52,463 IT AN HONOR FOR ME AND FOR THE 1330 00:48:52,463 --> 00:48:55,165 NATIONAL SOCIETY TO BE TOGETHER 1331 00:48:55,165 --> 00:49:01,004 WITH YOU TO DISCUSS THIS VERY 1332 00:49:01,004 --> 00:49:06,310 IMPORTANT THING AT THIS MEETING. 1333 00:49:06,310 --> 00:49:11,682 MY NAME IS EVAN DIMAKAKOS, I AM 1334 00:49:11,682 --> 00:49:12,649 THE VICE PRESIDENT OF THE 1335 00:49:12,649 --> 00:49:14,952 SCIENTIFIC COMMITTEE IN EUROPEAN 1336 00:49:14,952 --> 00:49:15,752 SOCIETY OF LYMPHOLOGY. 1337 00:49:15,752 --> 00:49:18,188 I AM PRESIDENT OF THE NATIONAL 1338 00:49:18,188 --> 00:49:21,992 SOCIETY OF LYMPHOLOGY. 1339 00:49:21,992 --> 00:49:25,529 I'M HEAD -- DIFFERENT 1340 00:49:25,529 --> 00:49:28,832 PUBLIC-PRIVATE HOSPITAL IN 1341 00:49:28,832 --> 00:49:31,768 GREECE, HELLO FROM GREECE, AND 1342 00:49:31,768 --> 00:49:38,041 THIS IS -- TO SAY A FEW THINGS 1343 00:49:38,041 --> 00:49:39,343 CONCERNING THE INTERNATIONAL 1344 00:49:39,343 --> 00:49:45,682 SOCIETY OF LYMPHOLOGY. 1345 00:49:45,682 --> 00:49:48,619 THIS I HAVE TO SAY TO YOU THAT 1346 00:49:48,619 --> 00:49:50,587 THE NATIONAL SOCIETY OF 1347 00:49:50,587 --> 00:49:54,424 LYMPHOLOGY IS THE -- THE 1348 00:49:54,424 --> 00:49:55,893 NATIONAL SOCIETY OF LYMPHOLOGY 1349 00:49:55,893 --> 00:50:04,535 IS THE SOUL OF EDUCATION. 1350 00:50:04,535 --> 00:50:06,103 ABOUT 1960, WE HAD THE CREATION 1351 00:50:06,103 --> 00:50:07,838 OF THE NATIONAL SOCIETY OF 1352 00:50:07,838 --> 00:50:12,976 LYMPHOLOGY, AND FEW PERSONS WERE 1353 00:50:12,976 --> 00:50:19,917 TOGETHER WITH THE DREAMS THAT 1354 00:50:19,917 --> 00:50:21,251 THE LYMPHATIC PROJECT AND THEY 1355 00:50:21,251 --> 00:50:24,521 GO TOGETHER IN ORDER TO -- THIS 1356 00:50:24,521 --> 00:50:29,459 SOCIETY IN ORDER TO -- THEIR 1357 00:50:29,459 --> 00:50:31,595 KNOWLEDGE AND THEIR EXPERIENCES 1358 00:50:31,595 --> 00:50:35,832 ON THE LYMPHATIC SYSTEM AND 1359 00:50:35,832 --> 00:50:39,903 DISEASE, LYMPHATIC DISEASE. 1360 00:50:39,903 --> 00:50:45,442 SO 1960, WE HAD THE NATIONAL 1361 00:50:45,442 --> 00:50:50,113 SYMPOSIUM OF LYMPHATIC -- THE 1362 00:50:50,113 --> 00:50:51,748 NATIONAL LYMPHATIC SYMPOSIUM, 1363 00:50:51,748 --> 00:50:57,020 AND THIS IS, I HAVE TO SAY, IN 1364 00:50:57,020 --> 00:51:05,162 THE YEARS OF 60s -- WAS THE 1365 00:51:05,162 --> 00:51:08,065 FIRST -- HIS FIRST STUDIES ON 1366 00:51:08,065 --> 00:51:18,609 IMAGING -- HIS STUDIES, WE HAVE 1367 00:51:19,176 --> 00:51:27,618 THE FIRST -- IMAGING METHODS -- 1368 00:51:27,618 --> 00:51:31,288 TUMOR OF LYMPHATIC SYSTEM. 1369 00:51:31,288 --> 00:51:32,923 CLAUDE JUST, A PLASTIC SURGEON 1370 00:51:32,923 --> 00:51:34,891 WHO WILL TALK ABOUT FOR THE 1371 00:51:34,891 --> 00:51:38,562 FIRST STEPS OF THE SURGEONS 1372 00:51:38,562 --> 00:51:41,431 OPERATION ON THE LYMPHATIC 1373 00:51:41,431 --> 00:51:46,770 PROBLEMS, AND ALLAN DUMONT, IN 1374 00:51:46,770 --> 00:51:51,174 1977, THEY PUBLISHED A BOOK 1375 00:51:51,174 --> 00:51:57,214 CONCERNING THE -- OF THORACIC 1376 00:51:57,214 --> 00:52:01,251 DUCT CANNULA. 1377 00:52:01,251 --> 00:52:04,588 ANOTHER LEADER OF THE NATIONAL 1378 00:52:04,588 --> 00:52:07,891 SOCIETY OF LYMPHOLOGY, OLEFSKY 1379 00:52:07,891 --> 00:52:10,527 FROM POLAND, A LOT OF 1380 00:52:10,527 --> 00:52:12,996 PUBLICATIONS CONCERNING THE 1381 00:52:12,996 --> 00:52:15,799 PHYSIOLOGY, PATHOPHYSIOLOGY, HE 1382 00:52:15,799 --> 00:52:21,972 WAS A SURGEON, WHO'S -- ON 1383 00:52:21,972 --> 00:52:25,142 INFECTIONS OF THE SKIN 1384 00:52:25,142 --> 00:52:26,777 CONCERNING THE LYMPHADEMA. 1385 00:52:26,777 --> 00:52:30,714 ANOTHER PERSON IS AKUMA FROM 1386 00:52:30,714 --> 00:52:32,716 JAPAN, A LOT OF PUBLICATIONS ON 1387 00:52:32,716 --> 00:52:34,384 INFECTION AND THE TREATMENT OF 1388 00:52:34,384 --> 00:52:37,988 THIS INFECTION CONCERNING THE 1389 00:52:37,988 --> 00:52:43,694 LYMPHATIC PROBLEMS. 1390 00:52:43,694 --> 00:52:49,833 BEESUS -- THE STEM -- THEY 1391 00:52:49,833 --> 00:52:56,640 FOCUSED ON -- WHAT IS LYMPHATIC 1392 00:52:56,640 --> 00:53:00,877 PROBLEM, YOU KNOW EVERYBODY THE 1393 00:53:00,877 --> 00:53:03,246 STEM SIDE. 1394 00:53:03,246 --> 00:53:04,648 -- TREATMENT. 1395 00:53:04,648 --> 00:53:09,453 WE HAD THE TECHNIQUES OF -- 1396 00:53:09,453 --> 00:53:11,154 TECHNIQUES, AND FEW PERSONS ALL 1397 00:53:11,154 --> 00:53:21,732 OVER THE WORLD, -- FOR AUSTRA 1398 00:53:24,067 --> 00:53:26,503 AUSTRALIA, THEY -- A LOT OF 1399 00:53:26,503 --> 00:53:30,173 THINGS AND NOW WE HAVE THE 1400 00:53:30,173 --> 00:53:33,677 COMPLETE -- THERAPY IS THE GOLD 1401 00:53:33,677 --> 00:53:35,412 STANDARD OF -- TREATMENT BECAUSE 1402 00:53:35,412 --> 00:53:43,520 OF THEM, OF THIS -- OF SOCIETY 1403 00:53:43,520 --> 00:53:47,924 OF LYMPHOLOGY PERSONS. 1404 00:53:47,924 --> 00:53:50,193 SURGICAL TREATMENT -- MOST OF 1405 00:53:50,193 --> 00:53:56,433 YOU KNOW THESE NAMES, A LOT OF 1406 00:53:56,433 --> 00:54:01,371 THANKS, NOW WE HAVE A LOT OF 1407 00:54:01,371 --> 00:54:03,473 SURGICAL TREATMENTS IF YOU HAVE 1408 00:54:03,473 --> 00:54:08,945 LYMPHATIC PROBLEMS WHEN -- CAN 1409 00:54:08,945 --> 00:54:12,682 MAKE THIS SURGICAL OPERATION. 1410 00:54:12,682 --> 00:54:19,623 CONCERNING ME, I PUBLISHED IN 1411 00:54:19,623 --> 00:54:29,132 THE FIRST PUBLICATION ON MRI 1412 00:54:29,132 --> 00:54:31,701 LYMPHOGRAPHY, OTHER PERSONS FROM 1413 00:54:31,701 --> 00:54:34,871 INDIA, THEY HAVE -- THEY 1414 00:54:34,871 --> 00:54:41,778 PUBLISHED A LOT OF PAPERS ON 1415 00:54:41,778 --> 00:54:43,480 FILARIASIS, SURGICAL TREATMENT 1416 00:54:43,480 --> 00:54:46,216 OF FILARIASIS, AND WE HAVE A LOT 1417 00:54:46,216 --> 00:54:46,416 OF -- 1418 00:54:46,416 --> 00:54:48,819 >> YOU HAVE ONE MINUTE 1419 00:54:48,819 --> 00:54:49,085 REMAINING. 1420 00:54:49,085 --> 00:54:53,223 >> OKAY. 1421 00:54:53,223 --> 00:54:55,959 SO THIS IS SPECIAL THAT I SAID 1422 00:54:55,959 --> 00:55:01,898 TO YOU, PRESIDENT OF THE 1423 00:55:01,898 --> 00:55:04,301 NATIONAL SOCIETY OF -- OF 1424 00:55:04,301 --> 00:55:06,570 LYMPHOLOGY, IT'S NOT THE WORK OF 1425 00:55:06,570 --> 00:55:09,739 ONE PERSON, BUT THE TEAM, A LOT 1426 00:55:09,739 --> 00:55:13,076 OF PERSONS WORK TOGETHER, COME 1427 00:55:13,076 --> 00:55:17,214 TOGETHER IN ORDER TO HAVE VERY 1428 00:55:17,214 --> 00:55:19,950 GOOD RESULTS. 1429 00:55:19,950 --> 00:55:22,886 THE PROBLEM NOW IS THAT IN 2024, 1430 00:55:22,886 --> 00:55:25,655 WE HAVE A LOT OF INFORMATION, A 1431 00:55:25,655 --> 00:55:30,160 LOT OF AWARENESS, ESPECIALLY FOR 1432 00:55:30,160 --> 00:55:36,299 THE ORGANIZATION -- MEDICAL 1433 00:55:36,299 --> 00:55:37,601 RESEARCH, BUT OUR PROBLEM IS 1434 00:55:37,601 --> 00:55:39,069 MORE THAT WE HAVE NO EDUCATION, 1435 00:55:39,069 --> 00:55:43,240 WE HAVE PROBLEM WHAT IS 1436 00:55:43,240 --> 00:55:44,774 LYMPHADEMA, WHAT IS -- WHAT IS 1437 00:55:44,774 --> 00:55:48,712 THE TREATMENT OF LYMPHADEMA. 1438 00:55:48,712 --> 00:55:50,914 THANK YOU VERY MUCH, ALL OF YOU, 1439 00:55:50,914 --> 00:55:59,356 AND ESPECIALLY PROFESSOR ROCK 1440 00:55:59,356 --> 00:56:00,156 ROCKSON, TO BE WITH YOU. 1441 00:56:00,156 --> 00:56:01,791 >> THANK YOU VERY MUCH, 1442 00:56:01,791 --> 00:56:02,559 DR. DIMAKAKOS, AND WE LOOK 1443 00:56:02,559 --> 00:56:03,960 FORWARD TO INTERACTING WITH YOU. 1444 00:56:03,960 --> 00:56:07,097 NOW OUR NEXT INVITED SPEAKER 1445 00:56:07,097 --> 00:56:09,599 REPRESENTS THE AMERICAN VENOUS 1446 00:56:09,599 --> 00:56:19,576 FORUM, DR. FEDOR LURIE. 1447 00:56:19,576 --> 00:56:20,477 >> THANK YOU. 1448 00:56:20,477 --> 00:56:21,978 MY APOLOGIES, MY CONNECTION MAY 1449 00:56:21,978 --> 00:56:25,115 NOT BE STABLE, SO I'D BETTER 1450 00:56:25,115 --> 00:56:28,485 TURN OFF THE CAMERA. 1451 00:56:28,485 --> 00:56:29,519 THANK YOU VERY MUCH FOR INVITING 1452 00:56:29,519 --> 00:56:31,187 ME TO THIS VERY IMPORTANT 1453 00:56:31,187 --> 00:56:34,024 MEETING, AND CONGRATULATIONS TO 1454 00:56:34,024 --> 00:56:37,093 THE COMMITTEE TO MAKING SUCH A 1455 00:56:37,093 --> 00:56:38,995 FANTASTIC PROGRESS IN A VERY 1456 00:56:38,995 --> 00:56:39,429 SHORT TIME. 1457 00:56:39,429 --> 00:56:40,530 MY NAME IS FEDOR LURIE. 1458 00:56:40,530 --> 00:56:44,534 I AM A VASCULAR SURGEON, 1459 00:56:44,534 --> 00:56:47,370 ASSOCIATE DIRECTOR IN TOLEDO, 1460 00:56:47,370 --> 00:56:49,372 OHIO AND RESEARCH PRO 1461 00:56:49,372 --> 00:56:53,276 >> Profes PROVE -- I 1462 00:56:53,276 --> 00:56:54,411 REPRESENT THE AMERICAN VENOUS 1463 00:56:54,411 --> 00:56:58,114 FORUM, TO WHICH I WAS -- AM PAST 1464 00:56:58,114 --> 00:56:59,249 PRESIDENT. 1465 00:56:59,249 --> 00:57:01,851 THROUGH MY PERSONAL CAREER AS A 1466 00:57:01,851 --> 00:57:03,753 VASCULAR SURGEON STUDYING IN 1467 00:57:03,753 --> 00:57:08,358 1980, MY RESEARCH AND CLINICAL 1468 00:57:08,358 --> 00:57:11,561 INTERESTS EVOLVE FROM 1469 00:57:11,561 --> 00:57:12,362 HEMODYNAMICAL ASPECTS OF THE 1470 00:57:12,362 --> 00:57:15,165 DISEASE TO MORE AND MORE 1471 00:57:15,165 --> 00:57:16,599 REALIZATION OF THE ROLE 1472 00:57:16,599 --> 00:57:20,303 LYMPHATICS BOTH IN NORMAL 1473 00:57:20,303 --> 00:57:24,207 PHYSIOLOGY AND IN A VARIETY OF 1474 00:57:24,207 --> 00:57:25,508 CONDITIONS RELATED TO VASCULAR 1475 00:57:25,508 --> 00:57:28,144 DISEASES. 1476 00:57:28,144 --> 00:57:30,680 AND SAME EXPERIENCE WE HAVE WITH 1477 00:57:30,680 --> 00:57:32,682 OUR ORGANIZATION THAT I'M 1478 00:57:32,682 --> 00:57:34,517 REPRESENTING, THE AMERICAN 1479 00:57:34,517 --> 00:57:37,821 VENOUS FORUM'S MISSION IS TO 1480 00:57:37,821 --> 00:57:40,924 PROMOTE SCIENCE, EDUCATION, AND 1481 00:57:40,924 --> 00:57:42,792 ADVOCACY IN VENOUS AND LYMPHATIC 1482 00:57:42,792 --> 00:57:45,195 DISORDERS. 1483 00:57:45,195 --> 00:57:47,097 IT STARTED ITS EXISTENCE 1484 00:57:47,097 --> 00:57:49,599 32 YEARS AGO, AND FROM THE 1485 00:57:49,599 --> 00:57:51,768 BEGINNING, VENOUS AND LYMPHATIC 1486 00:57:51,768 --> 00:57:52,335 DISORDERS WERE CONNECT WOULD 1487 00:57:52,335 --> 00:57:55,505 UNDER THE SAME UMBRELLA. 1488 00:57:55,505 --> 00:57:58,508 HOWEVER, AS I MENTIONED THROUGH 1489 00:57:58,508 --> 00:58:00,844 MY PERSONAL HISTORY SIMILAR 1490 00:58:00,844 --> 00:58:03,179 THINGS WAS HAPPENING WITH THIS 1491 00:58:03,179 --> 00:58:06,816 ORGANIZATION, AND THE FIRST FIVE 1492 00:58:06,816 --> 00:58:08,885 OR SIX YEARS WERE DEDICATED 1493 00:58:08,885 --> 00:58:15,859 MOSTLY TO THE DISEASE, AND -- 1494 00:58:15,859 --> 00:58:17,727 REPRESENTATION IN VENOUS AND 1495 00:58:17,727 --> 00:58:19,062 LYMPHATIC DISORDERS. 1496 00:58:19,062 --> 00:58:21,131 NOW THE AMERICAN VENOUS FORUM 1497 00:58:21,131 --> 00:58:23,433 MEMBERSHIP IS MULTI-SPECIALTY, 1498 00:58:23,433 --> 00:58:27,871 BUT MOSTLY FOCUSED ON PHYSICIANS 1499 00:58:27,871 --> 00:58:30,607 AND CLINICAL RESEARCHERS. 1500 00:58:30,607 --> 00:58:32,776 WE ABOUT 20 YEARS AGO STARTED 1501 00:58:32,776 --> 00:58:37,080 DEVELOPING THE BRANCH THAT WILL 1502 00:58:37,080 --> 00:58:40,150 IN THE FUTURE ADDRESS EDUCATION 1503 00:58:40,150 --> 00:58:42,285 AND TRAINING FOR MORE 1504 00:58:42,285 --> 00:58:44,354 TRANSLATIONAL AND CLINICAL 1505 00:58:44,354 --> 00:58:46,222 RESEARCH. 1506 00:58:46,222 --> 00:58:50,060 TO DO THAT, WE DEVELOPED THREE 1507 00:58:50,060 --> 00:58:54,297 GRANTS, WHICH ARE NOT -- BUT 1508 00:58:54,297 --> 00:58:55,965 SUBSTANTIAL. 1509 00:58:55,965 --> 00:58:57,000 HISTORICALLY, THE FIRST ONE IS 1510 00:58:57,000 --> 00:58:58,835 CLINICAL RESEARCH, THE SECOND 1511 00:58:58,835 --> 00:59:00,236 ONE WAS IN TRANSLATION RESEARCH, 1512 00:59:00,236 --> 00:59:02,272 AND FROM FOUR YEARS AGO, WE HAVE 1513 00:59:02,272 --> 00:59:05,675 ALSO A GRANT FOR BASIC RESEARCH 1514 00:59:05,675 --> 00:59:10,080 IN BOTH VEE MUST AND LYMPHATIC 1515 00:59:10,080 --> 00:59:11,514 DISORDERS. 1516 00:59:11,514 --> 00:59:12,615 UNFORTUNATELY UP TO THIS YEAR, 1517 00:59:12,615 --> 00:59:15,118 THE MAJORITY OF THE GRANTS WERE 1518 00:59:15,118 --> 00:59:19,722 GIVEN FOR PROJECTS IN VENOUS 1519 00:59:19,722 --> 00:59:21,091 DISEASES. 1520 00:59:21,091 --> 00:59:25,929 THE 2 25 GRANTEES, ONLY ONE 1521 00:59:25,929 --> 00:59:27,530 SUBMITTED APPLICATION AND 1522 00:59:27,530 --> 00:59:29,632 SUCCESSFULLY COMPLETED THE 1523 00:59:29,632 --> 00:59:36,339 PROCESS FOR LYMPHATIC DISORDERS. 1524 00:59:36,339 --> 00:59:37,874 THAT'S DEFINITELY A GAP AND 1525 00:59:37,874 --> 00:59:41,244 DEFINITELY NEEDS TO BE ADDRESSED 1526 00:59:41,244 --> 00:59:41,911 BY THE ORGANIZATION. 1527 00:59:41,911 --> 00:59:43,480 I WOULD LIKE TO ECHO THE 1528 00:59:43,480 --> 00:59:47,550 COMMENTS FROM PREVIOUS SPEAKERS, 1529 00:59:47,550 --> 00:59:50,487 THERE IS A REAL NEED FOR 1530 00:59:50,487 --> 00:59:53,056 TRAINING, AND REAL NEED FOR 1531 00:59:53,056 --> 00:59:54,190 ADVANCING THEIR YOUNGEST 1532 00:59:54,190 --> 00:59:56,926 SCIENTISTS IN THE AREA OF 1533 00:59:56,926 --> 00:59:58,561 LYMPHATIC DISORDERS, AND I AM 1534 00:59:58,561 --> 01:00:00,363 TALKING MOSTLY FROM PERSPECTIVE 1535 01:00:00,363 --> 01:00:02,866 OF AMERICAN -- FOR COLLABORATION 1536 01:00:02,866 --> 01:00:04,968 BETWEEN CLINICIANS, CLINICAL 1537 01:00:04,968 --> 01:00:06,636 RESEARCHERS, AND BASIC SCIENCE 1538 01:00:06,636 --> 01:00:08,505 RESEARCHERS. 1539 01:00:08,505 --> 01:00:11,708 SO I'M GRATEFUL FOR INVITING ME 1540 01:00:11,708 --> 01:00:14,777 TO THIS MEETING AND I'M LOOKING 1541 01:00:14,777 --> 01:00:17,447 FORWARD TO PARTICIPATE IN THE 1542 01:00:17,447 --> 01:00:17,780 CONVERSATION. 1543 01:00:17,780 --> 01:00:18,314 THANK YOU. 1544 01:00:18,314 --> 01:00:21,117 >> THANK YOU SO MUCH, FEDOR. 1545 01:00:21,117 --> 01:00:23,052 OUR FINAL PANELIST BEFORE WE 1546 01:00:23,052 --> 01:00:25,788 START OUR INTERACTIVE SESSION IS 1547 01:00:25,788 --> 01:00:28,491 THE SECOND OF OUR INVITED 1548 01:00:28,491 --> 01:00:30,660 CLINICIAN-SCIENTISTS, AND IN 1549 01:00:30,660 --> 01:00:32,262 ADDITION, REPRESENTS THE 1550 01:00:32,262 --> 01:00:36,132 NATIONAL HEART, LUNG AND BLOOD 1551 01:00:36,132 --> 01:00:37,300 INSTITUTE, THE INTRAMURAL 1552 01:00:37,300 --> 01:00:38,801 BRANCH, SO DR. JOEL MOSS, 1553 01:00:38,801 --> 01:00:40,837 WELCOME. 1554 01:00:40,837 --> 01:00:44,140 >> THANK YOU, INTER DR. ROCKSON. 1555 01:00:44,140 --> 01:00:48,111 I'M SENIOR INVESTIGATOR IN THE 1556 01:00:48,111 --> 01:00:49,546 LABORATORY OF TRANSLATIONAL 1557 01:00:49,546 --> 01:00:50,947 RESEARCH IN THE HEART, LUNG AND 1558 01:00:50,947 --> 01:01:01,224 BLOOD INSTITUTE. 1559 01:01:03,826 --> 01:01:07,964 THE HEA HEART, LUNG AND BLOOD 1560 01:01:07,964 --> 01:01:09,299 INSTITUTE INTRAMURAL RESEARCH 1561 01:01:09,299 --> 01:01:10,833 PROGRAM, I'M BASICALLY STUDYING 1562 01:01:10,833 --> 01:01:14,771 TWO DISEASES, 1563 01:01:14,771 --> 01:01:16,472 LYMPHANGIOLEIOMYOMATOSIS, OR 1564 01:01:16,472 --> 01:01:19,842 LEM, A SPORADIC FORM OF LUNG 1565 01:01:19,842 --> 01:01:21,010 DISEASE ASSOCIATED WITH ABOUT 1566 01:01:21,010 --> 01:01:23,780 20% OF PATIENTS DEVELOPING 1567 01:01:23,780 --> 01:01:24,847 LYMPHATIC ABNORMALITIES AND 1568 01:01:24,847 --> 01:01:33,556 OTHERS DEVELOPING RENAL ANG 1569 01:01:33,556 --> 01:01:38,294 ANGIOLIPOMASS, ASSOCIATED WITH 1570 01:01:38,294 --> 01:01:40,296 ASCITES, TUMOR-LIKE STRUCTURES 1571 01:01:40,296 --> 01:01:42,432 IN THE ABDOMEN AND PRIMARILY AND 1572 01:01:42,432 --> 01:01:46,636 ALSO IN THE THORAX, AND 1573 01:01:46,636 --> 01:01:49,405 ASSOCIATED WITH LYMPHATIC 1574 01:01:49,405 --> 01:01:56,246 INVOLVEMENT BY THE LYMPHATIC 1575 01:01:56,246 --> 01:01:58,848 CELLS INFILTRATING THE LYMPHATIC 1576 01:01:58,848 --> 01:02:02,218 SYSTEM AS CHARACTERISTIC OF THIS 1577 01:02:02,218 --> 01:02:05,054 CANCEROUS PROCESS. 1578 01:02:05,054 --> 01:02:06,823 THESE STUDIES ARE CARRIED OUT AT 1579 01:02:06,823 --> 01:02:11,728 THE CLINICAL CENTER OF THE NIH 1580 01:02:11,728 --> 01:02:15,565 WHICH IS A UNIQUE RESOURCE FOR 1581 01:02:15,565 --> 01:02:16,833 PROTOCOL DELIVERED RESEARCH. 1582 01:02:16,833 --> 01:02:19,135 THE NHLBI ALSO SUPPORTS TRAVEL 1583 01:02:19,135 --> 01:02:20,336 FOR PATIENTS FROM ANYWHERE IN 1584 01:02:20,336 --> 01:02:24,240 THE U.S. TO THE NIH IN BETHESDA, 1585 01:02:24,240 --> 01:02:25,041 MARYLAND, AS WELL AS PATIENTS 1586 01:02:25,041 --> 01:02:27,243 WHO COME OVERSEAS TO THE POINT 1587 01:02:27,243 --> 01:02:30,280 OF ENTRY INTO THE U.S. TO AGAIN 1588 01:02:30,280 --> 01:02:32,849 THE NIH. 1589 01:02:32,849 --> 01:02:35,184 WE ALSO, SINCE THE PHYSICIANS 1590 01:02:35,184 --> 01:02:36,486 WHO MAY BE CARING FOR THESE 1591 01:02:36,486 --> 01:02:37,720 PATIENTS ON THE OUTSIDE WHO MAY 1592 01:02:37,720 --> 01:02:39,555 NOT BE FAMILIAR WITH THESE RARE 1593 01:02:39,555 --> 01:02:42,025 DISEASES, BY GIVING THEM ANY OF 1594 01:02:42,025 --> 01:02:45,762 THE CLIA APPROVED DATA THAT WE 1595 01:02:45,762 --> 01:02:46,729 GENERATE AT THE NIH. 1596 01:02:46,729 --> 01:02:47,597 IMPORTANT FOR BOTH THESE 1597 01:02:47,597 --> 01:02:51,501 PATIENTS IS THE FACT THAT THE 1598 01:02:51,501 --> 01:02:59,242 STUDIES ON LAM -- THE LAM 1599 01:02:59,242 --> 01:03:01,077 FOUNDATION SUPPORTS STUDIES ON 1600 01:03:01,077 --> 01:03:06,649 SPORADIC LAM AND THE 1601 01:03:06,649 --> 01:03:09,218 TUBERCULOSIS -- WHICH OCCURS IN 1602 01:03:09,218 --> 01:03:12,488 THE PRESENCE OF -- WHICH 1603 01:03:12,488 --> 01:03:13,589 INVOLVES MANY OTHER ORGANS 1604 01:03:13,589 --> 01:03:14,457 WITHIN THE BODY. 1605 01:03:14,457 --> 01:03:15,692 ONE OF THE THINGS THAT IS VERY 1606 01:03:15,692 --> 01:03:17,493 IMPORTANT TO THE PATIENTS IS 1607 01:03:17,493 --> 01:03:18,928 THEIR ABILITY TO GET MORE 1608 01:03:18,928 --> 01:03:20,763 EDUCATION ABOUT THIS RARE 1609 01:03:20,763 --> 01:03:22,965 DISEASE, AND ON EVERY TUESDAY 1610 01:03:22,965 --> 01:03:25,668 EVENING, WE HAVE ABOUT A 1611 01:03:25,668 --> 01:03:27,103 TWO-HOUR SESSION WHERE WE 1612 01:03:27,103 --> 01:03:29,806 DISCUSS THEIR DISEASE, WE ANSWER 1613 01:03:29,806 --> 01:03:31,441 PATIENT QUESTIONS, AND WHAT WE 1614 01:03:31,441 --> 01:03:33,609 TRY TO DO IS HAVE A 1615 01:03:33,609 --> 01:03:35,812 PATIENT-ORIENTED MEETING THAT 1616 01:03:35,812 --> 01:03:37,647 ESSENTIALLY LOOKS TO THE PATIENT 1617 01:03:37,647 --> 01:03:39,549 VOICE IN EACH OF THESE DISEASES 1618 01:03:39,549 --> 01:03:40,550 IN TERMS OF WHAT THEIR CONCERNS 1619 01:03:40,550 --> 01:03:40,983 ARE. 1620 01:03:40,983 --> 01:03:44,287 WE USUALLY HAVE A LAM LIAISON 1621 01:03:44,287 --> 01:03:46,189 FROM THIS AREA WHO COMES TO 1622 01:03:46,189 --> 01:03:49,692 THESE MEETINGS AND IS WILLING TO 1623 01:03:49,692 --> 01:03:51,594 TALK TO THE PATIENTS AND 1624 01:03:51,594 --> 01:03:57,066 INTRODUCE BOTH THE -- SOCIETY AS 1625 01:03:57,066 --> 01:03:59,168 WELL AS THE LAM FOUNDATION TO 1626 01:03:59,168 --> 01:04:00,937 THE PATIENTS AND PROVIDE THEM 1627 01:04:00,937 --> 01:04:04,273 WITH DATA AND INFORMATION THAT 1628 01:04:04,273 --> 01:04:05,975 THE PATIENTS CAN USE TO CONTACT 1629 01:04:05,975 --> 01:04:06,809 THE SOCIETY THAT MAY BE 1630 01:04:06,809 --> 01:04:10,713 APPROPRIATE TO THEM. 1631 01:04:10,713 --> 01:04:11,814 IT'S ALSO IMPORTANT IN RARE 1632 01:04:11,814 --> 01:04:13,449 DISEASE TO HAVE ENROLLMENT, AND 1633 01:04:13,449 --> 01:04:15,718 IN THIS CASE, THE LAM FOUNDATION 1634 01:04:15,718 --> 01:04:17,387 AND TUBULAR SCLEROSIS ALLIANCE 1635 01:04:17,387 --> 01:04:18,221 ARE VERY IMPORTANT TO US IN 1636 01:04:18,221 --> 01:04:19,956 TERMS OF GETTING INCREASED 1637 01:04:19,956 --> 01:04:23,526 ENROLLMENTS TO THE SOCIETY. 1638 01:04:23,526 --> 01:04:24,460 OVER THE COURSE OF THE YEARS 1639 01:04:24,460 --> 01:04:26,262 THAT WE'VE BEEN STUDYING THESE 1640 01:04:26,262 --> 01:04:28,765 DISEASES, WE'VE ENROLLED OVER 1641 01:04:28,765 --> 01:04:33,102 800 PATIENTS WITH LAM AND ABOUT 1642 01:04:33,102 --> 01:04:35,972 A HUNDRED PATIENTS WITH TUBULAR 1643 01:04:35,972 --> 01:04:36,706 SCLEROSIS. 1644 01:04:36,706 --> 01:04:38,674 AS EVIDENT FROM THE NATURE OF 1645 01:04:38,674 --> 01:04:40,977 THE ORIGINS OF THE NATIONAL 1646 01:04:40,977 --> 01:04:42,945 COMMISSION, IT'S ALSO IMPORTANT 1647 01:04:42,945 --> 01:04:44,280 FOR OVERALL FOR LYMPHATIC 1648 01:04:44,280 --> 01:04:47,283 DISEASES, AND AGAIN, THE NHLBI 1649 01:04:47,283 --> 01:04:48,584 IS IMPORTANT IN TERMS OF 1650 01:04:48,584 --> 01:04:50,753 ORGANIZING VARIOUS MEETINGS 1651 01:04:50,753 --> 01:04:53,389 WITHIN THE -- AT THE NIH, AS 1652 01:04:53,389 --> 01:04:55,858 WELL AS INTERACTING WITH LEARN 1653 01:04:55,858 --> 01:04:58,594 AND BILL REPISI, WHO IS THE 1654 01:04:58,594 --> 01:05:00,563 DIRECTOR OF LEARN, IN TERMS OF A 1655 01:05:00,563 --> 01:05:01,164 PATIENT SUPPORT ORGANIZATION 1656 01:05:01,164 --> 01:05:02,598 THAT HELPS WITH OTHER LYMPHATIC 1657 01:05:02,598 --> 01:05:04,467 DISEASES. 1658 01:05:04,467 --> 01:05:08,471 THE NHLBI EXTRAMURAL PROGRAM HAS 1659 01:05:08,471 --> 01:05:09,906 ALSO BEEN USEFUL IN TERMS OF 1660 01:05:09,906 --> 01:05:11,541 HELPING DR. ROCKSON, WHO IS HERE 1661 01:05:11,541 --> 01:05:15,578 AS AN IPA INTERGOVERNMENTAL -- 1662 01:05:15,578 --> 01:05:17,079 TO WORK WITH THE NHLBI FOR A 1663 01:05:17,079 --> 01:05:20,283 NUMBER OF YEARS IN TERMS OF 1664 01:05:20,283 --> 01:05:22,285 DEVELOPING LICK FA TICK SYSTEM 1665 01:05:22,285 --> 01:05:27,123 WITHIN THEMENT -- ON WHAT WE CAN 1666 01:05:27,123 --> 01:05:29,559 DO IN LAM AND TUBULAR SCLEROSIS. 1667 01:05:29,559 --> 01:05:30,460 THANK YOU. 1668 01:05:30,460 --> 01:05:36,699 >> THANKS SO MUCH, JOEL. 1669 01:05:36,699 --> 01:05:38,468 SO I THINK THAT BRINGS US TO THE 1670 01:05:38,468 --> 01:05:42,271 CONCLUSION TO OUR INITIAL 1671 01:05:42,271 --> 01:05:43,473 INTRODUCTIONS AND NOW IT'S GOING 1672 01:05:43,473 --> 01:05:46,609 TO BE TIME FOR THE COMMISSION AS 1673 01:05:46,609 --> 01:05:47,743 A GROUP TO INTERACT WITH THE 1674 01:05:47,743 --> 01:05:54,383 GROUP OF YOU AS PANELISTS I ALSO 1675 01:05:54,383 --> 01:05:57,987 WANT TO MENTION DR. VIKKULA AND 1676 01:05:57,987 --> 01:05:59,188 DR. MOSS HAVE ALSO GRACIOUSLY 1677 01:05:59,188 --> 01:06:00,490 AGREED TO PARTICIPATE IN OUR 1678 01:06:00,490 --> 01:06:01,157 AFTERNOON PANEL DISCUSSION, SO 1679 01:06:01,157 --> 01:06:02,892 YOU GUYS ARE GOING TO GET TO 1680 01:06:02,892 --> 01:06:03,960 INTRODUCE YOURSELF ALL OVER 1681 01:06:03,960 --> 01:06:06,696 AGAIN TO THE NEW ATTENDEES THE 1682 01:06:06,696 --> 01:06:07,997 NEXT TIME AROUND. 1683 01:06:07,997 --> 01:06:11,367 SO THIS IS GOING TO BE THE TIME 1684 01:06:11,367 --> 01:06:13,436 IN WHICH WE AS COMMISSION 1685 01:06:13,436 --> 01:06:15,838 MEMBERS CAN DIRECTLY ASK 1686 01:06:15,838 --> 01:06:17,707 QUESTIONS OF SPECIFIC 1687 01:06:17,707 --> 01:06:20,109 REPRESENTATIVES WHO ARE HERE OR 1688 01:06:20,109 --> 01:06:24,347 COLLECTIVELY TO THE PANEL AS A 1689 01:06:24,347 --> 01:06:26,182 WHOLE, AND BECAUSE I THINK THE 1690 01:06:26,182 --> 01:06:28,484 VIRTUAL FORMAT MAY NOT BE HIGHLY 1691 01:06:28,484 --> 01:06:29,986 CONDUCIVE TO THIS KIND OF 1692 01:06:29,986 --> 01:06:30,753 INTERACTIVE ENVIRONMENT, I'M 1693 01:06:30,753 --> 01:06:32,388 GOING TO TAKE THE PREROGATIVE OF 1694 01:06:32,388 --> 01:06:37,126 STARTING OUT AND ASKING AN 1695 01:06:37,126 --> 01:06:38,794 INITIAL -- FOR PANEL AS A WHOLE, 1696 01:06:38,794 --> 01:06:40,096 AND I HOPE YOU ALL WILL RESPOND 1697 01:06:40,096 --> 01:06:41,631 TO THIS, ALL OF YOU ARE 1698 01:06:41,631 --> 01:06:42,899 REPRESENTING SOCIETIES OR 1699 01:06:42,899 --> 01:06:44,267 FOUNDATIONS WHO HAVE AN 1700 01:06:44,267 --> 01:06:45,902 IMPORTANT STAKE IN THIS TOPIC 1701 01:06:45,902 --> 01:06:48,971 AREA, AND WE'VE ALSO HEARD QUITE 1702 01:06:48,971 --> 01:06:51,140 COMPELLINGLY THROUGH THE COURSE 1703 01:06:51,140 --> 01:06:53,643 OF THE MORNING HOW MUCH 1704 01:06:53,643 --> 01:06:55,044 EDUCATIONAL IMPERATIVES ARE 1705 01:06:55,044 --> 01:06:56,345 VITAL AND THE DEGREE TO WHICH 1706 01:06:56,345 --> 01:06:58,414 THEY MAY BE LACKING IN CERTAIN 1707 01:06:58,414 --> 01:06:58,981 QUARTERS. 1708 01:06:58,981 --> 01:07:02,451 SO MY QUESTION TO ALL OF YOU IS, 1709 01:07:02,451 --> 01:07:04,086 ON BEHALF OF THE INDIVIDUAL 1710 01:07:04,086 --> 01:07:08,791 ORGANIZATION THAT YOU REPRESENT, 1711 01:07:08,791 --> 01:07:10,326 ARE THERE PRAGMATIC AVENUES THAT 1712 01:07:10,326 --> 01:07:11,561 WE CAN FOLLOW TO HARNESS THE 1713 01:07:11,561 --> 01:07:13,796 STRENGTH OF YOUR RELATIONSHIP TO 1714 01:07:13,796 --> 01:07:15,765 THE OUTSIDE COMMUNITY THAT YOU 1715 01:07:15,765 --> 01:07:17,900 REPRESENT TO BE ABLE TO FOSTER 1716 01:07:17,900 --> 01:07:19,802 THE EDUCATIONAL INITIATIVE, AND 1717 01:07:19,802 --> 01:07:22,939 IF SO, HOW CAN WE AS A 1718 01:07:22,939 --> 01:07:26,008 COMMISSION ENGAGE WITH YOU OR 1719 01:07:26,008 --> 01:07:28,277 WEAVE THIS INTO OUR SET OF 1720 01:07:28,277 --> 01:07:29,745 RECOMMENDATIONS TO THE ADVISORY 1721 01:07:29,745 --> 01:07:31,681 COUNCIL THAT WILL BE THE 1722 01:07:31,681 --> 01:07:33,015 ULTIMATE OUTPUT OF THE WORK OF 1723 01:07:33,015 --> 01:07:34,817 THIS COMMISSION OVER THE NEXT 1724 01:07:34,817 --> 01:07:35,518 TWO YEARS? 1725 01:07:35,518 --> 01:07:37,787 SO I'M OPENING THE FLOOR TO 1726 01:07:37,787 --> 01:07:39,655 ANYBODY WHO'D LIKE TO RESPOND TO 1727 01:07:39,655 --> 01:07:40,423 THAT. 1728 01:07:40,423 --> 01:07:43,125 JUST RAISE YOUR HAND IF YOU'RE 1729 01:07:43,125 --> 01:07:51,200 READY TO SPEAK. 1730 01:07:51,200 --> 01:07:53,202 ANY TAKERS? 1731 01:07:53,202 --> 01:07:55,271 >> JAN, GO AHEAD, I CAN SEE. 1732 01:07:55,271 --> 01:07:56,405 >> THANK YOU. 1733 01:07:56,405 --> 01:08:00,009 I WANTED TO BRING UP THE TOPIC 1734 01:08:00,009 --> 01:08:02,078 RELATED TO HOW TO SUPPORT 1735 01:08:02,078 --> 01:08:04,547 TRAINEES, AND IN PARTICULAR, PRE 1736 01:08:04,547 --> 01:08:10,953 AND POSTDOCTORAL TRAINEES. 1737 01:08:10,953 --> 01:08:12,521 NAVBO, FOR INSTANCE, REALLY IS A 1738 01:08:12,521 --> 01:08:13,923 MEETING PLACE FOR THESE TRAINEES 1739 01:08:13,923 --> 01:08:15,558 AND WE REALLY UNDERSTAND A LOT 1740 01:08:15,558 --> 01:08:20,896 OF THE CHALLENGES AND ANXIETIES 1741 01:08:20,896 --> 01:08:22,565 THEY HAVE IN TERMS OF GETTING 1742 01:08:22,565 --> 01:08:24,000 THE TRANSITION TO INDEPENDENCE 1743 01:08:24,000 --> 01:08:25,301 AND SETTING UP THEIR LAB. 1744 01:08:25,301 --> 01:08:27,003 SOME OF THE ISSUES RELATED TO 1745 01:08:27,003 --> 01:08:31,007 HOW TRAINEES INTERACT WITH THE 1746 01:08:31,007 --> 01:08:32,475 NIH ARE RELATED TO THE FACT THAT 1747 01:08:32,475 --> 01:08:35,378 BECAUSE THERE'S A SMALLER 1748 01:08:35,378 --> 01:08:36,846 COLLECTION OF TRAINEES, IT WOULD 1749 01:08:36,846 --> 01:08:37,913 BE VERY CHALLENGING, FOR 1750 01:08:37,913 --> 01:08:39,515 INSTANCE, TO DEVELOP A TRAINING 1751 01:08:39,515 --> 01:08:41,150 GRANT FOCUSED ON LYMPHATIC 1752 01:08:41,150 --> 01:08:42,618 BIOLOGY AND, IN FACT, I DID A 1753 01:08:42,618 --> 01:08:44,020 SEARCH AND I DON'T THINK THERE'S 1754 01:08:44,020 --> 01:08:45,955 ANY TRAINING GRANT THAT HAS 1755 01:08:45,955 --> 01:08:49,992 LYMPHATIC IN THE TITLE. 1756 01:08:49,992 --> 01:08:51,193 T32s ARE CHALLENGING TO 1757 01:08:51,193 --> 01:08:51,427 OBTAIN. 1758 01:08:51,427 --> 01:08:55,097 I'M THE PI ON A T32 IN VASCULAR 1759 01:08:55,097 --> 01:08:55,998 BIOLOGY, AND I THINK THE 1760 01:08:55,998 --> 01:08:57,133 COMMISSION MAY WANT TO THINK 1761 01:08:57,133 --> 01:09:02,938 ABOUT WAYS THAT THE NIH CAN 1762 01:09:02,938 --> 01:09:04,473 CROSS INSTITUTIONS TO SUPPORT A 1763 01:09:04,473 --> 01:09:06,042 BROADER TRAINING INITIATIVE IN 1764 01:09:06,042 --> 01:09:07,743 LYMPHATIC BIOLOGY. 1765 01:09:07,743 --> 01:09:09,278 BEYOND EDUCATION, WE COULD HAVE 1766 01:09:09,278 --> 01:09:13,315 A LONG DISCUSSION ABOUT 1767 01:09:13,315 --> 01:09:14,183 TRANSINSTITUTION SUPPORT FOR 1768 01:09:14,183 --> 01:09:16,018 LYMPHATIC RESEARCH BUT I'LL SAVE 1769 01:09:16,018 --> 01:09:17,019 THAT FOR ANOTHER TIME. 1770 01:09:17,019 --> 01:09:18,554 >> THANKS, JAN. 1771 01:09:18,554 --> 01:09:24,660 JERRY, I SEE YOUR HAND IS UP. 1772 01:09:24,660 --> 01:09:25,628 >> O YES. 1773 01:09:25,628 --> 01:09:29,331 WELL, ACTUALLY JUST TO SPEAK TO 1774 01:09:29,331 --> 01:09:32,034 WHAT JAN JUST MENTIONED THERE 1775 01:09:32,034 --> 01:09:33,536 ACTUALLY IS GOING TO BE A 1776 01:09:33,536 --> 01:09:37,173 LYMPHATIC T32 AND TEXAS A & M 1777 01:09:37,173 --> 01:09:38,374 STARTING PRETTY SOON, I KNOW 1778 01:09:38,374 --> 01:09:40,843 HE'S GOTTEN THE AWARD NOTICE, SO 1779 01:09:40,843 --> 01:09:42,478 JUST WAITING FOR TO START. 1780 01:09:42,478 --> 01:09:45,448 BUT I WANTED TO SPEAK TO MORE 1781 01:09:45,448 --> 01:09:48,818 LIKE MEDICAL STUDENT EDUCATION, 1782 01:09:48,818 --> 01:09:50,352 BECAUSE MY UNDERSTANDING IS THAT 1783 01:09:50,352 --> 01:09:53,289 AROUND THE COUNTRY, WE'RE STILL 1784 01:09:53,289 --> 01:09:57,293 IN KIND OF THE WILD WEST OF HOW 1785 01:09:57,293 --> 01:10:05,735 MEDICAL STUDENTS LEARN ABOUT LIT 1786 01:10:05,735 --> 01:10:06,302 LYMPHATICS, WHAT SPECIFIC 1787 01:10:06,302 --> 01:10:07,236 CONDITIONS THEY LEARNED ABOUT. 1788 01:10:07,236 --> 01:10:08,971 I KNOW HERE AND MY INSTITUTION, 1789 01:10:08,971 --> 01:10:13,609 I ACTUALLY LEAD AN ENGAGED 1790 01:10:13,609 --> 01:10:15,411 LEARNING SESSION THAT LASTS A 1791 01:10:15,411 --> 01:10:19,148 FEW HOURS WITH STUDENTS AND WE 1792 01:10:19,148 --> 01:10:20,883 KIND OF BRANCH OFF INTO LIX FROM 1793 01:10:20,883 --> 01:10:23,786 THERE. 1794 01:10:23,786 --> 01:10:24,787 LYMPHATICS FROM THERE. 1795 01:10:24,787 --> 01:10:27,389 BUT I WOULD THINK THAT OUR 1796 01:10:27,389 --> 01:10:28,424 SOCIETIES IN GENERAL, WHETHER IT 1797 01:10:28,424 --> 01:10:29,792 BE OUR EDUCATION COMMITTEES OR 1798 01:10:29,792 --> 01:10:31,127 TRAINING COMMITTEES, PROBABLY 1799 01:10:31,127 --> 01:10:35,431 COULD BE A RESOURCE FOR MAYBE 1800 01:10:35,431 --> 01:10:37,933 HELPING DEVELOP SOME TYPE OF 1801 01:10:37,933 --> 01:10:46,575 CURRICULUM THAT COULD BE 1802 01:10:46,575 --> 01:10:47,743 STANDARDIZED ACROSS DIFFERENT 1803 01:10:47,743 --> 01:10:48,144 MEDICAL SCHOOLS. 1804 01:10:48,144 --> 01:10:48,878 >> THANK YOU. 1805 01:10:48,878 --> 01:10:50,379 ROBERT, I THINK YOU'RE NEXT. 1806 01:10:50,379 --> 01:10:54,550 >> WE FACE A REAL CHALLENGE WITH 1807 01:10:54,550 --> 01:10:56,752 POST ONCOLOGY TREATMENT IN 1808 01:10:56,752 --> 01:10:57,686 GENERAL. 1809 01:10:57,686 --> 01:10:59,622 FOR THE LONGEST TIME, WE THOUGHT 1810 01:10:59,622 --> 01:11:02,691 THAT THE MEDICAL HOME MODEL 1811 01:11:02,691 --> 01:11:05,427 WOULD BE EFFECTIVE IN A WAY TO 1812 01:11:05,427 --> 01:11:06,829 ENSURE THAT PATIENTS GOT 1813 01:11:06,829 --> 01:11:07,696 PERSONALIZED CARE, WHATEVER 1814 01:11:07,696 --> 01:11:10,299 THEIR NEEDS WERE, BUT 1815 01:11:10,299 --> 01:11:11,100 INCREASINGLY, PRIMARY CARE 1816 01:11:11,100 --> 01:11:12,501 PROVIDERS ARE ASKED TO DO MORE 1817 01:11:12,501 --> 01:11:14,170 AND MORE AND MORE YEAR AFTER 1818 01:11:14,170 --> 01:11:19,508 YEAR AFTER YEAR, AND THEY STA 1819 01:11:19,508 --> 01:11:21,210 STARTED REBELLING A LONG TIME 1820 01:11:21,210 --> 01:11:22,311 AGO, THAT THERE'S A LIMIT TO 1821 01:11:22,311 --> 01:11:24,580 WHAT THEY CAN ACTUALLY MANAGE. 1822 01:11:24,580 --> 01:11:25,514 ONCOLOGISTS OFTENTIMES CONTINUE 1823 01:11:25,514 --> 01:11:26,749 TO SEE PATIENTS BUT THEY'RE 1824 01:11:26,749 --> 01:11:28,717 REALLY NOT ATTENTIVE TO THEIR 1825 01:11:28,717 --> 01:11:30,152 REHABILITATION NEEDS, AND ONCE 1826 01:11:30,152 --> 01:11:31,754 ONCOLOGY GOT OUTSIDE OF THE 1827 01:11:31,754 --> 01:11:34,056 HOSPITAL, THE LINK BETWEEN REHAB 1828 01:11:34,056 --> 01:11:36,592 WAS BROKEN AS WELL. 1829 01:11:36,592 --> 01:11:37,793 SURVIVORSHIP PLANS STILL HAVE 1830 01:11:37,793 --> 01:11:40,162 NOT QUITE TAKEN ROUTE. 1831 01:11:40,162 --> 01:11:43,165 THERE'S A LOT OF CONFLICT AND 1832 01:11:43,165 --> 01:11:44,099 CONTROVERSY AS TO WHETHER 1833 01:11:44,099 --> 01:11:46,101 THEY'RE USEFUL. 1834 01:11:46,101 --> 01:11:47,403 SO I SORT OF FEEL LIKE RIGHT 1835 01:11:47,403 --> 01:11:49,672 NOW, THE MAIN HOPE IS TO EDUCATE 1836 01:11:49,672 --> 01:11:51,407 PATIENTS, BUT WE ALL CAN 1837 01:11:51,407 --> 01:11:53,042 APPRECIATE THAT THE MEDICAL 1838 01:11:53,042 --> 01:11:56,145 LITERACY CHALLENGES ARE IMMENSE, 1839 01:11:56,145 --> 01:11:58,080 AND SO IF WE CAN HAVE A GOAL TO 1840 01:11:58,080 --> 01:12:00,349 MAKE SURE THAT THE ELECTRONIC 1841 01:12:00,349 --> 01:12:03,219 HEALTH RECORD HAS THESE KINDS OF 1842 01:12:03,219 --> 01:12:04,820 PROMPTS FOR POST TREATMENT 1843 01:12:04,820 --> 01:12:06,155 SURVEILLANCE EMBEDDED IN THEM, 1844 01:12:06,155 --> 01:12:08,958 THAT CAN BE A CONSTANT REMINDER 1845 01:12:08,958 --> 01:12:09,925 FOR THE KIND OF CARE THESE 1846 01:12:09,925 --> 01:12:14,430 PATIENTS SHOULD BE GETTING, 1847 01:12:14,430 --> 01:12:15,297 ONGOING CONDITIONS THAT HAVE TO 1848 01:12:15,297 --> 01:12:18,901 BE LOOKED FOR, BUT RIGHT NOW I 1849 01:12:18,901 --> 01:12:21,136 THINK NO ONE HAS QUITE FIGURED 1850 01:12:21,136 --> 01:12:23,038 OUT HOW TO DO THIS. 1851 01:12:23,038 --> 01:12:23,405 >> RIGHT. 1852 01:12:23,405 --> 01:12:24,807 THANK YOU. 1853 01:12:24,807 --> 01:12:26,542 GREAT POINTS. 1854 01:12:26,542 --> 01:12:29,378 MIIKKA AND I THINK AFTER THAT, 1855 01:12:29,378 --> 01:12:36,085 WE HAVE EVANGELOS. 1856 01:12:36,085 --> 01:12:38,153 >> I CAN DEFINITELY AGREE WITH 1857 01:12:38,153 --> 01:12:38,888 WHAT HAS BEEN SAID. 1858 01:12:38,888 --> 01:12:43,259 FOR ISSVA, ALSO IT'S A HUGE 1859 01:12:43,259 --> 01:12:45,561 PROBLEM, THERE'S A NEED FOR 1860 01:12:45,561 --> 01:12:47,963 COURSES, VIDEOS, AND 1861 01:12:47,963 --> 01:12:49,698 INFORMATION, BOTH FOR YOUNG 1862 01:12:49,698 --> 01:12:57,506 PHYSICIANS COMING TO THE FIELD, 1863 01:12:57,506 --> 01:13:02,111 BUT ALSO IN MORE COMPLICATED 1864 01:13:02,111 --> 01:13:03,178 FIELDS, AND ALSO TO REACH THE 1865 01:13:03,178 --> 01:13:03,445 PATIENTS. 1866 01:13:03,445 --> 01:13:05,247 SO THERE'S A LOT OF NEED. 1867 01:13:05,247 --> 01:13:07,116 IF WE WANT TO DO ALL THIS AT 1868 01:13:07,116 --> 01:13:08,117 ONCE, IT'S GOING TO BE TOO MUCH 1869 01:13:08,117 --> 01:13:08,651 FOR US. 1870 01:13:08,651 --> 01:13:11,353 WE HAVE TO KIND OF START -- THAT 1871 01:13:11,353 --> 01:13:14,089 WE DECIDED AT LEAST TO MAKE A 1872 01:13:14,089 --> 01:13:15,057 PATIENT TASK FORCE WHICH WE 1873 01:13:15,057 --> 01:13:20,629 DIDN'T HAVE BEFORE, SO WE'LL GET 1874 01:13:20,629 --> 01:13:22,932 A NEW WEBSITE, MORE MODERN 1875 01:13:22,932 --> 01:13:24,333 WEBSITE, THIS IS SOMETHING THAT 1876 01:13:24,333 --> 01:13:25,634 WE'LL PROVIDE. 1877 01:13:25,634 --> 01:13:27,703 IN THE EUROPEAN NETWORK THAT I'M 1878 01:13:27,703 --> 01:13:29,772 CHAIRING THE VASCULAR, AND ALSO 1879 01:13:29,772 --> 01:13:36,879 WE DO THESE KIND OF EITHER SMALL 1880 01:13:36,879 --> 01:13:44,219 WEBEX WEBINARS OR OTHER TYPES OF 1881 01:13:44,219 --> 01:13:46,789 VIRTUAL MEETINGS BUT WE DO IT 1882 01:13:46,789 --> 01:13:49,358 SEVERAL TIMES, SINCE I'M 1883 01:13:49,358 --> 01:13:50,326 GENETICIST, I ALSO SEE THIS 1884 01:13:50,326 --> 01:13:52,995 FIELD OF 7,000 DISEASES THAT 1885 01:13:52,995 --> 01:13:54,129 COULD BE SOME KIND OF AN AREA 1886 01:13:54,129 --> 01:13:55,364 THAT WE COULD START TALKING 1887 01:13:55,364 --> 01:13:58,834 ABOUT THE RARE DISEASES, THEN 1888 01:13:58,834 --> 01:13:59,802 FROM THERE, THE MEDICAL STUDENTS 1889 01:13:59,802 --> 01:14:01,503 ESPECIALLY COULD KIND OF FIND 1890 01:14:01,503 --> 01:14:05,407 INFORMATION ON THE VARIOUS RARE 1891 01:14:05,407 --> 01:14:08,577 DISEASES, WHICH IS SOMETHING 1892 01:14:08,577 --> 01:14:09,411 THAT -- NOBODY CAN KNOW THEM 1893 01:14:09,411 --> 01:14:09,979 ALL. 1894 01:14:09,979 --> 01:14:11,347 YOU I ALSO THINK THAT'S 1895 01:14:11,347 --> 01:14:12,548 SOMETHING THAT AI COULD HELP IN 1896 01:14:12,548 --> 01:14:15,718 THE SENSE THAT IT COULD SUGGEST, 1897 01:14:15,718 --> 01:14:16,885 OF COURSE WE NEED THE PHYSICIAN 1898 01:14:16,885 --> 01:14:18,387 BEHIND IT, BUT IT HELPS NOT TO 1899 01:14:18,387 --> 01:14:19,722 FORGET EVENTUALLY A RARE DISEASE 1900 01:14:19,722 --> 01:14:21,790 THAT YOU DID NOT THINK ABOUT. 1901 01:14:21,790 --> 01:14:23,092 AND ESPECIALLY IF YOU ARE NOT 1902 01:14:23,092 --> 01:14:24,059 AWARE OF IT, YOU CAN'T THINK 1903 01:14:24,059 --> 01:14:24,727 ABOUT IT. 1904 01:14:24,727 --> 01:14:29,832 THAT'S ALL. 1905 01:14:29,832 --> 01:14:30,332 >> THANK YOU. 1906 01:14:30,332 --> 01:14:34,837 NEXT WE HAVE EVANGELOS. 1907 01:14:34,837 --> 01:14:38,273 >> I WILL SAY THAT I AGREE 1908 01:14:38,273 --> 01:14:43,846 DEFINITELY WITH THE OTHERS. 1909 01:14:43,846 --> 01:14:46,115 THIS IS -- I SAY FROM THE 1910 01:14:46,115 --> 01:14:47,883 NATIONAL SOCIETY OF LYMPHOLOGY, 1911 01:14:47,883 --> 01:14:54,823 THAT'S WHY WE HAVE A CON 16 CONL 1912 01:14:54,823 --> 01:14:57,626 DOCUMENT TO UNDERSTAND THE 1913 01:14:57,626 --> 01:15:00,129 SCREENING, THE DIAGNOSIS, THE 1914 01:15:00,129 --> 01:15:02,164 TREATMENT -- BUT THIS IS -- WE 1915 01:15:02,164 --> 01:15:06,902 NEED TO ESTABLISH -- TO 1916 01:15:06,902 --> 01:15:07,336 ESTABLISH EDUCATION. 1917 01:15:07,336 --> 01:15:10,406 THIS IS THE PROBLEM, OUR PROBLEM 1918 01:15:10,406 --> 01:15:13,275 IS THAT FROM THE MEDICAL SCHO 1919 01:15:13,275 --> 01:15:16,345 SCHOOLS, THEY DON'T KNOW -- I 1920 01:15:16,345 --> 01:15:17,379 DON'T SPEAK FOR THE GENETIC 1921 01:15:17,379 --> 01:15:19,448 BECAUSE IT'S VERY SPECIAL 1922 01:15:19,448 --> 01:15:21,450 THINGS, BUT THE VERY SIMPLE 1923 01:15:21,450 --> 01:15:22,684 THINGS FOR LYMPHATIC SYSTEM, 1924 01:15:22,684 --> 01:15:28,424 THEY DON'T KNOW ABOUT THAT. 1925 01:15:28,424 --> 01:15:34,163 SO AT THE END OF THIS, WE HAVE 1926 01:15:34,163 --> 01:15:35,931 NO EDUCATION, NO GOOD SCREENING, 1927 01:15:35,931 --> 01:15:37,232 NO DIAGNOSIS, NO GOOD TREATMENT, 1928 01:15:37,232 --> 01:15:40,402 SO THIS IS THAT I FEEL THAT -- I 1929 01:15:40,402 --> 01:15:50,913 THINK THAT WHAT WE NEED IS TO 1930 01:15:53,148 --> 01:15:57,586 CREATE ONE EDUCATION, ONE 1931 01:15:57,586 --> 01:16:03,025 WITH -- TO EDUCATE THE -- ALL -- 1932 01:16:03,025 --> 01:16:03,659 LYMPHATIC SYSTEM FROM THE 1933 01:16:03,659 --> 01:16:05,327 MEDICAL SCHOOLS AND FROM 1934 01:16:05,327 --> 01:16:06,862 PHYSICAL THERAPY SCHOOLS, 1935 01:16:06,862 --> 01:16:08,931 FROM -- SCHOOLS, IN ORDER TO 1936 01:16:08,931 --> 01:16:19,475 UNDERSTAND WHICH IS THE PROBLEM. 1937 01:16:20,776 --> 01:16:25,881 THAT'S WHY GOOD OPPORTUNITY TO 1938 01:16:25,881 --> 01:16:26,882 ESTABLISH EDUCATION FOR 1939 01:16:26,882 --> 01:16:27,883 EVERYBODY FOR FUTURE ALL OVER 1940 01:16:27,883 --> 01:16:28,417 THE WORLD. 1941 01:16:28,417 --> 01:16:28,951 >> THANK YOU. 1942 01:16:28,951 --> 01:16:31,987 MIKE, I THINK YOU WERE NEXT. 1943 01:16:31,987 --> 01:16:33,989 >> THANK YOU, STAN. 1944 01:16:33,989 --> 01:16:35,524 I AGAIN AGREE WITH MUCH OF 1945 01:16:35,524 --> 01:16:39,094 WHAT'S BEEN SAID HERE. 1946 01:16:39,094 --> 01:16:40,496 I THINK FROM MY PERSPECTIVE, 1947 01:16:40,496 --> 01:16:43,799 WHAT WE HAVE DONE IS REALLY 1948 01:16:43,799 --> 01:16:46,635 FOCUSED ON EDUCATING THE PATIENT 1949 01:16:46,635 --> 01:16:50,572 WITH REGARD TO NOT ONLY THEIR 1950 01:16:50,572 --> 01:16:53,375 DISEASE BUT ALSO THE IMPACT OF 1951 01:16:53,375 --> 01:16:55,978 SCIENCE ON THEIR HEALTH. 1952 01:16:55,978 --> 01:17:00,549 AND I THINK THAT WE HAVE USED AI 1953 01:17:00,549 --> 01:17:04,620 IN ORDER TO SORT OF DRAFT LAY 1954 01:17:04,620 --> 01:17:06,688 SUMMARIES OF PRESENTATIONS, 1955 01:17:06,688 --> 01:17:11,193 SCIENTIFIC PRESENTATIONS OF 1956 01:17:11,193 --> 01:17:12,194 IMPORTANT ARTICLES THAT HAVE 1957 01:17:12,194 --> 01:17:16,331 BEEN PUBLISHED, AND AGAIN, HAVE 1958 01:17:16,331 --> 01:17:17,733 UTILIZED THE AUTHORS AND OTHER 1959 01:17:17,733 --> 01:17:22,337 MEDICAL AND SCIENCE PROFESSI 1960 01:17:22,337 --> 01:17:22,971 PROFESSIONALS IN ORDER TO EDIT 1961 01:17:22,971 --> 01:17:23,205 THOSE. 1962 01:17:23,205 --> 01:17:24,706 SO THAT'S BEEN WELL RECEIVED 1963 01:17:24,706 --> 01:17:27,876 WITHIN THE PATIENT COMMUNITY. 1964 01:17:27,876 --> 01:17:28,977 SO THAT'S CERTAINLY SOMETHING TO 1965 01:17:28,977 --> 01:17:31,914 CONSIDER. 1966 01:17:31,914 --> 01:17:33,982 WITH REGARD TO MEDICAL STUDENT 1967 01:17:33,982 --> 01:17:38,153 ENGAGEMENT, THERE ARE INTEREST 1968 01:17:38,153 --> 01:17:38,954 GROUPS, MEDICAL STUDENT INTEREST 1969 01:17:38,954 --> 01:17:40,889 GROUPS THAT ARE ARISING FOCUSED 1970 01:17:40,889 --> 01:17:45,360 ON RARE DISEASES. 1971 01:17:45,360 --> 01:17:47,462 SO CERTAINLY WE HAVE PLUGGED 1972 01:17:47,462 --> 01:17:48,997 INTO A NUMBER OF THOSE THAT HAVE 1973 01:17:48,997 --> 01:17:52,334 DEVELOPED OVER THE COURSE OF THE 1974 01:17:52,334 --> 01:17:53,335 LAST SEVERAL YEARS WITH REGARD 1975 01:17:53,335 --> 01:17:56,705 TO EDUCATING THEM ON RARE 1976 01:17:56,705 --> 01:17:59,875 LYMPHATIC DISEASES. 1977 01:17:59,875 --> 01:18:04,246 SO AGAIN, THERE IS A FOUNDATION 1978 01:18:04,246 --> 01:18:06,448 IN ORDER TO SORT OF REACH 1979 01:18:06,448 --> 01:18:08,750 TRAINEES THAT CERTAINLY ARE 1980 01:18:08,750 --> 01:18:09,885 INTERESTED. 1981 01:18:09,885 --> 01:18:10,919 IT DOESN'T REACH ALL OF THEM, 1982 01:18:10,919 --> 01:18:13,855 BUT AGAIN, I THINK IT'S A GREAT 1983 01:18:13,855 --> 01:18:16,792 PLACE TO THINK ABOUT STARTING 1984 01:18:16,792 --> 01:18:18,827 WITH REGARD TO EDUCATING NEXT 1985 01:18:18,827 --> 01:18:20,262 GENERATION ON RARE LYMPHATIC 1986 01:18:20,262 --> 01:18:20,996 DISEASES. 1987 01:18:20,996 --> 01:18:21,430 THANK YOU. 1988 01:18:21,430 --> 01:18:22,831 >> WONDERFUL. 1989 01:18:22,831 --> 01:18:24,366 MELISSA. 1990 01:18:24,366 --> 01:18:26,435 >> SO I JUST DID A LITTLE 1991 01:18:26,435 --> 01:18:28,070 GOOGLING, AND I'M NOT A 1992 01:18:28,070 --> 01:18:29,504 PHYSICIAN, I'M A PH.D. 1993 01:18:29,504 --> 01:18:33,308 I'VE OFFERED A COURSE IN 1994 01:18:33,308 --> 01:18:34,543 LYMPHATICS FOR GRADUATE STUDENTS 1995 01:18:34,543 --> 01:18:36,144 HERE, BUT I THINK TO MOVE IT AND 1996 01:18:36,144 --> 01:18:39,214 MAKE IT MORE MANDATORY IN 1997 01:18:39,214 --> 01:18:41,617 MEDICAL EDUCATION, HOW CAN WE 1998 01:18:41,617 --> 01:18:44,553 CONTACT LIKE THE U.S. M LE., THE 1999 01:18:44,553 --> 01:18:46,321 CREDENTIALING -- THE BOARD EXAM 2000 01:18:46,321 --> 01:18:46,655 PEOPLE? 2001 01:18:46,655 --> 01:18:48,357 WE HAVE A WEALTH OF PHYSICIANS 2002 01:18:48,357 --> 01:18:50,459 AND PHYSICIAN SCIENTISTS HERE, 2003 01:18:50,459 --> 01:18:51,927 AND WITHIN THE LYMPHATIC 2004 01:18:51,927 --> 01:18:55,697 COMMUNITY THAT COULD PERHAPS PUT 2005 01:18:55,697 --> 01:18:58,667 TOGETHER A LIST OF REQUIRED 2006 01:18:58,667 --> 01:19:00,135 QUESTIONS OR SOMETHING LIKE THAT 2007 01:19:00,135 --> 01:19:03,405 FOR BOARD EXAMS, FOR MDs, 2008 01:19:03,405 --> 01:19:05,540 PTs, OTs, KIND OF PUSH IT 2009 01:19:05,540 --> 01:19:07,309 FROM THE BACK END. 2010 01:19:07,309 --> 01:19:08,477 SO THAT SOMETHING HAS TO BE 2011 01:19:08,477 --> 01:19:08,810 TAUGHT. 2012 01:19:08,810 --> 01:19:09,878 SOMETHING HAS TO BE INCLUDED IN 2013 01:19:09,878 --> 01:19:11,546 THE CURRICULUM FOR THEM TO PASS 2014 01:19:11,546 --> 01:19:12,981 THE BOARD EXAMS. 2015 01:19:12,981 --> 01:19:14,549 I DON'T KNOW IF THAT'S FEASIBLE, 2016 01:19:14,549 --> 01:19:17,085 BUT TO ME, FROM THE OUTSIDE 2017 01:19:17,085 --> 01:19:18,287 LOOKING IN, IT SEEMS LIKE AN 2018 01:19:18,287 --> 01:19:19,421 APPROACH THAT COULD BE TAKEN. 2019 01:19:19,421 --> 01:19:20,722 >> I THINK WE'RE GOING TO BE 2020 01:19:20,722 --> 01:19:22,190 TOUCHING ON SOME OF THAT THIS 2021 01:19:22,190 --> 01:19:25,494 AFTERNOON AS WELL, WITH THE 2022 01:19:25,494 --> 01:19:26,361 COMPOSITION OF THE AFTERNOON 2023 01:19:26,361 --> 01:19:26,728 PANEL. 2024 01:19:26,728 --> 01:19:29,965 I THINK, FEDOR, YOU WERE NEXT. 2025 01:19:29,965 --> 01:19:31,833 >> THANKS, STAN. 2026 01:19:31,833 --> 01:19:34,236 YOU'RE ASKING FOR PRAGMATIC WAYS 2027 01:19:34,236 --> 01:19:35,771 TO DO THIS, AND I THINK YOU JUST 2028 01:19:35,771 --> 01:19:37,406 DID THAT. 2029 01:19:37,406 --> 01:19:40,776 BY CREATING THIS PANEL. 2030 01:19:40,776 --> 01:19:44,579 SO, SO MANY DIFFERENT SOCIETIES 2031 01:19:44,579 --> 01:19:46,348 AND GROUPS, EACH OF US HAVE OUR 2032 01:19:46,348 --> 01:19:48,317 UNIQUE INTERESTS, AND WHAT WOULD 2033 01:19:48,317 --> 01:19:50,519 BE, I THINK, REALLY INSTRUMENTAL 2034 01:19:50,519 --> 01:19:54,022 TO THE FIELD IS IF NIH CAN FUND 2035 01:19:54,022 --> 01:19:56,525 THIS ONGOING COMMUNICATION WITH 2036 01:19:56,525 --> 01:20:00,429 ALL OF US I AND THE PURPOSE IS O 2037 01:20:00,429 --> 01:20:01,129 HARMONIZE OUR EFFORTS. 2038 01:20:01,129 --> 01:20:04,066 SO WHILE WE'RE ADDRESSING THE 2039 01:20:04,066 --> 01:20:08,337 INDIVIDUAL GOALS AND NEEDS, WE 2040 01:20:08,337 --> 01:20:09,638 ALSO COORDINATE IN THIS EFFORT 2041 01:20:09,638 --> 01:20:12,240 SO THAT WE'LL BE MORE PRODUCTIVE 2042 01:20:12,240 --> 01:20:13,642 WHENEVER WE CAN COLLABORATE. 2043 01:20:13,642 --> 01:20:14,810 THANKS. 2044 01:20:14,810 --> 01:20:16,478 >> FEDOR, SINCE YOU'RE SPEAKING, 2045 01:20:16,478 --> 01:20:20,248 IF I COULD INTERJECT MY OWN 2046 01:20:20,248 --> 01:20:22,217 PERSONAL QUESTION AND MARK MAYBE 2047 01:20:22,217 --> 01:20:25,287 ALSO ON BEHALF OF THE AMERICAN 2048 01:20:25,287 --> 01:20:26,021 HEART ASSOCIATION, YOU BOTH 2049 01:20:26,021 --> 01:20:29,424 REPRESENT ORGANIZATIONS THAT I 2050 01:20:29,424 --> 01:20:30,625 PARTICIPATE IN AS PART OF MY 2051 01:20:30,625 --> 01:20:32,361 SPECIALTY TRAINING AND YET I 2052 01:20:32,361 --> 01:20:33,729 KNOW THAT MOST OF THE PEOPLE TO 2053 01:20:33,729 --> 01:20:35,197 MY LEFT AND RIGHT WHEN I GO TO 2054 01:20:35,197 --> 01:20:37,833 MEETINGS ARE NOT QUITE SO 2055 01:20:37,833 --> 01:20:41,870 INTERESTED OR FOCUSED ON THE 2056 01:20:41,870 --> 01:20:42,537 LYMPHATIC ELEMENT. 2057 01:20:42,537 --> 01:20:44,639 ARE THERE MECHANISMS IN WHICH WE 2058 01:20:44,639 --> 01:20:48,477 CAN ENGAGE BROADER PHYSICIAN 2059 01:20:48,477 --> 01:20:52,180 AUDIENCE GROUPS Q WITHIN THE 2060 01:20:52,180 --> 01:20:53,181 SPECIALTY SOCIETIES AND ALSO THE 2061 01:20:53,181 --> 01:20:55,617 GENERAL SOCIETIES THAT WILL HELP 2062 01:20:55,617 --> 01:21:00,055 US TO ENTRAIN INDIVIDUALS INTO 2063 01:21:00,055 --> 01:21:02,591 THIS FOCUS AREA WHICH WILL IN 2064 01:21:02,591 --> 01:21:04,426 TURN PROMOTE EDUCATION WHICH IS 2065 01:21:04,426 --> 01:21:05,627 ALONG THE LINES, MELISSA, THAT 2066 01:21:05,627 --> 01:21:06,628 YOU WERE ASKING ABOUT. 2067 01:21:06,628 --> 01:21:08,363 >> I'LL START, THEN. 2068 01:21:08,363 --> 01:21:09,798 STAN, THANKS. 2069 01:21:09,798 --> 01:21:14,703 I THINK YOU'RE EXACTLY RIGHT. 2070 01:21:14,703 --> 01:21:17,105 AND THE WAY I WOULD THINK WILL 2071 01:21:17,105 --> 01:21:21,042 BE HELPFUL TO ADDRESS THIS NEED 2072 01:21:21,042 --> 01:21:24,446 IS TO INTRODUCE THE PANELS AND 2073 01:21:24,446 --> 01:21:28,049 TOPICS ON THOSE SOCIETY MEETINGS 2074 01:21:28,049 --> 01:21:30,986 THAT ARE MORE BROADLY ADDRESSING 2075 01:21:30,986 --> 01:21:33,622 THE INVOLVEMENT OF LYMPHATIC 2076 01:21:33,622 --> 01:21:35,390 SYSTEM IN OTHER CONDITIONS. 2077 01:21:35,390 --> 01:21:38,493 SO YOU ATTRACT PEOPLE BY THEIR 2078 01:21:38,493 --> 01:21:42,197 SPECIALTIES AND INTERESTS WHO 2079 01:21:42,197 --> 01:21:45,467 ARE -- MAY NOT BE WELL EDUCATED 2080 01:21:45,467 --> 01:21:46,802 ABOUT THE ROLE OF LYMPHATICS, 2081 01:21:46,802 --> 01:21:52,073 BUT BY CREATING THAT DIRECTION, 2082 01:21:52,073 --> 01:21:53,542 WHERE THE ROLE OF THE LYMPHATIC 2083 01:21:53,542 --> 01:21:55,577 SYSTEM IS INCLUDED IN THOSE 2084 01:21:55,577 --> 01:21:56,878 DISCUSSIONS THAT MAY HELP THEM 2085 01:21:56,878 --> 01:21:57,879 TO, OVER TIME, DEVELOP THAT 2086 01:21:57,879 --> 01:22:01,183 INTEREST. 2087 01:22:01,183 --> 01:22:02,017 >> EXCELLENT. 2088 01:22:02,017 --> 01:22:02,784 MARK, ARE YOU THERE? 2089 01:22:02,784 --> 01:22:08,390 DO YOU WANT TO COMMENT? 2090 01:22:08,390 --> 01:22:10,525 >> YES. 2091 01:22:10,525 --> 01:22:11,993 HOPE YOU CAN HEAR ME. 2092 01:22:11,993 --> 01:22:12,494 >> YEP. 2093 01:22:12,494 --> 01:22:13,595 >> OKAY. 2094 01:22:13,595 --> 01:22:15,664 SO I WANTED TO SUGGEST THIS FROM 2095 01:22:15,664 --> 01:22:22,237 TWO PERSPECTIVES. 2096 01:22:22,237 --> 01:22:24,239 I AM A SPECIALIST WHO SEES 2097 01:22:24,239 --> 01:22:26,374 PATIENTS INCLUDING MANY PATIENTS 2098 01:22:26,374 --> 01:22:30,111 WITH LYMPHATIC DISORDERS. 2099 01:22:30,111 --> 01:22:33,181 -- AN AREA THAT HAS NOT REALLY 2100 01:22:33,181 --> 01:22:36,918 RECEIVED MUCH RECOGNITION AMONG 2101 01:22:36,918 --> 01:22:41,556 OUR -- INCLUDING THOSE WHO ARE 2102 01:22:41,556 --> 01:22:44,459 GENERAL INTERNISTS, PRIMARY CARE 2103 01:22:44,459 --> 01:22:50,565 PHYSICIANS, -- HAS RECEIVED VERY 2104 01:22:50,565 --> 01:22:54,002 LITTLE RECOGNITION IN TERMS OF 2105 01:22:54,002 --> 01:23:00,509 EDUCATION, AND -- IN THESE 2106 01:23:00,509 --> 01:23:02,043 PATIENTS IN THE CLINIC, TRAINING 2107 01:23:02,043 --> 01:23:02,911 FELLOWS AND OTHERS, THEY M KOL 2108 01:23:02,911 --> 01:23:06,214 IN VERY UNAWARE OF LYMPHADEMA, 2109 01:23:06,214 --> 01:23:11,586 HOW TO MAKE THE DIAGNOSIS AND 2110 01:23:11,586 --> 01:23:12,988 HAVE VERY LITTLE EDUCATION IN 2111 01:23:12,988 --> 01:23:21,129 TERMS OF TREATMENT ALTERNATIVES. 2112 01:23:21,129 --> 01:23:23,398 THAT REALLY NEED TO BEGIN AT THE 2113 01:23:23,398 --> 01:23:24,833 MEDICAL SCHOOL LEVEL BUT REALLY 2114 01:23:24,833 --> 01:23:28,637 CAN BEGIN -- AND THEN IN THE, 2115 01:23:28,637 --> 01:23:37,946 YOU KNOW, POST RESIDENCY AREA, 2116 01:23:37,946 --> 01:23:39,481 EDUCATING THEM AND REMINDING 2117 01:23:39,481 --> 01:23:40,248 THEM ABOUT LYMPHADEMA. 2118 01:23:40,248 --> 01:23:41,816 I JUST THINK IT'S NOT BEING 2119 01:23:41,816 --> 01:23:44,019 RECOGNIZED AT ALL, BUT IT'S -- 2120 01:23:44,019 --> 01:23:46,555 IT'S REALLY TOWARDS THE END OF 2121 01:23:46,555 --> 01:23:48,657 THE ROAD AND NOT AT THE 2122 01:23:48,657 --> 01:23:49,324 BEGINNING, WHERE IT SHOULD BE. 2123 01:23:49,324 --> 01:23:51,126 SO IT'S REALLY, REALLY A MAJOR 2124 01:23:51,126 --> 01:23:55,997 ISSUE. 2125 01:23:55,997 --> 01:23:58,633 I ACKNOWLEDGE THIS UP FRONT, I 2126 01:23:58,633 --> 01:24:00,068 WOULD SAY LYMPHATIC DISEASES ARE 2127 01:24:00,068 --> 01:24:02,904 FAR FROM OUR EMPHASIS, IT HASN'T 2128 01:24:02,904 --> 01:24:05,307 BEEN -- DES IN GENERAL HAVE 2129 01:24:05,307 --> 01:24:07,142 REALLY TAKEN A MUCH GREATER 2130 01:24:07,142 --> 01:24:08,143 EMPHASIS WITHIN THE 2131 01:24:08,143 --> 01:24:11,780 ORGANIZATION, AND THERE ARE 2132 01:24:11,780 --> 01:24:16,351 OPPORTUNITIES -- DISEASE, IN 2133 01:24:16,351 --> 01:24:18,420 TERMS OF PRESENTING SCIENCE AS 2134 01:24:18,420 --> 01:24:24,893 WELL AS OFFERING -- EVERY 2135 01:24:24,893 --> 01:24:25,760 SPRING, THE AMERICAN HEART 2136 01:24:25,760 --> 01:24:27,062 ASSOCIATION HAS ITS VASCULAR 2137 01:24:27,062 --> 01:24:35,637 DISCOVERY MEETING. 2138 01:24:35,637 --> 01:24:37,939 -- PLENARY SESSIONS, BREAKOUT 2139 01:24:37,939 --> 01:24:42,444 SESSIONS ON DIFFERENT -- ONE 2140 01:24:42,444 --> 01:24:47,215 EXCELLENT AREA TO BRING IN FOLKS 2141 01:24:47,215 --> 01:24:48,450 INTERESTED IN VASCULAR AND 2142 01:24:48,450 --> 01:24:49,951 LYMPHATIC DISEASES. 2143 01:24:49,951 --> 01:24:51,052 PART OF THAT MEETING ON 2144 01:24:51,052 --> 01:24:51,486 LYMPHATIC DISEASES. 2145 01:24:51,486 --> 01:24:53,288 COULD BE A BREAKOUT, COULD BE 2146 01:24:53,288 --> 01:24:53,755 PLENARY. 2147 01:24:53,755 --> 01:24:56,558 BUT I SEE THAT AS A REAL 2148 01:24:56,558 --> 01:25:02,797 OPPORTUNITY -- FORWARD WITH THE 2149 01:25:02,797 --> 01:25:11,306 PROGRAM PLANNERS. 2150 01:25:11,306 --> 01:25:11,906 THE AMERICAN HEART ASSOCIATION 2151 01:25:11,906 --> 01:25:13,708 REALLY OFFERS A LOT OF GRANTS 2152 01:25:13,708 --> 01:25:16,611 FOR PREDOCTORAL FELLOWS, 2153 01:25:16,611 --> 01:25:19,748 POSTDOCTORAL -- ESTABLISHED 2154 01:25:19,748 --> 01:25:20,682 INVESTIGATORS, AND I WOULD 2155 01:25:20,682 --> 01:25:22,684 SUBMIT THAT VERY FEW 2156 01:25:22,684 --> 01:25:25,420 APPLICATIONS, IF ANY, DEAL WITH 2157 01:25:25,420 --> 01:25:30,692 LYMPHATIC -- FOR RESEARCH 2158 01:25:30,692 --> 01:25:31,693 INITIATIVES BUT IT'S PROBABLY 2159 01:25:31,693 --> 01:25:32,994 NOT WELL-KNOWN TO THOSE DOING 2160 01:25:32,994 --> 01:25:36,197 RESEARCH IN THAT AREA. 2161 01:25:36,197 --> 01:25:37,232 >> THANK YOU, MARK. 2162 01:25:37,232 --> 01:25:40,769 NEXT I HAVE CARRIE, AND AFTER 2163 01:25:40,769 --> 01:25:43,905 THAT, GUILLERMO AND JOEL. 2164 01:25:43,905 --> 01:25:44,472 >> THANKS. 2165 01:25:44,472 --> 01:25:46,941 I WANT TO REITERATE THAT 2166 01:25:46,941 --> 01:25:48,243 EDUCATION IS SUCH AN ISSUE. 2167 01:25:48,243 --> 01:25:49,944 I ACTUALLY TRAIN A LOT OF 2168 01:25:49,944 --> 01:25:51,246 FELLOWS AND RESIDENTS IN MY JOB, 2169 01:25:51,246 --> 01:25:52,247 AND ONE OF THE QUESTIONS I ASK 2170 01:25:52,247 --> 01:25:53,648 THEM IS HOW MUCH HAVE YOU 2171 01:25:53,648 --> 01:25:54,883 LEARNED ABOUT LYMPHATICS IN YOUR 2172 01:25:54,883 --> 01:25:57,218 MEDICAL SCHOOL EDUCATION, AND 2173 01:25:57,218 --> 01:25:58,820 USUALLY IT'S NO MORE THAN AN 2174 01:25:58,820 --> 01:26:00,689 HOUR, AND IF SO, IT'S USUALLY 2175 01:26:00,689 --> 01:26:04,292 THE THORACIC DUCT AND NOT THE 2176 01:26:04,292 --> 01:26:08,663 DISEASES. 2177 01:26:08,663 --> 01:26:09,964 IN COMPARISON BE, WHICH I THINK 2178 01:26:09,964 --> 01:26:14,002 MAY BE A MODEL TO USE -- SCHOOLS 2179 01:26:14,002 --> 01:26:16,004 SPEND TWO WEEKS ON LYMPHATIC 2180 01:26:16,004 --> 01:26:17,806 DISEASES AND LYMPHADEMA, AND 2181 01:26:17,806 --> 01:26:19,708 THEY HAVE A REALLY WELL TRAINED 2182 01:26:19,708 --> 01:26:20,809 OUT PLAN TO DISCUSS THIS WITH 2183 01:26:20,809 --> 01:26:21,309 EVERYBODY. 2184 01:26:21,309 --> 01:26:23,111 I'D ALSO LIKE TO TALK ABOUT HOW 2185 01:26:23,111 --> 01:26:24,112 SUBSPECIALTIES ARE VERY SILOED 2186 01:26:24,112 --> 01:26:25,180 AND NOT COMMUNICATING WITH EACH 2187 01:26:25,180 --> 01:26:27,782 OTHER. 2188 01:26:27,782 --> 01:26:30,985 I'M AN OB-GYN, I INTERACT VERY 2189 01:26:30,985 --> 01:26:32,620 CLOSELY WITH MATERNAL FETAL 2190 01:26:32,620 --> 01:26:34,923 MEDICINE WHO SEES CONGENITAL 2191 01:26:34,923 --> 01:26:37,025 LYMPHATIC ANOMALIES WHICH 2192 01:26:37,025 --> 01:26:38,426 PRESENT ABOUT 80% IN UTERO AND 2193 01:26:38,426 --> 01:26:40,095 JUST TO REALIZE ONLY A THIRD OF 2194 01:26:40,095 --> 01:26:41,496 THOSE ARE ACTUALLY BORN AND GO 2195 01:26:41,496 --> 01:26:42,864 ON TO LIFE, SO IT'S ACTUALLY 2196 01:26:42,864 --> 01:26:44,032 MUCH MORE COMMON THAN PEOPLE 2197 01:26:44,032 --> 01:26:45,900 REALIZE. 2198 01:26:45,900 --> 01:26:46,768 IN CLINICAL CARE. 2199 01:26:46,768 --> 01:26:49,304 BUT I ACTUALLY HAVE BEEN TALKING 2200 01:26:49,304 --> 01:26:51,339 TO THEM, AND THEY DON'T 2201 01:26:51,339 --> 01:26:52,373 UNDERSTAND THE LYMPHATIC SYSTEM 2202 01:26:52,373 --> 01:26:53,641 AND THEY DON'T UNDERSTAND THIS. 2203 01:26:53,641 --> 01:26:55,543 THEN THE OTHER ISSUE BECOMES, 2204 01:26:55,543 --> 01:26:57,178 NOW THEY HAVE A LYMPHATIC 2205 01:26:57,178 --> 01:26:59,047 ANOMALY, THEY DO NOT GO AHEAD 2206 01:26:59,047 --> 01:27:00,782 AND ADVISE THEIR PATIENTS THAT 2207 01:27:00,782 --> 01:27:02,851 THERE'S VASCULAR ANOMALY GROUPS 2208 01:27:02,851 --> 01:27:04,185 OR CLINICS THAT CAN SEE THEIR 2209 01:27:04,185 --> 01:27:04,586 PATIENTS. 2210 01:27:04,586 --> 01:27:08,123 AND SO I THINK THERE'S ALSO A 2211 01:27:08,123 --> 01:27:09,224 NEED TO BRIDGE ALL THESE 2212 01:27:09,224 --> 01:27:10,191 SPECIALTIES THAT ARE SEEING 2213 01:27:10,191 --> 01:27:12,260 THESE PATIENTS AND BEING ABLE TO 2214 01:27:12,260 --> 01:27:13,161 SHARE COMMUNICATIONS BECAUSE 2215 01:27:13,161 --> 01:27:14,896 THEY ALSO DON'T REALIZE THERE'S 2216 01:27:14,896 --> 01:27:16,431 TREATMENT OPTIONS AND THEY HAVE 2217 01:27:16,431 --> 01:27:22,470 DIFFERENT BIASES AS WELL. 2218 01:27:22,470 --> 01:27:24,639 >> THANK YOU, THAT'S GREAT. 2219 01:27:24,639 --> 01:27:30,178 GEE YAG 2220 01:27:31,045 --> 01:27:33,314 >> I DON'T KNOW WHY MY CAMERA IS 2221 01:27:33,314 --> 01:27:33,715 BLOCKED. 2222 01:27:33,715 --> 01:27:35,483 SO YES, I THINK WE ALL AGREE 2223 01:27:35,483 --> 01:27:38,119 THAT LYMPHATICS ARE QUITE 2224 01:27:38,119 --> 01:27:42,257 IGNORED IN THE MEDICAL FIELD, 2225 01:27:42,257 --> 01:27:43,658 EDUCATION IS BAD, AND WE NEED TO 2226 01:27:43,658 --> 01:27:45,193 INCREASE THE NUMBER OF PEOPLE 2227 01:27:45,193 --> 01:27:48,897 WORKING IN THIS AREA. 2228 01:27:48,897 --> 01:27:50,865 BUT I THINK YOU GUYS, SOME OF 2229 01:27:50,865 --> 01:27:54,035 YOU KNOW ME, IF I HAVE BEEN 2230 01:27:54,035 --> 01:27:55,403 PREACHING ABOUT THIS FOR A LONG 2231 01:27:55,403 --> 01:27:56,738 TIME, BUT EVEN MANY OF YOU WHICH 2232 01:27:56,738 --> 01:27:58,373 ARE CLINICIANS, YOU TALK ABOUT 2233 01:27:58,373 --> 01:27:59,207 LYMPHATIC MALFORMATIONS, YOU 2234 01:27:59,207 --> 01:28:00,608 ONLY TALK ABOUT LYMPHADEMA OR 2235 01:28:00,608 --> 01:28:03,044 DISEASES LIKE THAT. 2236 01:28:03,044 --> 01:28:04,445 AND AGAIN, I THINK WE HAVE 2237 01:28:04,445 --> 01:28:06,514 PLENTY OF EVIDENCE TO ARGUE THAT 2238 01:28:06,514 --> 01:28:08,950 THERE ARE MANY OTHER THINGS THAT 2239 01:28:08,950 --> 01:28:11,953 SHOULD BE UNDER THAT UMBRELLA OF 2240 01:28:11,953 --> 01:28:15,423 DISEASES CAUSED BY LYMPHATIC 2241 01:28:15,423 --> 01:28:18,493 MALFUNCTION, AND I THINK IT'S ON 2242 01:28:18,493 --> 01:28:19,627 ALL OF YOU TO START TALKING 2243 01:28:19,627 --> 01:28:21,196 ABOUT THAT WHEN YOU START 2244 01:28:21,196 --> 01:28:22,997 TALKING ABOUT LYMPHATICS, 2245 01:28:22,997 --> 01:28:26,901 BECAUSE THAT WOULD BRING MORE 2246 01:28:26,901 --> 01:28:32,307 SUBSPECIALTIES TO THE FIELD, 2247 01:28:32,307 --> 01:28:34,776 COULD BECOME LYMPHATIC 2248 01:28:34,776 --> 01:28:37,078 MALFUNCTION, BUT ACTUALLY MORE 2249 01:28:37,078 --> 01:28:38,446 STUDENTS, MORE PH.D.s TO BRING 2250 01:28:38,446 --> 01:28:39,747 INTO THIS AREA BECAUSE THEY 2251 01:28:39,747 --> 01:28:43,585 REALIZE THERE IS MUCH MO TO THIS 2252 01:28:43,585 --> 01:28:46,421 THAN -- BEYOND LYMPHADEMA. 2253 01:28:46,421 --> 01:28:48,056 SO WHICH OBVIOUSLY IS EXTREMELY 2254 01:28:48,056 --> 01:28:49,257 IMPORTANT, BUT I THINK THAT IS 2255 01:28:49,257 --> 01:28:51,125 SOMETHING THAT WE REALLY NEED 2256 01:28:51,125 --> 01:28:53,795 ALL TO BE AGREED UPON. 2257 01:28:53,795 --> 01:28:56,831 THAT THERE IS MUCH MORE TO BE 2258 01:28:56,831 --> 01:29:01,769 DONE ABOUT LYMPHATICS THAT SO 2259 01:29:01,769 --> 01:29:04,639 FAR IS POORLY DISCUSSED, POORLY 2260 01:29:04,639 --> 01:29:06,574 EXPLORED AND POORLY RESEARCHED, 2261 01:29:06,574 --> 01:29:10,011 AND I'M SERIOUSLY CONVINCED 2262 01:29:10,011 --> 01:29:12,513 WE'LL ATTRACT MORE TRAINING 2263 01:29:12,513 --> 01:29:14,349 GRANTS, MORE COLLABORATIONS AND 2264 01:29:14,349 --> 01:29:16,551 MANY OTHER AGENCIES LIKE 2265 01:29:16,551 --> 01:29:17,552 AMERICAN HEART ASSOCIATION, FOR 2266 01:29:17,552 --> 01:29:20,622 EXAMPLE, THAT COULD MEAN MORE 2267 01:29:20,622 --> 01:29:21,189 INTERESTED ON THIS TOPIC. 2268 01:29:21,189 --> 01:29:22,490 THANK YOU. 2269 01:29:22,490 --> 01:29:29,697 >> THANKS, GE GUILLERMO. 2270 01:29:29,697 --> 01:29:31,332 JOEL, PAULA, MAX, BEN. 2271 01:29:31,332 --> 01:29:32,533 JUST SO YOU KNOW I'M SEEING YOUR 2272 01:29:32,533 --> 01:29:40,308 HAND. 2273 01:29:40,308 --> 01:29:40,842 JOEL. 2274 01:29:40,842 --> 01:29:46,481 I THINK YOU'RE MUTED, JOEL. 2275 01:29:46,481 --> 01:29:47,882 >> ONE OF THE THINGS THAT'S BEEN 2276 01:29:47,882 --> 01:29:50,318 VERY USEFUL IN TERMS OF 2277 01:29:50,318 --> 01:29:54,789 EXPANDING OUR KNOWLEDGE OF LAM 2278 01:29:54,789 --> 01:30:02,096 AND TOUR R TUBEROUS SCLEROSUS, E 2279 01:30:02,096 --> 01:30:03,965 CASE OF THE AMERICAN THORACIC 2280 01:30:03,965 --> 01:30:05,667 SOCIETY, WHAT THEY'VE DONE IS 2281 01:30:05,667 --> 01:30:09,237 HAVE PATIENT ORGANIZATIONS BE 2282 01:30:09,237 --> 01:30:11,973 PART OF THE ORGANIZATION OF THE 2283 01:30:11,973 --> 01:30:12,607 SOCIETY. 2284 01:30:12,607 --> 01:30:15,343 SO EACH SATURDAY RECENTLY, THE 2285 01:30:15,343 --> 01:30:16,811 PATIENT ORGANIZATIONS WILL 2286 01:30:16,811 --> 01:30:17,879 DISCUSS DIFFERENT MATTERS THAT 2287 01:30:17,879 --> 01:30:18,980 ARE RELEVANT. 2288 01:30:18,980 --> 01:30:22,250 SO SOME CASES, IT'S BEEN LAM, 2289 01:30:22,250 --> 01:30:23,351 TUBEROUS SCLEROSIS, BUT I THINK 2290 01:30:23,351 --> 01:30:24,886 THERE ARE OTHER LYMPHATIC 2291 01:30:24,886 --> 01:30:26,754 DISEASES THAT COULD GET INVOLVED 2292 01:30:26,754 --> 01:30:26,988 THERE. 2293 01:30:26,988 --> 01:30:29,057 I THINK IT'S A MATTER OF PUSHING 2294 01:30:29,057 --> 01:30:29,724 THEM TO DO SO. 2295 01:30:29,724 --> 01:30:32,226 THERE'S A SESSION OF VARIOUS 2296 01:30:32,226 --> 01:30:34,095 ORGANIZATIONS WITH THEIR OWN 2297 01:30:34,095 --> 01:30:35,430 SYMPOSIUM, AGAIN, THIS IS USEFUL 2298 01:30:35,430 --> 01:30:38,266 IN TERMS OF ORGANIZATIONS, AND 2299 01:30:38,266 --> 01:30:39,667 ALSO IN TERMS OF EDUCATIONAL 2300 01:30:39,667 --> 01:30:41,302 INFORMATION. 2301 01:30:41,302 --> 01:30:46,040 AND WITH REGARD TO THE NHLBI, 2302 01:30:46,040 --> 01:30:47,709 STAN, AS YOU ARE AWARE, THE 2303 01:30:47,709 --> 01:30:51,312 NHLBI HAS A TRANS-NIH 2304 01:30:51,312 --> 01:30:52,213 ORGANIZATION THAT ESSENTIALLY 2305 01:30:52,213 --> 01:30:53,681 TALKS TO PEOPLE IN VARIOUS 2306 01:30:53,681 --> 01:30:54,716 INSTITUTES IN TERMS OF WHAT THEY 2307 01:30:54,716 --> 01:30:56,384 CAN DO, IN TERMS OF GRANTS, ET 2308 01:30:56,384 --> 01:30:57,518 CETERA, SO THAT IS AVAILABLE, 2309 01:30:57,518 --> 01:30:59,287 AND I THINK IT'S MAYBE A LITTLE 2310 01:30:59,287 --> 01:31:01,289 BIT MORE PUSHING THEM TO GET IT, 2311 01:31:01,289 --> 01:31:02,957 BUT AGAIN, I THINK LEARN IS 2312 01:31:02,957 --> 01:31:04,058 TRYING TO DO THAT AS WELL. 2313 01:31:04,058 --> 01:31:06,361 SO THERE'S A LOT OUT THERE. 2314 01:31:06,361 --> 01:31:08,096 I THINK IT'S A MATTER OF GETTING 2315 01:31:08,096 --> 01:31:09,364 PEOPLE INVOLVED WITH THEIR 2316 01:31:09,364 --> 01:31:10,365 SPECIALTY ORGANIZATIONS TO GET 2317 01:31:10,365 --> 01:31:13,368 THEM TO PARTICIPATE. 2318 01:31:13,368 --> 01:31:14,435 >> THANKS, JOEL. 2319 01:31:14,435 --> 01:31:15,970 PAULA, I THINK YOU'RE NEXT AND 2320 01:31:15,970 --> 01:31:18,172 THEN MAX. 2321 01:31:18,172 --> 01:31:19,807 >> PERFECT. 2322 01:31:19,807 --> 01:31:20,975 ACTUALLY, JOEL, YOU KIND OF LED 2323 01:31:20,975 --> 01:31:22,110 INTO ONE OF MY QUESTIONS I 2324 01:31:22,110 --> 01:31:23,511 WANTED TO THROW OUT TO THE WHOLE 2325 01:31:23,511 --> 01:31:25,580 GROUP. 2326 01:31:25,580 --> 01:31:27,815 TO JUST UNDERSTAND FROM YOUR 2327 01:31:27,815 --> 01:31:38,960 ADVANTAGE TAVANTAGEPOINTS TO IN. 2328 01:31:38,960 --> 01:31:41,496 I WAS WONDERING IF THERE'S 2329 01:31:41,496 --> 01:31:42,530 ANYTHING THAT JUST KIND OF COMES 2330 01:31:42,530 --> 01:31:43,865 TO LIGHT WHERE YOU FEEL LIKE IT 2331 01:31:43,865 --> 01:31:45,333 ONE OF THE GREATER SUCCESSES 2332 01:31:45,333 --> 01:31:46,768 THAT MAYBE -- EITHER BY 2333 01:31:46,768 --> 01:31:50,304 LOGISTICS OF HOW IT WAS DONE OR 2334 01:31:50,304 --> 01:31:54,642 SOMETHING THAT JUST 2335 01:31:54,642 --> 01:31:59,147 PRAGMATICALLY LOOKING AT. 2336 01:31:59,147 --> 01:32:01,215 >> WELL, THIS IS JAN ON BEHALF 2337 01:32:01,215 --> 01:32:01,883 OF NAVBO. 2338 01:32:01,883 --> 01:32:03,418 I WOULD SAY TRAVEL GRANTS. 2339 01:32:03,418 --> 01:32:05,186 AND WE DO THIS IN PARTNERSHIP 2340 01:32:05,186 --> 01:32:06,387 WITH LEARN. 2341 01:32:06,387 --> 01:32:09,323 AND IT'S AN AMAZING WAY TO MAKE 2342 01:32:09,323 --> 01:32:13,628 TRAINEES FEEL PART OF THE FIELD, 2343 01:32:13,628 --> 01:32:14,729 RECOGNIZED, THE RESOURCES TO GO 2344 01:32:14,729 --> 01:32:16,931 TO MEETINGS, SO WE'VE SEEN BIG 2345 01:32:16,931 --> 01:32:21,169 SUCCESSES IN EXPANDING THE FIELD 2346 01:32:21,169 --> 01:32:23,471 AND ENGAGING TRAINEES THROUGH 2347 01:32:23,471 --> 01:32:24,072 TRAVEL GRANTS. 2348 01:32:24,072 --> 01:32:25,873 >> THIS IS JERRY. 2349 01:32:25,873 --> 01:32:27,542 I CAN SAY WE DO THE SAME THING. 2350 01:32:27,542 --> 01:32:30,945 IN FACT, WE PARTNER WITH NAVBO 2351 01:32:30,945 --> 01:32:34,682 QUITE OFTEN TO SUPPORT SPEAKERS 2352 01:32:34,682 --> 01:32:35,917 AT THE LYMPHATIC FORUM AND ALSO 2353 01:32:35,917 --> 01:32:37,652 TRAVEL GRANTS AS WELL. 2354 01:32:37,652 --> 01:32:40,955 >> GREAT. 2355 01:32:40,955 --> 01:32:44,826 >> JUST ON THAT POINT, BECAUSE 2356 01:32:44,826 --> 01:32:46,394 THAT WAS E ESSENTIALLY WHAT I WS 2357 01:32:46,394 --> 01:32:47,061 GOING TO RAISE. 2358 01:32:47,061 --> 01:32:49,230 I THINK THE GREAT SUCCESS HAS 2359 01:32:49,230 --> 01:32:51,432 BEEN THE LEARN POSTDOCTORAL 2360 01:32:51,432 --> 01:32:51,799 FELLOWSHIPS. 2361 01:32:51,799 --> 01:32:53,501 AS WELL AS TRAVEL GRANTS, THEY 2362 01:32:53,501 --> 01:32:55,803 HAVE PROMOTED MOVEMENT OF 2363 01:32:55,803 --> 01:32:57,004 SCIENTISTS, INTERNATIONALLY AND 2364 01:32:57,004 --> 01:32:58,673 A LOT OF MOVEMENT IN THE U.S. 2365 01:32:58,673 --> 01:33:01,175 I WAS VERY LUCKY TO HAVE A 2366 01:33:01,175 --> 01:33:02,777 POSTDOC EARLY ON WHO GOT ONE OF 2367 01:33:02,777 --> 01:33:04,378 THOSE FELLOWSHIPS. 2368 01:33:04,378 --> 01:33:06,814 SHE'S NOW A LECTURER AND RUNS 2369 01:33:06,814 --> 01:33:08,783 HER OWN LAB AND EDUCATES MED 2370 01:33:08,783 --> 01:33:10,084 STUDENTS AND BIOMEDICAL STUDENTS 2371 01:33:10,084 --> 01:33:11,085 IN LYMPHATIC BIOLOGY. 2372 01:33:11,085 --> 01:33:13,354 SO I THINK THOSE THINGS THAT 2373 01:33:13,354 --> 01:33:15,056 BOLSTER CAREER PATHWAYS REALLY 2374 01:33:15,056 --> 01:33:16,557 EARLY ON ARE JUST ABSOLUTELY 2375 01:33:16,557 --> 01:33:17,959 CRITICAL, AND THAT WAS A BIG 2376 01:33:17,959 --> 01:33:19,093 SUCCESS STORY, I THINK. 2377 01:33:19,093 --> 01:33:23,631 >> WONDERFUL. 2378 01:33:23,631 --> 01:33:25,967 >> MAX, I THINK YOU'RE NEXT. 2379 01:33:25,967 --> 01:33:27,201 >> THANK YOU. 2380 01:33:27,201 --> 01:33:30,271 A LOT OF THINGS I WOULD LIKE TO 2381 01:33:30,271 --> 01:33:31,139 TALK HAVE ALREADY BEEN TALKED 2382 01:33:31,139 --> 01:33:34,809 ABOUT SO I WILL TOUCH ABOUT THE 2383 01:33:34,809 --> 01:33:36,277 STUDENT EDUCATION AGAIN. 2384 01:33:36,277 --> 01:33:38,379 SO THE U.S. SYSTEM IS 2385 01:33:38,379 --> 01:33:39,247 TRADITIONALLY VERY DECENTRALIZED 2386 01:33:39,247 --> 01:33:41,015 IN EVERYTHING. 2387 01:33:41,015 --> 01:33:43,317 EVERY STATE, EVERY UNIVERSITY. 2388 01:33:43,317 --> 01:33:47,688 ANYBODY KNOWS ANY WAY FOR US TO 2389 01:33:47,688 --> 01:33:50,191 CREATE THE NATIONAL CURRICULUM? 2390 01:33:50,191 --> 01:33:51,626 IS THERE SUCH PRECEDENCE, WHERE 2391 01:33:51,626 --> 01:33:54,262 WE CAN RECOMMEND UNIVERSITIES 2392 01:33:54,262 --> 01:33:57,565 AND RECOMMEND THE -- TO FIND THE 2393 01:33:57,565 --> 01:33:58,432 PEOPLE THAT ARE GOING TO TEACH 2394 01:33:58,432 --> 01:33:59,867 IT, THAT'S ANOTHER BIG DEAL 2395 01:33:59,867 --> 01:34:00,268 RIGHT THERE. 2396 01:34:00,268 --> 01:34:01,903 WE CAN COME WITH CURRICULUM BUT 2397 01:34:01,903 --> 01:34:02,937 THEN WHO IS GOING TO DELIVER 2398 01:34:02,937 --> 01:34:04,338 THIS CURRICULUM? 2399 01:34:04,338 --> 01:34:05,373 BUT AT LEAST AS A START. 2400 01:34:05,373 --> 01:34:09,810 SO IF WE COME WITH SOME TIME OF 2401 01:34:09,810 --> 01:34:12,580 LECTURE SCHEDULE, TOPICS, AND 2402 01:34:12,580 --> 01:34:14,148 MAYBE WE AS A PEOPLE THAT ARE 2403 01:34:14,148 --> 01:34:18,386 INVOLVED WITH THAT CAN HELP THE 2404 01:34:18,386 --> 01:34:22,123 LOCAL PLACES, UNIVERSITIES, 2405 01:34:22,123 --> 01:34:23,257 EDUCATION COMMITTEES TO 2406 01:34:23,257 --> 01:34:24,725 INTRODUCE IT, CREATE IT, GIVE 2407 01:34:24,725 --> 01:34:25,960 THE TALKS MAYBE ONLINE. 2408 01:34:25,960 --> 01:34:28,029 RIGHT NOW ZOOM IS SUCH A POWER 2409 01:34:28,029 --> 01:34:31,832 IN THIS WORLD. 2410 01:34:31,832 --> 01:34:33,067 SO -- STAN, YOU PROBABLY KNOW 2411 01:34:33,067 --> 01:34:35,303 THAT BECAUSE YOU PUT A LOT OF 2412 01:34:35,303 --> 01:34:36,537 EFFORT INTO THIS, SO IS THERE 2413 01:34:36,537 --> 01:34:39,974 ANY WAY TO SPREAD THE -- CREATE 2414 01:34:39,974 --> 01:34:41,375 THE CURRICULUM BUT HOW CAN WE 2415 01:34:41,375 --> 01:34:42,610 SPREAD IT OUT? 2416 01:34:42,610 --> 01:34:46,547 >> SO ABOUT 10 OR 15 YEARS AGO, 2417 01:34:46,547 --> 01:34:47,715 TO TRY TO ANSWER THE QUESTION 2418 01:34:47,715 --> 01:34:51,819 I'LL TELL YOU THAT I WAS INVITED 2419 01:34:51,819 --> 01:34:53,087 TO THE ASSOCIATION OF AMERICAN 2420 01:34:53,087 --> 01:34:53,988 MEDICAL COLLEGES, WHICH IS ONE 2421 01:34:53,988 --> 01:34:55,690 ORGANIZATION THAT OVERSEES KIND 2422 01:34:55,690 --> 01:35:00,161 OF CURRICULAR ISSUES, TALKING 2423 01:35:00,161 --> 01:35:01,929 ABOUT EVOLVING CURRICULUM BASED 2424 01:35:01,929 --> 01:35:04,098 UPON NEW KNOWLEDGE AND WE USED 2425 01:35:04,098 --> 01:35:05,967 LYMPHATICS AS A PARADIGM FOR 2426 01:35:05,967 --> 01:35:07,702 THAT, AND THERE WERE A LOT OF 2427 01:35:07,702 --> 01:35:09,036 DISCUSSIONS THAT SURROUNDED 2428 01:35:09,036 --> 01:35:10,805 THAT, AND THE BOTTOM LINE IS 2429 01:35:10,805 --> 01:35:13,441 THAT WE LEARNED THAT THE MAJOR 2430 01:35:13,441 --> 01:35:17,044 WAY THAT CURRICULA EVOLVE ARE IN 2431 01:35:17,044 --> 01:35:19,547 RELATIONSHIP TO CERTIFYING 2432 01:35:19,547 --> 01:35:21,048 EXAMINATIONS SUCH THAT WHEN IN 2433 01:35:21,048 --> 01:35:22,650 MEDICAL SCHOOL, ACKNOWLEDGES 2434 01:35:22,650 --> 01:35:24,118 THAT QUESTIONS WILL BE ASKED ON 2435 01:35:24,118 --> 01:35:26,420 THE CERTIFYING EXAM, THEY WANT 2436 01:35:26,420 --> 01:35:27,421 THEIR STUDENTS TO DO WELL AND 2437 01:35:27,421 --> 01:35:28,589 THEY WILL THEN INCORPORATE THAT 2438 01:35:28,589 --> 01:35:30,591 IN THE CURRICULUM, AND THAT 2439 01:35:30,591 --> 01:35:32,360 HAPPENS MOST CONSISTENTLY IN THE 2440 01:35:32,360 --> 01:35:34,328 STATE SUPPORTED SCHOOLS AND THEN 2441 01:35:34,328 --> 01:35:36,864 AS YOU MOVE OUT TO PRIVATE 2442 01:35:36,864 --> 01:35:39,033 INSTITUTIONS, IT'S MUCH MORE 2443 01:35:39,033 --> 01:35:40,701 ELECTIVE, ABOUT HOW STRUCTURED 2444 01:35:40,701 --> 01:35:41,702 THE CURRICULUM IS. 2445 01:35:41,702 --> 01:35:43,571 I THINK THE BEST THAT WE CAN 2446 01:35:43,571 --> 01:35:46,173 HOPE FOR, IF WE DECIDE AS A 2447 01:35:46,173 --> 01:35:47,508 COMMISSION THAT WE WANT TO DO 2448 01:35:47,508 --> 01:35:50,444 THIS, IS TO TRY TO CREATE A 2449 01:35:50,444 --> 01:35:52,146 CURRICULAR PACKAGE THAT COULD BE 2450 01:35:52,146 --> 01:35:55,349 MARKETED TO SAY LOOK, WE WANT TO 2451 01:35:55,349 --> 01:35:57,852 PUT THIS AT YOUR DISPOSAL, 2452 01:35:57,852 --> 01:35:59,220 PLEASE USE IT, WE THINK IT'S 2453 01:35:59,220 --> 01:35:59,854 IMPORTANT TO EDUCATE YOUR 2454 01:35:59,854 --> 01:36:01,055 STUDENTS AND THEN IT'S UP TO THE 2455 01:36:01,055 --> 01:36:02,356 INDIVIDUAL SCHOOLS, I THINK, TO 2456 01:36:02,356 --> 01:36:03,591 EITHER ADOPT IT OR NOT AND FIND 2457 01:36:03,591 --> 01:36:05,793 THE PEOPLE THAT WOULD BE WILLING 2458 01:36:05,793 --> 01:36:07,428 TO DELIVER IT WITHIN THEIR OWN 2459 01:36:07,428 --> 01:36:13,034 INSTITUTION. 2460 01:36:13,034 --> 01:36:14,435 >> OF COURSE WE'VE ALREADY ASKED 2461 01:36:14,435 --> 01:36:16,337 THIS QUESTION, CAN WE ASK THEM 2462 01:36:16,337 --> 01:36:17,505 TO INTRODUCE QUESTIONS AND -- I 2463 01:36:17,505 --> 01:36:21,108 DON'T KNOW, WE NEVER THOUGHT 2464 01:36:21,108 --> 01:36:22,977 ABOUT -- SOUNDS LIKE IT'S THE 2465 01:36:22,977 --> 01:36:23,611 RIGHT THING TO DO. 2466 01:36:23,611 --> 01:36:28,416 >> YEAH, SO AGAIN, WH WHAT I WAS 2467 01:36:28,416 --> 01:36:30,051 TOLD A DECADE OR MORE AGO IS 2468 01:36:30,051 --> 01:36:31,385 THAT YOU NEED TO GET PEOPLE ON 2469 01:36:31,385 --> 01:36:32,520 THE COMMITTEES THAT ARE WRITING 2470 01:36:32,520 --> 01:36:33,688 THE EXAMS SO THAT THEY WILL 2471 01:36:33,688 --> 01:36:35,256 WRITE THE QUESTIONS THAT WILL 2472 01:36:35,256 --> 01:36:37,191 THEN MOTIVATE THE SCHOOLS TO 2473 01:36:37,191 --> 01:36:38,192 TEACH IT. 2474 01:36:38,192 --> 01:36:40,628 IT'S A VERY CIRCULAR ISSUE. 2475 01:36:40,628 --> 01:36:43,364 I DON'T THINK THAT -- I DON'T 2476 01:36:43,364 --> 01:36:45,199 KNOW THAT ANY OF THESE 2477 01:36:45,199 --> 01:36:48,636 CERTIFYING EXAMS HAVE MANDATED 2478 01:36:48,636 --> 01:36:49,270 CONTENT. 2479 01:36:49,270 --> 01:36:51,172 I THINK IT REALLY BASED ON 2480 01:36:51,172 --> 01:36:54,542 COMMITTEES THAT ARE BROUGHT 2481 01:36:54,542 --> 01:36:57,712 TOGETHER EITHER FOR SPECIALTY 2482 01:36:57,712 --> 01:36:58,646 EXAMS -- I THINK IT'S A QUESTION 2483 01:36:58,646 --> 01:37:00,414 OF CONTINUOUS PUSHING, 2484 01:37:00,414 --> 01:37:01,582 CONTINUOUS DISCUSSION AND 2485 01:37:01,582 --> 01:37:03,718 HOPEFULLY I THINK -- AGAIN, I 2486 01:37:03,718 --> 01:37:05,886 THINK SOME OF OUR PANEL THIS 2487 01:37:05,886 --> 01:37:07,288 AFTERNOON WILL TOUCH A BIT ON 2488 01:37:07,288 --> 01:37:09,423 THIS, ON THE EDUCATIONAL ISSUE, 2489 01:37:09,423 --> 01:37:10,291 BUT CERTAINLY THINGS THAT WE 2490 01:37:10,291 --> 01:37:12,793 NEED TO CARRY FORWARD. 2491 01:37:12,793 --> 01:37:15,096 SINCE I DON'T HAVE -- SEE A HAND 2492 01:37:15,096 --> 01:37:17,064 UP, I'M GOING TO BRING UP 2493 01:37:17,064 --> 01:37:20,801 ANOTHER QUESTION FROM A VERY 2494 01:37:20,801 --> 01:37:22,103 PERSONAL PERSPECTIVE, BECAUSE I 2495 01:37:22,103 --> 01:37:23,471 THINK IT TOUCHES ON WHAT WE'VE 2496 01:37:23,471 --> 01:37:26,874 BEEN TALKING ON THIS MORNING. 2497 01:37:26,874 --> 01:37:29,110 I PERSONALLY BELIEVE THAT -- OF 2498 01:37:29,110 --> 01:37:30,711 COURSE WE WANT TO EDUCATE 2499 01:37:30,711 --> 01:37:31,846 MEDICAL STUDENTS SO THAT THEY 2500 01:37:31,846 --> 01:37:34,915 BECOME KNOWLEDGEABLE CLINICIANS 2501 01:37:34,915 --> 01:37:39,887 OR RESEARCHERS IN THE CASE OF 2502 01:37:39,887 --> 01:37:41,021 SCIENTIFIC DISCIPLINES WHEN THEY 2503 01:37:41,021 --> 01:37:42,323 GO OUT INTO THEIR OWN CAREERS, 2504 01:37:42,323 --> 01:37:44,125 BUT I PERCEIVE A REAL PROBLEM 2505 01:37:44,125 --> 01:37:47,361 INSOFAR AS WE HAVE A CADRE OF 2506 01:37:47,361 --> 01:37:48,496 INDIVIDUALS PRACTICING MEDICINE 2507 01:37:48,496 --> 01:37:49,363 IN THE UNITED STATES WHO WILL BE 2508 01:37:49,363 --> 01:37:53,100 IN PLACE FOR THE NEXT 20 OR 30 2509 01:37:53,100 --> 01:37:54,969 YEARS WHO ARE BATHED IN A SEA OF 2510 01:37:54,969 --> 01:37:55,636 IGNORANCE REGARDING THIS 2511 01:37:55,636 --> 01:37:58,472 SITUATION AND NO FORMAL PLACE IN 2512 01:37:58,472 --> 01:38:00,508 WHICH THEY HAVE TO BE ENCOURAGED 2513 01:38:00,508 --> 01:38:03,644 TO LEARN IT, SO SPEAKING TO 2514 01:38:03,644 --> 01:38:07,515 THAT, I WANT TO RECOUNT A 2515 01:38:07,515 --> 01:38:09,049 PERSONAL EXPERIENCE AGAIN FROM A 2516 01:38:09,049 --> 01:38:10,251 NUMBER OF YEARS AGO. 2517 01:38:10,251 --> 01:38:13,454 I HAD THE OPPORTUNITY TO PUT 2518 01:38:13,454 --> 01:38:15,222 TOGETHER A SYMPOSIUM AT ONE OF 2519 01:38:15,222 --> 01:38:17,158 THE NATIONAL MEETINGS OF THE 2520 01:38:17,158 --> 01:38:19,059 AMERICAN HEART ASSOCIATION ON 2521 01:38:19,059 --> 01:38:20,795 LYMPHATIC BIOLOGY AND MEDICINE, 2522 01:38:20,795 --> 01:38:23,197 AND WE PUT TOGETHER A VERY NICE 2523 01:38:23,197 --> 01:38:25,232 PANEL, THERE WERE 2524 01:38:25,232 --> 01:38:34,241 REPRESENTATIVES FROM AT. 2525 01:38:34,241 --> 01:38:36,343 TELLO'S 2526 01:38:36,343 --> 01:38:39,413 LABORATORY, WORKING ON LYMPHATIC 2527 01:38:39,413 --> 01:38:40,781 VASCULATURE, AND WE REALLY HAD A 2528 01:38:40,781 --> 01:38:44,351 VERY ROBUST SET OF TOPICS TO 2529 01:38:44,351 --> 01:38:47,188 PRESENT TO THE AUDIENCE, AND BY 2530 01:38:47,188 --> 01:38:48,756 COUNT, THERE WERE SIX PEOPLE IN 2531 01:38:48,756 --> 01:38:51,826 THE ROOM THAT SEATED 400. 2532 01:38:51,826 --> 01:38:57,331 SO THE QUESTION IS, AGAIN TO THE 2533 01:38:57,331 --> 01:38:58,299 INDIVIDUALS HERE REPRESENTING 2534 01:38:58,299 --> 01:38:59,800 FOUNDATIONS AND OTHER SOCIETIES, 2535 01:38:59,800 --> 01:39:01,902 HOW DO WE NOT ONLY CREATE 2536 01:39:01,902 --> 01:39:04,805 OPPORTUNITIES BUT HOW DO WE 2537 01:39:04,805 --> 01:39:06,774 MARKET THIS APPROPRIATELY AND 2538 01:39:06,774 --> 01:39:09,043 CREATE ENTICING AVENUES TO 2539 01:39:09,043 --> 01:39:10,311 EDUCATE A PUBLIC THAT DOESN'T 2540 01:39:10,311 --> 01:39:11,979 KNOW THEY WANT TO BE EDUCATED 2541 01:39:11,979 --> 01:39:20,254 BUT REALLY NEEDS TO BE? 2542 01:39:20,254 --> 01:39:24,325 ANY TAKERS ON THAT? 2543 01:39:24,325 --> 01:39:27,228 >> I CAN TALK ON THAT. 2544 01:39:27,228 --> 01:39:29,730 I HAD THE OPPORTUNITY YEARS AGO 2545 01:39:29,730 --> 01:39:35,803 TO GO TO ITALY AND PARMA WITH 2546 01:39:35,803 --> 01:39:37,137 THE BIRTH MARKS FOUNDATION AND 2547 01:39:37,137 --> 01:39:38,105 REALLY THE POINT OF THAT WAS 2548 01:39:38,105 --> 01:39:41,342 ACTUALLY TO EDUCATE ACTIVE 2549 01:39:41,342 --> 01:39:45,379 CLINICIANS BROADLY ACROSS THE 2550 01:39:45,379 --> 01:39:46,480 WORLD AS TO THESE CONDITIONS. 2551 01:39:46,480 --> 01:39:48,015 SO I THINK HAVING AN OPPORTUNITY 2552 01:39:48,015 --> 01:39:49,783 OR A SYSTEM THAT CAN ACTUALLY GO 2553 01:39:49,783 --> 01:39:52,219 OUT WITH CMEs SO THAT PEOPLE 2554 01:39:52,219 --> 01:39:54,989 AREN'T JUST WATCHING A VIDEO AND 2555 01:39:54,989 --> 01:39:57,291 TRYING TO DO QUESTIONS AT THE 2556 01:39:57,291 --> 01:39:58,859 END, SOMETHING THAT'S MUCH MORE 2557 01:39:58,859 --> 01:39:59,827 INTERACTIVE AT DIFFERENT 2558 01:39:59,827 --> 01:40:00,828 REGIONAL CENTERS. 2559 01:40:00,828 --> 01:40:02,029 I THINK THERE WERE CLINICIANS 2560 01:40:02,029 --> 01:40:03,330 FROM ALL DIFFERENT BACKGROUNDS 2561 01:40:03,330 --> 01:40:05,299 AND THEY HAD NEVER HEARD ABOUT 2562 01:40:05,299 --> 01:40:06,700 THE LYMPHATICS AND TREATMENTS 2563 01:40:06,700 --> 01:40:07,935 AND GENETICS AND OPTIONS. 2564 01:40:07,935 --> 01:40:11,238 AND SO I THINK THAT'S SOMETHING 2565 01:40:11,238 --> 01:40:12,306 THAT FOUNDATIONS AND 2566 01:40:12,306 --> 01:40:14,241 ORGANIZATIONS CAN ACTUALLY DO AS 2567 01:40:14,241 --> 01:40:16,810 WELL, AND I THINK AS I SAID, THE 2568 01:40:16,810 --> 01:40:18,012 BIRTH MARKS FOUNDATION DOES THIS 2569 01:40:18,012 --> 01:40:20,447 AS PART OF THEIR AVENUE AND THEY 2570 01:40:20,447 --> 01:40:21,749 DO DIFFERENT LOCATIONS 2571 01:40:21,749 --> 01:40:26,820 THROUGHOUT THE WORLD EVERY YEAR. 2572 01:40:26,820 --> 01:40:29,023 I THINK IT NEEDS TO BE MUCH MORE 2573 01:40:29,023 --> 01:40:30,591 OF AN ORGANIZED TYPE OF SYSTEM. 2574 01:40:30,591 --> 01:40:30,958 >> RIGHT. 2575 01:40:30,958 --> 01:40:33,694 JUST TO RESPOND TO THAT, CARRIE 2576 01:40:33,694 --> 01:40:35,195 WEE A COMMISSION THAT'S GOING TO 2577 01:40:35,195 --> 01:40:36,297 MAKE RECOMMENDATIONS TO THE 2578 01:40:36,297 --> 01:40:38,198 ADVISORY COUNCIL, WHAT CAN WE 2579 01:40:38,198 --> 01:40:40,801 RECOMMEND THAT WOULD MAKE NIH A 2580 01:40:40,801 --> 01:40:45,639 VIBRANT PARTNER IN THAT KIND OF 2581 01:40:45,639 --> 01:40:46,206 ACTIVITY? 2582 01:40:46,206 --> 01:40:46,840 ANY IDEAS? 2583 01:40:46,840 --> 01:40:47,741 OR ANYBODY ON THE PANEL? 2584 01:40:47,741 --> 01:40:50,578 >> I MEAN, I THINK -- IS THERE 2585 01:40:50,578 --> 01:40:52,980 LIKE AN R13 FOR A SINGLE 2586 01:40:52,980 --> 01:40:53,714 MEETING. 2587 01:40:53,714 --> 01:40:58,052 IS THERE SOME TYPE OF FUNDING 2588 01:40:58,052 --> 01:41:00,287 SOURCE TO SUPPORT SOME TYPE OF 2589 01:41:00,287 --> 01:41:01,488 EDUCATION THAT GOES AROUND THE 2590 01:41:01,488 --> 01:41:02,256 COUNTRY, ESPECIALLY IN BIG 2591 01:41:02,256 --> 01:41:04,024 CENTERS TO EDUCATE CLINICIANS? 2592 01:41:04,024 --> 01:41:06,026 I DON'T KNOW IF THAT'S A FUNDING 2593 01:41:06,026 --> 01:41:08,529 MECHANISM RIGHT NOW, BUT I THINK 2594 01:41:08,529 --> 01:41:10,798 IT'S SOMETHING LIKE AN R13 2595 01:41:10,798 --> 01:41:12,833 THAT'S REPETITIVE FOR YEARS FOR 2596 01:41:12,833 --> 01:41:14,335 SOMETHING TO GO OUT. 2597 01:41:14,335 --> 01:41:16,870 MAYBE. 2598 01:41:16,870 --> 01:41:19,306 >> SELEN, I THINK MAYBE YOU'RE 2599 01:41:19,306 --> 01:41:20,274 RESPONDING TO THAT POSSIBLY? 2600 01:41:20,274 --> 01:41:23,477 >> NOT NECESSARILY, BUT R13s 2601 01:41:23,477 --> 01:41:27,081 ARE FOR -- THAT'S THE MECHANISM 2602 01:41:27,081 --> 01:41:28,582 THAT GIVES -- FUNDS THE 2603 01:41:28,582 --> 01:41:30,384 SCIENTIFIC MEETINGS, NOT 2604 01:41:30,384 --> 01:41:38,792 NECESSARILY EDUCATION. 2605 01:41:38,792 --> 01:41:40,327 I'LL ASK ANOTHER QUESTION WHEN 2606 01:41:40,327 --> 01:41:41,095 MY TURN COMES. 2607 01:41:41,095 --> 01:41:41,996 >> I'LL COME BACK TO YOU. 2608 01:41:41,996 --> 01:41:43,197 I THINK THERE'S JOEL AND MIKE. 2609 01:41:43,197 --> 01:41:45,532 >> MAY I INTERJECT AS PART OF 2610 01:41:45,532 --> 01:41:50,871 THE NIH, ACTUALLY, STAN, WITH 2611 01:41:50,871 --> 01:41:56,644 YOUR SORT OF WITH THE 2612 01:41:56,644 --> 01:41:57,945 INSPIRATION, WE WENT ON AND MADE 2613 01:41:57,945 --> 01:41:59,780 SURE THAT NO MATTER WHAT THE 2614 01:41:59,780 --> 01:42:02,816 TOPIC OF THE WORKSHOP THAT WE'RE 2615 01:42:02,816 --> 01:42:04,284 ORGANIZING, WE WOULD HAVE ONE 2616 01:42:04,284 --> 01:42:07,254 TALK AT LEAST ABOUT LYMPHATICS. 2617 01:42:07,254 --> 01:42:10,190 AND THAT HAD A VERY INTERESTING 2618 01:42:10,190 --> 01:42:11,859 EFFECT, BECAUSE IT WASN'T THAT 2619 01:42:11,859 --> 01:42:13,994 PEOPLE CAME THERE TO HEAR ABOUT 2620 01:42:13,994 --> 01:42:16,163 LYMPHATICS, BUT ANY TIME THEY 2621 01:42:16,163 --> 01:42:17,898 DID, THEY GOT INSPIRED. 2622 01:42:17,898 --> 01:42:19,900 THEY MADE CONNECTION THAT THEY 2623 01:42:19,900 --> 01:42:22,736 DIDN'T EVEN KNOW THEY COULD 2624 01:42:22,736 --> 01:42:26,674 MAKE, RIGHT? 2625 01:42:26,674 --> 01:42:29,543 SO IT A HUGE EFFORT TO ORGANIZE 2626 01:42:29,543 --> 01:42:31,078 SOMETHING ABOUT LYMPHATICS, BUT 2627 01:42:31,078 --> 01:42:33,514 YOU ARE PREACHING TO THE CHOIR. 2628 01:42:33,514 --> 01:42:37,317 SO CAN YOU PREACH TO THE ONES 2629 01:42:37,317 --> 01:42:41,655 WHO ARE NOT EVEN AWARE THAT THEY 2630 01:42:41,655 --> 01:42:42,956 WILL BECOME EXTREMELY INTERESTED 2631 01:42:42,956 --> 01:42:43,490 IN THIS? 2632 01:42:43,490 --> 01:42:49,196 SO THIS IS THE WAY WE BASICALLY 2633 01:42:49,196 --> 01:42:51,131 MET SOME OF YOU, BY INVITING TO 2634 01:42:51,131 --> 01:42:53,067 YOU GIVE A TALK IN SOME WORKSHOP 2635 01:42:53,067 --> 01:42:55,002 THAT NORMALLY YOU WOULDN'T THINK 2636 01:42:55,002 --> 01:42:56,070 RELATED TO LYMPHATICS, BUT YOU 2637 01:42:56,070 --> 01:42:57,604 MAKE THAT CONNECTION, AND THAT 2638 01:42:57,604 --> 01:43:08,549 COMES BACK ALSO TO GE G GE THE T 2639 01:43:09,116 --> 01:43:12,653 THIS IS AN UNDERLYING CONDITION 2640 01:43:12,653 --> 01:43:14,888 FOR MANY SPECIALTIES. 2641 01:43:14,888 --> 01:43:22,496 SO HAVING SOMEHOW MAYBE -- I 2642 01:43:22,496 --> 01:43:24,732 DON'T KNOW, SPONSORING A PERSON 2643 01:43:24,732 --> 01:43:26,467 FROM THE LYMPHATIC COMMUNITY TO 2644 01:43:26,467 --> 01:43:28,569 ATTEND MEETINGS THAT ARE NOT 2645 01:43:28,569 --> 01:43:30,003 NECESSARILY ABOUT LYMPHATICS BUT 2646 01:43:30,003 --> 01:43:33,640 THEY WOULD INTERSECT WITH THEIR 2647 01:43:33,640 --> 01:43:34,942 SPECIALTY, I THINK WOULD BE VERY 2648 01:43:34,942 --> 01:43:35,342 IMPORTANT. 2649 01:43:35,342 --> 01:43:35,976 JUST AN IDEA. 2650 01:43:35,976 --> 01:43:37,244 >> THAT'S A GREAT IDEA. 2651 01:43:37,244 --> 01:43:39,747 JOEL, I THINK YOU WERE NEXT, AND 2652 01:43:39,747 --> 01:43:41,548 THEN MIKE, THEN PAULA. 2653 01:43:41,548 --> 01:43:44,184 >> SO ONE OF THE THINGS THAT 2654 01:43:44,184 --> 01:43:46,353 WE'RE NOT DISCUSSING FOR PATIENT 2655 01:43:46,353 --> 01:43:47,888 VOICE, SO IF YOU LOOK AT A 2656 01:43:47,888 --> 01:43:50,691 NUMBER OF THE ORGANIZATIONS THAT 2657 01:43:50,691 --> 01:43:52,626 HAVE BEEN INVOLVED IN TERMS OF 2658 01:43:52,626 --> 01:43:54,828 LYMPHATICS OR IN MY CASE IN 2659 01:43:54,828 --> 01:43:57,598 TERMS OF LAM, IT'S THE PATIENTS 2660 01:43:57,598 --> 01:43:59,633 THAT HAVE USED ADVOCACY TO GET 2661 01:43:59,633 --> 01:44:00,801 SOMEONE TO BE INVOLVED WITH 2662 01:44:00,801 --> 01:44:02,302 THEIR DISEASE. 2663 01:44:02,302 --> 01:44:05,239 SO WHEN IT STARTED IN LAM, THERE 2664 01:44:05,239 --> 01:44:06,173 WERE NINE PATIENTS IDENTIFIED IN 2665 01:44:06,173 --> 01:44:06,740 THE U.S. 2666 01:44:06,740 --> 01:44:12,212 THERE ARE 4,000 NOW. 2667 01:44:12,212 --> 01:44:15,449 IT'S ALL DUE TO THE FACT THAT A 2668 01:44:15,449 --> 01:44:16,984 PATIENT ESSENTIALLY DECIDED HER 2669 01:44:16,984 --> 01:44:17,918 DAUGHTER HAD TO BE TREATED. 2670 01:44:17,918 --> 01:44:19,286 IT HELPED THAT YOU CAN FIND 2671 01:44:19,286 --> 01:44:20,420 SOMEBODY TO DO THAT, AND AS YOU 2672 01:44:20,420 --> 01:44:22,356 KNOW FROM EVERYTHING THAT'S BEEN 2673 01:44:22,356 --> 01:44:23,757 DONE WITH THE ARTICLE ON 2674 01:44:23,757 --> 01:44:26,126 LYMPHADEMA, FOR EXAMPLE, YEAH, 2675 01:44:26,126 --> 01:44:27,661 LYMPHADEMA, IS YOU HAVE TO HAVE 2676 01:44:27,661 --> 01:44:30,597 SOMEBODY INVOLVED, AND AS FAR AS 2677 01:44:30,597 --> 01:44:31,899 GETTING QUESTIONS ON EXAMPLES, 2678 01:44:31,899 --> 01:44:33,433 THE SAME THING, WE FOUND 2679 01:44:33,433 --> 01:44:36,103 SOMEBODY WHO IS WRITING VARIOUS 2680 01:44:36,103 --> 01:44:36,937 EXAMS, THEY'RE KNOWN, AND THEN 2681 01:44:36,937 --> 01:44:38,305 WHAT YOU HAVE TO DO IS EXPLAIN 2682 01:44:38,305 --> 01:44:40,440 WHY IT'S IMPORTANT TO BE ON THE 2683 01:44:40,440 --> 01:44:41,208 EXAM. 2684 01:44:41,208 --> 01:44:45,245 AND I REMEMBER WALKING BY A TALK 2685 01:44:45,245 --> 01:44:47,314 AT THE CHES MEETING AND IT WAS A 2686 01:44:47,314 --> 01:44:48,148 BEAUTIFUL QUESTION ON WHAT WAS 2687 01:44:48,148 --> 01:44:49,850 WRONG WITH THIS PERSON. 2688 01:44:49,850 --> 01:44:52,452 AND THEY SHOWED THE CYST, THEY 2689 01:44:52,452 --> 01:44:53,821 SHOWED LYMPHATICS AND THEY 2690 01:44:53,821 --> 01:44:55,022 SHOWED THE KIDNEY. 2691 01:44:55,022 --> 01:44:56,256 YOU GOT YOUR ANSWER THAT YOU 2692 01:44:56,256 --> 01:44:57,224 WANTED. 2693 01:44:57,224 --> 01:44:58,325 THE FDA NOW DOES THAT. 2694 01:44:58,325 --> 01:45:00,127 I WAS IN A MEETING WHERE THE 2695 01:45:00,127 --> 01:45:00,861 PATIENTS WERE PRESENTING WHAT 2696 01:45:00,861 --> 01:45:03,964 THEIR PROBLEMS WERE TO THE FDA, 2697 01:45:03,964 --> 01:45:05,232 AND IF THE FDA KNOWS ABOUT IT IN 2698 01:45:05,232 --> 01:45:07,167 TERMS OF APPROVAL, THEY'RE GOING 2699 01:45:07,167 --> 01:45:09,036 TO LOOK FOR DRUGS THAT DO WHAT 2700 01:45:09,036 --> 01:45:13,073 YOU WANT THEM TO DO. 2701 01:45:13,073 --> 01:45:13,941 >> GREAT, GREAT. 2702 01:45:13,941 --> 01:45:15,976 SO I THINK MIKE, THEN MIIKKA, 2703 01:45:15,976 --> 01:45:18,278 THEN ROBERT. 2704 01:45:18,278 --> 01:45:20,180 >> SO I'LL JUST SAY I AGREE WITH 2705 01:45:20,180 --> 01:45:21,281 JOEL ON THIS. 2706 01:45:21,281 --> 01:45:23,217 I THINK MANY OF THE SUGGESTIONS 2707 01:45:23,217 --> 01:45:25,319 HE MADE, I WAS GOING TO MAKE. 2708 01:45:25,319 --> 01:45:29,857 I WILL SAY FROM A PRACTICAL 2709 01:45:29,857 --> 01:45:31,191 PERSPECTIVE, ONE OF THE THINGS 2710 01:45:31,191 --> 01:45:33,060 THAT HAS HAPPENED IN THE 2711 01:45:33,060 --> 01:45:35,429 AMERICAN SOCIETY FOR PEDIATRIC 2712 01:45:35,429 --> 01:45:37,431 HEMATOLOGY/ONCOLOGY IS THAT 2713 01:45:37,431 --> 01:45:38,465 WE'VE CREATED AN INTEREST GROUP 2714 01:45:38,465 --> 01:45:40,434 FOR VASCULAR ANOMALIES. 2715 01:45:40,434 --> 01:45:44,271 IT BASICALLY INVITES PEOPLE, YOU 2716 01:45:44,271 --> 01:45:45,906 KNOW, INDIVIDUALS INTERESTED IN 2717 01:45:45,906 --> 01:45:49,209 KNOWING MORE ABOUT THESE 2718 01:45:49,209 --> 01:45:52,379 DISEASES, HAS A MESSAGE FORUM 2719 01:45:52,379 --> 01:45:55,749 WHERE YOU CAN ANSWER SPECIFIC 2720 01:45:55,749 --> 01:45:58,018 DISEASE MANAGEMENT DISEASE -- 2721 01:45:58,018 --> 01:45:59,152 DISEASE AND MANAGEMENT QUESTIONS 2722 01:45:59,152 --> 01:46:02,022 POSED BY PHYSICIANS AND 2723 01:46:02,022 --> 01:46:03,523 CLINICIANS, AND THEY'VE BEEN 2724 01:46:03,523 --> 01:46:07,327 REALLY INSTRUMENTAL IN HELPING 2725 01:46:07,327 --> 01:46:08,962 DEVELOP OR ORGANIZING 2726 01:46:08,962 --> 01:46:10,430 PRESENTATIONS AT NATIONAL 2727 01:46:10,430 --> 01:46:16,737 MEETINGS, NOT ONLY INCLUDING 2728 01:46:16,737 --> 01:46:22,109 ASBO BUT MORE RECENTLY NASH IN 2729 01:46:22,109 --> 01:46:23,477 ORDER TO ATTRACT MORE INTEREST 2730 01:46:23,477 --> 01:46:24,544 FROM THE ADULT COMMUNITY. 2731 01:46:24,544 --> 01:46:25,646 SO I THINK THERE'S SOME MODELS 2732 01:46:25,646 --> 01:46:27,581 OUT THERE THAT WE CAN LOOK AT 2733 01:46:27,581 --> 01:46:29,149 WITH REGARD TO THIS, AND AGAIN, 2734 01:46:29,149 --> 01:46:30,150 IT NOT GOING TO BE A GLOBAL 2735 01:46:30,150 --> 01:46:30,484 APPROACH. 2736 01:46:30,484 --> 01:46:32,452 I THINK WE'RE GOING TO HAVE TO 2737 01:46:32,452 --> 01:46:34,354 TAKE INDIVIDUAL APPROACHES WITH 2738 01:46:34,354 --> 01:46:37,190 DIFFERENT TYPES OF SOCIETIES AND 2739 01:46:37,190 --> 01:46:38,191 FOUNDATIONS IN ORDER TO ACLEAVE 2740 01:46:38,191 --> 01:46:38,959 THESE GOALS. 2741 01:46:38,959 --> 01:46:40,060 THANK YOU. 2742 01:46:40,060 --> 01:46:41,161 >> GREAT. 2743 01:46:41,161 --> 01:46:44,064 MIIKKA. 2744 01:46:44,064 --> 01:46:46,566 >> I JUST WANTED TO ADD, WHAT WE 2745 01:46:46,566 --> 01:46:47,901 ARE NOW DOING FOR THE FIRST TIME 2746 01:46:47,901 --> 01:46:49,970 THIS YEAR WITH THE VASCULAR IS 2747 01:46:49,970 --> 01:46:53,106 THAT WE ORGANIZE WHAT WE CALL A 2748 01:46:53,106 --> 01:46:55,108 SUMMER SCHOOL, SO I DON'T KNOW 2749 01:46:55,108 --> 01:46:57,044 IF THAT IS SOMETHING THAT 2750 01:46:57,044 --> 01:46:57,644 OCCURRED IN THE U.S., AND IT 2751 01:46:57,644 --> 01:47:00,714 WILL BE -- OR IT IS A SERIES OF 2752 01:47:00,714 --> 01:47:02,916 VIRTUAL SEMINARS FOLLOWED THEN 2753 01:47:02,916 --> 01:47:06,453 BY ONE WEEK IN PERSON SCHOOL. 2754 01:47:06,453 --> 01:47:07,988 AND WHEN WE WERE SETTING IT UP, 2755 01:47:07,988 --> 01:47:09,189 WE WERE KIND OF WONDERING IS 2756 01:47:09,189 --> 01:47:10,557 THIS GOING TO WORK, ARE WE GOING 2757 01:47:10,557 --> 01:47:12,326 TO GET EVEN 10 PEOPLE ATTENDING, 2758 01:47:12,326 --> 01:47:14,728 BUT THERE WAS A HUGE DEMAND BY 2759 01:47:14,728 --> 01:47:16,330 YOUNG PHYSICIANS TO PARTICIPATE 2760 01:47:16,330 --> 01:47:18,198 AND WE HAD TO LIMIT THE NUMBER 2761 01:47:18,198 --> 01:47:22,569 BECAUSE WE WERE NOT -- WE DIDN'T 2762 01:47:22,569 --> 01:47:25,739 PLAN FOR SUCH A BIG NUMBER. 2763 01:47:25,739 --> 01:47:28,442 WE WANTED THEM JUST TO HAVE 2764 01:47:28,442 --> 01:47:29,943 FINISHED MEDICAL SCHOOL BUT FROM 2765 01:47:29,943 --> 01:47:31,378 THERE ON, WE LEFT IT OPEN IN THE 2766 01:47:31,378 --> 01:47:33,313 SENSE THAT YOU HAD TO HAVE THE 2767 01:47:33,313 --> 01:47:34,281 MEDICAL CURRICULUM TO BE ABLE TO 2768 01:47:34,281 --> 01:47:36,883 FOLLOW THE COURSES BUT THERE WAS 2769 01:47:36,883 --> 01:47:37,584 NO UPPER LIMIT IN THE SENSE THAT 2770 01:47:37,584 --> 01:47:38,952 YOU COULD BE ALREADY A 2771 01:47:38,952 --> 01:47:40,153 SPECIALIST IN THE FIELD. 2772 01:47:40,153 --> 01:47:41,655 BUT MOST YOUNG PHYSICIANS WHO 2773 01:47:41,655 --> 01:47:44,992 WANTED TO COME AND LEARN ABOUT, 2774 01:47:44,992 --> 01:47:47,861 SO WE WILL COVER EVEN MORE -- 2775 01:47:47,861 --> 01:47:50,230 KIND OF VASCULAR -- RARE 2776 01:47:50,230 --> 01:47:52,366 VASCULAR DISEASES, THE VASCULAR 2777 01:47:52,366 --> 01:47:54,234 UNCOVERS MORE THAN JUST THE 2778 01:47:54,234 --> 01:47:55,335 LYMPHATIC MALFORMATIONS OR 2779 01:47:55,335 --> 01:47:56,036 LYMPHADEMA. 2780 01:47:56,036 --> 01:48:00,007 >> THIS INVOLVES MULTIPLE 2781 01:48:00,007 --> 01:48:01,108 INSTITUTIONS COLLABORATELY ON 2782 01:48:01,108 --> 01:48:01,708 THIS? 2783 01:48:01,708 --> 01:48:03,377 >> YES, MULTIPLE INSTITUTIONS, 2784 01:48:03,377 --> 01:48:06,913 MULTIPLE TEACHERS, SO FROM 2785 01:48:06,913 --> 01:48:08,749 PERIPHERAL VASCULAR 2786 01:48:08,749 --> 01:48:09,583 MALFORMATIONS AND LYMPHATIC 2787 01:48:09,583 --> 01:48:10,851 MALFORMATIONS ALL THE WAY TO -- 2788 01:48:10,851 --> 01:48:12,586 SO THE RARE VASCULAR DISEASES. 2789 01:48:12,586 --> 01:48:14,721 >> OKAY. 2790 01:48:14,721 --> 01:48:18,392 AND THEN THE IN-PERSON WEEK, DO 2791 01:48:18,392 --> 01:48:19,659 YOU ROTATE THAT AMONG THE 2792 01:48:19,659 --> 01:48:20,694 DIFFERENT INSTITUTIONS THAT -- 2793 01:48:20,694 --> 01:48:24,064 >> IT WILL NOW BE IN A CITY YOU 2794 01:48:24,064 --> 01:48:27,801 KNOW WELL, IN PARIS, SO I WILL 2795 01:48:27,801 --> 01:48:29,803 SEE NEXT YEAR WHAT THEY WILL DO, 2796 01:48:29,803 --> 01:48:31,471 BUT FOR NOW WE SELECTED A 2797 01:48:31,471 --> 01:48:33,106 CENTRAL CITY WHICH IS EASY TO 2798 01:48:33,106 --> 01:48:33,940 CONNECT FROM ANYWHERE. 2799 01:48:33,940 --> 01:48:34,775 >> WONDERFUL. 2800 01:48:34,775 --> 01:48:35,242 OKAY. 2801 01:48:35,242 --> 01:48:36,843 I THINK WE HAD ROBERT AND THEN 2802 01:48:36,843 --> 01:48:42,482 PAULA. 2803 01:48:42,482 --> 01:48:44,351 >> WE'VE BEEN AT THIS FOR A 2804 01:48:44,351 --> 01:48:46,520 VERY, VERY LONG TIME, AND I FIND 2805 01:48:46,520 --> 01:48:50,690 THAT I STILL GET CALLS FROM 2806 01:48:50,690 --> 01:48:52,092 PATIENTS VIA OUR NETWORK, 2807 01:48:52,092 --> 01:48:54,227 SOMEBODY WHO KNOWS SOMEBODY AND 2808 01:48:54,227 --> 01:48:56,063 WHO AS GOT A PROBLEM SO THEY 2809 01:48:56,063 --> 01:49:00,367 CALL THE AMERICAN CANCER SOCI 2810 01:49:00,367 --> 01:49:02,602 SOCIETY, AND WHEN THERE ARE 2811 01:49:02,602 --> 01:49:03,670 LYMPHADEMA PROBLEMS, THEY DON'T 2812 01:49:03,670 --> 01:49:04,838 SEEM TO BE ABLE TO GET AN ANSWER 2813 01:49:04,838 --> 01:49:05,372 TO THEM. 2814 01:49:05,372 --> 01:49:08,909 SO WE STRUGGLE WITH TRYING TO 2815 01:49:08,909 --> 01:49:10,577 GET PRIMARY CARE PROVIDERS TO 2816 01:49:10,577 --> 01:49:13,413 PROVIDE BASIC CARE AROUND CANCER 2817 01:49:13,413 --> 01:49:15,916 YEAR AFTER YEAR AFTER YEAR AFTER 2818 01:49:15,916 --> 01:49:17,284 YEAR AFTER YEAR. 2819 01:49:17,284 --> 01:49:18,385 AND WE DON'T HAVE A LOT OF 2820 01:49:18,385 --> 01:49:18,819 SUCCESS. 2821 01:49:18,819 --> 01:49:20,220 I WOULD ENCOURAGE THE COMMISSION 2822 01:49:20,220 --> 01:49:24,157 TO TRY TO FIGURE OUT THE BEST 2823 01:49:24,157 --> 01:49:26,526 STRATEGY BY TALKING TO THE 2824 01:49:26,526 --> 01:49:27,928 AMERICAN ACADEMY OF FAMILY 2825 01:49:27,928 --> 01:49:30,230 PHYSICIANS, THEIR LEADERSHIP. 2826 01:49:30,230 --> 01:49:31,665 AND STAN, YOU'RE ABSOLUTELY 2827 01:49:31,665 --> 01:49:33,133 RIGHT, YOU'RE NOT GOING TO GET 2828 01:49:33,133 --> 01:49:34,668 ANYTHING INTO MEDICAL EDUCATION. 2829 01:49:34,668 --> 01:49:39,639 IF IT'S NOT ON THE BOARDS. 2830 01:49:39,639 --> 01:49:42,275 WHEN WE GOT MAMMOGRAPHY ON THE 2831 01:49:42,275 --> 01:49:44,544 BOARDS AND IT BECAME A BASIS FOR 2832 01:49:44,544 --> 01:49:47,414 FAILING THE BOARDS -- 2833 01:49:47,414 --> 01:49:48,315 MAMMOGRAPHY OCCURRED OVERNIGHT. 2834 01:49:48,315 --> 01:49:49,883 AND WE DID HAVE A PROBLEM, YOU 2835 01:49:49,883 --> 01:49:52,719 KNOW, PEOPLE HAD BEEN ON THE 2836 01:49:52,719 --> 01:49:55,722 BOARD EXAM NERS FOR MANY YEARS 2837 01:49:55,722 --> 01:49:56,756 AND THEY'RE SAYING WE'RE NOT 2838 01:49:56,756 --> 01:49:57,924 GOING TO FAIL THE GUY BECAUSE HE 2839 01:49:57,924 --> 01:49:59,326 MISSED A MAMMOGRAM. 2840 01:49:59,326 --> 01:50:00,427 BUT THE POINT WAS THEY MADE THEM 2841 01:50:00,427 --> 01:50:00,927 DO IT. 2842 01:50:00,927 --> 01:50:02,295 YOU THINK ABOUT ALL THE THINGS 2843 01:50:02,295 --> 01:50:03,396 PRIMARY CARE PROVIDERS HAVE TO 2844 01:50:03,396 --> 01:50:05,332 DEAL WITH, YOU HAVE TO FIGURE 2845 01:50:05,332 --> 01:50:07,067 OUT A WAY TO MAKE THEM FEEL LIKE 2846 01:50:07,067 --> 01:50:09,569 THEY CAN HIT A HOME RUN BY 2847 01:50:09,569 --> 01:50:10,270 LEARNING SOMETHING WITHOUT 2848 01:50:10,270 --> 01:50:13,573 HAVING TO TAKE ON A HUGE AMOUNT 2849 01:50:13,573 --> 01:50:14,641 OF NEW INFORMATION THAT THEY 2850 01:50:14,641 --> 01:50:16,343 DON'T SEE THEMSELVES APPLYING 2851 01:50:16,343 --> 01:50:17,978 DAY TO DAY. 2852 01:50:17,978 --> 01:50:20,313 SO RATHER THAN TRY TO TEACH THEM 2853 01:50:20,313 --> 01:50:21,581 ABOUT LYMPHADEMA, YOU MIGHT TAKE 2854 01:50:21,581 --> 01:50:23,650 THE APPROACH LIKE, YOU KNOW, 2855 01:50:23,650 --> 01:50:24,951 YOU'RE GOING TO HAVE A LOT OF 2856 01:50:24,951 --> 01:50:26,386 BREAST CANCER PATIENTS IN YOUR 2857 01:50:26,386 --> 01:50:28,121 PRACTICE THAT SEEM TO BE DOING 2858 01:50:28,121 --> 01:50:29,256 JUST FINE. 2859 01:50:29,256 --> 01:50:31,658 BUT THEY MAY NOT BE. 2860 01:50:31,658 --> 01:50:36,463 SO HERE'S WHAT YOU NEED TO DO TO 2861 01:50:36,463 --> 01:50:40,634 RECOGNIZE THESE IMPAIRMENTS, AND 2862 01:50:40,634 --> 01:50:43,136 NOT JUST WRITE IT OFF, YOU'RE 2863 01:50:43,136 --> 01:50:44,437 GETTING OLDER, YOU'RE PUTTING ON 2864 01:50:44,437 --> 01:50:45,939 WEIGHT, THOSE SORTS OF THINGS. 2865 01:50:45,939 --> 01:50:47,140 AND YOU DON'T HAVE TO TREAT THIS 2866 01:50:47,140 --> 01:50:48,642 PATIENT, YOU JUST HAVE TO GET 2867 01:50:48,642 --> 01:50:49,609 THEM TO SOMEBODY WHO CAN. 2868 01:50:49,609 --> 01:50:52,245 YOU KNOW, IT'S PRETTY 2869 01:50:52,245 --> 01:50:52,679 STRAIGHTFORWARD. 2870 01:50:52,679 --> 01:50:54,080 IT LIKE GETTING THE PRIMARY CARE 2871 01:50:54,080 --> 01:50:55,382 PROVIDER TO DEAL WITH SMOKING 2872 01:50:55,382 --> 01:50:55,916 CESSATION. 2873 01:50:55,916 --> 01:50:57,284 YOU DON'T HAVE TO TAKE IT ON. 2874 01:50:57,284 --> 01:50:59,586 REFER THEM TO A SPECIALIST. 2875 01:50:59,586 --> 01:51:00,887 ALL YOU'VE GOT TO DO IS 2876 01:51:00,887 --> 01:51:02,155 RECOGNIZE AND TELL THEM THAT 2877 01:51:02,155 --> 01:51:05,025 THEY NEED TO STOP SMOKING. 2878 01:51:05,025 --> 01:51:07,794 I THINK WE ALSO HAVE TO TAKE THE 2879 01:51:07,794 --> 01:51:10,797 POSITION THAT IT'S NOT 2880 01:51:10,797 --> 01:51:11,965 NEGOTIABLE WHETHER OR NOT YOUR 2881 01:51:11,965 --> 01:51:12,966 MEMBERSHIP HAS TO KNOW THIS OR 2882 01:51:12,966 --> 01:51:14,267 NOT. 2883 01:51:14,267 --> 01:51:17,671 THE QUESTION IS, HOW CAN THEY 2884 01:51:17,671 --> 01:51:19,506 BEST SERVE THE NEEDS OF THEIR 2885 01:51:19,506 --> 01:51:24,177 PATIENTS IN A WAY THAT'S DOABLE, 2886 01:51:24,177 --> 01:51:25,579 AND HOW CAN WE HELP YOU HELP 2887 01:51:25,579 --> 01:51:30,850 THEM? 2888 01:51:30,850 --> 01:51:33,720 IT'S ONE OF THOSE THINGS, DECADE 2889 01:51:33,720 --> 01:51:35,288 AFTER DECADE AFTER DECADE, WE'RE 2890 01:51:35,288 --> 01:51:36,389 PLEADING WITH THESE FIRST 2891 01:51:36,389 --> 01:51:37,457 RESPONDERS TO GET THEM TO 2892 01:51:37,457 --> 01:51:38,692 RECOGNIZE THESE THINGS. 2893 01:51:38,692 --> 01:51:39,826 SO I WOULD GO TO THE 2894 01:51:39,826 --> 01:51:40,627 PROFESSIONAL SOCIETY AND SAY, WE 2895 01:51:40,627 --> 01:51:41,962 HAVE TO FIGURE OUT A WAY TO DO 2896 01:51:41,962 --> 01:51:42,429 THIS. 2897 01:51:42,429 --> 01:51:43,496 WHAT'S YOUR ADVICE? 2898 01:51:43,496 --> 01:51:45,131 EVEN A FOCUS GROUP WITH PRIMARY 2899 01:51:45,131 --> 01:51:46,466 CARE PROVIDERS COULD HELP. 2900 01:51:46,466 --> 01:51:48,802 >> WELL, AS LUCK WOULD HAVE IT, 2901 01:51:48,802 --> 01:51:50,203 WE'VE INVITED THE AMERICAN 2902 01:51:50,203 --> 01:51:51,438 ACADEMY OF FAMILY PRACTICE THIS 2903 01:51:51,438 --> 01:51:52,339 AFTERNOON. 2904 01:51:52,339 --> 01:51:54,107 SO WE WILL TRY TO BEGIN THAT 2905 01:51:54,107 --> 01:51:56,509 DIALOGUE, BUT IT'S VERY 2906 01:51:56,509 --> 01:51:57,644 PRESCIENT OF YOU TO SAY THAT. 2907 01:51:57,644 --> 01:51:58,745 SO NEXT, JUST TO ACKNOWLEDGE 2908 01:51:58,745 --> 01:51:59,646 EVERYBODY WITH HANDS UP SO YOU 2909 01:51:59,646 --> 01:52:02,482 KNOW I SEE YOU, I THINK NEXT WE 2910 01:52:02,482 --> 01:52:12,592 HAVE PAULA, -- JAN, BABOCK AND 2911 01:52:12,592 --> 01:52:12,826 HASINA. 2912 01:52:12,826 --> 01:52:15,829 >> GREAT DISCUSSION TO HELP US 2913 01:52:15,829 --> 01:52:17,497 UNDERSTAND WHERE OUR NEXT STEPS 2914 01:52:17,497 --> 01:52:17,998 WERE. 2915 01:52:17,998 --> 01:52:19,232 MIIKKA, CAN I ASK A QUICK 2916 01:52:19,232 --> 01:52:20,000 QUESTION ABOUT WHAT WAS THE 2917 01:52:20,000 --> 01:52:21,067 MARKETING THAT YOU ALL DID FOR 2918 01:52:21,067 --> 01:52:21,468 YOUR EERCHT? 2919 01:52:21,468 --> 01:52:23,670 HOW DID YOU MARKET? 2920 01:52:23,670 --> 01:52:28,174 >> IT WAS MAINLY BY USING THE 2921 01:52:28,174 --> 01:52:29,042 NETWORK THAT WE HAVE. 2922 01:52:29,042 --> 01:52:30,777 SO IT CONSISTS OF 14 2923 01:52:30,777 --> 01:52:32,012 DIFFERENT -- WELL, NO, ACTUALLY 2924 01:52:32,012 --> 01:52:35,181 EVEN MANY MORE. 2925 01:52:35,181 --> 01:52:37,183 WE ARE ABOUT 60 CENTERS, I 2926 01:52:37,183 --> 01:52:38,451 THINK, IN THE NETWORK, BECAUSE 2927 01:52:38,451 --> 01:52:40,553 WE COVER ALL EUROPEAN COUNTRIES, 2928 01:52:40,553 --> 01:52:42,155 AND THEN EACH OF THOSE NETWORKS, 2929 01:52:42,155 --> 01:52:45,859 SOME OF THEM ON TOP OF NATIONAL 2930 01:52:45,859 --> 01:52:49,529 NETWORK, SO THE INFORMATION WAS 2931 01:52:49,529 --> 01:52:53,199 DISTRIBUTED BY THESE -- SO IT T. 2932 01:52:53,199 --> 01:52:54,534 IT WAS NOT COMPLETELY OPEN, IT 2933 01:52:54,534 --> 01:52:56,036 WAS USING THESE NETWORKS. 2934 01:52:56,036 --> 01:52:58,338 WHERE WE KNEW THAT THERE WOULD 2935 01:52:58,338 --> 01:53:00,974 BE YOUNG PHYSICIANS IN THESE 2936 01:53:00,974 --> 01:53:03,576 UNIVERSITY HOSPITALS THAT HAVE 2937 01:53:03,576 --> 01:53:04,411 EXPERTISE, BECAUSE IT WAS A 2938 01:53:04,411 --> 01:53:08,348 LITTLE BIT GEARED TOWARDS 2939 01:53:08,348 --> 01:53:09,816 UNIVERSITY -- CENTERS WHERE 2940 01:53:09,816 --> 01:53:11,851 THERE WOULD BE YOUNG PHYSICIANS 2941 01:53:11,851 --> 01:53:14,321 PERHAPS SPECIALIZING ALSO INTO 2942 01:53:14,321 --> 01:53:16,222 THE FIELD WITHOUT HAVING REALLY 2943 01:53:16,222 --> 01:53:18,058 PUT IT AS A CRITERIA, BUT SINCE 2944 01:53:18,058 --> 01:53:19,859 WE FOCUSED ON THESE KIND OF 2945 01:53:19,859 --> 01:53:23,296 CENTERS AND HOSPITALS, THAT WAS 2946 01:53:23,296 --> 01:53:24,064 THE IDEA BEHIND IT. 2947 01:53:24,064 --> 01:53:25,699 >> AND IT SOUNDS LIKE IT WASN'T 2948 01:53:25,699 --> 01:53:27,734 SPECIFIC FOR LYMPHATICS, IT WAS 2949 01:53:27,734 --> 01:53:28,902 JUST YOUNG PHYSICIANS. 2950 01:53:28,902 --> 01:53:30,070 WAS THERE ANYTHING IN PARTICULAR 2951 01:53:30,070 --> 01:53:32,739 THAT YOU HAD PUT FOR THIS SUMMER 2952 01:53:32,739 --> 01:53:34,774 SCHOOL, BECAUSE IT'S ALL ABOUT 2953 01:53:34,774 --> 01:53:35,442 LYMPHATICS, RIGHT? 2954 01:53:35,442 --> 01:53:36,976 SO WAS THERE SOMETHING YOU ALL 2955 01:53:36,976 --> 01:53:38,211 HAD KEY SET PHRASES? 2956 01:53:38,211 --> 01:53:40,113 >> IT'S MORE BECAUSE IT'S THE 2957 01:53:40,113 --> 01:53:43,583 RARE VASCULAR DISEASES. 2958 01:53:43,583 --> 01:53:47,220 SO IT HAS SIX DIFFERENT WORKING 2959 01:53:47,220 --> 01:53:47,520 GROUPS. 2960 01:53:47,520 --> 01:53:51,758 ONE IS LYMPHADEMA, ONE IS 2961 01:53:51,758 --> 01:53:53,093 VASCULAR AMOMLIES AND 2962 01:53:53,093 --> 01:53:54,861 MALFORMATIONS AND THE OTHERS ARE 2963 01:53:54,861 --> 01:53:55,462 VASCULAR PROBLEMS GOING FROM 2964 01:53:55,462 --> 01:54:05,705 LARSMALL VESSELS TO LARGE VESSE. 2965 01:54:05,705 --> 01:54:07,474 AND THAT'S PROBABLY -- IT'S 2966 01:54:07,474 --> 01:54:08,375 INTERESTING BECAUSE THEN THEY 2967 01:54:08,375 --> 01:54:09,909 WILL HAVE ALL THE RARE VASCULAR 2968 01:54:09,909 --> 01:54:11,711 DISEASES COVERED IN ONE COURSE. 2969 01:54:11,711 --> 01:54:14,481 >> WHICH IS GREAT, BECAUSE WE 2970 01:54:14,481 --> 01:54:15,415 KNOW THE INFLUENCES THAT ARE 2971 01:54:15,415 --> 01:54:18,118 HAPPENING WITH LYMPHATICS IN THE 2972 01:54:18,118 --> 01:54:19,085 VASCULATURE AS WELL, AND THAT'S 2973 01:54:19,085 --> 01:54:20,653 A GREAT WAY TO KIND OF INCREASE 2974 01:54:20,653 --> 01:54:24,591 THE AUDIENCE'S INTEREST IN MAYBE 2975 01:54:24,591 --> 01:54:26,025 EVEN COMING, WHICH IS WONDERFUL. 2976 01:54:26,025 --> 01:54:27,660 I WANTED TO MAKE A QUICK 2977 01:54:27,660 --> 01:54:28,728 DOVETAIL BACK TO SOME OF OUR 2978 01:54:28,728 --> 01:54:29,629 CONVERSATION WE WERE JUST 2979 01:54:29,629 --> 01:54:30,063 HAVING. 2980 01:54:30,063 --> 01:54:31,898 IT SEEMS LIKE IN DIFFERENT 2981 01:54:31,898 --> 01:54:32,899 CONFERENCES, WHERE WE ALL ON 2982 01:54:32,899 --> 01:54:34,167 THIS CALL HAVE GONE TO MANY 2983 01:54:34,167 --> 01:54:35,135 CONFERENCES AND PROBABLY MANY OF 2984 01:54:35,135 --> 01:54:36,770 US HAVE ALSO CREATED A 2985 01:54:36,770 --> 01:54:38,071 CURRICULUM AT THESE 2986 01:54:38,071 --> 01:54:41,040 INTERNATIONAL AND NATIONAL 2987 01:54:41,040 --> 01:54:41,908 CONFERENCES, IS THAT SPECIFIC 2988 01:54:41,908 --> 01:54:44,010 ONES HAVE CERTAIN PEOPLE AT THAT 2989 01:54:44,010 --> 01:54:47,714 MOMENT IN THOSE YEARS THAT ARE 2990 01:54:47,714 --> 01:54:49,416 WELL RECOGNIZED IN THAT FIELD, 2991 01:54:49,416 --> 01:54:52,385 AND I'M KIND OF THINKING, WE'LL 2992 01:54:52,385 --> 01:54:56,055 CALL THEM KEY PERSONS, MAYBE WE 2993 01:54:56,055 --> 01:54:57,323 COULD TARGET AN EDUCATIONAL 2994 01:54:57,323 --> 01:54:58,892 SYSTEM TO THESE KEY PERSONS 2995 01:54:58,892 --> 01:55:00,293 WHO'S THEN POTENTIALLY, IF 2996 01:55:00,293 --> 01:55:01,895 THEY'RE INTERESTED, CAN ACTUALLY 2997 01:55:01,895 --> 01:55:03,196 START TO BRING THAT CONVERSATION 2998 01:55:03,196 --> 01:55:05,532 BACK TO THEIR AREA, WHERE STAN, 2999 01:55:05,532 --> 01:55:06,966 YOUR POINT IS WELL MADE, WHEN WE 3000 01:55:06,966 --> 01:55:07,834 BRING IN SOMETHING WHERE OTHERS 3001 01:55:07,834 --> 01:55:08,868 DON'T KNOW THAT THEY NEED TO 3002 01:55:08,868 --> 01:55:11,070 KNOW IT, THERE MIGHT ONLY BE SIX 3003 01:55:11,070 --> 01:55:13,039 OR 10 IN THE AUDIENCE, BUT IF WE 3004 01:55:13,039 --> 01:55:14,340 HAVE SOME OF THESE KEY 3005 01:55:14,340 --> 01:55:15,375 INDIVIDUALS WHERE OTHERS ARE 3006 01:55:15,375 --> 01:55:16,810 LIKE, OH, SO-AND-SO IS GOING TO 3007 01:55:16,810 --> 01:55:18,912 BE SPEAKING, I WANT TO LISTEN, 3008 01:55:18,912 --> 01:55:20,847 THAT MIGHT ACTUALLY INCREASE THE 3009 01:55:20,847 --> 01:55:23,516 NUMBER OF PEOPLE ATTENDING. 3010 01:55:23,516 --> 01:55:24,751 AND THEY'RE JUST EMBEDDED WITHIN 3011 01:55:24,751 --> 01:55:25,819 THE CONFERENCES LIKE WE ALL 3012 01:55:25,819 --> 01:55:27,554 TALKED ABOUT, NOT HAVING A 3013 01:55:27,554 --> 01:55:28,688 SEPARATE CONFERENCE BECAUSE WE 3014 01:55:28,688 --> 01:55:29,756 DON'T KNOW TO GO, WE NEED TO 3015 01:55:29,756 --> 01:55:32,358 KIND OF BRING IT IN TO THESE -- 3016 01:55:32,358 --> 01:55:33,560 IN TO EACH INDIVIDUAL 3017 01:55:33,560 --> 01:55:34,294 SPECIALTY'S CONFERENCES. 3018 01:55:34,294 --> 01:55:35,328 >> RIGHT. 3019 01:55:35,328 --> 01:55:38,198 MIIKKA, I JUST WANTED TO COMMENT 3020 01:55:38,198 --> 01:55:39,532 THAT ONE CHALLENGE WE WILL HAVE 3021 01:55:39,532 --> 01:55:42,469 IN EMBRACING YOUR BEAUTIFUL MO 3022 01:55:42,469 --> 01:55:44,204 MODEL IS AS YOU KNOW HOW MORE 3023 01:55:44,204 --> 01:55:45,004 DECENTRALIZED EVERYTHING IS HERE 3024 01:55:45,004 --> 01:55:47,240 IN THE UNITED STATES, SO 3025 01:55:47,240 --> 01:55:49,742 REACHING A CAPTIVE AUDIENCE EVEN 3026 01:55:49,742 --> 01:55:51,511 WITHIN A SET OF ANNOUNCEMENTS IS 3027 01:55:51,511 --> 01:55:53,346 MUCH MORE CHALLENGES, I THINK, 3028 01:55:53,346 --> 01:55:54,914 THAN THE ENVIRONMENT IN WHICH -- 3029 01:55:54,914 --> 01:55:56,216 IT'S A BEAUTIFUL MODEL. 3030 01:55:56,216 --> 01:55:58,985 I WISH WE COULD EMULATE IT. 3031 01:55:58,985 --> 01:56:00,453 >> PERHAPS WE CAN DO SOMETHING 3032 01:56:00,453 --> 01:56:01,821 THAT TRAVELS AROUND AND THE 3033 01:56:01,821 --> 01:56:03,923 VIRTUAL PART ANYHOW, IT'S 3034 01:56:03,923 --> 01:56:04,557 VIRTUAL, SO -- 3035 01:56:04,557 --> 01:56:08,828 >> YEAH, YEAH, ABSOLUTELY. 3036 01:56:08,828 --> 01:56:12,966 JERRY, I THINK YOU WERE UP NEXT. 3037 01:56:12,966 --> 01:56:15,869 >> SO THIS IS KIND OF A QUESTION 3038 01:56:15,869 --> 01:56:17,637 MORE FOR THE 3039 01:56:17,637 --> 01:56:20,006 CLINICIAN-SCIENTISTS OR THE 3040 01:56:20,006 --> 01:56:21,875 CLINICIANS THAT ARE HERE. 3041 01:56:21,875 --> 01:56:24,143 SO I HEARD SOME IDEAS THAT SOUND 3042 01:56:24,143 --> 01:56:29,816 LIKE CONTINUING EDUCATION, AND 3043 01:56:29,816 --> 01:56:31,618 ARE THERE ANY SPECIFIC 3044 01:56:31,618 --> 01:56:32,886 CONTINUING EDUCATION PROGRAMS 3045 01:56:32,886 --> 01:56:35,255 THAT PEOPLE GET CREDIT FOR IN 3046 01:56:35,255 --> 01:56:36,723 THE LYMPHATIC FIELD? 3047 01:56:36,723 --> 01:56:38,758 >> WELL, I CAN ANSWER -- I CAN 3048 01:56:38,758 --> 01:56:46,966 START WITH THAT. 3049 01:56:46,966 --> 01:56:48,234 MANY OF YOU KNOW STARTING WITH 3050 01:56:48,234 --> 01:56:53,573 THE PANDEMIC UNDER LERN, WE'VE 3051 01:56:53,573 --> 01:56:56,809 HAD FOUR NOW, THEY'VE BEEN 3052 01:56:56,809 --> 01:56:58,144 ATTENDED INTERNATIONALLY BY UP 3053 01:56:58,144 --> 01:56:59,379 TO 800 PARTICIPANTS PER YEAR, SO 3054 01:56:59,379 --> 01:57:01,614 I BEEN VERY SUCCESSFUL, AND WE 3055 01:57:01,614 --> 01:57:03,383 HAVE OFFERED CME CREDIT, BUT 3056 01:57:03,383 --> 01:57:08,655 AGAIN, I THINK WE END UP 3057 01:57:08,655 --> 01:57:09,689 PREACHING TO THE CONVERTED MORE 3058 01:57:09,689 --> 01:57:10,890 THAN BRINGING IN PEOPLE WHO SAY 3059 01:57:10,890 --> 01:57:12,392 OH, GEE, I WISH I KNEW MORE 3060 01:57:12,392 --> 01:57:14,594 ABOUT LYMPHATICS. 3061 01:57:14,594 --> 01:57:17,764 SO THAT'S THE CHALLENGE, IS 3062 01:57:17,764 --> 01:57:18,531 GETTING THIS MATERIAL IN FRONT 3063 01:57:18,531 --> 01:57:19,999 OF PEOPLE WHO DON'T REALIZE THAT 3064 01:57:19,999 --> 01:57:21,901 THEY MIGHT BE QUITE ENERGIZED TO 3065 01:57:21,901 --> 01:57:23,536 LEARN IF THEY WERE ACTUALLY 3066 01:57:23,536 --> 01:57:25,038 EXPOSED TO IT. 3067 01:57:25,038 --> 01:57:27,240 ANY OTHER CLINICIANS WANT TO 3068 01:57:27,240 --> 01:57:28,575 COMMENT ON THE CME SIDE OF 3069 01:57:28,575 --> 01:57:31,911 THINGS? 3070 01:57:31,911 --> 01:57:34,213 >> STAN, YOU'RE EXACTLY RIGHT. 3071 01:57:34,213 --> 01:57:37,450 IT'S ONE OF THOSE WHERE THE 3072 01:57:37,450 --> 01:57:38,184 CLINICIANS, IF THEY SOMEHOW GOT 3073 01:57:38,184 --> 01:57:40,853 IT THROUGH THEIR KRV CONFERENCER 3074 01:57:40,853 --> 01:57:42,255 THEIR OWN COLLEAGUES AND THEY 3075 01:57:42,255 --> 01:57:43,423 MIGHT START TO SEEK OUT SOME OF 3076 01:57:43,423 --> 01:57:43,856 THIS EDUCATION. 3077 01:57:43,856 --> 01:57:44,991 I DO THINK IT'S A GREAT 3078 01:57:44,991 --> 01:57:45,959 OPPORTUNITY FOR MANY OF THE 3079 01:57:45,959 --> 01:57:47,126 DIFFERENT SYMPOSIUMS THAT HAVE 3080 01:57:47,126 --> 01:57:48,661 BEEN CREATED AND THAT STILL 3081 01:57:48,661 --> 01:57:50,396 EXIST ON YOUTUBE FOR THEN 3082 01:57:50,396 --> 01:57:52,265 BRINGING IT INTO THE DIFFERENT 3083 01:57:52,265 --> 01:57:55,635 AREAS FOR EDUCATION. 3084 01:57:55,635 --> 01:57:57,270 LIKE STAN, YOU'RE A GREAT 3085 01:57:57,270 --> 01:57:58,471 EDUCATOR, AND AT OUR AREA, WHEN 3086 01:57:58,471 --> 01:58:01,341 I WAS HELPING MY OWN GROUP AND 3087 01:58:01,341 --> 01:58:02,275 MEDICAL STUDENTS, I'M A PHYSICAL 3088 01:58:02,275 --> 01:58:08,915 THEIR PACIFIC ISLTHERAPIST, SO R 3089 01:58:08,915 --> 01:58:11,150 MORE FROM A PHYSICIAN OR NP FOR 3090 01:58:11,150 --> 01:58:13,953 THAT MATTER, IN DIDACTICS SO 3091 01:58:13,953 --> 01:58:15,188 THEY HAD OPPORTUNITY TO HEAR 3092 01:58:15,188 --> 01:58:16,990 MORE FROM AN EXPERT THAN AT 3093 01:58:16,990 --> 01:58:18,191 THEIR SAME LEVEL AND THERE MIGHT 3094 01:58:18,191 --> 01:58:19,058 BE SOME OPPORTUNITIES THAT WAY 3095 01:58:19,058 --> 01:58:20,393 AS WELL. 3096 01:58:20,393 --> 01:58:22,261 SADLY, I THINK, I'LL SPEAK FOR 3097 01:58:22,261 --> 01:58:23,630 THE PHYSICAL THERAPY EA I THINK 3098 01:58:23,630 --> 01:58:26,566 SOME OF THE EDUCATION IS 3099 01:58:26,566 --> 01:58:27,800 MISEDUCATION. 3100 01:58:27,800 --> 01:58:30,703 THERE'S BEEN A LOT OF CHANGES IN 3101 01:58:30,703 --> 01:58:31,604 LYMPHATICS OVER THE LAST DECADE 3102 01:58:31,604 --> 01:58:32,805 SO IT'S ALSO GOING TO BE REALLY 3103 01:58:32,805 --> 01:58:34,374 IMPORTANT TO HELP RE-EDUCATE 3104 01:58:34,374 --> 01:58:35,475 THOSE WHO THINK THAT THEY'RE 3105 01:58:35,475 --> 01:58:38,211 ALREADY EDUCATED IN THIS SPACE. 3106 01:58:38,211 --> 01:58:38,678 >> RIGHT. 3107 01:58:38,678 --> 01:58:41,481 SO I THINK I HAVE JAN AND BABOCK 3108 01:58:41,481 --> 01:58:42,715 AND THEN MARK, PLEASE. 3109 01:58:42,715 --> 01:58:44,017 >> ONE OF THE EXCITING AREAS 3110 01:58:44,017 --> 01:58:45,451 THAT I'VE EXPERIENCED WHEN 3111 01:58:45,451 --> 01:58:49,122 WORKING IN TUMOR ANDROGEN CYST 3112 01:58:49,122 --> 01:58:51,090 IS A TREMENDOUS OPPORTUNITY TO 3113 01:58:51,090 --> 01:58:52,725 INTERACT WITH THE PHARMACEUTICAL 3114 01:58:52,725 --> 01:58:53,826 SECTOR, EITHER AT MEETINGS, 3115 01:58:53,826 --> 01:58:54,827 THROUGH GRANTS AND OTHER WAYS, 3116 01:58:54,827 --> 01:58:57,230 AND I WONDER IF THERE'S A KEY 3117 01:58:57,230 --> 01:58:58,665 ROLE OF THE COMMISSION EITHER AT 3118 01:58:58,665 --> 01:59:00,466 AN EARLY PHASE OR A MORE MATURE 3119 01:59:00,466 --> 01:59:04,203 PHASE TO ENGAGE PHARMACEUTICAL 3120 01:59:04,203 --> 01:59:06,072 STAKEHOLDERS TO EDUCATE THE 3121 01:59:06,072 --> 01:59:09,809 INDUSTRY ABOUT OPPORTUNITIES TO 3122 01:59:09,809 --> 01:59:11,744 UNDERSTAND AND USE KNOWLEDGE 3123 01:59:11,744 --> 01:59:13,746 ABOUT THE LYMPHATIC SYSTEM TO 3124 01:59:13,746 --> 01:59:15,748 ADVANCE TREATMENTS, WHETHER THEY 3125 01:59:15,748 --> 01:59:19,218 BE THERAPEUTICS OR DEVICES OR 3126 01:59:19,218 --> 01:59:20,553 OTHER TYPE OF THERAPEUTICS. 3127 01:59:20,553 --> 01:59:22,121 >> I CAN SPEAK A LITTLE BIT TO 3128 01:59:22,121 --> 01:59:25,224 THAT SINCE I WORK IN 3129 01:59:25,224 --> 01:59:26,292 PHARMACOLOGICAL DISCOVERY. 3130 01:59:26,292 --> 01:59:28,728 MY CONVERSATIONS WITH THE 3131 01:59:28,728 --> 01:59:31,197 PHARMACEUTICAL INDUSTRY IS THAT 3132 01:59:31,197 --> 01:59:33,633 THEY'RE STILL STRUGGLE TO TRY TO 3133 01:59:33,633 --> 01:59:34,233 UNDERSTAND THE SIZE OF THE 3134 01:59:34,233 --> 01:59:34,567 MARKET. 3135 01:59:34,567 --> 01:59:36,369 THEY DON'T KNOW IT AND THEY 3136 01:59:36,369 --> 01:59:37,704 WONDER ABOUT IT AND THEY DON'T 3137 01:59:37,704 --> 01:59:39,138 HAVE ANY PIPELINES FOR IT 3138 01:59:39,138 --> 01:59:42,875 BECAUSE THEY DON'T PERCEIVE IT 3139 01:59:42,875 --> 01:59:45,611 AS A LIST OF THINGS TO BE 3140 01:59:45,611 --> 01:59:48,014 CONCERNED WITH. 3141 01:59:48,014 --> 01:59:51,818 I JUST WAS TOLD, HASINA, THAT I 3142 01:59:51,818 --> 01:59:53,219 SKIPPED OVER YOU SO YOU'RE NEXT 3143 01:59:53,219 --> 01:59:53,586 ACTUALLY. 3144 01:59:53,586 --> 01:59:55,021 >> IT'S OKAY THE DON'T WORRY, 3145 01:59:55,021 --> 01:59:55,321 STAN. 3146 01:59:55,321 --> 01:59:57,690 I WAS GOING TO WAIT MY TURN 3147 01:59:57,690 --> 02:00:00,960 REGARDLESS, SO NOT TO WORRY. 3148 02:00:00,960 --> 02:00:02,128 WHAT I'M HEARING IS THIS 3149 02:00:02,128 --> 02:00:03,129 DEFINITELY NEEDS TO BE A 3150 02:00:03,129 --> 02:00:04,397 MULTIPRONGED APPROACH, SO THERE 3151 02:00:04,397 --> 02:00:05,998 HAS TO BE SOME DEGREE OF 3152 02:00:05,998 --> 02:00:07,166 ACCOUNTABILITY FROM MEDICAL 3153 02:00:07,166 --> 02:00:08,701 EDUCATION BECAUSE THAT SPURS THE 3154 02:00:08,701 --> 02:00:11,237 NEED FOR SORT OF EMERGING 3155 02:00:11,237 --> 02:00:13,039 PHYSICIANS AND CLINICIANS TO 3156 02:00:13,039 --> 02:00:14,073 LEARN ABOUT LYMPHATIC DISEASES 3157 02:00:14,073 --> 02:00:15,441 AS PART OF THE CURRICULUM, BUT 3158 02:00:15,441 --> 02:00:18,144 THEN THERE'S THE PROBLEM OF THE 3159 02:00:18,144 --> 02:00:20,446 EXISTING PHYSICIANS AND 3160 02:00:20,446 --> 02:00:22,415 CLINICIANS AS YOU HAVE RIGHTLY 3161 02:00:22,415 --> 02:00:24,016 IDENTIFIED, STOP, AND THAT SEEMS 3162 02:00:24,016 --> 02:00:24,617 SORT OF DIFFICULT BECAUSE YOU 3163 02:00:24,617 --> 02:00:26,119 HAVE TO SORT OF CAPTURE THEM TO 3164 02:00:26,119 --> 02:00:27,687 WANT TO BE INTERESTED, YOU'VE 3165 02:00:27,687 --> 02:00:28,588 ILLUSTRATED THE PROBLEM WITH 3166 02:00:28,588 --> 02:00:29,489 THAT AND I THINK WE'VE COME UP 3167 02:00:29,489 --> 02:00:30,356 WITH A FEW SOLUTIONS. 3168 02:00:30,356 --> 02:00:31,758 I WANT TO HEAR A LITTLE BIT MORE 3169 02:00:31,758 --> 02:00:33,059 FROM THE PEOPLE ON THE PANEL AND 3170 02:00:33,059 --> 02:00:35,495 THEIR EXPERTISE ABOUT MOBILIZING 3171 02:00:35,495 --> 02:00:38,431 PATIENT ADVOCACY TOWARD THAT 3172 02:00:38,431 --> 02:00:41,901 SECOND GROUP OF EXISTING 3173 02:00:41,901 --> 02:00:42,201 PHYSICIANS. 3174 02:00:42,201 --> 02:00:43,469 IF YOU HAVE A BUNCH OF PATIENTS 3175 02:00:43,469 --> 02:00:45,204 WHO ARE EDUCATED THIS COULD BE 3176 02:00:45,204 --> 02:00:46,739 SOMETHING THAT COULD BE GOING ON 3177 02:00:46,739 --> 02:00:48,007 WITH THEM AND THEY'RE 3178 02:00:48,007 --> 02:00:49,008 CONSISTENTLY ASKING THEIR 3179 02:00:49,008 --> 02:00:49,976 PHYSICIAN, COULD THIS BE 3180 02:00:49,976 --> 02:00:51,177 LYMPHADEMA, COULD THIS BE THIS, 3181 02:00:51,177 --> 02:00:52,512 AND THEY SORT OF GET A LITTLE 3182 02:00:52,512 --> 02:00:54,213 BIT MORE OF THAT IN THEIR HERE 3183 02:00:54,213 --> 02:00:55,381 AT THE SAME TIME AS THEY'RE 3184 02:00:55,381 --> 02:00:57,316 BEING EXPOSED TO THESE 3185 02:00:57,316 --> 02:00:58,251 CONTINUING MEDICAL EDUCATION, ET 3186 02:00:58,251 --> 02:00:59,118 CETERA, COULD THAT BE SOMETHING 3187 02:00:59,118 --> 02:01:00,653 THAT WE COULD LEVERAGE? 3188 02:01:00,653 --> 02:01:02,655 SO COULD BREAST CANCER AWARENESS 3189 02:01:02,655 --> 02:01:06,526 MONTH HAVE A HUGE THING TARGETED 3190 02:01:06,526 --> 02:01:08,494 TO -- NOW THEY'RE REALLY MORE 3191 02:01:08,494 --> 02:01:09,896 EDUCATED ABOUT THIS AND I'M 3192 02:01:09,896 --> 02:01:12,231 BRINGING THEM TO THEIR 3193 02:01:12,231 --> 02:01:13,432 CLINICIANS WHO NOW THEN WHEN 3194 02:01:13,432 --> 02:01:14,600 THEY SEE THERE COULD BE THIS 3195 02:01:14,600 --> 02:01:18,237 COURSE OR THIS CURRICULUM ABOUT 3196 02:01:18,237 --> 02:01:19,305 LYMPHADEMA, MAYBE THEY'LL SAY 3197 02:01:19,305 --> 02:01:20,573 MAYBE I SHOULD LEARN ABOUT THAT, 3198 02:01:20,573 --> 02:01:22,341 MY PATIENTS KEECH ASKING ME 3199 02:01:22,341 --> 02:01:24,744 ABOUT THESE KINDS OF THINGS. 3200 02:01:24,744 --> 02:01:29,649 CAN WE USE THAT AND LEVERAGE IT, 3201 02:01:29,649 --> 02:01:30,516 I'D LOVE TO HEAR MORE FROM THE 3202 02:01:30,516 --> 02:01:31,117 PANEL ABOUT THIS. 3203 02:01:31,117 --> 02:01:31,918 >> SURE. 3204 02:01:31,918 --> 02:01:33,886 LET ME ACKNOWLEDGE, I THINK NEXT 3205 02:01:33,886 --> 02:01:36,489 WE HAD BABOCK, AND WE HAD MARK 3206 02:01:36,489 --> 02:01:40,760 AND MIIKKA. 3207 02:01:40,760 --> 02:01:40,993 ROBERT. 3208 02:01:40,993 --> 02:01:42,195 >> I THINK THE IDEAS ABOUT 3209 02:01:42,195 --> 02:01:43,796 EDUCATION ARE GREAT, BUT I THINK 3210 02:01:43,796 --> 02:01:44,831 PRACTICALLY SPEAKING, IT'S GOING 3211 02:01:44,831 --> 02:01:47,200 TO BE VERY DIFFICULT TO DO. 3212 02:01:47,200 --> 02:01:49,268 I THINK THERE'S NOW MORE TO 3213 02:01:49,268 --> 02:01:50,803 LEARN FOR MEDICAL STUDENTS AND 3214 02:01:50,803 --> 02:01:52,638 PRIMARY CARE PHYSICIANS THAN 3215 02:01:52,638 --> 02:01:53,172 THERE EVER HAS BEEN. 3216 02:01:53,172 --> 02:01:54,207 SO THE AMOUNT OF KNOWLEDGE THAT 3217 02:01:54,207 --> 02:01:55,708 THEY NEED TO HAVE IN GENERAL IS 3218 02:01:55,708 --> 02:01:59,779 JUST SO MUCH HIGHER, FROM 3219 02:01:59,779 --> 02:02:00,713 PATHOLOGY TO PHARMACOLOGY TO 3220 02:02:00,713 --> 02:02:01,848 PHYSIOLOGY, SO I THINK WE NEED 3221 02:02:01,848 --> 02:02:03,316 THEM TO KNOW A LOT OF THE 3222 02:02:03,316 --> 02:02:06,953 INFORMATION, AND THEN TO ASK AN 3223 02:02:06,953 --> 02:02:13,793 ADDITIONAL SORT OF -- I THINK 3224 02:02:13,793 --> 02:02:15,127 THEY HAVE LESS TIME TO LEARN IT. 3225 02:02:15,127 --> 02:02:16,929 WHEN I WAS IN MEDICAL SCHOOL, WE 3226 02:02:16,929 --> 02:02:18,664 HAD TWO YEARS OF CLASSROOM AND 3227 02:02:18,664 --> 02:02:23,069 NOW IT'S LESS THAN A YEAR. 3228 02:02:23,069 --> 02:02:25,504 SO MEDICAL STUDENTS NOW SPEND 3229 02:02:25,504 --> 02:02:26,505 VERY LITTLE TIME IN THE 3230 02:02:26,505 --> 02:02:27,340 CLASSROOM, MOST OF THE TIME WITH 3231 02:02:27,340 --> 02:02:28,274 PATIENTS, SO I THINK THAT'S 3232 02:02:28,274 --> 02:02:29,008 DIFFICULT TOO. 3233 02:02:29,008 --> 02:02:31,110 AND I THINK MOST IMPORTANTLY FOR 3234 02:02:31,110 --> 02:02:33,012 PRIMARY CARE PHYSICIANS, THERE'S 3235 02:02:33,012 --> 02:02:37,183 NO DRUG TREATMENT FOR LYMPHATIC 3236 02:02:37,183 --> 02:02:37,750 DISORDERS. 3237 02:02:37,750 --> 02:02:40,453 THEY CAN'T PRESCRIBE ANYTHING, 3238 02:02:40,453 --> 02:02:41,520 YES, THEY CAN REFER THEM OUT, 3239 02:02:41,520 --> 02:02:45,925 BUT I THINK THEY FEEL KIND OF 3240 02:02:45,925 --> 02:02:48,394 LESS EMPOWER TODAY HELP THESE 3241 02:02:48,394 --> 02:02:49,061 FOLKS RATHER THAN ANYONE ELSE, 3242 02:02:49,061 --> 02:02:51,097 SO THE IDEA IS WHY SEE ME, THEN 3243 02:02:51,097 --> 02:02:52,365 GO SEE A SURGEON IF YOU HAVE 3244 02:02:52,365 --> 02:02:53,366 LYMPHADEMA BECAUSE I'M NOT GOING 3245 02:02:53,366 --> 02:02:55,201 TO BE ABLE TO REALLY HELP YOU AS 3246 02:02:55,201 --> 02:02:55,935 A PRIMARY CARE PHYSICIAN. 3247 02:02:55,935 --> 02:02:58,104 SO I THINK ALL THOSE ISSUES MAKE 3248 02:02:58,104 --> 02:02:59,338 IT DIFFICULT TO GET THIS INTO 3249 02:02:59,338 --> 02:03:01,641 THE CURRICULUM AND ALSO GET THIS 3250 02:03:01,641 --> 02:03:03,342 INTO THE MINDS OF THE PRIMARY 3251 02:03:03,342 --> 02:03:04,677 CARE PHYSICIANS AND I THINK THIS 3252 02:03:04,677 --> 02:03:07,179 REALLY CALLS FOR PATIENT 3253 02:03:07,179 --> 02:03:09,382 ADVOCACY AND AI FOR THEM TO BE 3254 02:03:09,382 --> 02:03:12,285 ABLE TO LOOK UP THE AVAILABLE 3255 02:03:12,285 --> 02:03:15,488 INFORMATION THAT IS THERE FOR 3256 02:03:15,488 --> 02:03:17,423 THEM, THE AI COULD HELP THEM 3257 02:03:17,423 --> 02:03:19,425 UNDERSTAND THE DISEASE PROCESS, 3258 02:03:19,425 --> 02:03:21,260 AND THESE CHATBOTS ARE GETTING 3259 02:03:21,260 --> 02:03:22,895 VERY, VERY GOODENOW, AND I THINK 3260 02:03:22,895 --> 02:03:24,630 IF IT'S DONE CORRECTLY, IT COULD 3261 02:03:24,630 --> 02:03:26,899 BE A VERY GOOD RESOURCE, AND IT 3262 02:03:26,899 --> 02:03:29,135 COULD BE A VERY GOOD SOURCE OF 3263 02:03:29,135 --> 02:03:30,069 PATIENT REFERRAL. 3264 02:03:30,069 --> 02:03:31,871 SO I THINK THAT'S A MUCH BETTER 3265 02:03:31,871 --> 02:03:35,007 AND MORE DIRECTED WAY TO GO. 3266 02:03:35,007 --> 02:03:38,277 >> THANK YOU, BABOCK. 3267 02:03:38,277 --> 02:03:38,477 MARK. 3268 02:03:38,477 --> 02:03:40,513 >> I'M IMPRESSED WITH ALL THE 3269 02:03:40,513 --> 02:03:45,051 COMMENTS I'VE JUST HEARD, AND -- 3270 02:03:45,051 --> 02:03:46,619 PATIENT PIECE BECAUSE THERE'S 3271 02:03:46,619 --> 02:03:51,290 OPPORTUNITY THERE. 3272 02:03:51,290 --> 02:03:53,926 I THOUGHT I'D DRAW AN ANALOGY TO 3273 02:03:53,926 --> 02:03:55,094 OTHER VASCULAR DISEASES YOU MAY 3274 02:03:55,094 --> 02:03:56,629 BE FAMILIAR WITH, PERIPHERAL 3275 02:03:56,629 --> 02:03:58,698 ARTERY DISEASE, DEEP VEIN 3276 02:03:58,698 --> 02:04:00,700 THROMBOSIS, WE'VE DONE A LOT IN 3277 02:04:00,700 --> 02:04:06,906 THOSE AREAS -- AND IT'S 3278 02:04:06,906 --> 02:04:09,642 REALLY -- IT'S RISEN TO A MUCH 3279 02:04:09,642 --> 02:04:12,812 MORE -- BOTH THINGS -- 3280 02:04:12,812 --> 02:04:13,679 PHARMACEUTICAL INDUSTRIES HAVE 3281 02:04:13,679 --> 02:04:15,348 TAKEN AN INTEREST IN BOTH OF 3282 02:04:15,348 --> 02:04:18,651 THOSE PROBLEMS, AND THERE ARE 3283 02:04:18,651 --> 02:04:21,387 DRUGS THAT ARE AVAILABLE. 3284 02:04:21,387 --> 02:04:25,091 I WAS SURPRISED TO HEAR YOU SAY, 3285 02:04:25,091 --> 02:04:28,160 STAN, THAT -- OVER THE LAST FOUR 3286 02:04:28,160 --> 02:04:32,231 YEARS, SYMPOSIUM -- I BET YOU 3287 02:04:32,231 --> 02:04:33,532 MANY PEOPLE DIDN'T KNOW ABOUT 3288 02:04:33,532 --> 02:04:36,435 THAT, AND TO GET OUT THERE AND 3289 02:04:36,435 --> 02:04:41,273 COMMUNICATE THAT, ADVERTISE I 3290 02:04:41,273 --> 02:04:43,809 IT -- RAISE THE LEVEL OF 3291 02:04:43,809 --> 02:04:44,777 ENTHUSIASM IF PEOPLE GET AN 3292 02:04:44,777 --> 02:04:46,645 OPPORTUNITY TO HEAR YOU. 3293 02:04:46,645 --> 02:04:54,153 AND I'D ALSO -- SPEAKER PANELS, 3294 02:04:54,153 --> 02:04:55,521 PEOPLE WHERE INSTITUTIONS CAN GO 3295 02:04:55,521 --> 02:04:58,724 TO AND INVITE THEM FOR GRAND 3296 02:04:58,724 --> 02:05:02,528 ROUNDS -- AND THIS WOULD BE A 3297 02:05:02,528 --> 02:05:02,928 GREAT OPPORTUNITY. 3298 02:05:02,928 --> 02:05:04,196 I THINK WE'VE GOT TO GET THE 3299 02:05:04,196 --> 02:05:04,930 WORD OUT THERE. 3300 02:05:04,930 --> 02:05:10,569 AND THEN FINALLY, THE -- CAN'T 3301 02:05:10,569 --> 02:05:11,504 UNDERSTATE THAT. 3302 02:05:11,504 --> 02:05:12,938 GETTING PATIENTS OUT THERE, 3303 02:05:12,938 --> 02:05:14,240 COMMUNICATING ON SOCIAL MEDIA, 3304 02:05:14,240 --> 02:05:21,280 WITH THEIR PHYSICIANS -- REALLY 3305 02:05:21,280 --> 02:05:22,248 BE VERY IMPORTANT IN GETTING 3306 02:05:22,248 --> 02:05:22,982 PHYSICIANS INTERESTED IN 3307 02:05:22,982 --> 02:05:27,686 LEARNING MORE ABOUT IT. 3308 02:05:27,686 --> 02:05:29,488 >> FANTASTIC, THANK YOU. 3309 02:05:29,488 --> 02:05:30,489 MIIKKA, AND THEN ROBERT. 3310 02:05:30,489 --> 02:05:33,793 >> ACTUALLY MARK ALREADY A 3311 02:05:33,793 --> 02:05:35,394 LITTLE BIT ALLUDED TO THIS. 3312 02:05:35,394 --> 02:05:39,165 WHAT I'VE SEEN IN THESE 3313 02:05:39,165 --> 02:05:40,232 MEETINGS, I GO TO CLINICAL 3314 02:05:40,232 --> 02:05:41,967 MEETINGS AND BASIC SCIENCE 3315 02:05:41,967 --> 02:05:43,702 MEETINGS AND I THINK THEY ARE 3316 02:05:43,702 --> 02:05:44,370 TWO WORLDS APART. 3317 02:05:44,370 --> 02:05:46,072 WHEN I GO TO THE CLINICAL 3318 02:05:46,072 --> 02:05:47,973 MEETINGS, THERE'S A BOOST IN ALL 3319 02:05:47,973 --> 02:05:50,376 THE LYMPHATIC MALFORMATIONS AND 3320 02:05:50,376 --> 02:05:51,444 VASCULAR MALFORMATIONS AND THE 3321 02:05:51,444 --> 02:05:53,779 INTEREST TO HEAR ABOUT THEM 3322 02:05:53,779 --> 02:05:56,715 BECAUSE THERE ARE DRUGS NOW THAT 3323 02:05:56,715 --> 02:06:02,221 WE CAN -- BUT JUST TO UNDERSTAND 3324 02:06:02,221 --> 02:06:04,356 THE BASIC BIOLOGY GOES VERY 3325 02:06:04,356 --> 02:06:05,591 QUICKLY. 3326 02:06:05,591 --> 02:06:08,928 WHICH I THINK IS ONE PROBLEM IN 3327 02:06:08,928 --> 02:06:09,128 THIS. 3328 02:06:09,128 --> 02:06:13,732 THAT WAS ALL. 3329 02:06:13,732 --> 02:06:17,870 >> ROBERT. 3330 02:06:17,870 --> 02:06:19,805 >> I WAS JUST GOING TO RESPOND 3331 02:06:19,805 --> 02:06:23,075 TO DR. REED'S QUESTIONS. 3332 02:06:23,075 --> 02:06:24,543 AND I THINK THE ANSWER TO 3333 02:06:24,543 --> 02:06:25,544 PROBABLY EVERY SINGLE ONE OF 3334 02:06:25,544 --> 02:06:27,446 THEM IS YES. 3335 02:06:27,446 --> 02:06:28,881 PATIENTS SHOULD GET A 3336 02:06:28,881 --> 02:06:29,615 SURVIVORSHIP PLAN, THEY SHOULD 3337 02:06:29,615 --> 02:06:31,350 KNOW THE SEQUELAE TO LOOK FOR IN 3338 02:06:31,350 --> 02:06:35,654 THE NEAR TERM AND THE LONG TERM. 3339 02:06:35,654 --> 02:06:36,722 THEY -- WHEN WE TALK ABOUT 3340 02:06:36,722 --> 02:06:38,290 BREAST CANCER AWARENESS, I LOVE 3341 02:06:38,290 --> 02:06:40,860 THIS IDEA OF MOVING BEYOND JUST 3342 02:06:40,860 --> 02:06:44,196 A PINK FEST FOCUSED ON 3343 02:06:44,196 --> 02:06:46,198 SCREENING, TO ACTUALLY -- YOU 3344 02:06:46,198 --> 02:06:49,969 KNOW, AND VERY VISIBLY CARVE OUT 3345 02:06:49,969 --> 02:06:51,871 SOMETIME FOR SURVIVORS, AND BEST 3346 02:06:51,871 --> 02:06:53,772 WAY TO DO THAT IN A WAY IS TO 3347 02:06:53,772 --> 02:06:54,940 ORGANIZE ALL THE GROUPS THAT 3348 02:06:54,940 --> 02:06:58,210 OUGHT TO BE CONTRIBUTING TO THE 3349 02:06:58,210 --> 02:06:59,678 AWARENESS MONTHS AND SAY CAN WE 3350 02:06:59,678 --> 02:07:01,514 COORDINATE SOME OF OUR MESSAGES. 3351 02:07:01,514 --> 02:07:05,151 YOU CAN GET PEOPLE TO TALK ON A 3352 02:07:05,151 --> 02:07:05,751 MORNING SHOW. 3353 02:07:05,751 --> 02:07:08,721 BELIEVE ME, BREAST CANCER 3354 02:07:08,721 --> 02:07:09,622 SURVIVORS WILL TUNE IN. 3355 02:07:09,622 --> 02:07:12,491 AND DOCTORS RESPOND TO PATIENTS' 3356 02:07:12,491 --> 02:07:14,193 REQUESTS. 3357 02:07:14,193 --> 02:07:21,500 SO IF WOMEN KNOW TO NOT JUST BE 3358 02:07:21,500 --> 02:07:23,569 PLACATED WITH ANSWERS TO THEIR 3359 02:07:23,569 --> 02:07:25,738 QUESTIONS THAT DON'T GIVE THEM 3360 02:07:25,738 --> 02:07:26,972 ANYTHING TO WORK WITH, THEY ALSO 3361 02:07:26,972 --> 02:07:29,074 NEED TO KNOW WHERE THEY CAN CALL 3362 02:07:29,074 --> 02:07:32,845 TO GET MORE INFORMATION. 3363 02:07:32,845 --> 02:07:33,846 THE AMERICAN CANCER SOCIETY HAS 3364 02:07:33,846 --> 02:07:36,382 A 24-HOUR HOTLINE AND ALL OF OUR 3365 02:07:36,382 --> 02:07:37,349 OPERATORS ARE PREPARED TO TALK 3366 02:07:37,349 --> 02:07:38,651 ABOUT LYMPHADEMA, BUT OTHER HOT 3367 02:07:38,651 --> 02:07:41,620 LINES COULD TO THIS AS WELL, OR 3368 02:07:41,620 --> 02:07:43,756 PATIENTS COULD KNOW. 3369 02:07:43,756 --> 02:07:45,124 BUT REALLY RIGHT NOW, WE JUST 3370 02:07:45,124 --> 02:07:47,826 DON'T HAVE A CONSISTENT OR 3371 02:07:47,826 --> 02:07:50,262 ANYTHING SYSTEMATIC WHERE PEOPLE 3372 02:07:50,262 --> 02:07:52,965 CAN GO AND GET DEPENDABLE 3373 02:07:52,965 --> 02:07:55,067 INFORMATION, NOT CLINICIANS, NOT 3374 02:07:55,067 --> 02:07:57,703 PATIENTS, AND THAT'S I THINK AN 3375 02:07:57,703 --> 02:07:59,672 AREA WHERE SOME KIND OF 3376 02:07:59,672 --> 02:08:00,839 COLLABORATION AMONG MANY 3377 02:08:00,839 --> 02:08:01,607 ORGANIZATIONS, WE COULD SAY WE 3378 02:08:01,607 --> 02:08:04,577 HAVE TO START FILLING THIS GAP. 3379 02:08:04,577 --> 02:08:06,111 AND AFFECTING PROACTIVE -- 3380 02:08:06,111 --> 02:08:07,813 BECAUSE MANY WOMEN ARE LIVING 3381 02:08:07,813 --> 02:08:09,381 WITH THESE SYMPTOMS AND THEY'VE 3382 02:08:09,381 --> 02:08:14,386 JUST NOT HAD -- NOT BEEN ABLE TO 3383 02:08:14,386 --> 02:08:16,522 TURN TO ANYONE SUCCESSFULLY OR 3384 02:08:16,522 --> 02:08:19,358 FOR ANSWERS. 3385 02:08:19,358 --> 02:08:21,293 >> SELEN, YOU'VE BEEN HOLDING 3386 02:08:21,293 --> 02:08:22,261 YOUR QUESTION FOR QUITE A WHILE 3387 02:08:22,261 --> 02:08:24,129 AND WE HAVE ABOUT FIVE MINUTES 3388 02:08:24,129 --> 02:08:24,630 OR SEVEN MINUTES. 3389 02:08:24,630 --> 02:08:25,764 >> WELL, THANK YOU. 3390 02:08:25,764 --> 02:08:31,704 THIS IS ACTUALLY FROM -- MEMBER 3391 02:08:31,704 --> 02:08:33,739 PATIENT WHO IS ALSO A 3392 02:08:33,739 --> 02:08:35,007 REPRESENTATIVE, SHE'S ASKING HER 3393 02:08:35,007 --> 02:08:36,809 QUESTION TO JOEL MOSS. 3394 02:08:36,809 --> 02:08:41,614 JOEL, THIS IS FOR YOU, DO THE 3395 02:08:41,614 --> 02:08:46,318 LAM FOUNDATION AND TUBEROUS -- 3396 02:08:46,318 --> 02:08:47,620 THOSE CONDITIONS FINANCIALLY IN 3397 02:08:47,620 --> 02:08:48,754 ADDITION TO PROVIDING PATIENT 3398 02:08:48,754 --> 02:08:50,222 SUPPORT AND RECRUITING PATIENTS 3399 02:08:50,222 --> 02:08:51,357 INTO STUDIES? 3400 02:08:51,357 --> 02:08:52,891 IF SO, HOW IS THAT SET UP WITH 3401 02:08:52,891 --> 02:08:57,696 THE NIH? 3402 02:08:57,696 --> 02:08:59,031 THANK YOU. 3403 02:08:59,031 --> 02:09:01,700 >> I DON'T KNOW EXACTLY HOW THEY 3404 02:09:01,700 --> 02:09:02,835 GET THEIR MONEY. 3405 02:09:02,835 --> 02:09:05,571 MOST OF THE MONEY COMES FROM 3406 02:09:05,571 --> 02:09:07,973 PATIENT ADVOCACY, AND FINDING 3407 02:09:07,973 --> 02:09:10,242 PEOPLE WHO CAN DONATE. 3408 02:09:10,242 --> 02:09:11,377 WHAT THEY'RE TRYING TO DO, 3409 02:09:11,377 --> 02:09:13,178 THOUGH, IS MOVE AWAY FROM THAT. 3410 02:09:13,178 --> 02:09:14,513 BECAUSE THE PROBLEM IS THAT'S 3411 02:09:14,513 --> 02:09:16,582 LIMITED IN TERMS OF WHAT THEY 3412 02:09:16,582 --> 02:09:18,350 CAN DO, AND ESPECIALLY DURING 3413 02:09:18,350 --> 02:09:25,324 THE PANDEMIC, IT WAS LIMITED. 3414 02:09:25,324 --> 02:09:27,860 SO THERE IS A CLEARCUT ANSWER 3415 02:09:27,860 --> 02:09:29,828 BUT IT'S ALSO CLEAR THEY HAVE A 3416 02:09:29,828 --> 02:09:30,796 PROBLEM. 3417 02:09:30,796 --> 02:09:31,764 ADVOCACY IS A BIG PART OF WHAT 3418 02:09:31,764 --> 02:09:32,398 THEY'RE DOING. 3419 02:09:32,398 --> 02:09:33,832 SO JUST BEFORE THE PANDEMIC, 3420 02:09:33,832 --> 02:09:34,767 THERE WAS A MEETING IN 3421 02:09:34,767 --> 02:09:35,334 WASHINGTON. 3422 02:09:35,334 --> 02:09:38,270 IT WAS A PURPOSE TO THAT. 3423 02:09:38,270 --> 02:09:39,972 SO THEY TRY TO GET PEOPLE TO GO 3424 02:09:39,972 --> 02:09:43,709 TO VARIOUS SENATORS AND 3425 02:09:43,709 --> 02:09:45,044 CONGRESSMEN AND PROBABLY AT THE 3426 02:09:45,044 --> 02:09:46,312 SAME TIME TALK TO THE FDA 3427 02:09:46,312 --> 02:09:48,981 BECAUSE THE FDA CAN'T TRAVEL AS 3428 02:09:48,981 --> 02:09:51,417 MUCH BECAUSE OF THE WAY PAYMENTS 3429 02:09:51,417 --> 02:09:53,585 ARE MADE, SO IF YOU WANT TO GET 3430 02:09:53,585 --> 02:09:54,420 THE PATIENT VOICE IN FRONT OF 3431 02:09:54,420 --> 02:09:58,223 THE FDA, HAVING A MEETING IN 3432 02:09:58,223 --> 02:10:00,359 WASHINGTON THAT IT PAYS FOR THEM 3433 02:10:00,359 --> 02:10:01,960 TO GO TO MAKES SENSE. 3434 02:10:01,960 --> 02:10:02,861 MY IMPRESSION HAS BEEN THAT WE 3435 02:10:02,861 --> 02:10:04,496 HAVE A HANDBOOK FROM THAT 3436 02:10:04,496 --> 02:10:05,698 MEETING, AND AT EACH OF MY 3437 02:10:05,698 --> 02:10:07,666 TUESDAY NIGHT MEETINGS, WE HAVE 3438 02:10:07,666 --> 02:10:10,269 A COPY OF THE HANDBOOK AND A 3439 02:10:10,269 --> 02:10:12,037 LIAISON FROM THE FOUNDATION THAT 3440 02:10:12,037 --> 02:10:13,272 PRESENTS THIS IS WHAT THE FDA 3441 02:10:13,272 --> 02:10:15,741 WAS DOING AND WHY THE PATIENT 3442 02:10:15,741 --> 02:10:16,875 WANTED -- WANTED TO HEAR THE 3443 02:10:16,875 --> 02:10:17,276 PATIENT VOICE. 3444 02:10:17,276 --> 02:10:18,944 AND I THINK A LOT OF THIS HAS TO 3445 02:10:18,944 --> 02:10:19,778 DO WITH THE PATIENT VOICE. 3446 02:10:19,778 --> 02:10:24,283 THEY HAVE TO REALLY GET OUT 3447 02:10:24,283 --> 02:10:27,219 THERE -- I THINK AGAIN WITH 3448 02:10:27,219 --> 02:10:28,420 LYMPHADEMA, I THINK IT'S FAIRLY 3449 02:10:28,420 --> 02:10:29,388 OBVIOUS WHERE IT IS, PATIENTS 3450 02:10:29,388 --> 02:10:31,590 ARE JUST NOT GOING FORWARD WITH 3451 02:10:31,590 --> 02:10:34,126 PUSHING PEOPLE TO GET SOMETHING 3452 02:10:34,126 --> 02:10:35,361 DONE. 3453 02:10:35,361 --> 02:10:36,195 MAYBE IT'S BECAUSE THERE'S A LOT 3454 02:10:36,195 --> 02:10:37,629 OF OTHER PEOPLE THERE, AND WHEN 3455 02:10:37,629 --> 02:10:40,866 THERE'S ONLY ONE PERSON, ONE 3456 02:10:40,866 --> 02:10:41,900 DAUGHTER THAT HAS THE DISEASE, 3457 02:10:41,900 --> 02:10:43,435 THEN THAT ONE PERSON WILL PUSH. 3458 02:10:43,435 --> 02:10:45,104 WHAT YOU HAVE TO DO IS GET 3459 02:10:45,104 --> 02:10:46,605 PEOPLE WHO KNOW THERE'S OTHER 3460 02:10:46,605 --> 02:10:48,440 PEOPLE INVOLVED TO GET OUT THERE 3461 02:10:48,440 --> 02:10:49,875 AND PUSH AS WELL. 3462 02:10:49,875 --> 02:10:51,009 I THINK PATIENT VOICE IS REALLY 3463 02:10:51,009 --> 02:10:51,377 IMPORTANT. 3464 02:10:51,377 --> 02:10:54,113 I THINK THE AMERICAN THORACIC 3465 02:10:54,113 --> 02:10:55,547 SOCIETY HAS DONE A BEAUTIFUL JOB 3466 02:10:55,547 --> 02:10:57,983 OF DEVOTING ONE SESSION AT A 3467 02:10:57,983 --> 02:11:00,252 MEETING CLEARLY FOR THE PATIENT 3468 02:11:00,252 --> 02:11:00,753 VOICE. 3469 02:11:00,753 --> 02:11:04,690 NOW, PART OF THIS WAS IN ONE 3470 02:11:04,690 --> 02:11:06,158 CASE LYMPHATIC, BUT MOST OF IT 3471 02:11:06,158 --> 02:11:07,593 OBVIOUSLY IS LUNG DISEASE, BUT 3472 02:11:07,593 --> 02:11:10,763 THEY ALSO SAY THERE'S A GROUP 3473 02:11:10,763 --> 02:11:12,264 YOU CAN GO TO WITH A BOOTH AT 3474 02:11:12,264 --> 02:11:14,066 THE EXHIBITOR HALL THAT CAN LOOK 3475 02:11:14,066 --> 02:11:17,069 AT YOUR PROBLEMS, TO MAKE IT 3476 02:11:17,069 --> 02:11:17,803 REALLY INTERACTIVE FOR THE 3477 02:11:17,803 --> 02:11:20,806 PATIENTS THAT COME. 3478 02:11:20,806 --> 02:11:21,640 >> WONDERFUL. 3479 02:11:21,640 --> 02:11:23,142 SO WE HAVE ABOUT FIVE MINUTES 3480 02:11:23,142 --> 02:11:23,342 LEFT. 3481 02:11:23,342 --> 02:11:27,112 I HAVE JAN AND MIKE AND MELISSA, 3482 02:11:27,112 --> 02:11:29,314 THAT MAY TAKE US TO THE END OF 3483 02:11:29,314 --> 02:11:29,515 THE -- 3484 02:11:29,515 --> 02:11:32,351 >> JUST RESPONDING TO HASINA'S 3485 02:11:32,351 --> 02:11:34,453 COMMENT, YES, I THINK THAT THE 3486 02:11:34,453 --> 02:11:36,722 CANCER ADVOCACY GROUPS CAN BE A 3487 02:11:36,722 --> 02:11:38,157 REALLY POWERFUL VOICE FOR 3488 02:11:38,157 --> 02:11:39,892 SURVIVORS, BUT I WOULD PROPOSE 3489 02:11:39,892 --> 02:11:43,429 WE BROADEN THAT TO PREVIVORS TO 3490 02:11:43,429 --> 02:11:45,264 SURVIVORS, SO A MORE ROBUST 3491 02:11:45,264 --> 02:11:46,598 DISCUSSION ABOUT THE 3492 02:11:46,598 --> 02:11:48,801 CONSEQUENCES, STRENGTHS AND 3493 02:11:48,801 --> 02:11:56,408 WEAKNESSES OF LYMPH NODE 3494 02:11:56,408 --> 02:11:57,843 REMOVAL, AT EARLY STAGES TO HELP 3495 02:11:57,843 --> 02:11:58,710 PATIENTS UNDERSTAND THAT 3496 02:11:58,710 --> 02:11:59,611 PARTICULAR AREA. 3497 02:11:59,611 --> 02:12:00,479 >> GREAT. 3498 02:12:00,479 --> 02:12:03,916 MIKE? 3499 02:12:03,916 --> 02:12:07,653 >> ALSO WOULD LIKE TO RESPOND TO 3500 02:12:07,653 --> 02:12:08,520 HASINA'S COMMENTS. 3501 02:12:08,520 --> 02:12:10,522 I THINK FROM LGDA'S PERSPECTIVE, 3502 02:12:10,522 --> 02:12:12,624 WE ARE REACHING PCPs OR 3503 02:12:12,624 --> 02:12:13,792 PRIMARY CARE PHYSICIANS THROUGH 3504 02:12:13,792 --> 02:12:17,863 THE PATIENT. 3505 02:12:17,863 --> 02:12:19,932 SO WE'RE PROVIDING THE PATIENT 3506 02:12:19,932 --> 02:12:21,033 INFORMATION THEY CAN TAKE TO 3507 02:12:21,033 --> 02:12:22,501 THEIR PCPs, AND ALSO THROUGH 3508 02:12:22,501 --> 02:12:27,072 THIS MECHANISM, WE'RE OFFERING 3509 02:12:27,072 --> 02:12:30,442 OPPORTUNITIES TO PARTICIPATE IN 3510 02:12:30,442 --> 02:12:36,248 THE MORE DETAILED EDUCATION 3511 02:12:36,248 --> 02:12:37,616 ABOUT COMPLEX LYMPHATIC 3512 02:12:37,616 --> 02:12:38,116 ANOMALIES. 3513 02:12:38,116 --> 02:12:39,218 WHAT WE'VE FOUND WITH THIS 3514 02:12:39,218 --> 02:12:41,487 APPROACH IS THAT YOU'RE NOT JUST 3515 02:12:41,487 --> 02:12:42,821 REACHING INDIVIDUAL PROVIDERS, 3516 02:12:42,821 --> 02:12:45,657 BUT YOU'RE REACHING PRACTICES OF 3517 02:12:45,657 --> 02:12:46,825 PROVIDERS. 3518 02:12:46,825 --> 02:12:50,462 SO WE'VE ACTUALLY FOUND -- WE'RE 3519 02:12:50,462 --> 02:12:51,897 GETTING MULTIPLES AS FAR AS 3520 02:12:51,897 --> 02:12:54,900 REACH IS CONCERNED, AND HAVING A 3521 02:12:54,900 --> 02:12:58,670 PATIENT WITH THESE DISORDERS IN 3522 02:12:58,670 --> 02:13:00,873 YOUR PRACTICE IS A REALLY 3523 02:13:00,873 --> 02:13:02,441 MOTIVATING FACTOR FOR PHYSICIANS 3524 02:13:02,441 --> 02:13:05,410 TO KNOW MORE ABOUT TH THEM. 3525 02:13:05,410 --> 02:13:06,111 >> TERRIFIC. 3526 02:13:06,111 --> 02:13:08,747 MELISSA. 3527 02:13:08,747 --> 02:13:10,215 >> I'LL GO QUICKLY. 3528 02:13:10,215 --> 02:13:12,251 IT SEEMS LIKE IN MEDICAL SCHOOLS 3529 02:13:12,251 --> 02:13:13,685 TOO, THERE IS AN OFFICE OF 3530 02:13:13,685 --> 02:13:14,786 PUBLIC RELATIONS, AND THEY 3531 02:13:14,786 --> 02:13:16,421 USUALLY RESPOND TO REQUESTS FROM 3532 02:13:16,421 --> 02:13:19,825 TV STATIONS AND RADIO STATIONS. 3533 02:13:19,825 --> 02:13:22,094 CAN YOU FIND SOMEONE WHO KNOWS 3534 02:13:22,094 --> 02:13:24,196 SOMETHING ABOUT CANCER-RELATED 3535 02:13:24,196 --> 02:13:25,063 LYMPHADEMA, AND THEN THEY HUNT 3536 02:13:25,063 --> 02:13:26,732 YOU DOWN AND ASK YOU IN ABOUT 10 3537 02:13:26,732 --> 02:13:29,101 MINUTES' NOTICE TO RUN OVER TO A 3538 02:13:29,101 --> 02:13:30,435 TV STUDIO OR TALK ON THE RADIO 3539 02:13:30,435 --> 02:13:31,203 OR SOMETHING. 3540 02:13:31,203 --> 02:13:32,738 BUT WE COULD BE, AS A COMMUNITY, 3541 02:13:32,738 --> 02:13:34,806 MORE PROACTIVE, AND INSTEAD OF 3542 02:13:34,806 --> 02:13:38,110 WAITING FOR A NEWS REPORTER WHO 3543 02:13:38,110 --> 02:13:39,745 HAS A FRIEND WHO'S GOING THROUGH 3544 02:13:39,745 --> 02:13:41,280 BREAST CANCER TO DECIDE TO RUN A 3545 02:13:41,280 --> 02:13:43,048 STORY ABOUT TO MAYBE ASK THE PR 3546 02:13:43,048 --> 02:13:44,483 PEOPLE AT THE INSTITUTIONS WHERE 3547 02:13:44,483 --> 02:13:48,754 WE WORK TO, ONCE A YEAR, LET 3548 02:13:48,754 --> 02:13:50,822 SOMEONE PREPARE SOMETHING AND GO 3549 02:13:50,822 --> 02:13:52,824 TO THE TV STATIONS AND TYPICALLY 3550 02:13:52,824 --> 02:13:54,459 THEY'RE VERY RECEPTIVE FOR THAT. 3551 02:13:54,459 --> 02:13:55,294 THEY'RE ALWAYS LOOKING FOR NEWS. 3552 02:13:55,294 --> 02:13:57,262 I LEARNED A LONG TIME AGO IN A 3553 02:13:57,262 --> 02:13:58,697 MARKETING CLASS, HALF OF STUFF 3554 02:13:58,697 --> 02:13:59,798 YOU READ IN NEWSPAPERS WAS SENT 3555 02:13:59,798 --> 02:14:02,501 IN BY A COMPANY OR SOMEONE WHO 3556 02:14:02,501 --> 02:14:05,137 HAD A KIND OF HIDDEN MOTIVE FOR 3557 02:14:05,137 --> 02:14:06,605 PUTTING THAT STORY TOGETHER. 3558 02:14:06,605 --> 02:14:07,739 WE COULD CERTAINLY DO SOMETHING 3559 02:14:07,739 --> 02:14:11,777 LIKE THAT AS A COMMUNITY. 3560 02:14:11,777 --> 02:14:12,911 >> GREAT IDEA. 3561 02:14:12,911 --> 02:14:14,780 WELL, I THINK WE HAVE ONE MINUTE 3562 02:14:14,780 --> 02:14:19,284 FOR ANY BURNING FINAL COMMENT, 3563 02:14:19,284 --> 02:14:20,719 QUESTION OR CRITICISM, WHATEVER 3564 02:14:20,719 --> 02:14:21,253 IT MAY BE? 3565 02:14:21,253 --> 02:14:22,454 I DON'T SEE ANY HANDS UP. 3566 02:14:22,454 --> 02:14:25,123 I REALLY WANT TO THANK -- 3567 02:14:25,123 --> 02:14:28,393 >> JUST ONE FOLLOWING MELISSA. 3568 02:14:28,393 --> 02:14:32,397 ON NPR3 DAYS AGO, THERE WAS AN 3569 02:14:32,397 --> 02:14:36,535 INTERVIEW WITH JOHNNY AND JEFF, 3570 02:14:36,535 --> 02:14:37,069 I THINK -- 3571 02:14:37,069 --> 02:14:38,170 >> AND JEFF. 3572 02:14:38,170 --> 02:14:40,539 >> AND IN FACT, YOU KNOW, THIS 3573 02:14:40,539 --> 02:14:41,506 IS GREAT ADVERTISEMENT BECAUSE 3574 02:14:41,506 --> 02:14:47,312 THIS IS ABOUT DRAINAGE OF BRAIN 3575 02:14:47,312 --> 02:14:48,413 LYMPHATICS AND THIS IS WHAT 3576 02:14:48,413 --> 02:14:51,583 PEOPLE GET VERY INTERESTED IN, 3577 02:14:51,583 --> 02:14:54,653 ALZHEIMER'S, HOW YOUR BRAIN -- 3578 02:14:54,653 --> 02:14:55,887 THOUGHTS, WHATEVER, SO I THINK 3579 02:14:55,887 --> 02:14:57,623 THIS IS WHAT WE NEED TO TAKE 3580 02:14:57,623 --> 02:15:00,325 ADVANTAGE AS WE MAKE IT BROADER, 3581 02:15:00,325 --> 02:15:01,827 PEOPLE GET INTERESTED IN THE 3582 02:15:01,827 --> 02:15:02,260 FIELD. 3583 02:15:02,260 --> 02:15:05,397 >> YEAH, FANTASTIC. 3584 02:15:05,397 --> 02:15:07,899 WELL, I REALLY WANT TO THANK OUR 3585 02:15:07,899 --> 02:15:09,334 PANELIST THIS MORNING FOR GIVING 3586 02:15:09,334 --> 02:15:12,638 US SO MUCH INFORMATION AND 3587 02:15:12,638 --> 02:15:16,441 INSIGHT INTO THE VARIOUS 3588 02:15:16,441 --> 02:15:16,975 PATHWAYS IN WHICH YOUR 3589 02:15:16,975 --> 02:15:18,210 ORGANIZATIONS OR YOU AS 3590 02:15:18,210 --> 02:15:19,011 INDIVIDUALS CAN INTERFACE WITH 3591 02:15:19,011 --> 02:15:19,645 US AS A COMMISSION. 3592 02:15:19,645 --> 02:15:25,417 THANKS TO THE COMMISSIONERS FOR 3593 02:15:25,417 --> 02:15:27,486 LUCID QUESTIONS AND I DO HOPE WE 3594 02:15:27,486 --> 02:15:28,654 CAN TAKE ALL THIS INFORMATION 3595 02:15:28,654 --> 02:15:30,222 FORWARD AND WEAVE IT INTO OUR 3596 02:15:30,222 --> 02:15:31,456 EVENTUAL SET OF RECOMMENDATIONS 3597 02:15:31,456 --> 02:15:33,325 TO THE ADVISORY COUNCIL. 3598 02:15:33,325 --> 02:15:34,426 SO THANKS, EVERYONE. 3599 02:15:34,426 --> 02:15:37,629 WE ARE DUE FOR A LUNCH BREAK, 3600 02:15:37,629 --> 02:15:39,898 AND WE RETURN TO THE NEXT 3601 02:15:39,898 --> 02:15:42,300 SESSION AT 12:25, I BELIEVE. 3602 02:15:42,300 --> 02:15:44,970 >> THANK YOU, STAN. 3603 02:15:44,970 --> 02:15:47,105 NHLBI THANKS EVERYONE TOO. 3604 02:15:47,105 --> 02:15:49,741 THANK YOU FOR SUPPORTING THIS 3605 02:15:49,741 --> 02:15:51,176 WORK AND JOINING US FROM ALL 3606 02:15:51,176 --> 02:15:52,110 AROUND THE WORLD. 3607 02:15:52,110 --> 02:15:54,546 PLEASE GO AND JOIN THE NIH 3608 02:15:54,546 --> 02:15:56,248 VIDEOCAST TO LISTEN TO THE NEXT 3609 02:15:56,248 --> 02:15:56,648 SESSION. 3610 02:15:56,648 --> 02:16:01,494 THANK YOU. 3611 02:16:01,494 --> 02:16:03,095 I WOULD LIKE TO WELCOME EVERYONE 3612 02:16:03,095 --> 02:16:06,632 TO THE AFTERNOON SESSION OF THE 3613 02:16:06,632 --> 02:16:07,333 THIRD NATIONAL COMMISSION ON 3614 02:16:07,333 --> 02:16:09,902 LYMPHATIC DISEASES MEETING. 3615 02:16:09,902 --> 02:16:11,337 WE THANK ALL THE PARTICIPANTS OF 3616 02:16:11,337 --> 02:16:13,506 PANEL B JOINING US TODAY. 3617 02:16:13,506 --> 02:16:21,080 BEFORE MASSING THEPASSING THE ME 3618 02:16:21,080 --> 02:16:22,715 DREYER, CO-CHAIR, IS IN 3619 02:16:22,715 --> 02:16:24,884 ATTENDANCE BUT WILL NOT BE 3620 02:16:24,884 --> 02:16:26,452 CO-LEADING THE MEETING ACTIVELY 3621 02:16:26,452 --> 02:16:27,787 DUE TO HER HEALTH-RELATED 3622 02:16:27,787 --> 02:16:28,287 PROBLEMS. 3623 02:16:28,287 --> 02:16:29,722 WITH THAT, IT IS MY GREAT 3624 02:16:29,722 --> 02:16:31,591 PLEASURE TO RE-INTRODUCE 3625 02:16:31,591 --> 02:16:34,260 DR. STANLEY ROCKSON, THE NCLD 3626 02:16:34,260 --> 02:16:35,194 CO-CHAIR, FOR HIS WELCOME 3627 02:16:35,194 --> 02:16:35,428 REMARKS. 3628 02:16:35,428 --> 02:16:36,662 THANK YOU. 3629 02:16:36,662 --> 02:16:41,500 >> THANK YOU, SELEN, AND THANK 3630 02:16:41,500 --> 02:16:42,368 YOU, EVERYONE, WHO IS ATTENDING 3631 02:16:42,368 --> 02:16:43,536 THIS AFTERNOON SESSION EITHER ON 3632 02:16:43,536 --> 02:16:45,838 THE VIDEOCAST AS PART OF THE 3633 02:16:45,838 --> 02:16:46,939 PUBLIC, OUR COMMISSIONERS WHO 3634 02:16:46,939 --> 02:16:48,174 HAVE BEEN HERE FROM THE START OF 3635 02:16:48,174 --> 02:16:52,111 THE DAY, AND MEMBERS OF PANEL B, 3636 02:16:52,111 --> 02:16:58,084 WHO HAVE BEEN INVITED TO WORK 3637 02:16:58,084 --> 02:17:00,119 WITH US TO TRY TO COME UP WITH 3638 02:17:00,119 --> 02:17:02,221 SOME CREATIVE SOLUTIONS TO THE 3639 02:17:02,221 --> 02:17:06,392 PROBLEMS OF LYMPHATIC DISEASE. 3640 02:17:06,392 --> 02:17:07,793 FLEUSH NOW THIS IS GOING TO BE 3641 02:17:07,793 --> 02:17:10,596 REPEAT FOR THOSE THAT WERE 3642 02:17:10,596 --> 02:17:11,330 PRESENT ON THE MORNING SESSION 3643 02:17:11,330 --> 02:17:14,000 BUT WE WANT PANELISTS TO BE 3644 02:17:14,000 --> 02:17:15,234 AWARE ABOUT THE CHARGE OF THIS 3645 02:17:15,234 --> 02:17:15,735 NATIONAL COMMISSION. 3646 02:17:15,735 --> 02:17:18,638 IT IS A TRANSPARENT INCLUSIVE 3647 02:17:18,638 --> 02:17:20,773 AND ACCESSIBLE PUBLIC FORUM. 3648 02:17:20,773 --> 02:17:22,341 WE'RE ATTEMPTING TO ASSESS 3649 02:17:22,341 --> 02:17:24,610 CRITICAL CHALLENGES AND 3650 02:17:24,610 --> 02:17:26,145 SCIENTIFIC AND CLINICAL TEUPTS 3651 02:17:26,145 --> 02:17:31,183 RELATED TO LYMPHATIC DISEASING. 3652 02:17:31,183 --> 02:17:33,185 YOU, THE PANELISTS, ARE INVITED 3653 02:17:33,185 --> 02:17:34,620 AS IMPORTANT STAKEHOLDERS 3654 02:17:34,620 --> 02:17:36,489 IMPLICITLY IN THIS PROCESS, AND 3655 02:17:36,489 --> 02:17:37,590 TODAY WE'RE GOING TO TRY TO 3656 02:17:37,590 --> 02:17:38,224 GATHER INPUT FROM YOU 3657 02:17:38,224 --> 02:17:40,726 SPECIFICALLY THAT WILL HELP US 3658 02:17:40,726 --> 02:17:44,563 TO ARRIVE AT SOME DECISIONS 3659 02:17:44,563 --> 02:17:45,831 REGARDING OUR ACTIONS AND 3660 02:17:45,831 --> 02:17:47,967 EVENTUALLY WE WILL PROVIDE 3661 02:17:47,967 --> 02:17:48,601 ACTIONABLE PROGRESS UPDATES AND 3662 02:17:48,601 --> 02:17:50,970 A FINAL REPORT TO THE NATIONAL 3663 02:17:50,970 --> 02:17:51,604 HEART, LUNG AND BLOOD ADVISORY 3664 02:17:51,604 --> 02:17:54,507 COUNCIL TO REFLECT THESE VARIOUS 3665 02:17:54,507 --> 02:17:59,879 PERSPECTIVES AND TO IDENTIFY A 3666 02:17:59,879 --> 02:18:01,948 PATH FORWARD FOR CREATING 3667 02:18:01,948 --> 02:18:02,248 CHANGE. 3668 02:18:02,248 --> 02:18:03,516 SO IF WE CAN HAVE THE NEXT 3669 02:18:03,516 --> 02:18:08,354 SLIDE, PLEASE. 3670 02:18:08,354 --> 02:18:09,355 THERE ARE 15 INDIVIDUALS 3671 02:18:09,355 --> 02:18:11,190 APPOINTED TO THIS NCLD WHO COME 3672 02:18:11,190 --> 02:18:14,293 FROM A VARIETY OF DISCIPLINES, 3673 02:18:14,293 --> 02:18:17,463 INCLUDING BASIC INVESTIGATION, 3674 02:18:17,463 --> 02:18:18,965 TRANSLATIONAL INVESTIGATION, 3675 02:18:18,965 --> 02:18:21,600 CLINICIANS, PATIENT 3676 02:18:21,600 --> 02:18:24,337 STAKEHOLDERS, AND TOGETHER WE 3677 02:18:24,337 --> 02:18:26,005 ARE DELIBERATING ON THIS MATTER 3678 02:18:26,005 --> 02:18:27,974 TO CARRY OUR MISSION FORWARD, WE 3679 02:18:27,974 --> 02:18:29,508 HAVE CREATED SIX SUBCOMMITTEES 3680 02:18:29,508 --> 02:18:32,912 THAT YOU SEE LISTED HERE, 3681 02:18:32,912 --> 02:18:36,115 SEVERAL MEMBERS ARE ON MORE THAN 3682 02:18:36,115 --> 02:18:37,550 ONE COMMITTEE, BUT WE HAVE 3683 02:18:37,550 --> 02:18:39,352 IDENTIFIED THESE AS THE VERY 3684 02:18:39,352 --> 02:18:42,154 IMPORTANT FOCUS AREAS THAT MAY 3685 02:18:42,154 --> 02:18:43,456 COME UP IN OUR DISCUSSIONS 3686 02:18:43,456 --> 02:18:45,157 TODAY, THESE INCLUDE SCIENTIFIC 3687 02:18:45,157 --> 02:18:47,259 ADVANCEMENT, EDUCATIONAL 3688 02:18:47,259 --> 02:18:48,394 IMPERATIVES, MEASURABLE RESULTS, 3689 02:18:48,394 --> 02:18:50,096 PATIENT TOOLS, THIRD PARTY 3690 02:18:50,096 --> 02:18:51,764 COVERAGE AND COMMUNITY GROWTH. 3691 02:18:51,764 --> 02:18:53,265 THAT YOU SEE AT THE TOP OF THE 3692 02:18:53,265 --> 02:18:57,436 PAGE, THERE IS A URL THAT YOU 3693 02:18:57,436 --> 02:18:59,071 CAN UTILIZE TO GAIN MORE DIRECT 3694 02:18:59,071 --> 02:19:00,206 INFORMATION ABOUT THE 3695 02:19:00,206 --> 02:19:03,609 COMPOSITION OF THE COMMISSION 3696 02:19:03,609 --> 02:19:06,812 AND ITS INDIVIDUAL MEMBERS. 3697 02:19:06,812 --> 02:19:10,649 SO I'D LIKE TO NOW INTRODUCE THE 3698 02:19:10,649 --> 02:19:17,957 INVITED MEMBERS OF THIS PANEL B. 3699 02:19:17,957 --> 02:19:19,058 I WILL GO DOWN THIS LIST IN 3700 02:19:19,058 --> 02:19:19,392 ORDER. 3701 02:19:19,392 --> 02:19:20,693 I WILL MENTION YOUR NAME AND THE 3702 02:19:20,693 --> 02:19:27,466 ORGANIZATION THAT YOU REPRESENT. 3703 02:19:27,466 --> 02:19:29,135 , AT WHICH YOU WILL HAVE 7 OR 3704 02:19:29,135 --> 02:19:30,136 8 MINUTES TO TALK ABOUT YOURSELF 3705 02:19:30,136 --> 02:19:31,670 AND YOUR RELATIONSHIP, IF THERE 3706 02:19:31,670 --> 02:19:33,606 IS ONE ALREADY, TO LYMPHATIC 3707 02:19:33,606 --> 02:19:36,242 DISEASE, OR TO THE LYMPHATIC 3708 02:19:36,242 --> 02:19:39,545 REALM, AND THEN ALSO TO TALK 3709 02:19:39,545 --> 02:19:40,179 SPECIFICALLY ABOUT THE 3710 02:19:40,179 --> 02:19:43,616 ORGANIZATION THAT YOU REPRESENT 3711 02:19:43,616 --> 02:19:45,051 AND HOW IT MIGHT INTERFACE 3712 02:19:45,051 --> 02:19:46,919 POTENTIALLY WITH THE ACTIVITIES 3713 02:19:46,919 --> 02:19:48,988 OF THIS COMMISSION. 3714 02:19:48,988 --> 02:19:50,156 A SUBTEXT FOR MUCH OF WHAT WE'LL 3715 02:19:50,156 --> 02:19:51,490 BE TALKING ABOUT TODAY, I 3716 02:19:51,490 --> 02:19:56,395 BELIEVE, IS GOING TO BE 3717 02:19:56,395 --> 02:19:57,930 EDUCATION SO YOU MIGHT 3718 02:19:57,930 --> 02:19:58,764 SPECIFICALLY BE THINKING ABOUT 3719 02:19:58,764 --> 02:20:00,933 THE REALM IN WHICH YOUR 3720 02:20:00,933 --> 02:20:01,767 ORGANIZATION MIGHT BECOME 3721 02:20:01,767 --> 02:20:04,070 INVOLVED IN THE EDUCATIONAL 3722 02:20:04,070 --> 02:20:05,471 IMPERATIVE SURROUNDING LYMPHATIC 3723 02:20:05,471 --> 02:20:05,871 DISEASE. 3724 02:20:05,871 --> 02:20:08,140 SO I'M GOING TO START WITH 3725 02:20:08,140 --> 02:20:11,444 ELIZABETH CAMPIONE, WHO IS HERE 3726 02:20:11,444 --> 02:20:16,215 TO REPRESENT LANA. 3727 02:20:16,215 --> 02:20:18,184 >> HI, GOOD MORNING. 3728 02:20:18,184 --> 02:20:19,318 IT'S STILL MORNING WHERE I AM. 3729 02:20:19,318 --> 02:20:21,220 THANK YOU, I'M REALLY HONORED TO 3730 02:20:21,220 --> 02:20:22,221 HAVE BEEN INVITED TO BE PART OF 3731 02:20:22,221 --> 02:20:23,222 THIS PANEL. 3732 02:20:23,222 --> 02:20:25,958 I ACTUALLY GO BY BETSY, SO I'M 3733 02:20:25,958 --> 02:20:27,493 BETSY CAMPIONE, I AM A PHYSICAL 3734 02:20:27,493 --> 02:20:27,927 THERAPIST. 3735 02:20:27,927 --> 02:20:29,795 I'VE GOT ABOUT TWO DECADES WORTH 3736 02:20:29,795 --> 02:20:31,197 OF EXPERIENCE WORKING WITH 3737 02:20:31,197 --> 02:20:33,632 PATIENTS WHO HAVE BEEN DIAGNOSED 3738 02:20:33,632 --> 02:20:35,367 WITH LYMPHADEMA OF VARIOUS 3739 02:20:35,367 --> 02:20:36,469 ETIOLOGIES. 3740 02:20:36,469 --> 02:20:39,839 I'M AN ASSOCIATE PROFESSOR AND 3741 02:20:39,839 --> 02:20:41,073 DOCTOR OF PHYSICAL THERAPY 3742 02:20:41,073 --> 02:20:41,941 PROGRAM AT MIDWESTERN 3743 02:20:41,941 --> 02:20:42,341 UNIVERSITY. 3744 02:20:42,341 --> 02:20:46,545 IT'S A SMALL UNIVERSITY JUST 3745 02:20:46,545 --> 02:20:48,848 OUTSIDE OF CHICAGO, AND I'M ALSO 3746 02:20:48,848 --> 02:20:50,382 PRESIDENT OF THE LYMPHOLOGY 3747 02:20:50,382 --> 02:20:52,918 ASSOCIATION OF NORTH AMERICA, SO 3748 02:20:52,918 --> 02:20:56,856 I'M REALLY HERE WEARING MY HATS 3749 02:20:56,856 --> 02:20:58,190 ON THAT BUT DO SOME OTHER 3750 02:20:58,190 --> 02:20:59,191 PROJECTS RELATED TO OTHER 3751 02:20:59,191 --> 02:21:01,894 PROFESSIONAL ORGANIZATIONS. 3752 02:21:01,894 --> 02:21:03,896 WE DO SUMMARY SEARCH IN TERMS OF 3753 02:21:03,896 --> 02:21:05,798 IMPLEMENTATION SCIENCE, VERY 3754 02:21:05,798 --> 02:21:07,633 SMALL SCALE, REALLY WORKING WITH 3755 02:21:07,633 --> 02:21:08,968 SOME OF THE CLINICAL PRACTICE 3756 02:21:08,968 --> 02:21:11,003 GUIDELINES THAT COME OUT OF THE 3757 02:21:11,003 --> 02:21:11,737 APTA, BUT OTHERS ARE HERE TO 3758 02:21:11,737 --> 02:21:12,905 TALK ABOUT THAT, SO I'M NOT 3759 02:21:12,905 --> 02:21:16,408 GOING TO STEAL THEIR THUNDER. 3760 02:21:16,408 --> 02:21:17,943 SO I JUST WANT TO SHARE A LITTLE 3761 02:21:17,943 --> 02:21:20,579 BIT ABOUT LANA. 3762 02:21:20,579 --> 02:21:23,182 LANA IS A NON-PROFIT 3763 02:21:23,182 --> 02:21:24,083 ORGANIZATION CERTIFIED IN THE 3764 02:21:24,083 --> 02:21:24,850 SPECIALIST OF HEALTHCARE 3765 02:21:24,850 --> 02:21:26,785 PROFESSIONALS WHO DIAGNOSE 3766 02:21:26,785 --> 02:21:29,221 AND/OR TREAT LYMPHADEMA AND ITS 3767 02:21:29,221 --> 02:21:30,222 RELATED DISORDERS. 3768 02:21:30,222 --> 02:21:31,157 DR. SMITH THIS MORNING 3769 02:21:31,157 --> 02:21:32,791 HIGHLIGHTED THE ROLE THAT THE 3770 02:21:32,791 --> 02:21:33,993 AMERICAN CANCER SOCIETY PLAYED 3771 02:21:33,993 --> 02:21:36,695 IN THE ESTABLISHMENT OF LANA. 3772 02:21:36,695 --> 02:21:39,465 BUT IT WAS CREATED AFTER THEIR 3773 02:21:39,465 --> 02:21:41,000 MEETINGS IN THE LATE 1990s, 3774 02:21:41,000 --> 02:21:41,834 WHERE THERE WAS A RECOMMENDATION 3775 02:21:41,834 --> 02:21:44,203 THAT WE NEEDED TO ESTABLISH 3776 02:21:44,203 --> 02:21:45,638 CERTIFICATION GUIDELINES TO 3777 02:21:45,638 --> 02:21:46,639 ASSURE CONTEMPORARY TREATMENT 3778 02:21:46,639 --> 02:21:48,507 FOR THOSE WHO WERE DIAGNOSED 3779 02:21:48,507 --> 02:21:50,176 WITH LYMPHADEMA AND THOSE 3780 02:21:50,176 --> 02:21:51,710 RELATED DISORDERS, AND THEY HAVE 3781 02:21:51,710 --> 02:21:52,778 BEEN INSTRUMENTAL IN THE 3782 02:21:52,778 --> 02:21:54,513 DEVELOPMENT OF LANA AND WE'VE 3783 02:21:54,513 --> 02:21:56,215 ALSO BEEN ABLE TO ACCESS FUNDS 3784 02:21:56,215 --> 02:21:58,384 THROUGH THE LONGABERGER 3785 02:21:58,384 --> 02:21:59,251 FOUNDATION TO SUPPORT SOME OF 3786 02:21:59,251 --> 02:22:00,553 OUR ACTIVITIES OVER THE TIME 3787 02:22:00,553 --> 02:22:01,420 THAT THE ORGANIZATION HAS BEEN 3788 02:22:01,420 --> 02:22:05,291 IN EXISTENCE. 3789 02:22:05,291 --> 02:22:06,258 BOTH THE BOARD OF DIRECTORS FOR 3790 02:22:06,258 --> 02:22:07,459 LANA AND THOSE CERTIFIED BY THE 3791 02:22:07,459 --> 02:22:08,561 ORGANIZATION ARE REPRESENTED BY 3792 02:22:08,561 --> 02:22:10,296 A NUMBER OF HEALTHCARE 3793 02:22:10,296 --> 02:22:11,463 DISCIPLINES, INCLUDING 3794 02:22:11,463 --> 02:22:13,098 PHYSICIANS AND NURSES, BUT THE 3795 02:22:13,098 --> 02:22:15,067 VAST MAJORITY OF THOSE WHO SIT 3796 02:22:15,067 --> 02:22:16,869 FOR THE LANA CERTIFICATION EXAM 3797 02:22:16,869 --> 02:22:19,038 ARE PHYSICAL THERAPISTS AND 3798 02:22:19,038 --> 02:22:22,975 OCCUPATIONAL THERAPISTS, AS WELL 3799 02:22:22,975 --> 02:22:24,643 AS PHYSICAL THERAPY ASSISTANTS 3800 02:22:24,643 --> 02:22:26,078 AND CERTIFIED PHYSICAL THERAPY 3801 02:22:26,078 --> 02:22:26,812 ASSISTANTS, AS WELL AS A NUMBER 3802 02:22:26,812 --> 02:22:29,915 OF OTHER HEALTHCARE PROVIDERS. 3803 02:22:29,915 --> 02:22:31,450 OUR MISSION IS REALLY TO PROMOTE 3804 02:22:31,450 --> 02:22:32,351 THE STANDARDS FOR THE 3805 02:22:32,351 --> 02:22:33,552 CERTIFICATION OF HEALTHCARE 3806 02:22:33,552 --> 02:22:35,521 PROVIDERS, REALLY TO PROMOTE 3807 02:22:35,521 --> 02:22:37,923 AWARENESS AND THE SCIENCE OF 3808 02:22:37,923 --> 02:22:39,925 LYMPHOLOGY. 3809 02:22:39,925 --> 02:22:42,461 OUR EXAM TESTS THE HEALTHCARE 3810 02:22:42,461 --> 02:22:43,495 PROVIDERS' KNOWLEDGE OF THE 3811 02:22:43,495 --> 02:22:44,763 LYMPHATIC SYSTEM INCLUDING 3812 02:22:44,763 --> 02:22:45,764 ASSESSMENT, TREATMENT PLANNING 3813 02:22:45,764 --> 02:22:47,199 AND THE IMPLEMENTATION OF 3814 02:22:47,199 --> 02:22:49,602 INTERVENTIONS TO HELP RESTORE OR 3815 02:22:49,602 --> 02:22:50,803 MAXIMIZE FUNCTION AND IMPROVE 3816 02:22:50,803 --> 02:22:52,104 THE QUALITY OF LIFE. 3817 02:22:52,104 --> 02:22:53,906 AS DR. SMITH MENTIONED, WE 3818 02:22:53,906 --> 02:22:55,107 RECENTLY PARTNERED AGAIN WITH 3819 02:22:55,107 --> 02:22:57,509 THEM AS WELL AS THE WASHINGTON 3820 02:22:57,509 --> 02:22:58,410 UNIVERSITY SCHOOL OF MEDICINE IN 3821 02:22:58,410 --> 02:22:58,677 ST. LOUIS. 3822 02:22:58,677 --> 02:23:00,613 THIS WAS THE 25TH ANNIVERSARY OF 3823 02:23:00,613 --> 02:23:02,915 THAT ORIGINAL AMERICAN CANCER 3824 02:23:02,915 --> 02:23:04,350 SOCIETY WORKSHOP, AND IT WAS 3825 02:23:04,350 --> 02:23:05,618 REALLY A SUMMIT THAT WAS 3826 02:23:05,618 --> 02:23:07,186 DEDICATED TO ADVANCING 3827 02:23:07,186 --> 02:23:09,054 LYMPHADEMA MANAGEMENT. 3828 02:23:09,054 --> 02:23:10,256 THIS EVENT BROUGHT TOGETHER 3829 02:23:10,256 --> 02:23:12,124 EXPERTS IN THE FIELD OF 3830 02:23:12,124 --> 02:23:14,126 LYMPHOLOGY FROM THE FRONT LINES 3831 02:23:14,126 --> 02:23:15,928 OF HEALTHCARE, RESEARCH AND 3832 02:23:15,928 --> 02:23:16,328 ADVOCACY GROUPS. 3833 02:23:16,328 --> 02:23:18,397 IT PROVIDED A PLATFORM TO 3834 02:23:18,397 --> 02:23:20,566 EXCHANGE INNOVATIVE IDEAS IN 3835 02:23:20,566 --> 02:23:21,467 RESEARCH AS WELL AS HIGHLIGHT 3836 02:23:21,467 --> 02:23:23,302 THE GAPS IN THE LITERATURE AS IT 3837 02:23:23,302 --> 02:23:24,870 RELATES TO PATIENT CARE. 3838 02:23:24,870 --> 02:23:25,604 WE'RE CURRENTLY WORKING WITH THE 3839 02:23:25,604 --> 02:23:29,575 JOURNAL OF MEDICAL ONCOLOGY TO 3840 02:23:29,575 --> 02:23:30,876 PUBLISH THESE WORKS IN AN OPEN 3841 02:23:30,876 --> 02:23:32,678 ACCESS FORMAT INCLUDING SORT OF 3842 02:23:32,678 --> 02:23:33,879 EXPERT CONSENSUS STATEMENTS THAT 3843 02:23:33,879 --> 02:23:35,981 ARE REALLY HIGHLIGHTING THE 3844 02:23:35,981 --> 02:23:41,120 EXISTING CAPS EXISTING GAPS IN E 3845 02:23:41,120 --> 02:23:42,521 TO ACHIEVE EFFECTIVE OUTCOMES. 3846 02:23:42,521 --> 02:23:44,723 WE'VE ALSO BEEN A STAUNCH 3847 02:23:44,723 --> 02:23:45,924 ADVOCATE OF THE LYMPHADEMA 3848 02:23:45,924 --> 02:23:46,859 TREATMENT ACT WHICH WOULD NOT 3849 02:23:46,859 --> 02:23:48,260 HAVE BEEN PASSED OR IMPLEMENTED 3850 02:23:48,260 --> 02:23:50,562 WITHOUT THE TIRELESS EFFORTS OF 3851 02:23:50,562 --> 02:23:52,865 HEATHER FERGUSON AND THE 3852 02:23:52,865 --> 02:23:53,666 LYMPHADEMA ADVOCACY GROUP. 3853 02:23:53,666 --> 02:23:55,534 THIS WAS A HUGE VICTORY FOR THE 3854 02:23:55,534 --> 02:23:56,769 LYMPHADEMA COMMUNITY AS IT HAS 3855 02:23:56,769 --> 02:23:58,070 PROVIDED WELL-NEEDED ACCESS TO 3856 02:23:58,070 --> 02:24:00,272 MEDICAL SUPPLIES TO MANAGE 3857 02:24:00,272 --> 02:24:01,273 LYMPHADEMA. 3858 02:24:01,273 --> 02:24:04,276 WHILE THIS HAS BEEN PASSED, THE 3859 02:24:04,276 --> 02:24:05,077 PT AND OT COMMUNITIES CONTINUE 3860 02:24:05,077 --> 02:24:06,345 TO STRUGGLE WITH PROPER 3861 02:24:06,345 --> 02:24:07,579 REIMBURSEMENT FOR THE CARE THAT 3862 02:24:07,579 --> 02:24:11,016 THEY PROVIDE TO THOSE PATIENTS, 3863 02:24:11,016 --> 02:24:11,950 AS WELL AS BEING REIMBURSED 3864 02:24:11,950 --> 02:24:15,688 FORFEITING OFFORFITTING OF THOSD 3865 02:24:15,688 --> 02:24:16,588 THERE'S STILL FRUSTRATION ON THE 3866 02:24:16,588 --> 02:24:17,790 SIDE OF HEALTHCARE PROVIDERS AND 3867 02:24:17,790 --> 02:24:19,658 BEING ABLE TO ACCESS THOSE 3868 02:24:19,658 --> 02:24:20,893 NECESSARY ITEMS EVEN WITH 3869 02:24:20,893 --> 02:24:21,760 INSURANCE REIMBURSEMENT. 3870 02:24:21,760 --> 02:24:23,295 SO WHILE A HUGE WIN FOR THE 3871 02:24:23,295 --> 02:24:24,263 COMMUNITY, WE STILL HAVE SOME 3872 02:24:24,263 --> 02:24:27,266 STEPS THAT WE NEED TO TAKE. 3873 02:24:27,266 --> 02:24:29,234 WHILE LANA IS NOT INHERENTLY 3874 02:24:29,234 --> 02:24:31,537 DIRECTLY INVOLVED IN SIGNIFICANT 3875 02:24:31,537 --> 02:24:33,372 RESEARCH PER SE, IT IS CLEAR TO 3876 02:24:33,372 --> 02:24:35,607 US AS WE PREPARE OUR 3877 02:24:35,607 --> 02:24:36,375 CERTIFICATION EXAM AND AS WE 3878 02:24:36,375 --> 02:24:38,277 WORK WITH THE TRAINING PROGRAMS, 3879 02:24:38,277 --> 02:24:39,912 THERE ARE SIGNIFICANT GAPS AND I 3880 02:24:39,912 --> 02:24:42,114 THINK IT WAS HIGHLIGHTED EARLIER 3881 02:24:42,114 --> 02:24:44,049 THIS MORNING THAT WE NEED TO DO 3882 02:24:44,049 --> 02:24:46,118 SOME DEIMPLEMENTATION OF SOME 3883 02:24:46,118 --> 02:24:47,753 EXISTING EDUCATIONAL MODELS IN 3884 02:24:47,753 --> 02:24:49,521 TERMS OF WHAT WE'RE DOING IN 3885 02:24:49,521 --> 02:24:51,190 TERMS OF JUST TREATING THIS 3886 02:24:51,190 --> 02:24:53,058 PATIENT POPULATION, SO I'M 3887 02:24:53,058 --> 02:24:54,493 REALLY HONORED TO BE A PART OF 3888 02:24:54,493 --> 02:24:55,961 THIS CONVERSATION AS I THINK WE 3889 02:24:55,961 --> 02:24:57,363 HAVE A LONG WAY TO MOVE FORWARD 3890 02:24:57,363 --> 02:24:59,665 IN TERMS OF BEING ABLE TO 3891 02:24:59,665 --> 02:25:02,000 EDUCATE PROVIDERS IN ORDER TO 3892 02:25:02,000 --> 02:25:03,235 REACH MAXIMUM OUTCOMES FOR OUR 3893 02:25:03,235 --> 02:25:03,769 PATIENTS. 3894 02:25:03,769 --> 02:25:08,540 SO THANK YOU. 3895 02:25:08,540 --> 02:25:10,776 >> THANK YOU, ELIZABETH. 3896 02:25:10,776 --> 02:25:12,111 OUR NEXT REPRESENTATIVE IS 3897 02:25:12,111 --> 02:25:14,346 DR. HILLARY HAFTEL, REPRESENTING 3898 02:25:14,346 --> 02:25:15,047 THE AMERICAN ACADEMY OF 3899 02:25:15,047 --> 02:25:15,814 PEDIATRICS. 3900 02:25:15,814 --> 02:25:17,416 >> GOOD MORNING, OR GOOD 3901 02:25:17,416 --> 02:25:18,617 AFTERNOON DEPENDING ON WHERE YOU 3902 02:25:18,617 --> 02:25:20,052 ARE. 3903 02:25:20,052 --> 02:25:22,588 THANK YOU VERY MUCH FOR 3904 02:25:22,588 --> 02:25:25,958 INCLUDING ME IN THIS PANEL, IN 3905 02:25:25,958 --> 02:25:26,558 THIS CONVERSATION. 3906 02:25:26,558 --> 02:25:30,262 I HAVE TO ADMIT THAT I AM A 3907 02:25:30,262 --> 02:25:32,297 PEDIATRIC AND ADULT 3908 02:25:32,297 --> 02:25:33,899 RHEUMATOLOGIST, SO I AM -- WHILE 3909 02:25:33,899 --> 02:25:37,736 I HAVE SOME EXPOSURE OBVIOUSLY 3910 02:25:37,736 --> 02:25:40,372 TO THIS BEVY OF DISEASES, I'M 3911 02:25:40,372 --> 02:25:42,141 CERTAINLY NOT A CONTENT EXPERT, 3912 02:25:42,141 --> 02:25:43,776 BUT I'M HAPPY TO BE HERE AND TO 3913 02:25:43,776 --> 02:25:46,111 DESCRIBE WHAT WE DO AT THE 3914 02:25:46,111 --> 02:25:49,281 ACADEMY FOR EDUCATION AND 3915 02:25:49,281 --> 02:25:53,118 PROMOTING THE UNDERSTANDING OF 3916 02:25:53,118 --> 02:25:55,954 DISEASES SUCH AS THIS WITH OUR 3917 02:25:55,954 --> 02:25:56,889 COMMUNITY. 3918 02:25:56,889 --> 02:25:58,924 SO THE AMERICAN ACADEMY OF 3919 02:25:58,924 --> 02:26:01,226 PEDIATRICS IS OVER 90 YEARS OLD, 3920 02:26:01,226 --> 02:26:04,430 AND HAS BEEN CENTERED SINCE ITS 3921 02:26:04,430 --> 02:26:07,599 INCEPTION ON THREE MAIN PILLARS, 3922 02:26:07,599 --> 02:26:11,670 THAT OF POLICY, EDUCATION AND 3923 02:26:11,670 --> 02:26:12,571 ADVOCACY. 3924 02:26:12,571 --> 02:26:13,472 SO EDUCATION, I'M THE SENIOR 3925 02:26:13,472 --> 02:26:14,973 VICE PRESIDENT FOR EDUCATION, 3926 02:26:14,973 --> 02:26:19,912 AND WE SPENT A LOT OF TIME 3927 02:26:19,912 --> 02:26:21,980 IDENTIFYING AND DEVELOPING 3928 02:26:21,980 --> 02:26:26,185 MATERIALS TO FILL GAPS IN 3929 02:26:26,185 --> 02:26:26,752 KNOWLEDGE. 3930 02:26:26,752 --> 02:26:30,088 WE SERVE ALMOST 67,000 3931 02:26:30,088 --> 02:26:31,857 PEDIATRICIANS ACROSS THE 3932 02:26:31,857 --> 02:26:34,626 COUNTRY. 3933 02:26:34,626 --> 02:26:36,161 WE ALSO SERVE ALLIED HEALTH 3934 02:26:36,161 --> 02:26:37,796 PROFESSIONALS, PAs, NURSE 3935 02:26:37,796 --> 02:26:39,865 PRACTITIONERS, PEDIATRIC NURSES, 3936 02:26:39,865 --> 02:26:41,300 PEDIATRIC PHARMACOLOGISTS, 3937 02:26:41,300 --> 02:26:46,004 SOCIAL WORKERS, A VERY WIDE 3938 02:26:46,004 --> 02:26:48,006 RANGE OF HEALTH PROFESSIONALS 3939 02:26:48,006 --> 02:26:51,543 THAT WORK IN A COLLABORATIVE WAY 3940 02:26:51,543 --> 02:26:54,046 TO IMPROVE POLICY, ADVOCACY AND 3941 02:26:54,046 --> 02:26:58,951 EDUCATION IN THE U.S. AND ABR 3942 02:26:58,951 --> 02:26:59,518 ABROAD. 3943 02:26:59,518 --> 02:27:02,521 SO WHEN IT DO COMES TO WHAT WE , 3944 02:27:02,521 --> 02:27:04,957 WE HAVE A NUMBER -- WE SERVE 3945 02:27:04,957 --> 02:27:07,759 GENERAL PEDIATRICIANS, BUT WE 3946 02:27:07,759 --> 02:27:14,766 ALSO HAVE A NUMBER OF SECTIONS 3947 02:27:14,766 --> 02:27:16,768 OF SUBSPECIALISTS, 3948 02:27:16,768 --> 02:27:17,402 HEMATOLOGY/ONCOLOGY IS THE GROUP 3949 02:27:17,402 --> 02:27:20,305 THAT IS VERY INVESTED IN 3950 02:27:20,305 --> 02:27:23,475 PARTICIPATING IN THIS PROJECT 3951 02:27:23,475 --> 02:27:27,312 AND IN THIS COLLABORATIVE. 3952 02:27:27,312 --> 02:27:29,448 AND OUR ONE MEMBER WHO IS VERY 3953 02:27:29,448 --> 02:27:31,683 INTERESTED IN THIS APOLOGIZES AS 3954 02:27:31,683 --> 02:27:32,885 SHE COULDN'T JOIN ME BECAUSE SHE 3955 02:27:32,885 --> 02:27:34,219 IS ACTUALLY OUT OF COUNTRY RIGHT 3956 02:27:34,219 --> 02:27:35,721 NOW. 3957 02:27:35,721 --> 02:27:39,825 BUT THEY WORK VERY HARD AT 3958 02:27:39,825 --> 02:27:40,526 IDENTIFYING -- EACH SECTION 3959 02:27:40,526 --> 02:27:42,861 WORKS REALLY HARD ON IDENTIFYING 3960 02:27:42,861 --> 02:27:46,665 WHAT KNOWLEDGE GAPS MAY EXIST, 3961 02:27:46,665 --> 02:27:49,835 DEVELOPING AN -- DEVELOPING 3962 02:27:49,835 --> 02:27:51,270 POLICY, CLINICAL REPORTS AND 3963 02:27:51,270 --> 02:27:56,041 TECHNICAL REPORTS REGARDING THIS 3964 02:27:56,041 --> 02:27:57,109 INFORMATION AND DISSEMINATING 3965 02:27:57,109 --> 02:27:58,844 THEM TO THE MEMBERSHIP AND 3966 02:27:58,844 --> 02:27:59,511 BEYOND. 3967 02:27:59,511 --> 02:28:02,915 IN ADDITION, THE SECTIONS AND 3968 02:28:02,915 --> 02:28:05,751 MEMO MEMBERS COLLABORATE WITH TE 3969 02:28:05,751 --> 02:28:06,885 DEPARTMENT OF EDUCATION IN 3970 02:28:06,885 --> 02:28:10,289 DEVELOPING EDUCATIONAL 3971 02:28:10,289 --> 02:28:13,191 MATERIALS, AND THOSE ARE WIDE 3972 02:28:13,191 --> 02:28:15,627 RANGING FROM THINGS LIKE 3973 02:28:15,627 --> 02:28:16,929 WEBINARS ALL THE WAY TO 3974 02:28:16,929 --> 02:28:20,933 ASYNCHRONOUS COURSES, LIVE 3975 02:28:20,933 --> 02:28:25,437 COURSES, EDUCATION AS YOU MAY 3976 02:28:25,437 --> 02:28:28,540 KNOW IS FOCUSING MORE ON MICRO 3977 02:28:28,540 --> 02:28:31,610 LEARNING, SO SMALL AMOUNTS OF 3978 02:28:31,610 --> 02:28:34,046 EDUCATION OVER TIME THAT'S 3979 02:28:34,046 --> 02:28:36,148 EASILY ACCESSIBLE TO OUR 3980 02:28:36,148 --> 02:28:37,916 MEMBERS, AND WE ALSO PARTNER 3981 02:28:37,916 --> 02:28:40,252 WITH GOVERNMENT AGENCIES TO 3982 02:28:40,252 --> 02:28:45,357 DEVELOP EDUCATIONAL MATERIALS 3983 02:28:45,357 --> 02:28:46,792 THOUGHT TO BE IMPORTANT AND IN 3984 02:28:46,792 --> 02:28:48,727 THE ABILITY TO BE ABLE TO REACH 3985 02:28:48,727 --> 02:28:50,829 OUR MEMBERS AND IMPROVE 3986 02:28:50,829 --> 02:28:53,599 UNDERSTANDING OF CARE AS THINGS 3987 02:28:53,599 --> 02:28:54,900 SUCH AS LYMPHATIC DISEASES. 3988 02:28:54,900 --> 02:28:56,768 SO WE HAVE A WIDE RANGE OF 3989 02:28:56,768 --> 02:28:59,304 EDUCATIONAL MODALITIES THAT WE 3990 02:28:59,304 --> 02:29:01,540 CAN USE, AND FRANKLY IN MY 3991 02:29:01,540 --> 02:29:03,041 EXPERIENCE, YOU USE MORE THAN 3992 02:29:03,041 --> 02:29:04,476 ONE, BECAUSE PEOPLE HAVE 3993 02:29:04,476 --> 02:29:06,545 DIFFERENT LEARNING PURPOSES AND 3994 02:29:06,545 --> 02:29:09,881 LEARNING STYLES AND SINCE WE ARE 3995 02:29:09,881 --> 02:29:12,417 SPREAD ACROSS THE COUNTRY AND 3996 02:29:12,417 --> 02:29:16,221 BEYOND, WE ALSO HAVE A LOT OF 3997 02:29:16,221 --> 02:29:18,023 VIRTUAL EDUCATION THAT WE DO, 3998 02:29:18,023 --> 02:29:20,626 PARTICULARLY FOR OUR REMOTE 3999 02:29:20,626 --> 02:29:24,930 MEMBERS WHO ARE OUT IN RURAL 4000 02:29:24,930 --> 02:29:29,301 COMMUNITIES OR DON'T HAVE AS 4001 02:29:29,301 --> 02:29:30,736 EASY ACCESS TO ACADEMIC CENTERS 4002 02:29:30,736 --> 02:29:34,272 WHERE THE PRACTITIONERS ARE AND 4003 02:29:34,272 --> 02:29:35,907 WHERE THINGS MAY BE CENTERED. 4004 02:29:35,907 --> 02:29:37,709 SO WE'VE BUILT QUITE A NICE 4005 02:29:37,709 --> 02:29:38,910 INFRASTRUCTURE AND I'M EXCITED 4006 02:29:38,910 --> 02:29:40,345 ABOUT THE POSSIBILITY OF 4007 02:29:40,345 --> 02:29:43,815 PARTICIPATING IN HELPING 4008 02:29:43,815 --> 02:29:45,751 DISSEMINATE INFORMATION AND 4009 02:29:45,751 --> 02:29:46,718 EDUCATION ABOUT THIS IMPORTANT 4010 02:29:46,718 --> 02:29:50,422 TOPIC TO OUR MEMBERS. 4011 02:29:50,422 --> 02:29:51,323 SO THANK YOU. 4012 02:29:51,323 --> 02:29:52,224 >> THANK YOU, HILLARY. 4013 02:29:52,224 --> 02:29:53,792 THAT WAS WONDERFUL. 4014 02:29:53,792 --> 02:29:55,761 OUR NEXT REPRESENTATIVE IS 4015 02:29:55,761 --> 02:30:01,933 DR. LISA HO HOWLEY, REPRESENTING 4016 02:30:01,933 --> 02:30:02,668 THE AMERICAN ASSOCIATION OF 4017 02:30:02,668 --> 02:30:03,468 MEDICAL COLLEGES. 4018 02:30:03,468 --> 02:30:06,605 >> THANK YOU SO MUCH. 4019 02:30:06,605 --> 02:30:07,339 DELIGHTED TO BE HERE. 4020 02:30:07,339 --> 02:30:10,742 I APPRECIATE THE OPPORTUNITY TO 4021 02:30:10,742 --> 02:30:12,177 TELL US AND LEARN FROM ALL OF 4022 02:30:12,177 --> 02:30:13,278 AND SHARE A LITTLE ABOUT MY 4023 02:30:13,278 --> 02:30:15,380 ORGANIZATION, THAT'S THE 4024 02:30:15,380 --> 02:30:16,014 ASSOCIATION OF AMERICAN MEDICAL 4025 02:30:16,014 --> 02:30:16,281 COLLEGES. 4026 02:30:16,281 --> 02:30:19,651 AS WAS JUST MENTIONED. 4027 02:30:19,651 --> 02:30:23,622 SO BY FIRST OF ALL MYSELF I AM 4028 02:30:23,622 --> 02:30:25,357 THE SENIOR DIRECTOR FOR 4029 02:30:25,357 --> 02:30:26,591 TRANSFORMING EDUCATION, I'M AN 4030 02:30:26,591 --> 02:30:28,126 EDUCATIONAL PSYCHOLOGIST BY 4031 02:30:28,126 --> 02:30:31,029 TRAINING AND HAVE WORKED MY 4032 02:30:31,029 --> 02:30:32,731 ENTIRE CAREER IN APPLYING 4033 02:30:32,731 --> 02:30:34,933 EDUCATIONAL PSYCHOLOGY TO 4034 02:30:34,933 --> 02:30:35,734 TEACHING AND LEARNING IN 4035 02:30:35,734 --> 02:30:36,968 MEDICINE AND OTHER HEALTH 4036 02:30:36,968 --> 02:30:38,537 PROFESSIONS. 4037 02:30:38,537 --> 02:30:40,739 SO I WANT TO SHARE A LITTLE BIT 4038 02:30:40,739 --> 02:30:42,841 ABOUT THE ORGANIZATION FOR THOSE 4039 02:30:42,841 --> 02:30:44,376 OF YOU WHO AREN'T FAMILIAR WITH 4040 02:30:44,376 --> 02:30:44,910 US. 4041 02:30:44,910 --> 02:30:46,978 WE'RE BASED IN WASHINGTON, D.C. 4042 02:30:46,978 --> 02:30:48,413 WE'VE BEEN AROUND A LONG TIME, 4043 02:30:48,413 --> 02:30:50,215 SINCE THE LATE 1800s, AND OUR 4044 02:30:50,215 --> 02:30:53,285 MEMBERS ARE ACTUALLY MEDICAL 4045 02:30:53,285 --> 02:30:54,586 SCHOOLS, THEY'RE MEMBER 4046 02:30:54,586 --> 02:30:57,255 INSTITUTIONS, SO THEY'RE 4047 02:30:57,255 --> 02:30:58,290 CURRENTLY 171 MEMBER MEDICAL 4048 02:30:58,290 --> 02:31:01,560 SCHOOLS OF THE AAMC, BUT ALSO 4049 02:31:01,560 --> 02:31:03,095 OVER 400 TEACHING HOSPITALS AND 4050 02:31:03,095 --> 02:31:05,297 HEALTH SYSTEMS, AS WELL AS OVER 4051 02:31:05,297 --> 02:31:08,500 70 ACADEMIC AND SPECIALTY 4052 02:31:08,500 --> 02:31:09,334 SOCIETIES. 4053 02:31:09,334 --> 02:31:11,970 THOSE ORGANIZATIONS AND 4054 02:31:11,970 --> 02:31:14,973 INSTITUTIONS MAKE UP NEARLY 4055 02:31:14,973 --> 02:31:17,609 2,000 -- 200,000, EXCUSE ME, 4056 02:31:17,609 --> 02:31:18,844 FULL TIME FACULTY. 4057 02:31:18,844 --> 02:31:21,646 ALSO ABOUT 150,000 RESIDENT 4058 02:31:21,646 --> 02:31:23,248 TRAINEES OR RESIDENT PHYSICIANS 4059 02:31:23,248 --> 02:31:26,218 AND ABOUT 100,000 MEDICAL 4060 02:31:26,218 --> 02:31:27,919 STUDENTS. 4061 02:31:27,919 --> 02:31:30,455 WE WORK VERY CLOSELY WITH OUR 4062 02:31:30,455 --> 02:31:32,891 SIBLING ORGANIZATION ACOM, 4063 02:31:32,891 --> 02:31:33,759 THAT'S THE AMERICAN ASSOCIATION 4064 02:31:33,759 --> 02:31:35,627 OF COLLEGES OF OSTEOPATHIC 4065 02:31:35,627 --> 02:31:37,863 MEDICINE, SO THOSE ARE OF COURSE 4066 02:31:37,863 --> 02:31:44,536 THE DO TRAINING PROGRAMS, 4067 02:31:44,536 --> 02:31:45,704 ALTHOUGH THEY'RE A DIFFERENT 4068 02:31:45,704 --> 02:31:46,838 MEMBER ORGANIZATION, WE DO WORK 4069 02:31:46,838 --> 02:31:48,640 VERY CLOSELY WITH THEM, WHICH IS 4070 02:31:48,640 --> 02:31:49,741 WONDERFUL, AND I ALSO WANT TO 4071 02:31:49,741 --> 02:31:51,309 MENTION IPEC, WHICH IS ANOTHER 4072 02:31:51,309 --> 02:31:53,445 ORGANIZATION WE ALSO ARE 4073 02:31:53,445 --> 02:31:54,713 ACTUALLY A FOUNDING MEMBER OF 4074 02:31:54,713 --> 02:31:56,782 AND THAT'S THE INTERPROFESSIONAL 4075 02:31:56,782 --> 02:31:58,550 EDUCATION COLLABORATIVE. 4076 02:31:58,550 --> 02:32:00,819 THAT ORGANIZATION IS NOW MADE UP 4077 02:32:00,819 --> 02:32:05,423 OF 23 PROFESSIONS, AND ACROSS 4078 02:32:05,423 --> 02:32:08,960 ALL OF HEALTHCARE ACTUALLY, SO 4079 02:32:08,960 --> 02:32:11,730 DO A LOT OF WORK IN REGARDS TO 4080 02:32:11,730 --> 02:32:13,632 FACULTY DEVELOPMENT ACROSS 4081 02:32:13,632 --> 02:32:14,933 PROFESSIONS IN SUPPORTING MORE 4082 02:32:14,933 --> 02:32:16,701 EFFECTIVE TEACHING AND 4083 02:32:16,701 --> 02:32:19,538 CONTEMPORARY PRACTICES IN HEALTH 4084 02:32:19,538 --> 02:32:24,309 PROFESSIONS EDUCATION. 4085 02:32:24,309 --> 02:32:25,610 SO THAT'S JUST A LITTLE BIT 4086 02:32:25,610 --> 02:32:30,148 ABOUT MY O THE AAMC, AS WELL AS 4087 02:32:30,148 --> 02:32:30,849 IPEC. 4088 02:32:30,849 --> 02:32:32,350 I ALSO WANTED TO MENTION ONE OF 4089 02:32:32,350 --> 02:32:33,451 OUR TWO JOURNALS BECAUSE I THINK 4090 02:32:33,451 --> 02:32:34,419 IT'S VERY RELEVANT HERE AND WE 4091 02:32:34,419 --> 02:32:36,555 HAVE A NUMBER OF RELEVANT 4092 02:32:36,555 --> 02:32:40,058 RESOURCES AND PUBLICATIONS 4093 02:32:40,058 --> 02:32:44,196 WITHIN WHAT WE CALL MEDIPORTAL, 4094 02:32:44,196 --> 02:32:45,263 ONE OF OUR TWO JOURNALS WITHIN 4095 02:32:45,263 --> 02:32:46,031 THE ASSOCIATION. 4096 02:32:46,031 --> 02:32:50,202 IT'S A UNIQUE PUBLICATION IN 4097 02:32:50,202 --> 02:32:52,537 THAT IT OFFERS STANDALONE 4098 02:32:52,537 --> 02:32:53,371 COMPLETE TEACHING OR LEARNING 4099 02:32:53,371 --> 02:32:54,840 MODULES THAT HAVE BEEN 4100 02:32:54,840 --> 02:32:57,309 IMPLEMENTED AND IMPORTANTLY 4101 02:32:57,309 --> 02:32:58,810 EVALUATED WITH PHYSICIAN 4102 02:32:58,810 --> 02:33:01,313 TRAINEES OR OTHER HEALTH 4103 02:33:01,313 --> 02:33:02,514 PRACTITIONERS. 4104 02:33:02,514 --> 02:33:04,382 SO THOSE SUBMISSIONS ARE FREELY 4105 02:33:04,382 --> 02:33:05,684 AVAILABLE AND ACCESSIBLE, AND WE 4106 02:33:05,684 --> 02:33:07,485 WOULD LOVE TO CONTINUE TO BUILD 4107 02:33:07,485 --> 02:33:12,390 THE COLLECTION AROUND LYMPHATICS 4108 02:33:12,390 --> 02:33:16,127 AND LYMPHADEMA. 4109 02:33:16,127 --> 02:33:17,963 SO THERE ARE A NUMBER OF 4110 02:33:17,963 --> 02:33:18,930 PUBLICATIONS WITHIN THAT 4111 02:33:18,930 --> 02:33:19,564 COLLECTION NOW, BUT WE WOULD 4112 02:33:19,564 --> 02:33:20,565 LOVE TO SEE EVEN MORE. 4113 02:33:20,565 --> 02:33:21,733 SO THANK YOU FOR THIS 4114 02:33:21,733 --> 02:33:23,001 OPPORTUNITY, AND AGAIN, LOOK 4115 02:33:23,001 --> 02:33:24,002 FORWARD TO BEING HERE AND BEING 4116 02:33:24,002 --> 02:33:25,804 PART OF THE CONVERSATION. 4117 02:33:25,804 --> 02:33:31,710 >> THANK YOU SO MUCH. 4118 02:33:31,710 --> 02:33:34,746 NEXT WE'RE GOING TO HEAR FROM 4119 02:33:34,746 --> 02:33:41,119 DRS. CLAIRE DAVIS AND CHRIS 4120 02:33:41,119 --> 02:33:41,686 WILSON. 4121 02:33:41,686 --> 02:33:46,992 I'LL ASK YOU TO DIVIDE YOUR TIME 4122 02:33:46,992 --> 02:33:48,226 ACCORDING TO YOUR WISHES. 4123 02:33:48,226 --> 02:33:49,160 >> THANK YOU, EVERYONE. 4124 02:33:49,160 --> 02:33:50,595 GREAT TO SEE YOU, IT WAS A GREAT 4125 02:33:50,595 --> 02:33:52,130 SESSION AND I'M GLAD TO BE PACK 4126 02:33:52,130 --> 02:33:55,767 BBACKFOR THE ACH NOON. 4127 02:33:55,767 --> 02:33:58,503 I'M A DOCTOR OF SCIENCE AND 4128 02:33:58,503 --> 02:33:59,037 PHYSICAL THERAPY. 4129 02:33:59,037 --> 02:34:01,306 I AM ALSO THE PRESIDENT OF THE 4130 02:34:01,306 --> 02:34:02,707 ACADEMY OF ONCOLOGIC PHYSICAL 4131 02:34:02,707 --> 02:34:03,241 THERAPY. 4132 02:34:03,241 --> 02:34:05,677 I'M A RESEARCHER DOING RESEARCH 4133 02:34:05,677 --> 02:34:08,813 IN ADVANCED DISEASE WITH CANCER 4134 02:34:08,813 --> 02:34:09,981 SPECIFICALLY ADAPTATIONS FOR 4135 02:34:09,981 --> 02:34:11,383 PHYSICAL THERAPISTS WORKING WITH 4136 02:34:11,383 --> 02:34:12,751 PALLIATIVE CARE, INCLUDING 4137 02:34:12,751 --> 02:34:14,419 LYMPHADEMA. 4138 02:34:14,419 --> 02:34:16,154 I'M AN ASSOCIATE PROFESSOR AT 4139 02:34:16,154 --> 02:34:17,155 OAKLAND UNIVERSITY AND DIRECTOR 4140 02:34:17,155 --> 02:34:19,224 OF CLINICAL EDUCATION, WHICH IS 4141 02:34:19,224 --> 02:34:20,558 IN METRO DETROIT, MICHIGAN IN 4142 02:34:20,558 --> 02:34:23,094 THE UNITED STATES. 4143 02:34:23,094 --> 02:34:25,864 AND I ALSO PRACTICE AS A CL 4144 02:34:25,864 --> 02:34:26,865 NICHE IN MICHIGAN WHERE WE 4145 02:34:26,865 --> 02:34:30,168 FOUNDED THE FIRST CLINICAL 4146 02:34:30,168 --> 02:34:32,237 RESIDENCY IN ONCOLOGY FOR 4147 02:34:32,237 --> 02:34:33,204 PHYSICAL THERAPISTS IN THE 4148 02:34:33,204 --> 02:34:33,571 UNITED STATES. 4149 02:34:33,571 --> 02:34:35,040 I'M GOING TO TALK A LITTLE ABOUT 4150 02:34:35,040 --> 02:34:37,208 THE APTA AND ITS ACADEMY AND 4151 02:34:37,208 --> 02:34:39,945 THEN I'M GOING TO PASS IT OFF TO 4152 02:34:39,945 --> 02:34:41,646 TALK ABOUT THE CLINICAL PRACTICE 4153 02:34:41,646 --> 02:34:42,847 GUIDELINE INITIATIVE WE'VE BEEN 4154 02:34:42,847 --> 02:34:44,516 SPENDING A LOT OF TIME ON. 4155 02:34:44,516 --> 02:34:47,118 SO APTA IS NOT QUITE AS OLD AS 4156 02:34:47,118 --> 02:34:49,054 AMC BUT WE WERE FOUNDED IN 1921. 4157 02:34:49,054 --> 02:34:51,756 WE HAVE OVER 100,000 PHYSICAL 4158 02:34:51,756 --> 02:34:53,959 THERAPISTS AND PHYSICAL 4159 02:34:53,959 --> 02:34:54,726 THERAPIST ASSISTANT MEMBERS. 4160 02:34:54,726 --> 02:34:56,695 IT IS THE LARGEST PHYSICAL 4161 02:34:56,695 --> 02:34:58,063 THERAPY CLINICAL AND SCIENTIFIC 4162 02:34:58,063 --> 02:34:59,998 ORGANIZATION IN THE UNITED 4163 02:34:59,998 --> 02:35:01,032 STATES. 4164 02:35:01,032 --> 02:35:02,867 THE APTA'S MISSION IS TO BUILD A 4165 02:35:02,867 --> 02:35:04,436 COMMUNITY THAT ADVANCES THE 4166 02:35:04,436 --> 02:35:07,305 PROFESSION OF PHYSICAL THERAPY 4167 02:35:07,305 --> 02:35:08,740 TO REALLY IMPROVE THE HEALTH OF 4168 02:35:08,740 --> 02:35:09,708 THE ENTIRE SOCIETY. 4169 02:35:09,708 --> 02:35:14,679 SO WITHIN THE APTA, THERE ARE 18 4170 02:35:14,679 --> 02:35:18,216 SUSUBSPECIALTIES IN ACADEMIES, U 4171 02:35:18,216 --> 02:35:21,286 MIGHT THINK OF ORTHOPEDICS OR 4172 02:35:21,286 --> 02:35:26,024 KNEWOLNEUROLOGY, BUT PEDIATRICS, 4173 02:35:26,024 --> 02:35:27,492 GERIATRIC AND CARDIOVASCULAR AND 4174 02:35:27,492 --> 02:35:27,892 PULMONARY. 4175 02:35:27,892 --> 02:35:29,995 SO THE APTA AND ITS ACADEMY 4176 02:35:29,995 --> 02:35:31,596 OFFERS BOARD CERTIFICATION, 4177 02:35:31,596 --> 02:35:34,866 RESIDENCIES AND FELLOWSHIPS. 4178 02:35:34,866 --> 02:35:35,967 ESPECIALLY BOARD CERTIFICATION 4179 02:35:35,967 --> 02:35:37,869 AS AN ONCOLOGIC PHYSICAL 4180 02:35:37,869 --> 02:35:38,136 THERAPIST. 4181 02:35:38,136 --> 02:35:39,637 IT'S A RELATIVELY NEW BOARD 4182 02:35:39,637 --> 02:35:40,205 CERTIFICATION PROCESS THAT 4183 02:35:40,205 --> 02:35:43,274 STARTED IN ABOUT 2018, WHICH 4184 02:35:43,274 --> 02:35:45,310 DOES INCLUDE CONTENT IN 4185 02:35:45,310 --> 02:35:45,810 LYMPHADEMA DIAGNOSIS AND 4186 02:35:45,810 --> 02:35:47,579 MANAGEMENT. 4187 02:35:47,579 --> 02:35:49,581 FOR OUR RESIDENCY PROGRAMS, 4188 02:35:49,581 --> 02:35:50,849 THEY'RE GENERAL LIE 12 TO 20 4189 02:35:50,849 --> 02:35:52,584 MONTH RESIDENCIES, RESIDENTS WHO 4190 02:35:52,584 --> 02:35:54,886 GRADUATE FROM AN ACCREDITED 4191 02:35:54,886 --> 02:35:57,088 PROGRAM WILL GRADUATE WITH SOME 4192 02:35:57,088 --> 02:35:58,223 FOUNDATIONAL TRAINING IN 4193 02:35:58,223 --> 02:35:59,257 LYMPHATIC SYSTEM FUNCTION BUT 4194 02:35:59,257 --> 02:36:03,461 NOT NECESSARILY BE CLTs OR 4195 02:36:03,461 --> 02:36:04,796 OTHER CREDENTIALS WHERE YOU HAVE 4196 02:36:04,796 --> 02:36:08,366 SPECIALTY TRAINING. 4197 02:36:08,366 --> 02:36:10,435 THEY DO A LOT WITH LEGISLATIVE 4198 02:36:10,435 --> 02:36:12,670 ADVOCACY. 4199 02:36:12,670 --> 02:36:14,873 DR. CAMPIONE ALREADY TALKED 4200 02:36:14,873 --> 02:36:16,007 ABOUT THE TREATMENT ACT. 4201 02:36:16,007 --> 02:36:19,144 ONE OF OUR KEY LEADERS WAS PAULA 4202 02:36:19,144 --> 02:36:20,845 STOUTT HELPING TO BE AN ADVOCATE 4203 02:36:20,845 --> 02:36:22,580 FOR PASSAGE AND OF COURSE AFTER 4204 02:36:22,580 --> 02:36:26,084 PASSAGE, PROMULGATING THE RULES. 4205 02:36:26,084 --> 02:36:28,553 WE DO A LOT OF WORK WITH 4206 02:36:28,553 --> 02:36:29,320 CONTINUING EDUCATION IN PERSON 4207 02:36:29,320 --> 02:36:30,388 AND VIRTUAL COURSES. 4208 02:36:30,388 --> 02:36:31,856 MOST RECENTLY WE HAD A COUPLE OF 4209 02:36:31,856 --> 02:36:33,858 VIRTUAL COURSES CALLED KIND OF 4210 02:36:33,858 --> 02:36:34,759 WHERE LYMPHADEMA FITS INTO THE 4211 02:36:34,759 --> 02:36:35,727 CLINICAL CARE FOR A LITTLE BIT 4212 02:36:35,727 --> 02:36:43,134 MORE OF THE GENERAL LIST ON GEN. 4213 02:36:43,134 --> 02:36:44,636 WE HAVE SPECIAL GROUPS THAT HOST 4214 02:36:44,636 --> 02:36:46,571 PERIODIC WEBINARS AND THEY'RE 4215 02:36:46,571 --> 02:36:48,706 REALLY KIND OF SERVING AS 4216 02:36:48,706 --> 02:36:50,408 COLLECTIVE VOICE OF LYMPHADEMA 4217 02:36:50,408 --> 02:36:51,476 CLINICIANS AND RESEARCHERS. 4218 02:36:51,476 --> 02:36:52,310 PROBABLY ONE OF THE BIGGEST 4219 02:36:52,310 --> 02:36:53,611 THINGS WE TALK ABOUT IS 4220 02:36:53,611 --> 02:36:54,079 SCIENTIFIC ADVOCACY. 4221 02:36:54,079 --> 02:36:55,914 WE DO HAVE A PEER REVIEWED 4222 02:36:55,914 --> 02:36:57,515 JOURNAL REHABILITATION ONCOLOGY 4223 02:36:57,515 --> 02:36:59,918 IN THE APT ONCOLOGY ACADEMY. 4224 02:36:59,918 --> 02:37:02,287 A SPECIAL ISSUE A FEW YEARS AGO 4225 02:37:02,287 --> 02:37:02,954 FOCUSED SPECIFICALLY ON 4226 02:37:02,954 --> 02:37:03,254 LYMPHADEMA. 4227 02:37:03,254 --> 02:37:04,789 WE WERE REALLY EXCITED TO HAVE A 4228 02:37:04,789 --> 02:37:07,592 GUEST EDITORIAL BY ACTOR CATHY 4229 02:37:07,592 --> 02:37:09,360 BATES, WHO WROTE A LETTER TO THE 4230 02:37:09,360 --> 02:37:12,063 EDITOR AND DR. NICOLE STOUTT. 4231 02:37:12,063 --> 02:37:15,266 SO WE'VE BEEN SUPPORTING A LOT 4232 02:37:15,266 --> 02:37:16,801 OF CLINICAL PRACTICE BASED 4233 02:37:16,801 --> 02:37:17,569 GUIDELINES WHICH DR. DAVIS WILL 4234 02:37:17,569 --> 02:37:19,170 BE TALKING ABOUT. 4235 02:37:19,170 --> 02:37:21,606 IN ADDITION, WE ALWAYS HAVE A 4236 02:37:21,606 --> 02:37:23,741 IN-PERSON CONFERENCE CALLED 4237 02:37:23,741 --> 02:37:25,210 COMBINED SECTIONS MEETING WHICH 4238 02:37:25,210 --> 02:37:28,847 HOSTS ANYWHERE BETWEEN 10 TO 15, 4239 02:37:28,847 --> 02:37:29,881 16,000 REHABILITATION 4240 02:37:29,881 --> 02:37:33,184 PROFESSIONALS AND HEALTHCARE 4241 02:37:33,184 --> 02:37:35,487 PROVIDERS. 4242 02:37:35,487 --> 02:37:37,555 IT'S REALLY WELL ATTENDED, WE 4243 02:37:37,555 --> 02:37:39,290 ALWAYS HAVE AT LEAST FOUR OR 4244 02:37:39,290 --> 02:37:40,892 FIVE FULL EDUCATIONAL SESSIONS 4245 02:37:40,892 --> 02:37:42,760 ON LYMPHADEMA AND RESEARCH 4246 02:37:42,760 --> 02:37:43,862 PLATFORMS AND POSTER 4247 02:37:43,862 --> 02:37:44,262 PRESENTATIONS. 4248 02:37:44,262 --> 02:37:45,463 PROBABLY THE LAST NOTABLE THING 4249 02:37:45,463 --> 02:37:47,398 THAT I'LL TALK ABOUT IS WE'VE 4250 02:37:47,398 --> 02:37:48,833 BEEN SPENDING A LOT OF TIME ON 4251 02:37:48,833 --> 02:37:50,235 REALLY ESTABLISHING WHAT IS 4252 02:37:50,235 --> 02:37:51,836 ENTRY LEVEL PRACTICE FOR 4253 02:37:51,836 --> 02:37:52,937 PHYSICAL THERAPISTS WHEN THEY 4254 02:37:52,937 --> 02:37:54,472 GRADUATE WHEN IT COMES TO 4255 02:37:54,472 --> 02:37:56,341 ONCOLOGY AND LID. 4256 02:37:56,341 --> 02:37:56,641 LYMPHADEMA. 4257 02:37:56,641 --> 02:37:58,376 SO WE JUST PUBLISHED THOSE 4258 02:37:58,376 --> 02:37:59,377 GUIDELINES AFTER A MODIFIED 4259 02:37:59,377 --> 02:38:01,246 DELPHI STUDY WE'VE BEEN WORKING 4260 02:38:01,246 --> 02:38:02,914 ON AND IT'S GOING TO BE COMING 4261 02:38:02,914 --> 02:38:04,115 OUT IN THE APTA VERY SOON. 4262 02:38:04,115 --> 02:38:05,850 SO WITH THAT, I'LL PASS IT OVER 4263 02:38:05,850 --> 02:38:09,888 TO DR. DAVIS. 4264 02:38:09,888 --> 02:38:10,855 >> THANK YOU, CHRIS. 4265 02:38:10,855 --> 02:38:12,090 GOOD AFTERNOON, GOOD MORNING, 4266 02:38:12,090 --> 02:38:12,690 WHEREVER YOU ARE. 4267 02:38:12,690 --> 02:38:14,359 I'M CLAIRE. 4268 02:38:14,359 --> 02:38:17,862 I'M A PHYSICAL THERAPIST OF 30 4269 02:38:17,862 --> 02:38:18,897 YEARS. 4270 02:38:18,897 --> 02:38:21,633 I HAVE BEEN 20 YEARS HERE IN 4271 02:38:21,633 --> 02:38:22,901 LEXINGTON, KENTUCKY HERE AT A 4272 02:38:22,901 --> 02:38:23,902 COMMUNITY HOSPITAL, SO I HAVE A 4273 02:38:23,902 --> 02:38:25,837 UNIQUE ROLE OF BEING A RESEARCH 4274 02:38:25,837 --> 02:38:26,971 CONSULTANT NOW. 4275 02:38:26,971 --> 02:38:29,807 AND AS PART OF THAT ROLE, I DO 4276 02:38:29,807 --> 02:38:31,643 HAVE TIME TO DO SOME LYMPHADEMA 4277 02:38:31,643 --> 02:38:34,245 RESEARCH. 4278 02:38:34,245 --> 02:38:37,048 SO I AM REPRESENTING THE APTA 4279 02:38:37,048 --> 02:38:39,884 AND THE ONCOLOGIC ACADEMY. 4280 02:38:39,884 --> 02:38:43,388 AND I GOT STARTED IN MY RESEARCH 4281 02:38:43,388 --> 02:38:46,925 IN LYMPHADEMA AND THE CANCER 4282 02:38:46,925 --> 02:38:51,262 REHAB WORLD. 4283 02:38:51,262 --> 02:38:53,765 WHAT THE APTA STARTED WITH WAS 4284 02:38:53,765 --> 02:38:55,066 EDGE OUTCOME MEASURES AND WE 4285 02:38:55,066 --> 02:38:57,535 STARTED THAT BACK IN 2012, AND 4286 02:38:57,535 --> 02:39:00,305 EDGE STANDS FOR EVALUATION, 4287 02:39:00,305 --> 02:39:04,709 DATABASE, TO GUIDE EFFECTIVE OUT 4288 02:39:04,709 --> 02:39:05,210 OUTCOME RECOMMENDATIONS. 4289 02:39:05,210 --> 02:39:07,478 SO THERE WAS A CALL FOR 4290 02:39:07,478 --> 02:39:08,546 VOLUNTEERS, COMBINED SECTION AS 4291 02:39:08,546 --> 02:39:11,482 CHRIS JUST MENTIONED, AND A 4292 02:39:11,482 --> 02:39:15,787 GROUP OF US GOT STARTED LOOKING 4293 02:39:15,787 --> 02:39:17,155 AT OUTCOME MEASURES THAT WE USED 4294 02:39:17,155 --> 02:39:19,190 IN THE OUTPATIENT ARENA, MOSTLY 4295 02:39:19,190 --> 02:39:25,263 TO BEGIN WITH, AND THEN THIS IS 4296 02:39:25,263 --> 02:39:27,065 WHAT WAS USED IN THE ORTHOPEDIC 4297 02:39:27,065 --> 02:39:28,700 POPULATION, WHAT CAN WE APPLY TO 4298 02:39:28,700 --> 02:39:31,402 THOSE WITH CANCER AND THEN ON TO 4299 02:39:31,402 --> 02:39:32,837 THOSE WITH -- WHO DEVELOP 4300 02:39:32,837 --> 02:39:33,404 LYMPHADEMA. 4301 02:39:33,404 --> 02:39:35,873 AND ALL OUR WORK SO FAR THAT 4302 02:39:35,873 --> 02:39:38,710 I'VE BEEN INVOLVED IN IS IN 4303 02:39:38,710 --> 02:39:41,312 BREAST CANCER AND BREAST 4304 02:39:41,312 --> 02:39:41,879 CANCER-RELATED LYMPHADEMA 4305 02:39:41,879 --> 02:39:44,115 BECAUSE THAT'S WHERE WE HAVE THE 4306 02:39:44,115 --> 02:39:46,517 MAJORITY OF THE RESEARCH AND THE 4307 02:39:46,517 --> 02:39:47,518 EVIDENCE. 4308 02:39:47,518 --> 02:39:50,455 SO WE DID OUTCOME MEASURES, EDGE 4309 02:39:50,455 --> 02:39:51,889 DOCUMENTS THAT RECOMMENDED OUT 4310 02:39:51,889 --> 02:39:55,226 COME MEASURES FOR THE SHOULDER, 4311 02:39:55,226 --> 02:39:56,628 FOR STRENGTH, MUSCLE ENDURANCE, 4312 02:39:56,628 --> 02:39:59,497 AND THEN WE WENT ON TO 4313 02:39:59,497 --> 02:40:00,465 FUNCTIONAL MOBILITY. 4314 02:40:00,465 --> 02:40:03,735 WE THEN MOVED ON TO THOSE WITH 4315 02:40:03,735 --> 02:40:05,136 PROSTATE CANCER AND DEVELOPED 4316 02:40:05,136 --> 02:40:07,839 EDGE DOCUMENTS FOR THOSE, AND 4317 02:40:07,839 --> 02:40:09,607 THEN WE STARTED ON 4318 02:40:09,607 --> 02:40:10,541 CANCER-RELATED FATIGUE OUT COME 4319 02:40:10,541 --> 02:40:18,650 MEASURES. 4320 02:40:18,650 --> 02:40:22,253 NEXT IN 2015, LOOKING IN THE 4321 02:40:22,253 --> 02:40:23,621 UPPER QUADRANT, AT THAT TIME IT 4322 02:40:23,621 --> 02:40:26,758 INCLUDED THE HEAD, THE NECK, 4323 02:40:26,758 --> 02:40:30,395 UPPER QUADRANT, TRUNK, UPPER 4324 02:40:30,395 --> 02:40:30,928 EXTREMITY. 4325 02:40:30,928 --> 02:40:34,098 AND FROM THAT WORK, WE THEN WENT 4326 02:40:34,098 --> 02:40:36,167 ON TO MOVE INTO THE DIRECTION OF 4327 02:40:36,167 --> 02:40:37,435 CLINICAL PRACTICE GUIDELINES. 4328 02:40:37,435 --> 02:40:40,104 AND AT THAT TIME, THE AMERICAN 4329 02:40:40,104 --> 02:40:42,206 PHYSICAL THERAPY ASSOCIATION WAS 4330 02:40:42,206 --> 02:40:43,875 PROVIDING SOME SMALL FUNDING TO 4331 02:40:43,875 --> 02:40:47,945 GET US STARTED ON LOOKING AT THE 4332 02:40:47,945 --> 02:40:51,082 EVIDENCE AND LOOKING AT MOVING 4333 02:40:51,082 --> 02:40:52,884 INTO THE CLINICAL PRACTICE 4334 02:40:52,884 --> 02:40:53,985 GUIDELINES. 4335 02:40:53,985 --> 02:40:57,922 SO BACK IN 2017, I WAS INVOLVED 4336 02:40:57,922 --> 02:41:03,127 IN PUBLISHING CLINICAL PRACTICE 4337 02:41:03,127 --> 02:41:04,462 GUIDELINE ON DIAGNOSING 4338 02:41:04,462 --> 02:41:05,530 SECONDARY UPPER QUADRANT 4339 02:41:05,530 --> 02:41:10,234 LYMPHADEMA BECAUSE OF CANCER, 4340 02:41:10,234 --> 02:41:11,936 AND WE LOOKED TO THE 4341 02:41:11,936 --> 02:41:14,772 RELIGHTABILITY, VALIDITY AND 4342 02:41:14,772 --> 02:41:15,873 DIAGNOSTIC ACCURACY OF MEASURES 4343 02:41:15,873 --> 02:41:16,874 USED TO DIAGNOSE LYMPHADEMA. 4344 02:41:16,874 --> 02:41:18,476 I CAN TELL YOU RIGHT NOW THAT WE 4345 02:41:18,476 --> 02:41:22,180 ARE WORKING ON UPDATES OF THAT 4346 02:41:22,180 --> 02:41:23,214 DOCUMENT BECAUSE CLINICAL 4347 02:41:23,214 --> 02:41:25,283 PRACTICE GUIDELINES ARE UPDATED 4348 02:41:25,283 --> 02:41:26,317 EVERY FIVE YEARS, BUT I CAN TELL 4349 02:41:26,317 --> 02:41:27,819 YOU IT CAN TAKE A COUPLE YEARS 4350 02:41:27,819 --> 02:41:31,155 TO JUST GET THROUGH THE EVIDENCE 4351 02:41:31,155 --> 02:41:32,423 TO WORK TOWARDS THE CLINICAL 4352 02:41:32,423 --> 02:41:37,628 PRACTICE GUIDELINE. 4353 02:41:37,628 --> 02:41:38,896 SO WE'RE UPDATING THAT RIGHT 4354 02:41:38,896 --> 02:41:39,464 NOW. 4355 02:41:39,464 --> 02:41:41,065 THE SECOND PRACTICE GUIDELINE WE 4356 02:41:41,065 --> 02:41:41,699 DEVELOPED WAS IN 2018 AND THAT 4357 02:41:41,699 --> 02:41:44,268 WAS ON INTERVENTIONS FOR BREAST 4358 02:41:44,268 --> 02:41:47,538 CANCER RELATED LYMPHADEMA. 4359 02:41:47,538 --> 02:41:52,477 SO MOST RECENTLY, I WAS INVOLVED 4360 02:41:52,477 --> 02:41:54,712 IN THE AMERICAN CA AMERICAN CANY 4361 02:41:54,712 --> 02:41:56,881 AND LANA MEETING BACK IN 4362 02:41:56,881 --> 02:41:57,582 OCTOBER, AND WE HAVE BEEN 4363 02:41:57,582 --> 02:42:00,985 WORKING ON DEVELOPING THE 4364 02:42:00,985 --> 02:42:09,060 CONSENSUS DOCUMENTS FOR CDT AND 4365 02:42:09,060 --> 02:42:10,328 MANUAL LYMPH DRAINAGE, SO THAT'S 4366 02:42:10,328 --> 02:42:11,396 THE INTERVENTION WORK I'VE BEEN 4367 02:42:11,396 --> 02:42:12,296 DOING OVER THE LAST COUPLE OF 4368 02:42:12,296 --> 02:42:15,199 YEARS. 4369 02:42:15,199 --> 02:42:18,035 BUT MY EXPERTISE HERE IS TO TRY 4370 02:42:18,035 --> 02:42:21,139 AND HELP GET SOME OF THIS 4371 02:42:21,139 --> 02:42:22,039 INFORMATION FROM OUR CLINICAL 4372 02:42:22,039 --> 02:42:25,710 PRACTICE GUIDELINES AND OTHER 4373 02:42:25,710 --> 02:42:28,312 EVIDENCE-BASED RECOMMENDATIONS 4374 02:42:28,312 --> 02:42:30,815 INTO THE CURRICULUM FOR -- AND 4375 02:42:30,815 --> 02:42:31,883 INCREASED KNOWLEDGE AND 4376 02:42:31,883 --> 02:42:33,951 AWARENESS THAT THESE DOCUMENTS 4377 02:42:33,951 --> 02:42:36,921 ARE OUT IN CIRCULATION, AS WELL 4378 02:42:36,921 --> 02:42:39,957 AS TO HELP IDENTIFY AREAS FOR 4379 02:42:39,957 --> 02:42:41,592 RESEARCH, BECAUSE IN SOME OF THE 4380 02:42:41,592 --> 02:42:43,428 AREAS WE LOOKED AT, WE ARE 4381 02:42:43,428 --> 02:42:46,063 LACKING IN SOME DEPTH OF THE 4382 02:42:46,063 --> 02:42:48,833 RESEARCH IN THERE, SO THAT'S MY 4383 02:42:48,833 --> 02:42:50,401 BACKGROUND, AND I REALLY 4384 02:42:50,401 --> 02:42:58,943 APPRECIATE THE OPPORTUNITY. 4385 02:42:58,943 --> 02:43:00,578 >> THANK YOU, DR. DAVIS. 4386 02:43:00,578 --> 02:43:01,646 WE LOOK FORWARD TO DISCUSSING 4387 02:43:01,646 --> 02:43:02,814 THAT MORE IN THE OPEN PART OF 4388 02:43:02,814 --> 02:43:04,515 THE SESSION. 4389 02:43:04,515 --> 02:43:06,651 OUR NEXT PRESENTATION WILL BE 4390 02:43:06,651 --> 02:43:08,686 FOR THE AMERICAN SOCIETY OF 4391 02:43:08,686 --> 02:43:11,456 BREAST SURGEONS AND ITS 4392 02:43:11,456 --> 02:43:12,089 FOUNDATION. 4393 02:43:12,089 --> 02:43:13,658 BETH BOYD IS NOT ABLE TO ATTEND 4394 02:43:13,658 --> 02:43:20,498 BUT DR. SARAH MCLAUGHLIN WILL 4395 02:43:20,498 --> 02:43:21,899 REPRESENT BOTH ASPECTS. 4396 02:43:21,899 --> 02:43:23,034 >> HI, EVERYONE. 4397 02:43:23,034 --> 02:43:23,901 THANKS SO MUCH FOR INCLUDING US. 4398 02:43:23,901 --> 02:43:25,736 JUST A LITTLE BIT OF BACKGROUND 4399 02:43:25,736 --> 02:43:26,337 ABOUT THE AMERICAN SOCIETY OF 4400 02:43:26,337 --> 02:43:27,472 BREAST SURGEONS. 4401 02:43:27,472 --> 02:43:30,741 WE ARE AN ORGANIZATION OF ABOUT 4402 02:43:30,741 --> 02:43:31,843 3,000 BREARS SURGEONS ACROSS THE 4403 02:43:31,843 --> 02:43:32,610 COUNTRY. 4404 02:43:32,610 --> 02:43:35,079 THE ORGANIZATION IS 25 YEARS OLD 4405 02:43:35,079 --> 02:43:36,180 JUST CELEBRATING ITS 25TH 4406 02:43:36,180 --> 02:43:36,514 ANNIVERSARY. 4407 02:43:36,514 --> 02:43:40,251 IN ADDITION TO SUPPORTING BREAST 4408 02:43:40,251 --> 02:43:41,586 SURGEONS WHICH BY THE WAY CAN 4409 02:43:41,586 --> 02:43:42,820 ACHIEVE THAT PATHWAY EITHER 4410 02:43:42,820 --> 02:43:44,655 THROUGH A DEDICATED BREAST 4411 02:43:44,655 --> 02:43:48,059 FELLOWSHIP, A COMPLEX GENERAL D. 4412 02:43:48,059 --> 02:43:50,261 OR BY BEING GENERAL SURGEONS, IN 4413 02:43:50,261 --> 02:43:51,262 FACT GENERAL SURGEONS REPRESENT 4414 02:43:51,262 --> 02:43:52,196 ALMOST ABOUT 50% OF OUR 4415 02:43:52,196 --> 02:43:52,864 ORGANIZATION. 4416 02:43:52,864 --> 02:43:54,532 SO IT IS AN IMPORTANT AUDIENCE 4417 02:43:54,532 --> 02:43:55,900 WITH RESPECT TO BREAST SURGERY 4418 02:43:55,900 --> 02:43:57,001 AND EVERYTHING THAT THAT 4419 02:43:57,001 --> 02:43:57,235 ENTAILS. 4420 02:43:57,235 --> 02:43:58,836 IN ADDITION TO THAT, WE DO HAVE 4421 02:43:58,836 --> 02:44:00,905 AN APP TRAINING ARM AS WELL SO 4422 02:44:00,905 --> 02:44:03,541 WE DO HAVE A PATHWAY FOR 4423 02:44:03,541 --> 02:44:06,077 ADVANCED PRACTICE PROVIDERS TO 4424 02:44:06,077 --> 02:44:07,879 BECOME EXPERTS IN BREAST CARE 4425 02:44:07,879 --> 02:44:09,847 AND FACILITATING THAT CARE WITH 4426 02:44:09,847 --> 02:44:12,016 THEIR SURGEON COUNTERPARTS. 4427 02:44:12,016 --> 02:44:14,385 IN ADDITION TO THAT, THE 4428 02:44:14,385 --> 02:44:14,952 AMERICAN SOCIETY OF BREAST 4429 02:44:14,952 --> 02:44:16,554 SURGEONS ALONG WITH THE SOCIETY 4430 02:44:16,554 --> 02:44:18,122 OF SURGICAL ONCOLOGY CO-SPONSORS 4431 02:44:18,122 --> 02:44:20,157 A TOTAL OF 65 BREAST SURGICAL 4432 02:44:20,157 --> 02:44:20,958 FELLOWSHIPS ACROSS THE COUNTRY 4433 02:44:20,958 --> 02:44:23,895 AND THIS IS IMPORTANT BECAUSE IT 4434 02:44:23,895 --> 02:44:25,630 ALLOWS US TO CONTRIBUTE TO 4435 02:44:25,630 --> 02:44:27,798 CURRICULUM DESIGN, CASE MINIMUMS 4436 02:44:27,798 --> 02:44:29,567 AND CERTIFICATION WHICH SPANS 4437 02:44:29,567 --> 02:44:31,435 THE LIFECYCLE OF BREAST CANCER 4438 02:44:31,435 --> 02:44:33,271 REALLY FROM PREVENTION THROUGH 4439 02:44:33,271 --> 02:44:35,239 SURVIVORSHIP, WHICH, THEREFORE, 4440 02:44:35,239 --> 02:44:35,973 OBVIOUSLY LYMPHADEMA IS 4441 02:44:35,973 --> 02:44:38,309 INCORPORATED WITHIN THAT. 4442 02:44:38,309 --> 02:44:39,477 THE ORGANIZATION IS VERY 4443 02:44:39,477 --> 02:44:40,211 HANDS-ON. 4444 02:44:40,211 --> 02:44:42,179 WE HAVE MANY HANDS-ON TRAINING 4445 02:44:42,179 --> 02:44:44,315 COURSES FOR SURGEONS, 4446 02:44:44,315 --> 02:44:46,317 SPECIFICALLY RELATED TO AXILLARY 4447 02:44:46,317 --> 02:44:47,618 DISEASE AND AXILLARY DISEASE 4448 02:44:47,618 --> 02:44:49,153 MANAGEMENT, WHICH INCLUDES THEN 4449 02:44:49,153 --> 02:44:50,454 DIFFERENT STRATEGIES FROM A 4450 02:44:50,454 --> 02:44:51,756 SURGICAL PERSPECTIVE RELATED TO 4451 02:44:51,756 --> 02:44:53,324 PREVENTION AND TREATMENT OF 4452 02:44:53,324 --> 02:44:54,058 LYMPHADEMA. 4453 02:44:54,058 --> 02:44:55,593 THAT THEN KIND OF TRANSLATES 4454 02:44:55,593 --> 02:44:58,529 INTO WEBINARS HE AS WELL AS 4455 02:44:58,529 --> 02:44:59,931 ENDURING MATERIALS AND 4456 02:44:59,931 --> 02:45:00,665 EDUCATIONAL PLATFORMS AND 4457 02:45:00,665 --> 02:45:01,566 MATERIALS THAT ARE AVAILABLE ON 4458 02:45:01,566 --> 02:45:03,034 OUR SITE FOR ALL OF OUR BREAST 4459 02:45:03,034 --> 02:45:05,836 SURGEONS TO ACCESS. 4460 02:45:05,836 --> 02:45:07,705 WE HAVE HAD A FEW EXPERT PANELS 4461 02:45:07,705 --> 02:45:10,508 AND ESTABLISHED SOME GUIDELINES 4462 02:45:10,508 --> 02:45:12,376 AND POSITION PAPERS SPECIFICALLY 4463 02:45:12,376 --> 02:45:12,944 RELATED TO LYMPHADEMA, MOST 4464 02:45:12,944 --> 02:45:13,978 RECENT VERSION OF THAT WAS 4465 02:45:13,978 --> 02:45:16,847 PUBLISHED A FEW YEARS AGO. 4466 02:45:16,847 --> 02:45:18,583 I WOULD SAY REALLY WHAT THE 4467 02:45:18,583 --> 02:45:19,450 ORGANIZATION DOES WELL IS 4468 02:45:19,450 --> 02:45:20,484 ADVOCACY FOR EDUCATION WITHIN 4469 02:45:20,484 --> 02:45:23,521 THIS SPACE, REALLY LOOKING AT 4470 02:45:23,521 --> 02:45:24,422 EMBRACING THINGS LIKE 4471 02:45:24,422 --> 02:45:25,423 PROSPECTIVE SCREENING AND 4472 02:45:25,423 --> 02:45:26,724 MONITORING FOR THESE PATIENTS 4473 02:45:26,724 --> 02:45:28,492 AND ACKNOWLEDGING THAT THAT'S A 4474 02:45:28,492 --> 02:45:32,597 CRITICAL COMPONENT TO HOW 4475 02:45:32,597 --> 02:45:34,465 DIAGNOSING AND TREATING THESE 4476 02:45:34,465 --> 02:45:35,166 PATIENTS LONG TERM. 4477 02:45:35,166 --> 02:45:37,668 ALSO THE ORGANIZATION IS VERY 4478 02:45:37,668 --> 02:45:39,070 ACTIVE IN TERMS OF CLINICAL 4479 02:45:39,070 --> 02:45:41,305 TRIAL PARTICIPATION, SO WHEN 4480 02:45:41,305 --> 02:45:42,540 THERE ARE TRIALS THAT ARE IN 4481 02:45:42,540 --> 02:45:43,741 SPACES THAT ARE IMPORTANT TO US, 4482 02:45:43,741 --> 02:45:45,042 THERE'S ACTIVE ENROLLMENT IN 4483 02:45:45,042 --> 02:45:46,711 THOSE AND SUPPORT FOR THOSE 4484 02:45:46,711 --> 02:45:47,545 TRIALS, AND WE'VE SEEN THAT WITH 4485 02:45:47,545 --> 02:45:49,547 SOME OF THE RECENT ALLIANCE 4486 02:45:49,547 --> 02:45:51,682 TRIALS RELATED TO SURGICAL 4487 02:45:51,682 --> 02:45:53,217 OUTCOMES OF AXILLARY SURGERY 4488 02:45:53,217 --> 02:45:54,685 WITH AND WITHOUT AXILLARY 4489 02:45:54,685 --> 02:46:01,258 REVERSE MAPPING AND LYMPHOVENOUS 4490 02:46:01,258 --> 02:46:01,492 BYPASS. 4491 02:46:01,492 --> 02:46:02,693 WITH THAT I WOULD SAY THE 4492 02:46:02,693 --> 02:46:03,694 ORGANIZATION VERY MUCH EMBRACES 4493 02:46:03,694 --> 02:46:04,996 TECHNOLOGY IN THIS SPACE AND IN 4494 02:46:04,996 --> 02:46:06,163 MANY SPACES AND IS LOOKING FOR 4495 02:46:06,163 --> 02:46:07,798 WAYS TO PUSH THE RESEARCH AND 4496 02:46:07,798 --> 02:46:08,366 THE SCIENCE FORWARD. 4497 02:46:08,366 --> 02:46:10,167 WE DO PARTICIPATE IN A PEER 4498 02:46:10,167 --> 02:46:12,203 REVIEWED JOURNAL ALONG WITH THE 4499 02:46:12,203 --> 02:46:12,803 SOCIETY OF SURGICAL ONCOLOGY 4500 02:46:12,803 --> 02:46:14,338 WHICH IS THE ANNALS OF SURGICAL 4501 02:46:14,338 --> 02:46:15,406 ONCOLOGY. 4502 02:46:15,406 --> 02:46:16,874 WITH THAT, I WOULD SAY SOME OF 4503 02:46:16,874 --> 02:46:18,409 THE MOST RECENT COURSES THAT WE 4504 02:46:18,409 --> 02:46:21,045 HAVE HAD HAVE BEEN AROUND, YOU 4505 02:46:21,045 --> 02:46:22,313 KNOW, THINGS LIKE AXILLARY 4506 02:46:22,313 --> 02:46:23,814 REVERSE MAPPING AND THE GOALS 4507 02:46:23,814 --> 02:46:27,218 AND VALUES OF LYMPHOVENOUS 4508 02:46:27,218 --> 02:46:28,886 BYPASS FROM A SURGICAL 4509 02:46:28,886 --> 02:46:29,186 PERSPECTIVE. 4510 02:46:29,186 --> 02:46:30,388 SO WE'RE HAPPY TO BE PART OF THE 4511 02:46:30,388 --> 02:46:31,522 PANEL, AND LOOK FORWARD TO THE 4512 02:46:31,522 --> 02:46:31,822 DISCUSSION. 4513 02:46:31,822 --> 02:46:33,691 THANK YOU. 4514 02:46:33,691 --> 02:46:35,159 >> THANK YOU, SARAH. 4515 02:46:35,159 --> 02:46:38,629 NEXT WE'RE GOING TO HEAR FROM 4516 02:46:38,629 --> 02:46:41,832 DR. CARLOS GONZALES, 4517 02:46:41,832 --> 02:46:42,466 REPRESENTING THE AMERICAN BOARD 4518 02:46:42,466 --> 02:46:42,900 OF FAMILY MEDICINE. 4519 02:46:42,900 --> 02:46:44,769 >> GOOD MORNING FROM OUT HERE IN 4520 02:46:44,769 --> 02:46:47,772 THE WEST. 4521 02:46:47,772 --> 02:46:50,207 I AM -- JUST SO YOU KNOW WHO I 4522 02:46:50,207 --> 02:46:54,812 AM, I'M A NATIVE AMERICAN, 4523 02:46:54,812 --> 02:46:56,213 PASCOYAKI AND MY MOTHER IS 4524 02:46:56,213 --> 02:46:56,447 MEXICAN. 4525 02:46:56,447 --> 02:46:59,483 I'M HERE REPRESENTING THE 4526 02:46:59,483 --> 02:47:01,385 AMERICAN BOARD OF FAMILY 4527 02:47:01,385 --> 02:47:06,957 MEDICINE AS CHAIR-ELECT. 4528 02:47:06,957 --> 02:47:09,126 THE BOARD IS REALLY 4529 02:47:09,126 --> 02:47:11,829 CERTIFICATION AND CREDENTIALING 4530 02:47:11,829 --> 02:47:12,196 ORGANIZATION. 4531 02:47:12,196 --> 02:47:14,498 WE'VE BEEN IN EXISTENCE 55 4532 02:47:14,498 --> 02:47:14,799 YEARS. 4533 02:47:14,799 --> 02:47:17,201 WE'VE BEEN IN EXISTENCE SINCE 4534 02:47:17,201 --> 02:47:20,037 1969. 4535 02:47:20,037 --> 02:47:23,474 I MYSELF AM A PRACTICING FAMILY 4536 02:47:23,474 --> 02:47:27,178 PHYSICIAN, 40 YEARS OF PRACTICE 4537 02:47:27,178 --> 02:47:28,846 IN MULTIPLE SITES, ON THE 4538 02:47:28,846 --> 02:47:31,582 RESERVATION, IN RURAL AREAS, 4539 02:47:31,582 --> 02:47:33,384 URBAN AREAS AND IN ACADEMIC 4540 02:47:33,384 --> 02:47:35,886 CENTERS. 4541 02:47:35,886 --> 02:47:37,888 I'M CURRENTLY THE ASSOCIATE DEAN 4542 02:47:37,888 --> 02:47:39,457 FOR INDIGENOUS AFFAIRS AT THE 4543 02:47:39,457 --> 02:47:41,625 COLLEGE OF HEALTH SCIENCES AT 4544 02:47:41,625 --> 02:47:43,961 THE UNIVERSITY OF ARIZONA, AND 4545 02:47:43,961 --> 02:47:45,730 I'M AN ASSOCIATE PROFESSOR OF 4546 02:47:45,730 --> 02:47:47,832 FAMILY MEDICINE AT THE 4547 02:47:47,832 --> 02:47:49,734 UNIVERSITY OF ARIZONA COLLEGE OF 4548 02:47:49,734 --> 02:47:54,672 MEDICINE, TUCSON. 4549 02:47:54,672 --> 02:47:59,910 THE EPFM HAS APPROXIMATELY 4550 02:47:59,910 --> 02:48:00,911 103,000 DIPLOMATS. 4551 02:48:00,911 --> 02:48:04,749 WE REPRESENT ABOUT 70% OF ALL 4552 02:48:04,749 --> 02:48:07,685 PRIMARY CARE PHYSICIANS IN THE 4553 02:48:07,685 --> 02:48:11,822 UNITED STATES. 4554 02:48:11,822 --> 02:48:12,923 WE'VE BEEN DOING SOME RESEARCH 4555 02:48:12,923 --> 02:48:14,291 TO TRY TO FIGURE OUT THE EXTENT 4556 02:48:14,291 --> 02:48:16,260 OF OUR KNOWLEDGE OF THIS 4557 02:48:16,260 --> 02:48:21,065 DISEASE, AND DISEASE PROCESS, 4558 02:48:21,065 --> 02:48:24,034 AND PRACTICE ANALYSIS OF 4559 02:48:24,034 --> 02:48:25,569 APPROXIMATELY 100,000 DIPLOMATS 4560 02:48:25,569 --> 02:48:27,638 WITH 50% RESPONSE RATE 4561 02:48:27,638 --> 02:48:30,875 DEMONSTRATED THAT 57% OF THE 4562 02:48:30,875 --> 02:48:34,912 SURVEY RESPONDENTS SAW THIS 4563 02:48:34,912 --> 02:48:38,749 CLINICAL ISSUE OF LYMPHADEMA 4564 02:48:38,749 --> 02:48:40,251 ABOUT ONE TIME PER MONTH, ABOUT 4565 02:48:40,251 --> 02:48:42,686 20% OF THE RESPONDENTS SAW THIS 4566 02:48:42,686 --> 02:48:48,025 CONDITION ONE TIME PER WEEK. 4567 02:48:48,025 --> 02:48:49,493 REFLECTING ON MY OWN PERSONAL 4568 02:48:49,493 --> 02:48:50,761 EXPERIENCE WHEN I WAS IN 4569 02:48:50,761 --> 02:48:53,430 ARIZONA, IT WAS A RARE CONDITION 4570 02:48:53,430 --> 02:48:54,832 I SAW MAYBE ONCE, TWICE A YEAR 4571 02:48:54,832 --> 02:48:56,000 BECAUSE THE POPULATION THERE WAS 4572 02:48:56,000 --> 02:48:58,636 STABLE AND IT WAS A SMALL 4573 02:48:58,636 --> 02:48:59,470 POPULATION, 2500, AND THE 4574 02:48:59,470 --> 02:49:02,206 SERVICE AREA IS 1600 SQUARE 4575 02:49:02,206 --> 02:49:04,742 MILES. 4576 02:49:04,742 --> 02:49:06,177 HOWEVER I TALKED TO MY DAHL TER 4577 02:49:06,177 --> 02:49:07,678 WHO'S A FAMILY PHYSICIAN IN A 4578 02:49:07,678 --> 02:49:11,315 VERY BUSY UNIVERSITY, PRIMARY 4579 02:49:11,315 --> 02:49:16,086 CARE CLINIC IN TUCSON, AND SHE 4580 02:49:16,086 --> 02:49:21,392 SAYS THAT SHE AND HER COLLEAGUES 4581 02:49:21,392 --> 02:49:24,428 SEE LYMPHADEMA ISSUES ABOUT ONCE 4582 02:49:24,428 --> 02:49:24,995 A WEEK. 4583 02:49:24,995 --> 02:49:26,697 SO IT IS A COMMON PROBLEM IN THE 4584 02:49:26,697 --> 02:49:32,203 BIGGER SETTINGS. 4585 02:49:32,203 --> 02:49:33,871 WE NEED TO MAKE SURE THAT 4586 02:49:33,871 --> 02:49:35,339 EVERYBODY UNDERSTANDS THAT WE'RE 4587 02:49:35,339 --> 02:49:38,642 PRIMARY CARE PHYSICIANS, SO FOR 4588 02:49:38,642 --> 02:49:41,545 US IT'S ABOUT THE CLINICAL 4589 02:49:41,545 --> 02:49:43,547 ASSESSMENT AND MANAGEMENT OF 4590 02:49:43,547 --> 02:49:44,515 PATIENTS AS THEY PRESENT IN THE 4591 02:49:44,515 --> 02:49:46,717 PRIMARY CARE SETTING, AND THIS 4592 02:49:46,717 --> 02:49:50,421 IS A VERY DIFFERENT AND DISTINT 4593 02:49:50,421 --> 02:49:51,288 POPULATION FROM THOSE THAT 4594 02:49:51,288 --> 02:49:54,558 ATTEND OR GO TO SPECIALTY 4595 02:49:54,558 --> 02:49:59,697 CLINICS, SO WE NEED TO BE AWARE 4596 02:49:59,697 --> 02:50:03,200 OF THE FACT OF EVEN THOUGH WE 4597 02:50:03,200 --> 02:50:04,702 SEE THESE PATIENTS LESS 4598 02:50:04,702 --> 02:50:05,803 FREQUENTLY THAN OUR COLLEAGUES, 4599 02:50:05,803 --> 02:50:10,674 IT'S STILL AN IMPORTANT ISSUE. 4600 02:50:10,674 --> 02:50:15,112 WE ARE GLAD TO PARTICIPATE AND 4601 02:50:15,112 --> 02:50:15,546 LEARN. 4602 02:50:15,546 --> 02:50:18,482 AS A FAMILY DOC, I CAN TELL YOU 4603 02:50:18,482 --> 02:50:21,652 I ALWAYS APPRECIATE LEARNING AND 4604 02:50:21,652 --> 02:50:24,588 GROWING MY EXPERTISE IN ALL 4605 02:50:24,588 --> 02:50:29,326 ISSUES AFFECTING PATIENTS, AND I 4606 02:50:29,326 --> 02:50:31,028 WILL SHARE INFORMATION FROM THIS 4607 02:50:31,028 --> 02:50:32,363 CONFERENCE WITH MY COLLEAGUES ON 4608 02:50:32,363 --> 02:50:34,765 THE BOARD, BUT WE ALSO NEED TO 4609 02:50:34,765 --> 02:50:37,835 REMEMBER THAT THE EDUCATIONAL 4610 02:50:37,835 --> 02:50:40,337 MATERIALS AND PROGRAMS AND CME 4611 02:50:40,337 --> 02:50:45,476 IS REALLY PRODUCED BY OUR SISTER 4612 02:50:45,476 --> 02:50:46,343 ORGANIZATION, THE AMERICAN 4613 02:50:46,343 --> 02:50:47,778 ACADEMY OF FAMILY PHYSICIANS, SO 4614 02:50:47,778 --> 02:50:51,916 WE NEED TO COMMUNICATE ANY 4615 02:50:51,916 --> 02:50:53,250 RECOMMENDATIONS TO THAT 4616 02:50:53,250 --> 02:50:55,653 ORGANIZATION AND I WILL BE GLAD 4617 02:50:55,653 --> 02:50:58,422 TO DO THAT AND SHARE WHATEVER I 4618 02:50:58,422 --> 02:50:59,123 CAN. 4619 02:50:59,123 --> 02:51:00,190 ONCE AGAIN, THANK YOU FOR HAVING 4620 02:51:00,190 --> 02:51:06,864 ME HERE AND I'M HERE TO LEARN. 4621 02:51:06,864 --> 02:51:09,934 THAT WWITH THAT, I'LL PASS IT OO 4622 02:51:09,934 --> 02:51:10,534 THE NEXT PERSON. 4623 02:51:10,534 --> 02:51:11,869 >> THANK YOU, CARLOS. 4624 02:51:11,869 --> 02:51:12,569 THOSE ARE GREAT COMMENTS AND WE 4625 02:51:12,569 --> 02:51:13,971 LOVE TO DOVETAIL ON THAT IN THE 4626 02:51:13,971 --> 02:51:15,306 OPEN DISCUSSION. 4627 02:51:15,306 --> 02:51:17,374 WE DID HAVE A REPRESENTATIVE 4628 02:51:17,374 --> 02:51:20,311 FROM THE SOCIETY FOR 4629 02:51:20,311 --> 02:51:21,712 INTERVENTIONAL RADIOLOGY 4630 02:51:21,712 --> 02:51:24,448 INVITED, DR. BISHAY, BUT 4631 02:51:24,448 --> 02:51:25,983 APPARENTLY UNABLE TO MAKE IT, SO 4632 02:51:25,983 --> 02:51:28,485 WE'RE GOING TO GO ON TO OUR LAST 4633 02:51:28,485 --> 02:51:29,853 TWO PANELISTS. 4634 02:51:29,853 --> 02:51:31,488 EVERYBODY WHO WAS PRESENT DURING 4635 02:51:31,488 --> 02:51:32,923 THE MORNING SESSION KNOWS THAT 4636 02:51:32,923 --> 02:51:36,126 WE INVITED THESE TWO 4637 02:51:36,126 --> 02:51:37,861 CLINICIAN-SCIENTISTS WHO HAVE 4638 02:51:37,861 --> 02:51:39,263 DEVOTED THEIR CAREERS TO 4639 02:51:39,263 --> 02:51:40,431 PROVIDING IMPORTANT ADVANCES 4640 02:51:40,431 --> 02:51:44,101 THROUGH RESEARCH IN THE FIELD OF 4641 02:51:44,101 --> 02:51:45,469 LYMPHATIC BIOLOGY AND DISEASE, 4642 02:51:45,469 --> 02:51:48,505 AND WE ARE SEEKING THEIR 4643 02:51:48,505 --> 02:51:50,274 SPECIFIC INPUT BASED ON THE DUAL 4644 02:51:50,274 --> 02:51:52,076 ROLE THAT THEY HAVE AS 4645 02:51:52,076 --> 02:51:54,144 CLINICIANS AND SCIENTISTS, SO 4646 02:51:54,144 --> 02:51:56,013 I'M GOING TO ASK YOU BOTH TO, 4647 02:51:56,013 --> 02:51:56,880 AGAIN, BRIEFLY INTRODUCE 4648 02:51:56,880 --> 02:51:58,515 YOURSELF SINCE THE PANELISTS ON 4649 02:51:58,515 --> 02:51:59,917 PANEL B HAVE NOT YET MET YOU. 4650 02:51:59,917 --> 02:52:01,919 WE'LL START WITH MIIKKA VIKKULA, 4651 02:52:01,919 --> 02:52:09,927 PLEASE. 4652 02:52:09,927 --> 02:52:10,260 >> THANK YOU. 4653 02:52:10,260 --> 02:52:11,829 THANK YOU, STAN, FOR THE 4654 02:52:11,829 --> 02:52:12,696 INVITATION, IT'S A PLEASURE TO 4655 02:52:12,696 --> 02:52:13,464 BE HERE. 4656 02:52:13,464 --> 02:52:16,700 MY NAME IS MIIKKA VIKKULA. 4657 02:52:16,700 --> 02:52:18,335 I'M THE NEW VICE PRESIDENT OF 4658 02:52:18,335 --> 02:52:20,371 THE ISSVA, WHICH IS 4659 02:52:20,371 --> 02:52:21,271 INTERNATIONAL SOCIETY FOR THE 4660 02:52:21,271 --> 02:52:23,107 STUDY OF VASCULAR ANOMALIES, 4661 02:52:23,107 --> 02:52:25,976 WHICH ACTUALLY WAS STARTED 4662 02:52:25,976 --> 02:52:28,479 AROUND 1976 AND IT WAS JUST AN 4663 02:52:28,479 --> 02:52:29,680 EVERY SECOND YEAR SMALL MEETING 4664 02:52:29,680 --> 02:52:32,649 OF PEOPLE, COLLEAGUES, 4665 02:52:32,649 --> 02:52:35,152 INTERESTED IN MANAGEMENT AND 4666 02:52:35,152 --> 02:52:36,520 DIAGNOSIS OF LYMPHATIC AND 4667 02:52:36,520 --> 02:52:37,221 VASCULAR ANOMALIES. 4668 02:52:37,221 --> 02:52:41,191 AND SINCE THEN, IT HAS GROWN 4669 02:52:41,191 --> 02:52:45,229 INTO A VERY MULTIDISCIPLINARY 4670 02:52:45,229 --> 02:52:46,764 SOCIETY. 4671 02:52:46,764 --> 02:52:48,732 IT'S MOSTLY CLINICIANS, NOT TOO 4672 02:52:48,732 --> 02:52:51,668 MANY SCIENTISTS, A LITTLE BIT OF 4673 02:52:51,668 --> 02:52:52,536 TRANSLATIONAL PEOPLE ARE 4674 02:52:52,536 --> 02:52:54,304 INVOLVED IN ISSVA. 4675 02:52:54,304 --> 02:52:57,808 I MYSELF DID MY STUDIES IN 4676 02:52:57,808 --> 02:52:59,410 HELSINKI, AND THEN I WENT TO 4677 02:52:59,410 --> 02:53:00,544 BOSTON TO HARVARD MEDICAL SCHOOL 4678 02:53:00,544 --> 02:53:03,280 AS A POSTDOC, 93-97, AND THAT IS 4679 02:53:03,280 --> 02:53:05,749 WHEN I WAS -- OR I GOT TO KNOW 4680 02:53:05,749 --> 02:53:07,951 WHAT VASCULAR ANOMALIES AND 4681 02:53:07,951 --> 02:53:10,020 LYMPHADEMA ARE ABOUT, AND SINCE 4682 02:53:10,020 --> 02:53:11,889 THEN, I'VE DONE MY WHOLE CAREER 4683 02:53:11,889 --> 02:53:14,391 IN THIS FIELD. 4684 02:53:14,391 --> 02:53:16,994 SO I'M A HUMAN AND CLINICAL 4685 02:53:16,994 --> 02:53:19,296 GENETICIST AND WORK IN VERY 4686 02:53:19,296 --> 02:53:20,597 CLOSE CONNECTION WITH THE 4687 02:53:20,597 --> 02:53:21,331 MULTIDISCIPLINARY CENTER THAT IS 4688 02:53:21,331 --> 02:53:22,666 IN OUR HOSPITAL AND IT'S 4689 02:53:22,666 --> 02:53:26,070 ACTUALLY MY WIFE WHO'S A PLASTIC 4690 02:53:26,070 --> 02:53:27,671 RECONSTRUCTIVE SURGEON WHO IS 4691 02:53:27,671 --> 02:53:28,405 RUNNING/COORDINATING THE CENTER, 4692 02:53:28,405 --> 02:53:31,575 SO WE HAVE A VERY TIGHT 4693 02:53:31,575 --> 02:53:32,376 COLLABORATION DURING THESE 30 4694 02:53:32,376 --> 02:53:34,211 YEARS, AND SHE ACTUALLY ALSO WAS 4695 02:53:34,211 --> 02:53:36,513 IN BOSTON AT THE CHILDREN'S 4696 02:53:36,513 --> 02:53:37,748 HOSPITAL. 4697 02:53:37,748 --> 02:53:40,017 AND SO I'M CURRENTLY LAB 4698 02:53:40,017 --> 02:53:42,319 DIRECTOR AT THE INSTITUTE. 4699 02:53:42,319 --> 02:53:44,288 I'M ALSO CO-DIRECTOR OF THIS 4700 02:53:44,288 --> 02:53:46,090 INSTITUTE. 4701 02:53:46,090 --> 02:53:48,625 AND NOT ONLY I'M VICE PRESIDENT 4702 02:53:48,625 --> 02:53:49,960 OF THIS BUT I'M ALSO THE CHAIR 4703 02:53:49,960 --> 02:53:52,663 OF THE EUROPEAN NETWORK THAT IS 4704 02:53:52,663 --> 02:53:55,999 CALLED VASKAR, WHICH IS ALREADY 4705 02:53:55,999 --> 02:53:57,067 DEVELOPING CERTAIN TYPES OF 4706 02:53:57,067 --> 02:53:58,135 ACTIVITIES, ALSO IN EDUCATION, 4707 02:53:58,135 --> 02:54:00,337 AND WE WOULD LIKE TO LINK THOSE 4708 02:54:00,337 --> 02:54:02,439 ACTIVITIES MORE CLOSELY ALSO 4709 02:54:02,439 --> 02:54:04,041 WITH THE ISSVA STRUCTURE, WHICH 4710 02:54:04,041 --> 02:54:07,144 IS AN INTERNATIONAL STRUCTURE, 4711 02:54:07,144 --> 02:54:10,414 WHEREAS THIS IS A EUROPEAN-WIDE 4712 02:54:10,414 --> 02:54:10,881 STRUCTURE. 4713 02:54:10,881 --> 02:54:12,349 THE ERNs, THERE ARE ACTUALLY 4714 02:54:12,349 --> 02:54:14,952 24 OF THEM, AND IT REPRESENTS 48 4715 02:54:14,952 --> 02:54:20,424 EXPERT TEAMS IN 39 DIFFERENT 4716 02:54:20,424 --> 02:54:22,426 SPECIALIZED MULTIDISCIPLINARY 4717 02:54:22,426 --> 02:54:23,994 CENTERS, SO FROM A LITTLE BIT 4718 02:54:23,994 --> 02:54:25,129 TOP-DOWN SYSTEM SAYING THAT ALL 4719 02:54:25,129 --> 02:54:27,564 RARE DISEASES MUST BE COVERED BY 4720 02:54:27,564 --> 02:54:30,167 24 NETWORKS AND OURS COVERS 4721 02:54:30,167 --> 02:54:32,069 EVERYTHING THAT IS LYMPHATIC AND 4722 02:54:32,069 --> 02:54:34,671 VASCULAR, FROM VERY SMALL 4723 02:54:34,671 --> 02:54:38,408 VESSELS TO MARFAN AND AORTA AND 4724 02:54:38,408 --> 02:54:39,710 EVERYTHING IN BETWEEN AND OF 4725 02:54:39,710 --> 02:54:41,411 COURSE THE LYMPHATIC SYSTEM. 4726 02:54:41,411 --> 02:54:42,779 AND SO WHAT WE WOULD LIKE TO SEE 4727 02:54:42,779 --> 02:54:45,449 AND WE'RE TRYING TO DO IN BOTH 4728 02:54:45,449 --> 02:54:46,717 NETWORKS IS TO HAVE EDUCATION 4729 02:54:46,717 --> 02:54:51,788 TASK FORCES, AND INVOLVEMENT OF 4730 02:54:51,788 --> 02:54:53,390 PATIENTS, ESPECIALLY IN THE ERN 4731 02:54:53,390 --> 02:54:55,659 NETWORK, WE HAVE A VERY STRONG 4732 02:54:55,659 --> 02:54:56,360 INVOLVEMENT OF PATIENTS AND 4733 02:54:56,360 --> 02:54:58,395 DURING THE MORE OR LESS FIVE, 4734 02:54:58,395 --> 02:55:00,497 SIX YEARS THAT WE HAVE HAD THIS 4735 02:55:00,497 --> 02:55:02,399 NETWORK, WE FEEL THE INPUT AND 4736 02:55:02,399 --> 02:55:04,134 THE IMPORTANCE OF THAT BECAUSE 4737 02:55:04,134 --> 02:55:06,303 IT GIVES IDEAS AND IT SHOWS 4738 02:55:06,303 --> 02:55:08,138 WHERE PATIENTS FEEL THAT THE 4739 02:55:08,138 --> 02:55:10,107 MOST CRUCIAL QUESTIONS ARE. 4740 02:55:10,107 --> 02:55:13,310 AND ALSO FOR THE DISTRIBUTION OF 4741 02:55:13,310 --> 02:55:18,282 INFORMATION, AND AS SOME PARTS 4742 02:55:18,282 --> 02:55:19,550 HAVE GONE INTO THE CLINICAL 4743 02:55:19,550 --> 02:55:23,287 TRIALS PART, THEY HAVE AN EVEN 4744 02:55:23,287 --> 02:55:24,755 MORE IMPORTANT ROLE TO EXPLAIN, 4745 02:55:24,755 --> 02:55:26,456 TO RECRUIT PEOPLE AND EXPLAIN 4746 02:55:26,456 --> 02:55:26,990 THE CONTENTS. 4747 02:55:26,990 --> 02:55:28,292 SO I'M VERY HAPPY TO BE HERE, 4748 02:55:28,292 --> 02:55:32,329 ALSO IN THIS PANEL B. 4749 02:55:32,329 --> 02:55:33,130 I THOUGHT PANEL A WAS VERY 4750 02:55:33,130 --> 02:55:35,832 INTERESTING BUT I HOPE TO HEAR 4751 02:55:35,832 --> 02:55:36,934 SOME MORE FRUITFUL DISCUSSIONS 4752 02:55:36,934 --> 02:55:37,267 HERE. 4753 02:55:37,267 --> 02:55:38,368 SO THANK YOU VERY MUCH FOR 4754 02:55:38,368 --> 02:55:39,369 HAVING ME HERE. 4755 02:55:39,369 --> 02:55:42,406 >> THANKS SO MUCH, MIIKKA. 4756 02:55:42,406 --> 02:55:47,244 AND LAST BUT CERTAINLY NOT 4757 02:55:47,244 --> 02:55:51,048 LEAST, DR. JOEL MOSS, INTRAMURAL 4758 02:55:51,048 --> 02:55:53,450 INVESTIGATOR IN THE NATIONAL 4759 02:55:53,450 --> 02:55:55,352 HEART, LUNG AND BLOOD INSTITUTE. 4760 02:55:55,352 --> 02:55:59,122 >> THANK YOU, DR. ROCKSON. 4761 02:55:59,122 --> 02:56:01,525 SO I'M HEAD OF THE DIVISION OF 4762 02:56:01,525 --> 02:56:03,627 THE LABORATORY OF TRANSLATIONAL 4763 02:56:03,627 --> 02:56:05,796 RESEARCH IN THE HEART, LUNG AND 4764 02:56:05,796 --> 02:56:07,097 BLOOD INSTITUTE, SPECIFICALLY IN 4765 02:56:07,097 --> 02:56:09,800 THE INTRAMURAL PROGRAM. 4766 02:56:09,800 --> 02:56:13,704 THE INTEREST IS IN PULMONARY 4767 02:56:13,704 --> 02:56:17,174 DISEASE IN PARTICULAR, DISEASE 4768 02:56:17,174 --> 02:56:18,909 CALLED LYMPHANGIOLEIOMYOMATOSIS 4769 02:56:18,909 --> 02:56:21,078 OR LAM WHICH IS SPORADIC OR ALSO 4770 02:56:21,078 --> 02:56:23,046 THE INHERENT FORM, WHICH IS 4771 02:56:23,046 --> 02:56:25,582 FOUND IN TUBULAR SCLEROSUS 4772 02:56:25,582 --> 02:56:28,518 COMPLEX AND THIS INCLUDES BOTH 4773 02:56:28,518 --> 02:56:33,824 PULMONARY AS WELL AS OTHER ORG 4774 02:56:33,824 --> 02:56:34,658 ORGANS. 4775 02:56:34,658 --> 02:56:37,494 OUR RESEARCH HAS GONE -- HAS 4776 02:56:37,494 --> 02:56:42,299 BEEN DEVELOPED THROUGH THE NIH, 4777 02:56:42,299 --> 02:56:44,501 NHLBI PROGRAM IN ASSOCIATION 4778 02:56:44,501 --> 02:56:49,072 WITH THE CLINICAL CENTER AT THE 4779 02:56:49,072 --> 02:56:50,574 NIH, AND THROUGH THOSE PROGRAMS, 4780 02:56:50,574 --> 02:56:51,908 WE'RE ABLE TO ADMIT PATIENTS 4781 02:56:51,908 --> 02:56:54,311 THAT COME FROM -- THROUGHOUT THE 4782 02:56:54,311 --> 02:56:58,949 UNITED STATES AND OTHER PLACES 4783 02:56:58,949 --> 02:57:01,918 WITHOUT -- IN THE GLOBAL 4784 02:57:01,918 --> 02:57:02,252 ECONOMY. 4785 02:57:02,252 --> 02:57:03,387 THE FACT THAT WE'RE ABLE TO DO 4786 02:57:03,387 --> 02:57:05,155 MUCH WITH THESE PATIENTS IS 4787 02:57:05,155 --> 02:57:07,457 DEVELOPED BECAUSE OF OUR 4788 02:57:07,457 --> 02:57:08,759 INTEREST, BECAUSE OF THE 4789 02:57:08,759 --> 02:57:10,327 ADVOCACY OF VARIOUS 4790 02:57:10,327 --> 02:57:12,896 ORGANIZATIONS, IN PARTICULAR THE 4791 02:57:12,896 --> 02:57:21,338 LAM FOUNDATION, AND THE -- IN 4792 02:57:21,338 --> 02:57:24,941 TERMS OF WHAT WE'RE DOING. 4793 02:57:24,941 --> 02:57:31,315 IN TERMS OF PATIENT EDUCATION, 4794 02:57:31,315 --> 02:57:33,216 IT'S VERY IMPORTANT TO GET THE 4795 02:57:33,216 --> 02:57:34,017 PATIENT VOICE IN TERMS OF WHAT 4796 02:57:34,017 --> 02:57:34,685 WE'RE DOING. 4797 02:57:34,685 --> 02:57:37,721 EVERY TUESDAY NIGHT FOR PATIENTS 4798 02:57:37,721 --> 02:57:38,789 THAT COME FROM THROUGHOUT THE 4799 02:57:38,789 --> 02:57:40,490 COUNTRY TO THE NIH, I HAVE A 4800 02:57:40,490 --> 02:57:44,061 MEETING WHERE PATIENTS DISCUSS 4801 02:57:44,061 --> 02:57:45,028 VARIOUS ISSUES THAT ARE 4802 02:57:45,028 --> 02:57:45,462 IMPORTANT TO THEM. 4803 02:57:45,462 --> 02:57:46,697 THIS IS ALIGNED WITH THE PROGRAM 4804 02:57:46,697 --> 02:57:53,236 THAT THE FDA HAS AS WELL WHERE 4805 02:57:53,236 --> 02:57:54,671 WE WANT TO HEAR THE PATIENT 4806 02:57:54,671 --> 02:57:56,073 VOICE IN TERMS OF WHAT IS BEING 4807 02:57:56,073 --> 02:57:56,673 DONE. 4808 02:57:56,673 --> 02:57:59,042 ALSO THE LAM FOUNDATION AS WELL 4809 02:57:59,042 --> 02:58:01,678 AS THE TOUR LAR SCLEROSIS -- 4810 02:58:01,678 --> 02:58:02,713 HAVE CLINICS THROUGHOUT THE U.S. 4811 02:58:02,713 --> 02:58:05,482 AS WELL AS THE WORLD, AND THESE 4812 02:58:05,482 --> 02:58:07,884 CLINICS ALSO PARTICIPATE IN 4813 02:58:07,884 --> 02:58:10,587 TERMS OF GIVING SPECIALIZED CARE 4814 02:58:10,587 --> 02:58:11,722 AS WELL AS AN OPPORTUNITY TO 4815 02:58:11,722 --> 02:58:12,622 UNDERSTAND BETTER WHAT PATIENT 4816 02:58:12,622 --> 02:58:17,861 ARE GOING THROUGH. 4817 02:58:17,861 --> 02:58:18,829 WITH THESE ORGANIZATIONS, IT'S 4818 02:58:18,829 --> 02:58:21,732 IMPORTANT TO BE ABLE TO ENROLL 4819 02:58:21,732 --> 02:58:25,602 PATIENTS AND SINCE IT'S A RARE 4820 02:58:25,602 --> 02:58:26,269 DISEASE, THE ORGANIZATIONS HELP 4821 02:58:26,269 --> 02:58:27,404 US IN TERMS OF RECRUITING 4822 02:58:27,404 --> 02:58:30,273 PATIENTS TO OUR STUDIES AT THE 4823 02:58:30,273 --> 02:58:31,441 NIH AND IN PARTICULAR, WE'RE 4824 02:58:31,441 --> 02:58:32,876 ABLE TO GET PEOPLE THAT ARE 4825 02:58:32,876 --> 02:58:35,078 SPECIFICALLY INTERESTED IN 4826 02:58:35,078 --> 02:58:36,780 VARIOUS DIFFERENT PHENOTYPES IN 4827 02:58:36,780 --> 02:58:39,249 THESE ORGANIZATIONS. 4828 02:58:39,249 --> 02:58:40,183 REGARDING LYMPHATICS, ABOUT 20% 4829 02:58:40,183 --> 02:58:42,419 OF THE PATIENTS THAT WE DEAL 4830 02:58:42,419 --> 02:58:46,456 WITH ARE FOCUSED ON LYMPHATIC 4831 02:58:46,456 --> 02:58:48,091 ABNORMALITIES. 4832 02:58:48,091 --> 02:58:50,961 IN PARTICULAR, WE FOUND THESE 4833 02:58:50,961 --> 02:58:53,897 PATIENTS HAVE PLEURAL EFFUSIONS, 4834 02:58:53,897 --> 02:58:57,467 ASCITES, A TUMOR-LIKE STRUCTURE 4835 02:58:57,467 --> 02:58:58,468 FOUND IN THE THORAX AS WELL AS 4836 02:58:58,468 --> 02:59:00,404 IN THE ABDOMEN, AND WHAT WE'VE 4837 02:59:00,404 --> 02:59:05,041 FOUND EARLY ON IS THAT THESE 4838 02:59:05,041 --> 02:59:07,778 PHENOMENON APPEAR TO RESPOND TO 4839 02:59:07,778 --> 02:59:18,088 TREATMENT WITH -- 4840 02:59:18,688 --> 02:59:20,657 >> LOOKS LIKE WE LOST 4841 02:59:20,657 --> 02:59:22,759 CONNECTION. 4842 02:59:22,759 --> 02:59:33,170 LET'S WAIT FOR A SECOND. 4843 02:59:40,710 --> 02:59:43,013 >> THIS IS JONATHAN WITH AV. 4844 02:59:43,013 --> 02:59:45,215 JOEL MOSS HAS LOST CONNECTION. 4845 02:59:45,215 --> 02:59:45,682 >> OKAY. 4846 02:59:45,682 --> 02:59:47,184 PERHAPS WE'LL MOVE ON AND WE CAN 4847 02:59:47,184 --> 02:59:50,454 LET HIM FINISH HIS COMMENTS WHEN 4848 02:59:50,454 --> 02:59:51,888 HE REJOINS. 4849 02:59:51,888 --> 02:59:53,457 SO THAT CONCLUDES THE 4850 02:59:53,457 --> 02:59:54,624 INTRODUCTIONS. 4851 02:59:54,624 --> 02:59:56,927 NOW IDEALLY EVERYBODY KNOWS 4852 02:59:56,927 --> 03:00:01,031 WHO'S AT THE PARTY. 4853 03:00:01,031 --> 03:00:02,098 WE'RE GOING TO HAVE AN OPEN 4854 03:00:02,098 --> 03:00:02,732 DISCUSSION BETWEEN THE 4855 03:00:02,732 --> 03:00:04,167 COMMISSION MEMBERS AND THE 4856 03:00:04,167 --> 03:00:11,842 MEMBERS OF THE PANEL BECAUSE 4857 03:00:11,842 --> 03:00:12,576 CROWD CONTROL IS A LITTLE BIT 4858 03:00:12,576 --> 03:00:13,643 DIFFICULT IN THE ZOOM, I'M GOING 4859 03:00:13,643 --> 03:00:15,545 TO TAKE THE PREROGATIVE OF 4860 03:00:15,545 --> 03:00:16,480 ASKING MAYBE A LEADING QUESTION 4861 03:00:16,480 --> 03:00:18,281 TO THE PANELISTS AS I DID IN THE 4862 03:00:18,281 --> 03:00:18,949 MORNING SESSION. 4863 03:00:18,949 --> 03:00:21,551 I THINK WE'VE IDENTIFIED MAJOR 4864 03:00:21,551 --> 03:00:26,089 THEMES IN THIS LYMPHATIC DISEASE 4865 03:00:26,089 --> 03:00:30,193 CONUNDRUM WHICH INCLUDE THE 4866 03:00:30,193 --> 03:00:31,261 ABILITY TO PROVIDE EDUCATION 4867 03:00:31,261 --> 03:00:32,596 BOTH TO HEALTHCARE PROVIDERS AND 4868 03:00:32,596 --> 03:00:34,898 TO PATIENTS, TO PROVIDE 4869 03:00:34,898 --> 03:00:38,034 RESOURCES FOR PATIENTS AND 4870 03:00:38,034 --> 03:00:40,737 ACCESS TO THOSE RESOURCES AND TO 4871 03:00:40,737 --> 03:00:41,771 SUPPORT THE INVESTIGATIVE 4872 03:00:41,771 --> 03:00:46,309 PLATFORM SO THAT WE BECOME MORE 4873 03:00:46,309 --> 03:00:46,943 KNOWLEDGEABLE OVER TIME. 4874 03:00:46,943 --> 03:00:49,246 SO I'D LIKE TO ASK THE 4875 03:00:49,246 --> 03:00:49,980 PANELISTS, PERHAPS WE CAN START 4876 03:00:49,980 --> 03:00:52,649 WITH THE PROBLEM OF EDUCATION, 4877 03:00:52,649 --> 03:00:54,651 WHICH WE DISCUSSED IN GREAT 4878 03:00:54,651 --> 03:00:55,585 DETAIL IN THE MORNING SESSION AS 4879 03:00:55,585 --> 03:00:59,756 WELL AND ASK FROM THE VANTAGE 4880 03:00:59,756 --> 03:01:00,390 POINT OF THE ORGANIZATION THAT 4881 03:01:00,390 --> 03:01:03,026 YOU REPRESENT, HOW CAN YOU 4882 03:01:03,026 --> 03:01:06,530 PARTNER WITH US AS A COMMISSION 4883 03:01:06,530 --> 03:01:08,298 TO HELP US FOSTER THE MISSION 4884 03:01:08,298 --> 03:01:10,667 THAT WE'RE TRYING TO ACCOMPLISH 4885 03:01:10,667 --> 03:01:13,870 AND GIVE US INPUT THAT WILL BE 4886 03:01:13,870 --> 03:01:15,171 MEANINGFUL TO THE ADVISORY 4887 03:01:15,171 --> 03:01:17,040 COUNCIL OF NHLBI AS WE PROVIDE 4888 03:01:17,040 --> 03:01:20,577 OUR FINAL REPORT BASED UPON THE 4889 03:01:20,577 --> 03:01:22,812 DELIBERATIONS OF THIS 4890 03:01:22,812 --> 03:01:23,280 COMMISSION. 4891 03:01:23,280 --> 03:01:24,748 SO OPEN -- I'LL OPEN THE FLOOR 4892 03:01:24,748 --> 03:01:26,449 TO ANYBODY WHO WOULD LIKE TO 4893 03:01:26,449 --> 03:01:36,893 BEGIN TO COMMENT ON THAT. 4894 03:01:39,629 --> 03:01:40,230 NO HANDS RAISED? 4895 03:01:40,230 --> 03:01:41,298 THIS IS OUR CHANCE TO HEAR FROM 4896 03:01:41,298 --> 03:01:49,039 YOU. 4897 03:01:49,039 --> 03:01:50,640 YES, DR. HOWLEY. 4898 03:01:50,640 --> 03:01:53,043 >> THANK YOU. 4899 03:01:53,043 --> 03:01:55,145 TOOK ME A MINUTE TO FIND MY 4900 03:01:55,145 --> 03:01:56,846 HAND-RAISING BUTTON. 4901 03:01:56,846 --> 03:01:59,849 I APPRECIATE THE QUESTION. 4902 03:01:59,849 --> 03:02:01,251 ONE THING, AND I BRIEFLY 4903 03:02:01,251 --> 03:02:04,321 MENTIONED THIS IN MY OPENING 4904 03:02:04,321 --> 03:02:07,390 REMARK AND NOTE ABOUT 4905 03:02:07,390 --> 03:02:08,592 METAPORTAL, ONE OF OUR TWO 4906 03:02:08,592 --> 03:02:10,093 PUBLICATIONS, WE WOULD LOVE TO 4907 03:02:10,093 --> 03:02:12,896 SEE THE NUMBER OF RESOURCES AND 4908 03:02:12,896 --> 03:02:16,366 EDUCATIONAL TOOLS GROW IN THIS 4909 03:02:16,366 --> 03:02:16,700 AREA. 4910 03:02:16,700 --> 03:02:19,035 YOU ALL ARE THE EXPERTS, THE 4911 03:02:19,035 --> 03:02:20,403 COMMUNITY THAT YOU WORK WITH ARE 4912 03:02:20,403 --> 03:02:22,872 THE EXPERTS IN THIS SPACE. 4913 03:02:22,872 --> 03:02:24,407 OUR MEDICAL EDUCATORS WHO ARE 4914 03:02:24,407 --> 03:02:29,012 LOOKING TO THE EXPERTS TO THEN 4915 03:02:29,012 --> 03:02:30,013 TRANSLATE THAT INFORMATION AND 4916 03:02:30,013 --> 03:02:31,982 THEN APPLY THAT, INTEGRATE IT 4917 03:02:31,982 --> 03:02:33,917 INTO THE PARTICULARLY EARLY 4918 03:02:33,917 --> 03:02:35,852 CURRICULUM OF THE MEDICAL SCHOOL 4919 03:02:35,852 --> 03:02:40,156 WOULD LOVE YOUR RESOURCES AND 4920 03:02:40,156 --> 03:02:41,725 METAPORTAL IS FREQUENTLY WHERE 4921 03:02:41,725 --> 03:02:42,926 THEY FIRST GO TO LOOK FOR THEM, 4922 03:02:42,926 --> 03:02:45,095 FOR WHAT'S AVAILABLE, WHAT'S 4923 03:02:45,095 --> 03:02:46,896 EVIDENCE-BASED, PEER REVIEWED, 4924 03:02:46,896 --> 03:02:49,432 FOR EXAMPLE, SO NOT ONLY AN 4925 03:02:49,432 --> 03:02:51,534 OPPORTUNITY TO INCREASE THE 4926 03:02:51,534 --> 03:02:52,669 SCHOLARSHIP AMONGST THE EXPERTS 4927 03:02:52,669 --> 03:02:55,739 IN THIS SPACE, BUT ALSO MAKE 4928 03:02:55,739 --> 03:02:58,775 THOSE RESOURCES, MODULES, 4929 03:02:58,775 --> 03:02:59,843 EDUCATIONAL TOOLS AND RESOURCES 4930 03:02:59,843 --> 03:03:02,045 MORE ACCESSIBLE TO OUR 4931 03:03:02,045 --> 03:03:03,913 COMMUNITY, WHO ARE SEEKING THEM 4932 03:03:03,913 --> 03:03:04,214 OUT. 4933 03:03:04,214 --> 03:03:06,750 AND IT'S NOT JUST EDUCATORS OF 4934 03:03:06,750 --> 03:03:08,551 PHYSICIANS, BUT WE DO HAVE OTHER 4935 03:03:08,551 --> 03:03:09,486 HEALTH PROFESSIONALS OF COURSE 4936 03:03:09,486 --> 03:03:12,188 WHO ARE ACCESSING THOSE TOOLS 4937 03:03:12,188 --> 03:03:13,757 AND RESOURCES AS WELL. 4938 03:03:13,757 --> 03:03:17,027 SO THAT IS ONE IDEA AND 4939 03:03:17,027 --> 03:03:19,896 SOMETHING WE WOULD LOVE TO SEE 4940 03:03:19,896 --> 03:03:21,564 AND HAVE WANTED TO SEE GROW FOR 4941 03:03:21,564 --> 03:03:22,499 QUITE A WHILE, SO THANK YOU. 4942 03:03:22,499 --> 03:03:25,035 >> IF I CAN ASK A SPECIFIC 4943 03:03:25,035 --> 03:03:26,436 QUESTION TO DOVETAIL ON THAT 4944 03:03:26,436 --> 03:03:28,705 BECAUSE WE ACTUALLY TOUCHED ON 4945 03:03:28,705 --> 03:03:31,608 MEDICAL CURRICULAR REFORM THIS 4946 03:03:31,608 --> 03:03:32,842 MORNING, ARE THERE AVENUES 4947 03:03:32,842 --> 03:03:35,178 WHEREBY THE AAMC CAN HELP TO 4948 03:03:35,178 --> 03:03:39,382 MORE FORMALLY INFLUENCE WHAT THE 4949 03:03:39,382 --> 03:03:43,319 VARIOUS MEDICAL COLLEGES ARE 4950 03:03:43,319 --> 03:03:46,656 EXPECTED TO TEACH OR PERHAPS 4951 03:03:46,656 --> 03:03:47,624 ENTREATED TO TEACH IF IT'S 4952 03:03:47,624 --> 03:03:50,126 NOT -- WE ALL RECOGNIZE THAT THE 4953 03:03:50,126 --> 03:03:52,128 CURRICULUM FOR FORMAL LYMPHATIC 4954 03:03:52,128 --> 03:03:54,230 EDUCATION IS RELATIVELY 4955 03:03:54,230 --> 03:03:55,699 DIMINUTIVE IN CURRENT STANDARDS, 4956 03:03:55,699 --> 03:04:00,203 AND ARE THERE AVENUES THAT ARE 4957 03:04:00,203 --> 03:04:02,338 OPEN THAT WE CAN INFLUENCE 4958 03:04:02,338 --> 03:04:05,809 THROUGH THE NIH, FOR EXAMPLE? 4959 03:04:05,809 --> 03:04:10,814 >> THANK YOU FOR THAT. 4960 03:04:10,814 --> 03:04:12,182 SO YES, I THINK THERE ARE 4961 03:04:12,182 --> 03:04:14,150 DEFINITELY AVENUES. 4962 03:04:14,150 --> 03:04:20,023 ONE OF THEM IS KIND OF FROM OUR 4963 03:04:20,023 --> 03:04:21,324 SUPPORT AND IDEAS AND 4964 03:04:21,324 --> 03:04:22,759 ENCOURAGEMENT OF INNOVATIONS IN 4965 03:04:22,759 --> 03:04:26,262 THIS SPACE, PARTICULARLY KIND OF 4966 03:04:26,262 --> 03:04:28,231 INTEGRATING ACROSS THE CONTINUUM 4967 03:04:28,231 --> 03:04:30,333 OF MEDICAL EDUCATION ACTUALLY, 4968 03:04:30,333 --> 03:04:32,435 SO SUPPORTING FACULTY 4969 03:04:32,435 --> 03:04:33,737 DEVELOPMENT AND RETRAINING AND 4970 03:04:33,737 --> 03:04:36,806 RETOOLING OUR FACULTY TO BE ABLE 4971 03:04:36,806 --> 03:04:40,977 TO EFFECTIVELY TEACH AND ADDRESS 4972 03:04:40,977 --> 03:04:42,412 THIS AMONGST A BROAD, DIVERSE 4973 03:04:42,412 --> 03:04:44,714 GROUP OF LEARNERS, BUT ALSO, YOU 4974 03:04:44,714 --> 03:04:48,318 KNOW, WE HAVE FOUND THAT GRANTS, 4975 03:04:48,318 --> 03:04:49,619 SMALL GRANTS EVEN TO SUPPORT 4976 03:04:49,619 --> 03:04:51,321 CURRICULAR DEVELOPMENT HAVE BEEN 4977 03:04:51,321 --> 03:04:54,224 EFFECTIVE IN OTHER SPACES. 4978 03:04:54,224 --> 03:04:58,561 WE'VE DONE A LOT OF WORK AROUND 4979 03:04:58,561 --> 03:04:59,829 JUST RECENTLY -- AND ACTUALLY 4980 03:04:59,829 --> 03:05:01,264 IT'S ONGOING, BUT TO IMPROVE HOW 4981 03:05:01,264 --> 03:05:03,266 WE TEACH AND LEARN ABOUT 4982 03:05:03,266 --> 03:05:05,869 ADDICTION, FOR EXAMPLE, STARTED 4983 03:05:05,869 --> 03:05:07,003 SEVERAL YEARS AGO, OF COURSE, 4984 03:05:07,003 --> 03:05:09,372 WITH THE OPIOID EPIDEMIC AND 4985 03:05:09,372 --> 03:05:10,607 CONTINUED TO SEE GREAT 4986 03:05:10,607 --> 03:05:12,442 IMPROVEMENTS IN THAT SPACE. 4987 03:05:12,442 --> 03:05:15,411 BUT IT WAS KIND OF A MULTITIERED 4988 03:05:15,411 --> 03:05:16,212 APPROACH. 4989 03:05:16,212 --> 03:05:18,715 IT WAS HOLDING UP AND 4990 03:05:18,715 --> 03:05:20,250 SPOTLIGHTING OUR PROGRAMS AND 4991 03:05:20,250 --> 03:05:22,952 CURRICULA WHERE THERE WERE 4992 03:05:22,952 --> 03:05:24,988 REALLY EXEMPLARY MODELS, SO 4993 03:05:24,988 --> 03:05:26,122 DOING KIND OF SOMETHING SIMILAR 4994 03:05:26,122 --> 03:05:27,590 IN THIS SPACE, I COULD SEE. 4995 03:05:27,590 --> 03:05:36,466 AND THEN PROVIDING SMALL FEE -- 4996 03:05:36,466 --> 03:05:37,333 INNOVATIVE GRANTS TO DEVELOP 4997 03:05:37,333 --> 03:05:39,002 MORE EFFECTIVE AND ROBUST 4998 03:05:39,002 --> 03:05:40,403 TRAINING PROGRAMS THAT IS 4999 03:05:40,403 --> 03:05:41,638 IMPORTANTLY INTEGRATED, THREADED 5000 03:05:41,638 --> 03:05:44,574 AND CONNECTED TO ORGAN SYSTEMS 5001 03:05:44,574 --> 03:05:46,409 OR DEPENDING ON HOW THE 5002 03:05:46,409 --> 03:05:48,278 CURRICULUM IS STRUCTURED, TO 5003 03:05:48,278 --> 03:05:49,379 CLINICAL APPLICATIONS. 5004 03:05:49,379 --> 03:05:51,247 SO A LOT OF -- AND WE HAVE FOUND 5005 03:05:51,247 --> 03:05:54,417 THAT KIND OF SPOTLIGHTING WHAT 5006 03:05:54,417 --> 03:05:56,286 IS THOSE PROGRAMS THAT ARE DOING 5007 03:05:56,286 --> 03:05:57,720 GREAT, GOOD WORK IN THIS SPACE 5008 03:05:57,720 --> 03:06:00,990 AND THEN SUPPORTING AND 5009 03:06:00,990 --> 03:06:02,525 PROVIDING -- SUPPORT, I SHOULD 5010 03:06:02,525 --> 03:06:03,493 SAY, FINANCIALLY EVEN SMALL 5011 03:06:03,493 --> 03:06:06,462 GRANTS CAN GO A LONG WAY IN 5012 03:06:06,462 --> 03:06:07,864 MEDICAL EDUCATION AND OTHER 5013 03:06:07,864 --> 03:06:09,399 HEALTH PROFESSIONS EDUCATION. 5014 03:06:09,399 --> 03:06:11,201 SO JUST A COUPLE EXAMPLES. 5015 03:06:11,201 --> 03:06:11,434 FOR 5016 03:06:11,434 --> 03:06:12,001 YOU. 5017 03:06:12,001 --> 03:06:16,272 >> WONDERFUL. 5018 03:06:16,272 --> 03:06:17,774 NEXT WE HAVE SARAH, YOU HAD 5019 03:06:17,774 --> 03:06:18,408 SOMETHING TO CONTRIBUTE? 5020 03:06:18,408 --> 03:06:20,243 >> YEP, I WAS JUST GOING TO SAY 5021 03:06:20,243 --> 03:06:21,845 FROM THE PERSPECTIVE OF THE 5022 03:06:21,845 --> 03:06:22,412 AMERICAN SOCIETY OF BREAST 5023 03:06:22,412 --> 03:06:23,947 SURGEONS WHERE WE REALLY SIT ON 5024 03:06:23,947 --> 03:06:27,250 THIS CONTINUUM IS THAT 5025 03:06:27,250 --> 03:06:28,251 PREVENTION PERSPECTIVE, THAT 5026 03:06:28,251 --> 03:06:29,619 WE'RE SEEING THE PATIENTS WHO 5027 03:06:29,619 --> 03:06:31,120 ARE DIAGNOSED WITH BREAST CANCER 5028 03:06:31,120 --> 03:06:32,388 BEFORE THEY'VE HAD ANY TYPE OF 5029 03:06:32,388 --> 03:06:33,690 SURGICAL TREATMENT, AND THEN 5030 03:06:33,690 --> 03:06:35,258 WE'RE SEEING THEM IN FOLLOW-UP. 5031 03:06:35,258 --> 03:06:38,127 SO WE HAVE KIND OF A WIDE 5032 03:06:38,127 --> 03:06:39,462 AUDIENCE THERE. 5033 03:06:39,462 --> 03:06:41,064 WE ALSO LIKE I SAID IN 5034 03:06:41,064 --> 03:06:42,365 CONJUNCTION WITH THE SOCIETY OF 5035 03:06:42,365 --> 03:06:45,235 SURGICAL ONCOLOGY, OVERSEE AND 5036 03:06:45,235 --> 03:06:46,569 CERTIFY ALL OF THE BREAST 5037 03:06:46,569 --> 03:06:47,971 SURGICAL FELLOWSHIPS THAT HAPPEN 5038 03:06:47,971 --> 03:06:49,405 ACROSS THE COUNTRY AND HAVE 5039 03:06:49,405 --> 03:06:50,640 INPUT INTO THE COMPLEX GENERAL 5040 03:06:50,640 --> 03:06:52,242 SURGICAL ONCOLOGY FELLOWSHIPS AS 5041 03:06:52,242 --> 03:06:54,244 WELL, AND THAT'S REALLY SPECIFIC 5042 03:06:54,244 --> 03:06:55,445 WITH RESPECT TO CURRICULUM 5043 03:06:55,445 --> 03:06:55,979 DEVELOPMENT AS WELL AS 5044 03:06:55,979 --> 03:06:56,980 DETERMINING CASE MINIMUMS AND 5045 03:06:56,980 --> 03:06:58,581 THINGS LIKE THAT, SO IF WE 5046 03:06:58,581 --> 03:07:01,417 WANTED TO SET AN ESTABLISHED 5047 03:07:01,417 --> 03:07:02,919 CURRICULUM OR CRITERIA NECESSARY 5048 03:07:02,919 --> 03:07:04,721 FOR GRADUATION, WE CERTAINLY 5049 03:07:04,721 --> 03:07:05,488 WOULD HAVE INFLUENCE IN THAT 5050 03:07:05,488 --> 03:07:07,423 SPACE. 5051 03:07:07,423 --> 03:07:09,659 AND THEN I WOULD SAY WE HAVE AN 5052 03:07:09,659 --> 03:07:10,960 ANNUAL MEETING EVERY YEAR, WE 5053 03:07:10,960 --> 03:07:12,228 HAVE HANDS-ON SESSIONS, COULD 5054 03:07:12,228 --> 03:07:15,331 ALWAYS HAVE A PRE-MEETING COURSE 5055 03:07:15,331 --> 03:07:16,399 OR SOMETHING LIKE THAT 5056 03:07:16,399 --> 03:07:16,866 SURROUNDING THIS AREA. 5057 03:07:16,866 --> 03:07:18,201 WE'VE HAD ONE IN THE LAST 5058 03:07:18,201 --> 03:07:19,535 SEVERAL YEARS RELATED TO, LIKE I 5059 03:07:19,535 --> 03:07:21,671 SAID, MANAGEMENT OF THE AXILLA, 5060 03:07:21,671 --> 03:07:23,039 AXILLARY SURGERY, EVEN WITH 5061 03:07:23,039 --> 03:07:23,873 CADAVER DISSECTIONS AND THINGS 5062 03:07:23,873 --> 03:07:25,608 LIKE THAT THAT MAY PROMOTE SOME 5063 03:07:25,608 --> 03:07:27,010 OF THESE SKILLS, BUT OUR ROLE IS 5064 03:07:27,010 --> 03:07:28,378 REALLY IN THAT PREVENTION AND 5065 03:07:28,378 --> 03:07:29,479 EDUCATION STANDPOINT, THE 5066 03:07:29,479 --> 03:07:31,347 SCIENCE IS VERY IMPORTANT, BUT 5067 03:07:31,347 --> 03:07:33,249 IT'S EDUCATING OUR MEMBERS ABOUT 5068 03:07:33,249 --> 03:07:34,784 THE IMPORTANCE AND THE VALUE OF 5069 03:07:34,784 --> 03:07:36,953 SCREENING THESE PATIENTS 5070 03:07:36,953 --> 03:07:38,154 PROSPECTIVELY AS WELL AS THEN 5071 03:07:38,154 --> 03:07:39,689 EDUCATING THE PATIENTS ABOUT 5072 03:07:39,689 --> 03:07:42,191 SIGNS AND SYMPTOMS TO LOOK FOR 5073 03:07:42,191 --> 03:07:43,559 AND DEVELOPING SCREENING 5074 03:07:43,559 --> 03:07:45,528 STRATEGIES THAT CAN THEN BE 5075 03:07:45,528 --> 03:07:46,195 IMPLEMENTED BROADLY. 5076 03:07:46,195 --> 03:07:47,163 >> THAT'S WONDERFUL. 5077 03:07:47,163 --> 03:07:48,031 THANK YOU. 5078 03:07:48,031 --> 03:07:52,835 CHRIS, I THINK YOU'RE NEXT. 5079 03:07:52,835 --> 03:07:53,670 >> THANK YOU. 5080 03:07:53,670 --> 03:07:54,570 SO I HAD A COUPLE OF THOUGHTS 5081 03:07:54,570 --> 03:07:55,872 SPEAKING FROM A PHYSICAL THERAPY 5082 03:07:55,872 --> 03:07:56,572 STANDPOINT. 5083 03:07:56,572 --> 03:07:58,207 ONE OF THE FIRST THINGS THAT 5084 03:07:58,207 --> 03:08:01,110 REALLY DRAWS MY MIND IS REALLY 5085 03:08:01,110 --> 03:08:02,779 LEANING ON ACCREDITATION 5086 03:08:02,779 --> 03:08:03,980 STANDARDS, AND I THINK YOU'D 5087 03:08:03,980 --> 03:08:05,815 SPOKE ABOUT IT, STANLEY, EARLIER 5088 03:08:05,815 --> 03:08:06,916 IN THE MORNING AS KIND OF 5089 03:08:06,916 --> 03:08:10,820 SAYING, YOU KNOW, PROGRAMS WILL 5090 03:08:10,820 --> 03:08:13,656 CHANGE THEIR CURRICULUM WHEN THE 5091 03:08:13,656 --> 03:08:14,257 LICENSURE EXAM HAS QUESTIONS 5092 03:08:14,257 --> 03:08:16,025 ABOUT A SPECIFIC TOPIC. 5093 03:08:16,025 --> 03:08:18,328 AND CERTAINLY I'VE DONE PHYSICAL 5094 03:08:18,328 --> 03:08:19,996 THERAPY EDUCATION FOR ALMOST 21 5095 03:08:19,996 --> 03:08:23,266 YEARS, AND CERTAINLY WHEN 5096 03:08:23,266 --> 03:08:25,335 EDUCATION ACCREDITATION 5097 03:08:25,335 --> 03:08:26,002 CURRICULUM SAY THIS NEEDS TO BE 5098 03:08:26,002 --> 03:08:28,471 A REQUIRED COMPONENT WITHIN 5099 03:08:28,471 --> 03:08:29,806 THE -- IN ENTRY LEVEL CURRICULUM 5100 03:08:29,806 --> 03:08:31,708 AND HERE IS THE DEPTH AND 5101 03:08:31,708 --> 03:08:34,911 BREADTH AND EXTENT, I THINK 5102 03:08:34,911 --> 03:08:36,779 THAT'S WHERE THE EDUCATORS LEND 5103 03:08:36,779 --> 03:08:37,981 A LOT OF WEIGHT TO THAT AS WELL. 5104 03:08:37,981 --> 03:08:39,615 SO I THINK THAT'S WHERE 5105 03:08:39,615 --> 03:08:41,351 CERTAINLY WITHIN THE AMERICAN 5106 03:08:41,351 --> 03:08:42,986 PHYSICAL THERAPY ASSOCIATION, 5107 03:08:42,986 --> 03:08:44,287 ACCREDITING BODIES, WE CERTAINLY 5108 03:08:44,287 --> 03:08:45,688 HAVE A VOICE WITH OURS, AND I 5109 03:08:45,688 --> 03:08:46,823 THINK THAT COULD BE SOMETHING 5110 03:08:46,823 --> 03:08:51,527 THAT ALL OF THE ORGANIZATIONS, 5111 03:08:51,527 --> 03:08:52,929 MAYBE EERCH FACILITATING A PANEL 5112 03:08:52,929 --> 03:08:54,664 LIKE THIS WITH SOME OF THE 5113 03:08:54,664 --> 03:08:55,331 ASSOCIATION ACCREDITING AGENCIES 5114 03:08:55,331 --> 03:08:57,166 TO REALLY KIND OF SAY HERE'S OUR 5115 03:08:57,166 --> 03:08:58,901 VOICE, HERE'S OUR PROBLEMS, THIS 5116 03:08:58,901 --> 03:09:01,371 IS A SOCIETAL PROBLEM, THIS IS 5117 03:09:01,371 --> 03:09:02,872 HOW MUCH MONEY IT'S COSTING. 5118 03:09:02,872 --> 03:09:04,207 I ALSO SERVE ON THE COMMISSION 5119 03:09:04,207 --> 03:09:05,975 ON CANCER FOR THE AMERICAN 5120 03:09:05,975 --> 03:09:07,677 COLLEGE OF SURGEONS, AND WE WERE 5121 03:09:07,677 --> 03:09:09,178 TALKING A LITTLE BIT ABOUT 5122 03:09:09,178 --> 03:09:12,081 ACCREDITATION OF HEALTHCARE 5123 03:09:12,081 --> 03:09:13,216 PROGRAMS, AND THERE'S A NEW 5124 03:09:13,216 --> 03:09:15,284 STANDARD, RELATIVELY NEW 5125 03:09:15,284 --> 03:09:16,386 STANDARD 4.6 FOR CANCER 5126 03:09:16,386 --> 03:09:18,287 REHABILITATION, BUT THERE HAS TO 5127 03:09:18,287 --> 03:09:19,622 BE SOME LEVEL OF CANCER 5128 03:09:19,622 --> 03:09:22,892 REHABILITATION, AND SOME OF THE 5129 03:09:22,892 --> 03:09:24,093 FRUSTRATIONS FROM THE SITE 5130 03:09:24,093 --> 03:09:25,561 VISITORS WAS THEY WOULD SAY, 5131 03:09:25,561 --> 03:09:27,330 WHICH WAS NOT WRONG BUT IS A 5132 03:09:27,330 --> 03:09:28,631 GOOD PLACE TO START IS, DO YOU 5133 03:09:28,631 --> 03:09:31,367 HAVE A CANCER -- PROGRAM AND 5134 03:09:31,367 --> 03:09:32,902 THEY WOULD SAY, YES, WE HAVE A 5135 03:09:32,902 --> 03:09:33,770 LYMPHADEMA THERAPIST. 5136 03:09:33,770 --> 03:09:35,004 THAT'S GREAT, THAT IS A 5137 03:09:35,004 --> 03:09:36,239 WONDERFUL PLACE TO START, BUT 5138 03:09:36,239 --> 03:09:38,641 THAT SEEMS TO BE KIND OF THE 5139 03:09:38,641 --> 03:09:40,476 DEFAULT THAT SOME PROGRAMS THINK 5140 03:09:40,476 --> 03:09:41,911 I'VE GOT ONE LYMPHADEMA 5141 03:09:41,911 --> 03:09:43,613 THERAPIST, THAT'S MY WHOLE 5142 03:09:43,613 --> 03:09:46,649 CANCER REHAB PROGRAM, SO MAYBE 5143 03:09:46,649 --> 03:09:48,184 JUST KIND OF PUTTING THAT OUT 5144 03:09:48,184 --> 03:09:50,586 THERE AS KIND OF A WAY FOR US TO 5145 03:09:50,586 --> 03:09:51,821 CONSIDER LEVERAGING SOME OF THAT 5146 03:09:51,821 --> 03:09:54,891 DEFAULT KNOWLEDGE TO SAY, HEY, 5147 03:09:54,891 --> 03:09:57,527 THEY HAVE THE STANDARD 4.6, YES, 5148 03:09:57,527 --> 03:09:58,194 LYMPHADEMA IS A HUGE IMPORTANT 5149 03:09:58,194 --> 03:10:00,329 PART OF THAT, HOW DO WE CHANGE 5150 03:10:00,329 --> 03:10:01,798 PRACTICE AND AGAIN HOW DO WE 5151 03:10:01,798 --> 03:10:04,567 DRIVE MORE CLINICIANS TO WANT TO 5152 03:10:04,567 --> 03:10:06,869 PURSUE THE KNOWLEDGE AND 5153 03:10:06,869 --> 03:10:07,637 EDUCATION. 5154 03:10:07,637 --> 03:10:10,039 I THINK THAT'S THE OTHER BIG 5155 03:10:10,039 --> 03:10:11,407 PART OF IT, GETTING FOLKS TO 5156 03:10:11,407 --> 03:10:13,042 SAY, YES, THIS IS REALLY, REALLY 5157 03:10:13,042 --> 03:10:14,644 IMPORTANT, AND THEN ALL THESE 5158 03:10:14,644 --> 03:10:17,847 GREAT SPOTS FOR EDUCATION WILL 5159 03:10:17,847 --> 03:10:18,881 BE PLACES THAT THEY CAN GET THAT 5160 03:10:18,881 --> 03:10:21,617 INFORMATION FROM. 5161 03:10:21,617 --> 03:10:24,587 >> THANK YOU, THOSE ARE GREAT 5162 03:10:24,587 --> 03:10:26,856 POINTS. 5163 03:10:26,856 --> 03:10:28,191 THERE'S BETSY, I THINK YOU'RE UP 5164 03:10:28,191 --> 03:10:28,391 NEXT. 5165 03:10:28,391 --> 03:10:31,494 >> THANK YOU. 5166 03:10:31,494 --> 03:10:32,161 CHRIS, THANKS FOR THAT. 5167 03:10:32,161 --> 03:10:33,796 BECAUSE I THINK ACCREDITING 5168 03:10:33,796 --> 03:10:34,897 BODIES ARE VALUABLE, AND WHEN I 5169 03:10:34,897 --> 03:10:37,233 THINK SORT OF ENTRY LEVEL 5170 03:10:37,233 --> 03:10:38,835 EDUCATION, THAT'S A REALLY 5171 03:10:38,835 --> 03:10:39,435 OBVIOUS PLACE TO START BECAUSE 5172 03:10:39,435 --> 03:10:42,071 IN ORDER TO MAINTAIN OUR 5173 03:10:42,071 --> 03:10:43,806 ACCREDITATION AND PT EDUCATION, 5174 03:10:43,806 --> 03:10:45,708 OUR STUDENTS ARE TESTED ON THE 5175 03:10:45,708 --> 03:10:48,544 LYMPHATICS AS PART OF LICENSURE, 5176 03:10:48,544 --> 03:10:49,178 HOWEVER, LYMPHADEMA MANAGEMENT 5177 03:10:49,178 --> 03:10:51,080 IS NOT CONSIDERED AN ENTRY LEVEL 5178 03:10:51,080 --> 03:10:52,915 SKILL PER SE. 5179 03:10:52,915 --> 03:10:54,317 SO THEY'RE AWARE POTENTIALLY 5180 03:10:54,317 --> 03:10:56,352 ABLE TO REFER, SO THAT I THINK 5181 03:10:56,352 --> 03:10:58,354 IS ONE BARRIER AT LEAST ON THE 5182 03:10:58,354 --> 03:10:58,788 REHAB SIDE. 5183 03:10:58,788 --> 03:11:01,190 IF I PUT MY LANA HAT BACK ON, 5184 03:11:01,190 --> 03:11:04,694 SOME OF THE CHALLENGES THAT WE 5185 03:11:04,694 --> 03:11:07,029 FACE ARE, OUR CERTIFICATION EXAM 5186 03:11:07,029 --> 03:11:11,434 IS AN ACCREDITED EXARM AND WE EE 5187 03:11:11,434 --> 03:11:12,301 HAVE ELIGIBILITY REQUIREMENTS 5188 03:11:12,301 --> 03:11:14,203 THAT OUR CANDIDATES MUCH MEES SO 5189 03:11:14,203 --> 03:11:18,374 THAT REQUIRES THEM TO TA TAKE 5190 03:11:18,374 --> 03:11:21,110 ADDITIONAL CONTINUING EDUCATION 5191 03:11:21,110 --> 03:11:22,278 CREDITS FROM OUTSIDE SOURCES. 5192 03:11:22,278 --> 03:11:23,513 THERE ARE SORT OF MINIMUM 5193 03:11:23,513 --> 03:11:24,680 STANDARDS THAT THEY HAVE TO 5194 03:11:24,680 --> 03:11:25,815 MEET, BUT WE'RE NOT IN A 5195 03:11:25,815 --> 03:11:28,017 POSITION WHERE WE'RE ACCREDITING 5196 03:11:28,017 --> 03:11:29,552 THOSE DIFFERENT BODY, AND I 5197 03:11:29,552 --> 03:11:32,421 THINK THE CHALLENGES WE FACE ARE 5198 03:11:32,421 --> 03:11:34,624 LACK OF STANDARDIZATION OF HOW 5199 03:11:34,624 --> 03:11:35,825 THAT'S BEING TAUGHT, LACK OF 5200 03:11:35,825 --> 03:11:42,165 STAND DAITION OF HOW WE'RE 5201 03:11:42,165 --> 03:11:44,267 STANDARDIZATION IN HOW WE'RE 5202 03:11:44,267 --> 03:11:46,435 ACTUALLY DECIDING WHO OR WHO 5203 03:11:46,435 --> 03:11:47,904 DOES NOT HAVE LYMPHADEMA AND HOW 5204 03:11:47,904 --> 03:11:48,671 WE'RE GOING TO TREAT THAT. 5205 03:11:48,671 --> 03:11:50,573 SO I THINK IT GOES BEYOND THE 5206 03:11:50,573 --> 03:11:51,574 EDUCATION PIECE BECAUSE WE CAN 5207 03:11:51,574 --> 03:11:56,612 CONTINUE TO EDUCATE BUT WE 5208 03:11:56,612 --> 03:11:58,581 CONTINUE TO HAVE ALL THESE OTHER 5209 03:11:58,581 --> 03:11:59,849 ISSUES WITHIN THE REALM OF 5210 03:11:59,849 --> 03:12:00,583 LYMPHADEMA MANAGEMENT TO 5211 03:12:00,583 --> 03:12:01,350 ACTUALLY SPEAK THE SAME 5212 03:12:01,350 --> 03:12:01,617 LANGUAGE. 5213 03:12:01,617 --> 03:12:05,621 SO WE HAVE CHALLENGES BOTH BEE 5214 03:12:05,621 --> 03:12:07,590 BETWEEN AND AMONG THE GROUPS. 5215 03:12:07,590 --> 03:12:08,658 SO THERE IS THE CHALLENGE FROM 5216 03:12:08,658 --> 03:12:09,892 AN INTERDISCIPLINARY PERSPECTIVE 5217 03:12:09,892 --> 03:12:10,993 BUT WE ALSO HAVE THE CHALLENGES 5218 03:12:10,993 --> 03:12:12,662 OF MAYBE I'M USING BIOIMPEDANCE 5219 03:12:12,662 --> 03:12:14,163 IN MY CLINICAL ENVIRONMENT BUT I 5220 03:12:14,163 --> 03:12:16,032 CAN'T SPEAK TO DR. DAVIES IN HER 5221 03:12:16,032 --> 03:12:17,066 ENVIRONMENT BECAUSE THEY'RE 5222 03:12:17,066 --> 03:12:18,067 USING SOMETHING ELSE. 5223 03:12:18,067 --> 03:12:20,002 SO I THINK FROM A BASELINE 5224 03:12:20,002 --> 03:12:21,904 STANDPOINT, WE'VE NOT MADE 5225 03:12:21,904 --> 03:12:23,339 STRONG DECISIONS ABOUT HOW TO 5226 03:12:23,339 --> 03:12:25,608 BEST ASSESS, DIAGNOSE AND MANAGE 5227 03:12:25,608 --> 03:12:27,710 THIS PATIENT POPULATION TO THEN 5228 03:12:27,710 --> 03:12:30,546 LET THAT REACH OUT INTO THE 5229 03:12:30,546 --> 03:12:31,647 OTHER HEALTHCARE PROVIDERS SO 5230 03:12:31,647 --> 03:12:33,182 THAT WE CAN PROVIDE A REALLY 5231 03:12:33,182 --> 03:12:41,224 SEAMLESS CONTINUUM OF CARE. 5232 03:12:41,224 --> 03:12:42,024 >> LENT POINTS. 5233 03:12:42,024 --> 03:12:45,261 >> EXCELLENT POINTS. 5234 03:12:45,261 --> 03:12:48,331 DO YOU HAVE SPECIFIC QUESTIONS 5235 03:12:48,331 --> 03:12:49,498 FOR THIS GROUP OR PERHAPS 5236 03:12:49,498 --> 03:12:50,833 INDIVIDUALS YOU'VE HEARD SPEAK 5237 03:12:50,833 --> 03:12:52,368 ALREADY? 5238 03:12:52,368 --> 03:12:56,239 MAX, PLEASE. 5239 03:12:56,239 --> 03:12:59,809 >> I'M PART OF THE COMMISSION 5240 03:12:59,809 --> 03:13:05,014 BUT ALSO INTERNATIONAL -- INTERL 5241 03:13:05,014 --> 03:13:05,314 RADIOLOGIST. 5242 03:13:05,314 --> 03:13:06,515 I HAVE A QUESTION TO LISA 5243 03:13:06,515 --> 03:13:07,083 HOWLEY. 5244 03:13:07,083 --> 03:13:09,485 SO OUR GOAL, AND WE TALKED ABOUT 5245 03:13:09,485 --> 03:13:14,023 THIS THIS MORNING, TO INTRODUCE 5246 03:13:14,023 --> 03:13:16,559 THE -- AT THE STUDENT LEVEL. 5247 03:13:16,559 --> 03:13:20,563 AND IT'S VERY DIFFERENT IN 5248 03:13:20,563 --> 03:13:21,864 DIFFERENT INSTITUTIONS, OF 5249 03:13:21,864 --> 03:13:23,232 COURSE. 5250 03:13:23,232 --> 03:13:26,969 AND ONE OF THE -- SAID ONE OF 5251 03:13:26,969 --> 03:13:32,642 THE MOST -- THE STRONGEST DRIVER 5252 03:13:32,642 --> 03:13:37,280 FOR AN INSTITUTION IS TO 5253 03:13:37,280 --> 03:13:40,116 INTRODUCE THE QUESTION OR 5254 03:13:40,116 --> 03:13:47,657 TESTINGS OF THE EXAMS SUCH AS -- 5255 03:13:47,657 --> 03:13:49,091 AND THE MORE THE INSTITUTIONS 5256 03:13:49,091 --> 03:13:50,793 SEE THERE IS A QUESTION, 5257 03:13:50,793 --> 03:13:52,261 SPECIFIC QUESTION ABOUT CERTAIN 5258 03:13:52,261 --> 03:13:54,997 DISEASE, THEY WILL TRY TO 5259 03:13:54,997 --> 03:13:59,302 COMPENSATE FOR THAT OR -- WITH 5260 03:13:59,302 --> 03:14:00,303 EDUCATION. 5261 03:14:00,303 --> 03:14:00,970 SO WHAT ARE YOUR THOUGHTS ABOUT 5262 03:14:00,970 --> 03:14:01,203 THAT? 5263 03:14:01,203 --> 03:14:05,975 HOW CAN WE GET INTO -- CAN WE 5264 03:14:05,975 --> 03:14:07,209 HAVE A MEETING WITH THEM, 5265 03:14:07,209 --> 03:14:08,577 DISCUSS WITH THEM, AND WHAT IS 5266 03:14:08,577 --> 03:14:12,048 EVEN THE PROCESS FOR THE 5267 03:14:12,048 --> 03:14:16,018 CREATING OF -- OR USE OF 5268 03:14:16,018 --> 03:14:19,021 QUESTIONNAIRES? 5269 03:14:19,021 --> 03:14:24,994 >> LISA, IF YOU CAN ANSWER? 5270 03:14:24,994 --> 03:14:26,762 >> YES, YES, THANK YOU. 5271 03:14:26,762 --> 03:14:27,997 I ASSUME YOU'RE REFERRING TO 5272 03:14:27,997 --> 03:14:30,866 THIS LISA, RIGHT? 5273 03:14:30,866 --> 03:14:31,534 >> LISA HOWLEY. 5274 03:14:31,534 --> 03:14:34,503 >> I WANTED TO MAKE SURE, I 5275 03:14:34,503 --> 03:14:36,639 HEARD SOMEBODY ELSE SPEAK UP. 5276 03:14:36,639 --> 03:14:39,208 NO, THAT'S A GREAT QUESTION. 5277 03:14:39,208 --> 03:14:43,145 AND WE KNOW -- AS MUCH AS WE 5278 03:14:43,145 --> 03:14:44,246 WOULD LIKE TO SAY THAT TESTING 5279 03:14:44,246 --> 03:14:45,948 DOES NOT DRIVE LEARNING, TESTING 5280 03:14:45,948 --> 03:14:49,185 DRIVES LEARNING, WE KNOW THAT. 5281 03:14:49,185 --> 03:14:51,620 IT'S -- IT SHOULDN'T BE THE ONLY 5282 03:14:51,620 --> 03:14:54,390 DRIVER, OUR OWN FACTOR, AND IT'S 5283 03:14:54,390 --> 03:14:56,692 NOT, OF COURSE, BUT IT IS ONE 5284 03:14:56,692 --> 03:15:02,898 AND IT'S A PRETTY STRONG ONE. 5285 03:15:02,898 --> 03:15:05,601 THE AAMC IS NOT RESPONSIBLE, WE 5286 03:15:05,601 --> 03:15:09,805 HAVE NO RELATIONSHIP WITH THE 5287 03:15:09,805 --> 03:15:11,474 U.S. MLE. 5288 03:15:11,474 --> 03:15:12,375 I'M GOING TO PUT A LINK IN THE 5289 03:15:12,375 --> 03:15:13,876 CHAT THAT WILL TAKE TO YOU THE 5290 03:15:13,876 --> 03:15:16,912 CONTENT OUTLINE OF THE U.S. MLE, 5291 03:15:16,912 --> 03:15:17,747 ALL OF THE THREE STEPS. 5292 03:15:17,747 --> 03:15:19,482 EACH STEP HAS A MORE SPECIFIC 5293 03:15:19,482 --> 03:15:21,250 DETAILED BLUEPRINT OR OUTLINE AS 5294 03:15:21,250 --> 03:15:24,487 WELL, SO YOU CAN SEE WHERE THIS 5295 03:15:24,487 --> 03:15:27,990 CONTENT IS COMING UP, AND YOU 5296 03:15:27,990 --> 03:15:30,292 WILL SEE IT ACTUALLY IN THIS 5297 03:15:30,292 --> 03:15:31,527 OUTLINE THAT I JUST SHARED WITH 5298 03:15:31,527 --> 03:15:33,763 YOU IN A NUMBER OF PLACES 5299 03:15:33,763 --> 03:15:34,964 ACTUALLY. 5300 03:15:34,964 --> 03:15:37,266 AND AS YOU WOULD -- WELL, I HOPE 5301 03:15:37,266 --> 03:15:41,537 YOU WOULD EXPECT BECAUSE IT IS 5302 03:15:41,537 --> 03:15:45,040 INTEGRATED THROUGHOUT THOSE 5303 03:15:45,040 --> 03:15:47,143 EXAMS. 5304 03:15:47,143 --> 03:15:49,345 AS FAR AS REACHING OUT, 5305 03:15:49,345 --> 03:15:51,781 CONNECTING AND COMMUNICATING 5306 03:15:51,781 --> 03:15:53,949 WITH THE U.S. MLE, THEY'RE 5307 03:15:53,949 --> 03:15:54,950 ACTUALLY A PARTNER ORGANIZATION 5308 03:15:54,950 --> 03:16:02,291 OF THE MVME AND THE FSMV, SO I 5309 03:16:02,291 --> 03:16:04,427 WOULD, AND MANY DO AND HAVE, 5310 03:16:04,427 --> 03:16:06,262 CONNECT, REACH OUT TO THE U.S. 5311 03:16:06,262 --> 03:16:08,531 MLE ABOUT TEST IM CONTENT AND 5312 03:16:08,531 --> 03:16:11,367 MANY OF YOU MAY BE ITEM WRITERS 5313 03:16:11,367 --> 03:16:13,302 ACTUALLY FOR THE DIFFERENT 5314 03:16:13,302 --> 03:16:13,803 EXAMS. 5315 03:16:13,803 --> 03:16:18,574 THEY ALSO HAVE, OF COURSE, NOT 5316 03:16:18,574 --> 03:16:20,910 JUST THE STEPP EXAMS, THEY ALSO 5317 03:16:20,910 --> 03:16:23,446 HAVE IN-TRAINING EXAMS AS WELL, 5318 03:16:23,446 --> 03:16:24,647 SO THERE'S ANOTHER OPPORTUNITY 5319 03:16:24,647 --> 03:16:28,751 TO REVIEW CONTENT AND THEN ALSO 5320 03:16:28,751 --> 03:16:30,085 IDENTIFY IF THERE ARE ANY GAPS. 5321 03:16:30,085 --> 03:16:34,557 SO A NUMBER OF ORGANIZATIONS OR 5322 03:16:34,557 --> 03:16:37,960 JUST INTERESTED EDUCATORS HAVE 5323 03:16:37,960 --> 03:16:40,996 DONE JUST THAT, AND SO I WOULD 5324 03:16:40,996 --> 03:16:43,532 ENCOURAGE YOU TO CONNECT 5325 03:16:43,532 --> 03:16:49,238 DIRECTLY WITH THE U.S. MLE AND I 5326 03:16:49,238 --> 03:16:50,606 CAN SHARE WITH YOU OFFLINE IF 5327 03:16:50,606 --> 03:16:51,740 YOU DON'T KNOW HOW TO DO THAT, 5328 03:16:51,740 --> 03:16:52,741 I'M HAPPY TO TALK TO YOU ABOUT 5329 03:16:52,741 --> 03:16:55,211 THAT, BUT AGAIN, THEY ARE NOT 5330 03:16:55,211 --> 03:16:57,179 US, THEY ARE SIBLING 5331 03:16:57,179 --> 03:16:58,080 ORGANIZATIONS, WE DO WORK WITH 5332 03:16:58,080 --> 03:16:59,915 THEM FROM TIME TO TIME ON 5333 03:16:59,915 --> 03:17:01,917 DIFFERENT THINGS AND DIFFERENT 5334 03:17:01,917 --> 03:17:03,285 PROJECTS. 5335 03:17:03,285 --> 03:17:04,887 >> I WAS GOING TO SAY, ON BEHALF 5336 03:17:04,887 --> 03:17:06,856 OF THE COMMISSION, I WILL 5337 03:17:06,856 --> 03:17:09,391 ENTHUSIASTICALLY ACCEPT THAT 5338 03:17:09,391 --> 03:17:12,828 OFFER OFFLINE TO HELP GUIDE US 5339 03:17:12,828 --> 03:17:13,829 BECAUSE WE ARE VERY INTERESTED 5340 03:17:13,829 --> 03:17:15,931 IN THIS PATH, AS MAX IS 5341 03:17:15,931 --> 03:17:16,232 INDICATING. 5342 03:17:16,232 --> 03:17:18,000 >> AND I JUST ACTUALLY DID A 5343 03:17:18,000 --> 03:17:21,136 DOCUMENT SEARCH ON LYMPH, AND 5344 03:17:21,136 --> 03:17:23,272 THERE'S ONLY ONE LYMPHATIC 5345 03:17:23,272 --> 03:17:25,441 DISORDER, IN THE SECTION OF 5346 03:17:25,441 --> 03:17:30,012 POORLY DEFINED DISEASES, IS 5347 03:17:30,012 --> 03:17:30,579 LYMPHADEMA. 5348 03:17:30,579 --> 03:17:35,551 THAT'S IT. 5349 03:17:35,551 --> 03:17:41,023 THERE WAS -- THERE'S ONLY ONE, 5350 03:17:41,023 --> 03:17:43,259 POORLY DEFINED DISORDERS. 5351 03:17:43,259 --> 03:17:45,294 >> I CAN ATTEST TO THE FACT THAT 5352 03:17:45,294 --> 03:17:47,563 AS A BOARD CERTIFIED 5353 03:17:47,563 --> 03:17:48,864 CARDIOLOGIST, YEARS AGO, ONE OF 5354 03:17:48,864 --> 03:17:52,768 OUR CLINICAL TRAINEES VERY 5355 03:17:52,768 --> 03:17:54,470 EXCITEDLY TOLD ME THERE WAS A 5356 03:17:54,470 --> 03:17:57,673 QUESTION ON LYMPHADEMA ON THE 5357 03:17:57,673 --> 03:17:58,407 CARDIOVASCULAR CERTIFYING EXAM. 5358 03:17:58,407 --> 03:17:59,975 THIS IS AFTER TEACHING IT FOR 5359 03:17:59,975 --> 03:18:01,977 TWO DECADES. 5360 03:18:01,977 --> 03:18:05,114 SO WE HAVE AN UPHILL BATTLE TO 5361 03:18:05,114 --> 03:18:07,082 MAKE SURE THAT THE CONTENT IS 5362 03:18:07,082 --> 03:18:11,754 CONS CONSONANT WITH THE DEPTH OE 5363 03:18:11,754 --> 03:18:13,122 PEERL WE ALL APPRECIATE 5364 03:18:13,122 --> 03:18:14,223 POTENTIALLY IS THERE. 5365 03:18:14,223 --> 03:18:21,530 NEXT I HAVE CARLOS, PLEASE. 5366 03:18:21,530 --> 03:18:26,969 >> YES, I WANTED TO JUST POINT 5367 03:18:26,969 --> 03:18:28,270 OUT THE FACT THAT AS A 5368 03:18:28,270 --> 03:18:33,108 PRACTICING FAMILY PHYSICIAN, ANY 5369 03:18:33,108 --> 03:18:35,444 EDUCATIONAL MATERIALS THAT ARE 5370 03:18:35,444 --> 03:18:37,780 DEVELOPED NEED TO REALLY HELP US 5371 03:18:37,780 --> 03:18:41,817 AS PRIMARY CARE DOCS WHO SEE 5372 03:18:41,817 --> 03:18:44,887 THESE PATIENTS ON A FIRST-TERM 5373 03:18:44,887 --> 03:18:46,088 BASIS AND THEN DO THE REFERRAL 5374 03:18:46,088 --> 03:18:48,157 TO THE APPROPRIATE SPECIALIST 5375 03:18:48,157 --> 03:18:51,060 AND ENTITIES. 5376 03:18:51,060 --> 03:18:53,195 GIVE US SOME PRACTICAL 5377 03:18:53,195 --> 03:18:54,597 INFORMATION OF WHAT WE CAN DO IN 5378 03:18:54,597 --> 03:18:55,698 THE PRIMARY CARE OFFICE. 5379 03:18:55,698 --> 03:18:57,866 WHEN WE SEE THE PATIENT. 5380 03:18:57,866 --> 03:18:58,567 GIVE US SOME PRACTICAL 5381 03:18:58,567 --> 03:19:00,736 INFORMATION ON HOW TO MANAGE IT. 5382 03:19:00,736 --> 03:19:04,173 UNTIL THE PATIENT CAN BE SEEN BY 5383 03:19:04,173 --> 03:19:07,009 THE SPECIALIST. 5384 03:19:07,009 --> 03:19:08,877 AND THAT WILL IMPROVE THE CARE 5385 03:19:08,877 --> 03:19:13,882 AND MANAGEMENT FOR OUR PATIENTS, 5386 03:19:13,882 --> 03:19:15,451 FROM THE ASPECT OF THE PRIMARY 5387 03:19:15,451 --> 03:19:18,887 CARE DOC. 5388 03:19:18,887 --> 03:19:21,557 AND WE REALLY NEED PRACTICAL 5389 03:19:21,557 --> 03:19:22,558 INFORMATION. 5390 03:19:22,558 --> 03:19:23,892 WE NEED INFORMATION THAT WILL 5391 03:19:23,892 --> 03:19:26,128 HELP US TO IMPROVE CARE. 5392 03:19:26,128 --> 03:19:26,829 THANK YOU. 5393 03:19:26,829 --> 03:19:27,463 >> THANK YOU. 5394 03:19:27,463 --> 03:19:28,864 THANK YOU, CARLOS. 5395 03:19:28,864 --> 03:19:31,000 CHRIS, I THINK YOU'RE NEXT. 5396 03:19:31,000 --> 03:19:33,402 >> THANK YOU. 5397 03:19:33,402 --> 03:19:34,103 GOOD POINT SO FAR. 5398 03:19:34,103 --> 03:19:36,238 SO THE ONE THING I WAS BRINGING 5399 03:19:36,238 --> 03:19:37,506 BACK TO ENTRY LEVEL EDUCATION 5400 03:19:37,506 --> 03:19:42,878 AND KIND OF HOW TO INFLUENCE 5401 03:19:42,878 --> 03:19:47,549 THOSE ACCREDITORS AND THOSE WHO 5402 03:19:47,549 --> 03:19:49,318 WROTE THE -- I'VE ACTUALLY WRIT 5403 03:19:49,318 --> 03:19:51,320 EP FOR OUR BOARD CERTIFICATION 5404 03:19:51,320 --> 03:19:52,354 SPECIALTY AND WE REALLY ARE HELD 5405 03:19:52,354 --> 03:19:53,889 VERY, VERY TIGHTLY TO THOSE 5406 03:19:53,889 --> 03:19:54,757 CONTENT OUTLINES. 5407 03:19:54,757 --> 03:19:56,558 SO I'M GLAD WE'RE KIND OF 5408 03:19:56,558 --> 03:19:57,626 TALKING ABOUT THE CONTENT 5409 03:19:57,626 --> 03:19:59,561 OUTLINE BECAUSE EVEN IF I WANTED 5410 03:19:59,561 --> 03:20:01,397 TO SNEAK A LYMPHADEMA QUESTION 5411 03:20:01,397 --> 03:20:02,598 ON THERE IF IT'S NOT ON THE 5412 03:20:02,598 --> 03:20:04,333 CONTENT OUTLINE, IT'S GOING TO 5413 03:20:04,333 --> 03:20:05,901 BE THROWN OUT UNFORTUNATELY. 5414 03:20:05,901 --> 03:20:07,670 SO ONE OF THE THINGS THAT OUR 5415 03:20:07,670 --> 03:20:09,672 ACADEMY HAS DONE, AND I THINK I 5416 03:20:09,672 --> 03:20:11,073 ALLUDED TO IN OUR INTRODUCTION, 5417 03:20:11,073 --> 03:20:13,475 WAS KIND OF REALLY -- WE DID A 5418 03:20:13,475 --> 03:20:16,378 DELPHI STUDY TO REALLY TRY AND 5419 03:20:16,378 --> 03:20:18,914 ESTABLISH WHAT REALLY IS ENTRY 5420 03:20:18,914 --> 03:20:20,482 LEVEL FOR PHYSICAL THERAPISTS, 5421 03:20:20,482 --> 03:20:22,551 AND IT REALLY ENDS UP BEING WHAT 5422 03:20:22,551 --> 03:20:25,087 SHOULD THEY BE KNOWING BY THE 5423 03:20:25,087 --> 03:20:27,322 TIME THEY GRADUATE FROM PHYSICAL 5424 03:20:27,322 --> 03:20:29,491 THERAPY SCHOOL AS A GENERALIST? 5425 03:20:29,491 --> 03:20:31,026 NOT NECESSARILY A SPECIALIST. 5426 03:20:31,026 --> 03:20:33,328 I'LL PUT IT IN THE CHAT HERE FOR 5427 03:20:33,328 --> 03:20:34,830 YOU GUYS TO TAKE A LOOK AT IT, 5428 03:20:34,830 --> 03:20:35,798 BUT AGAIN, THAT'S ONE OF THE 5429 03:20:35,798 --> 03:20:38,067 WAYS THAT REALLY OUR NEXT 5430 03:20:38,067 --> 03:20:39,468 INTENTION IS TO REALLY TAKE THAT 5431 03:20:39,468 --> 03:20:41,537 TO OUR ACCREDITING AGENCIES. 5432 03:20:41,537 --> 03:20:44,073 SO THE ONES THAT ARE ACCREDITED 5433 03:20:44,073 --> 03:20:44,873 PHYSICAL THERAPY ENTRY LEVEL 5434 03:20:44,873 --> 03:20:46,208 PROGRAMS, THOSE WHO ARE WRITING 5435 03:20:46,208 --> 03:20:48,310 THE CONTENT OUTLINE FOR THE 5436 03:20:48,310 --> 03:20:48,744 LICENSURE EXAM. 5437 03:20:48,744 --> 03:20:52,247 AND EVEN FOR THE SPECIALTY 5438 03:20:52,247 --> 03:20:54,516 EXAMINATION CONTENT DEVELOPERS, 5439 03:20:54,516 --> 03:20:57,286 SO THEY KNOW IDEALLY WHAT 5440 03:20:57,286 --> 03:20:59,288 STUDENTS SHOULD BE COMING OUT 5441 03:20:59,288 --> 03:21:00,956 WITH WHEN THEY GRADUATE FROM A 5442 03:21:00,956 --> 03:21:02,458 DOCTOR OF PHYSICAL THERAPY 5443 03:21:02,458 --> 03:21:03,759 PROGRAM, AND THEN THEY CAN KIND 5444 03:21:03,759 --> 03:21:04,693 OF BUILD ON IT FROM THERE. 5445 03:21:04,693 --> 03:21:06,228 I THINK THE CHALLENGE IS THAT, 5446 03:21:06,228 --> 03:21:07,463 OF COURSE, EVERY MEDICAL SCHOOL 5447 03:21:07,463 --> 03:21:09,031 AND PHYSICAL THERAPY SCHOOL AND 5448 03:21:09,031 --> 03:21:11,633 ENTRY LEVEL EDUCATION PROGRAM 5449 03:21:11,633 --> 03:21:12,968 SAYS, MY CONTENT IS SO FULL, HOW 5450 03:21:12,968 --> 03:21:14,503 CAN I CRAM SOMETHING ELSE IN, 5451 03:21:14,503 --> 03:21:15,871 AND CERTAINLY WE'RE EVEN DEALING 5452 03:21:15,871 --> 03:21:17,973 WITH THAT IN OUR INSTITUTION, 5453 03:21:17,973 --> 03:21:19,775 AND OUR GOAL IS TO KIND OF 5454 03:21:19,775 --> 03:21:23,679 REALLY CUT DOWN ON ENTRY LEVEL 5455 03:21:23,679 --> 03:21:26,181 CREDIT HOURS OR CUT DOWN ON 5456 03:21:26,181 --> 03:21:27,483 CONTENT BECAUSE THE STUDENT LOAN 5457 03:21:27,483 --> 03:21:30,185 DEBT FOR HEALTHCARE PROFESSIONS, 5458 03:21:30,185 --> 03:21:32,054 ESPECIALLY PHYSICAL THERAPISTS, 5459 03:21:32,054 --> 03:21:32,988 IS UNSUSTAINABLE RIGHT NOW. 5460 03:21:32,988 --> 03:21:35,424 SO WE'RE ASKING FOR MORE, BUT 5461 03:21:35,424 --> 03:21:37,793 WE'RE KIND OF FIGHTING AN UPHILL 5462 03:21:37,793 --> 03:21:40,329 BATTLE, SO WE'RE KIND OF 5463 03:21:40,329 --> 03:21:42,631 SWIMMING UPSTREAM JUST A LITTLE 5464 03:21:42,631 --> 03:21:42,798 BIT. 5465 03:21:42,798 --> 03:21:43,031 THANKS. 5466 03:21:43,031 --> 03:21:43,565 >> THANK YOU. 5467 03:21:43,565 --> 03:21:46,869 HILLARY, PLEASE. 5468 03:21:46,869 --> 03:21:53,308 >> I TOTALLY AGREE THAT IN ORDER 5469 03:21:53,308 --> 03:21:57,379 FOR TO BE COVERED OR EMPHASIZED 5470 03:21:57,379 --> 03:21:58,847 HAVING IN THE CONTENT SPECS AND 5471 03:21:58,847 --> 03:22:01,250 REQUIREMENTS IS CRITICAL. 5472 03:22:01,250 --> 03:22:06,421 MY CONCERN IS THE STEP BEFORE 5473 03:22:06,421 --> 03:22:08,457 THAT, AND THAT IS IDENTIFYING 5474 03:22:08,457 --> 03:22:11,894 THE GAP, RIGHT? 5475 03:22:11,894 --> 03:22:14,830 SO WE GET INTO PART OF THE 5476 03:22:14,830 --> 03:22:16,198 PROBLEM, PARTICULARLY IN 5477 03:22:16,198 --> 03:22:17,566 PEDIATRICS WHERE THIS IS LOW 5478 03:22:17,566 --> 03:22:21,804 VOLUME, I MEAN, YOU'VE GOT YOUR 5479 03:22:21,804 --> 03:22:24,573 CONGENITAL LYMPHATIC PROBLEMS, 5480 03:22:24,573 --> 03:22:25,340 POST SURGICAL, THOSE THINGS 5481 03:22:25,340 --> 03:22:27,543 OCCUR BUT THE FREQUENCY OF A 5482 03:22:27,543 --> 03:22:29,178 PRACTITIONER SEEING THOSE OR 5483 03:22:29,178 --> 03:22:31,880 EVEN A TRAINEE SEEING THOSE IS 5484 03:22:31,880 --> 03:22:32,481 FAIRLY LOW. 5485 03:22:32,481 --> 03:22:33,615 SO PART OF THE PROBLEM IS THEY 5486 03:22:33,615 --> 03:22:35,050 DON'T KNOW WHAT THEY DON'T KNOW, 5487 03:22:35,050 --> 03:22:36,451 RIGHT? 5488 03:22:36,451 --> 03:22:40,989 AND SO WE CANNOT ADVOCATE FOR IT 5489 03:22:40,989 --> 03:22:44,026 BEING INCLUDED IN THE CONTENT 5490 03:22:44,026 --> 03:22:45,260 SPECS UNTIL WE HAVE THE 5491 03:22:45,260 --> 03:22:46,328 PRACTITIONERS ACTUALLY REALIZE 5492 03:22:46,328 --> 03:22:47,496 THAT THEY HAVE A KNOWLEDGE GAP. 5493 03:22:47,496 --> 03:22:50,999 SO I THINK THAT PART OF THIS IS 5494 03:22:50,999 --> 03:22:53,902 GOING TO BE EDUCATION, 5495 03:22:53,902 --> 03:22:58,440 DISSEMINATION, ADVOCACY TOWARDS 5496 03:22:58,440 --> 03:22:59,408 PEOPLE UNDERSTANDING THE 5497 03:22:59,408 --> 03:23:01,810 PREVALENCE AND IMPORTANCE OF 5498 03:23:01,810 --> 03:23:02,077 THESE. 5499 03:23:02,077 --> 03:23:03,545 I KNOW THIS IS WHAT YOU'RE ALL 5500 03:23:03,545 --> 03:23:08,283 ABOUT, RIGHT, BUT I CAN'T REDUCE 5501 03:23:08,283 --> 03:23:10,552 THE EMPHASIS THAT THE STANDARD 5502 03:23:10,552 --> 03:23:14,022 PRACTITIONER OUT THERE MAY NOT 5503 03:23:14,022 --> 03:23:15,757 SEE A HIGH VOLUME, NEEDS TO HAVE 5504 03:23:15,757 --> 03:23:17,960 A BETTER UNDERSTANDING OF WHY 5505 03:23:17,960 --> 03:23:19,795 THIS IS CRITICAL FOR THEIR 5506 03:23:19,795 --> 03:23:20,295 KNOWLEDGE AND FOR THEIR 5507 03:23:20,295 --> 03:23:20,696 PRACTICE. 5508 03:23:20,696 --> 03:23:25,267 >> CAN I ASK TO CLARIFY, ARE YOU 5509 03:23:25,267 --> 03:23:29,705 ARE YOU SAYING THAT WE NEED 5510 03:23:29,705 --> 03:23:30,806 BETTER EPIDEMIOLOGY TO BE ABLE 5511 03:23:30,806 --> 03:23:33,942 TO COME UP WITH THAT FACTUAL 5512 03:23:33,942 --> 03:23:35,477 INFORMATION TO THEN INVEST THE 5513 03:23:35,477 --> 03:23:36,979 PROCESS DOWNSTREAM FROM THAT? 5514 03:23:36,979 --> 03:23:39,281 >> I DEFINITELY THINK THAT WOULD 5515 03:23:39,281 --> 03:23:39,815 HELP. 5516 03:23:39,815 --> 03:23:42,251 DATA, PEOPLE THAT ARE 5517 03:23:42,251 --> 03:23:43,385 DATA-DRIVEN, PEOPLE ARE GOING TO 5518 03:23:43,385 --> 03:23:46,321 SPEND A LOT MORE TIME ON 5519 03:23:46,321 --> 03:23:47,522 HYPERTENSION GUIDELINES THAN 5520 03:23:47,522 --> 03:23:48,824 THEY NECESSARILY WILL ON 5521 03:23:48,824 --> 03:23:50,559 SOMETHING THAT'S LESS FREQUENT, 5522 03:23:50,559 --> 03:23:52,661 UNLESS THEY UNDERSTAND THAT THIS 5523 03:23:52,661 --> 03:23:54,062 IS SOMETHING THAT'S GOING TO 5524 03:23:54,062 --> 03:23:56,265 COME UP IN THEIR PRACTICE. 5525 03:23:56,265 --> 03:23:57,799 AND WHY IT IS IMPORTANT. 5526 03:23:57,799 --> 03:24:00,235 >> CAN I ASK A SUBSIDIARY 5527 03:24:00,235 --> 03:24:00,802 QUESTION? 5528 03:24:00,802 --> 03:24:02,437 BECAUSE I THINK THIS PROBABLY 5529 03:24:02,437 --> 03:24:04,873 DOES COME UP A LOT MORE IN MANY 5530 03:24:04,873 --> 03:24:07,042 WAYS IN PEDIATRICS THAN IN ADULT 5531 03:24:07,042 --> 03:24:09,111 MEDICINE IS, WITHOUT REGARD TO 5532 03:24:09,111 --> 03:24:12,681 WHAT THE DISEASE ENTITY IS, IS 5533 03:24:12,681 --> 03:24:15,651 THERE A KIND OF A CURRICULAR 5534 03:24:15,651 --> 03:24:18,587 APPROACH FOR THE GENERALLY 5535 03:24:18,587 --> 03:24:19,855 PRACTICING PEDIATRICIAN TO KNOW 5536 03:24:19,855 --> 03:24:22,858 WHAT TO DO WITH RARE DISORDERS 5537 03:24:22,858 --> 03:24:26,128 AND HOW TO TRIAGE THEM INTO THE 5538 03:24:26,128 --> 03:24:27,663 SPECIALTY PRACTICE WITHIN 5539 03:24:27,663 --> 03:24:29,831 PEDIATRICS BECAUSE I THINK 5540 03:24:29,831 --> 03:24:31,433 THAT'S THE MORE GENERAL PATTERN 5541 03:24:31,433 --> 03:24:32,301 THAT WE'RE TALKING ABOUT THAT 5542 03:24:32,301 --> 03:24:34,670 WOULD APPLY TO LYMPHATIC 5543 03:24:34,670 --> 03:24:35,270 PROBLEMS. 5544 03:24:35,270 --> 03:24:43,779 >> THERE IS NOT FOR SPECIFIC 5545 03:24:43,779 --> 03:24:44,846 DISEASE BUT THERE IS A GENERAL 5546 03:24:44,846 --> 03:24:45,414 APPROACH. 5547 03:24:45,414 --> 03:24:46,782 THAT PARTICULARLY IS VERY 5548 03:24:46,782 --> 03:24:48,317 PREVALENT WHEN IT COMES UP FOR 5549 03:24:48,317 --> 03:24:50,686 THE METABOLIC OR GENETIC 5550 03:24:50,686 --> 03:24:51,987 DISEASES THAT -- THERE ARE SO 5551 03:24:51,987 --> 03:24:53,655 MANY DIFFERENT ONES BUT YOU 5552 03:24:53,655 --> 03:24:54,823 NEED -- YOU FIRST NEED TO 5553 03:24:54,823 --> 03:24:56,191 IDENTIFY THAT THERE IS A PROBLEM 5554 03:24:56,191 --> 03:24:56,792 OR THERE IS NOT. 5555 03:24:56,792 --> 03:25:04,333 >> RIGHT. 5556 03:25:04,333 --> 03:25:04,466 I 5557 03:25:04,466 --> 03:25:07,569 >> I THINK THERE'S A RELATIVELY 5558 03:25:07,569 --> 03:25:08,537 STANDARD APPROACH WE TRY TO 5559 03:25:08,537 --> 03:25:09,504 TEACH IN CLINICAL REASONING, BUT 5560 03:25:09,504 --> 03:25:12,040 AS YOU GET FARTHER AND FARTHER 5561 03:25:12,040 --> 03:25:16,411 AWAY FROM YOUR TRAINING AND YOU 5562 03:25:16,411 --> 03:25:17,679 MAY NOT BE AS WELL ACQUAINTED 5563 03:25:17,679 --> 03:25:22,250 WITH SOME OF THESE MORE COMPLEX 5564 03:25:22,250 --> 03:25:25,354 BUT LESS COMMON DISORDERS, THAT 5565 03:25:25,354 --> 03:25:28,924 APPROACH MAY NOT HOLD, SO I 5566 03:25:28,924 --> 03:25:31,860 THINK IT'S SOMETHING THAT BEARS 5567 03:25:31,860 --> 03:25:33,428 EMPHASIZING, AND ON A REGULAR 5568 03:25:33,428 --> 03:25:33,929 BASIS. 5569 03:25:33,929 --> 03:25:37,632 I THINK OUR MAINTENANCE OF 5570 03:25:37,632 --> 03:25:38,633 CERTIFICATION PROCESS TRIES 5571 03:25:38,633 --> 03:25:40,335 REALLY HARD TO DO THAT. 5572 03:25:40,335 --> 03:25:43,138 IT'S VERY CLINICALLY FOCUSED, 5573 03:25:43,138 --> 03:25:44,473 PARTICULARLY IN GENERAL 5574 03:25:44,473 --> 03:25:46,541 PEDIATRICS. 5575 03:25:46,541 --> 03:25:48,410 HAVING -- DOING MAINTENANCE AND 5576 03:25:48,410 --> 03:25:50,445 CERTIFICATION FOR BOTH 5577 03:25:50,445 --> 03:25:51,446 RHEUMATOLOGY AND GENERAL 5578 03:25:51,446 --> 03:25:56,018 PEDIATRICS, I CAN TELL YOU THAT 5579 03:25:56,018 --> 03:25:57,019 WHILE CLINICAL, THEY TEND TO 5580 03:25:57,019 --> 03:25:58,653 HAVE MUCH MORE SCIENCE IN THEM 5581 03:25:58,653 --> 03:25:59,921 THAN THE GENERAL PEDIATRICS 5582 03:25:59,921 --> 03:26:00,255 DOES. 5583 03:26:00,255 --> 03:26:01,523 THEY'RE MUCH MORE CLINICALLY 5584 03:26:01,523 --> 03:26:02,391 FOCUSED. 5585 03:26:02,391 --> 03:26:04,893 BUT THAT'S WHAT YOU NEED. 5586 03:26:04,893 --> 03:26:10,532 SO I THINK INCORPORATION OF SOME 5587 03:26:10,532 --> 03:26:13,268 OF THIS INTO THE MAINTENANCE OF 5588 03:26:13,268 --> 03:26:14,636 CERTIFICATION PROCESS, WHEN OURS 5589 03:26:14,636 --> 03:26:17,005 IS LONGITUDAL AS OPPOSED TO A 5590 03:26:17,005 --> 03:26:22,878 HIGH STAKES EXAM AFTER PRIMARY 5591 03:26:22,878 --> 03:26:24,413 CERTIFICATION WOULD BE A PLACE 5592 03:26:24,413 --> 03:26:27,549 THAT COULD BE -- EITHER IT LIKE 5593 03:26:27,549 --> 03:26:29,851 THESE OTHER ACCREDITING BOARDS 5594 03:26:29,851 --> 03:26:32,254 WOULD BE IMPORTANT. 5595 03:26:32,254 --> 03:26:33,021 >> THANK YOU. 5596 03:26:33,021 --> 03:26:33,622 THAT'S GREAT. 5597 03:26:33,622 --> 03:26:36,058 I'M GOING TO INTERRUPT THE 5598 03:26:36,058 --> 03:26:36,625 QUESTIONS FOR JUST A MOMENT 5599 03:26:36,625 --> 03:26:37,793 BECAUSE WE HAVE JOEL MOSS BACK. 5600 03:26:37,793 --> 03:26:39,327 I WANT TO GIVE JOEL AN 5601 03:26:39,327 --> 03:26:41,329 OPPORTUNITY TO CONCLUDE WHAT HE 5602 03:26:41,329 --> 03:26:42,364 WAS SAYING AND THEN WE'LL GO ON 5603 03:26:42,364 --> 03:26:43,331 WITH THE DISCUSSION. 5604 03:26:43,331 --> 03:26:46,935 SO JOEL, DO YOU WANT TO FINISH 5605 03:26:46,935 --> 03:26:55,677 UP FROM WHERE WE LOST YOU? 5606 03:26:55,677 --> 03:26:57,179 >> I'M JOINING THIS CONVERSATION 5607 03:26:57,179 --> 03:26:57,846 MUCH MORE NOW. 5608 03:26:57,846 --> 03:26:59,481 SO I THINK I'VE GIVEN MOST OF 5609 03:26:59,481 --> 03:27:01,950 WHAT I INTENDED TO SAY, SO JUST 5610 03:27:01,950 --> 03:27:02,551 CONTINUE, PLEASE. 5611 03:27:02,551 --> 03:27:02,851 THANK YOU. 5612 03:27:02,851 --> 03:27:03,251 >> GREAT. 5613 03:27:03,251 --> 03:27:03,685 THANKS. 5614 03:27:03,685 --> 03:27:07,255 SO JEFF, YOU'RE UP NEXT. 5615 03:27:07,255 --> 03:27:08,890 >> ACTUALLY, DR. HAFTEL, I THINK 5616 03:27:08,890 --> 03:27:10,659 YOU GOT HALFWAY THROUGH MY 5617 03:27:10,659 --> 03:27:14,262 QUESTION WITHOUT ME ASKING IT. 5618 03:27:14,262 --> 03:27:17,299 SO THINKING ABOUT NOT NEW 5619 03:27:17,299 --> 03:27:19,134 LEARNERS BUT PRACTICING 5620 03:27:19,134 --> 03:27:22,370 GENERALISTS IN PARTICULAR, AND 5621 03:27:22,370 --> 03:27:23,738 MAYBE DR. GONZALES COULD SPEAK 5622 03:27:23,738 --> 03:27:24,639 TO THIS ALSO. 5623 03:27:24,639 --> 03:27:26,208 SO OUTSIDE OF NOT KNOWING WHAT 5624 03:27:26,208 --> 03:27:29,511 THEY DON'T KNOW, AND OUTSIDE OF 5625 03:27:29,511 --> 03:27:31,680 THIS ONGOING CREDENTIALING 5626 03:27:31,680 --> 03:27:33,315 PROCESS, ARE THERE SPECIFIC 5627 03:27:33,315 --> 03:27:35,083 STRUCTURAL BARRIERS OR SOLUTIONS 5628 03:27:35,083 --> 03:27:38,854 THAT YOU SEE FOR GENERALISTS WHO 5629 03:27:38,854 --> 03:27:39,988 ARE OUT IN PRACTICE, THEY MIGHT 5630 03:27:39,988 --> 03:27:42,557 BE 10, 15, 20 OR EVEN 30 YEARS 5631 03:27:42,557 --> 03:27:48,530 POST TRAINING FOR GAINING 5632 03:27:48,530 --> 03:27:49,731 EXPERTISE, OR NOT EVEN 5633 03:27:49,731 --> 03:27:52,601 EXPERTISE, EVEN JUST PASSING 5634 03:27:52,601 --> 03:27:54,002 FAMILIARITY WITH LYMPHATIC 5635 03:27:54,002 --> 03:27:55,070 DISEASES, WHERE DO YOU SEE THE 5636 03:27:55,070 --> 03:27:56,271 STRUCTURAL BARRIERS FOR THAT 5637 03:27:56,271 --> 03:27:58,974 POPULATION IN PARTICULAR? 5638 03:27:58,974 --> 03:28:00,976 >> FROM MY PERSPECTIVE, I THINK 5639 03:28:00,976 --> 03:28:03,445 TIME IS THE BIGGEST BARRIER. 5640 03:28:03,445 --> 03:28:07,082 FOR EDUCATION IN GENERAL, BUT ON 5641 03:28:07,082 --> 03:28:08,683 THESE LESS COMMON ONES IN 5642 03:28:08,683 --> 03:28:10,385 PARTICULAR, I THINK THE FIRST 5643 03:28:10,385 --> 03:28:13,688 STEP IS FOR THEM TO IDENTIFY THE 5644 03:28:13,688 --> 03:28:15,223 NEED TO BE EDUCATED IN THIS 5645 03:28:15,223 --> 03:28:18,160 AREA. 5646 03:28:18,160 --> 03:28:22,931 AND SO NE THAT'S WHERE THE 5647 03:28:22,931 --> 03:28:24,699 EPIDEMIOLOGY DATA, CASE 5648 03:28:24,699 --> 03:28:25,667 PRESENTATIONS, ANYTHING THAT 5649 03:28:25,667 --> 03:28:27,235 WOULD -- THEY'RE ALL ADULT 5650 03:28:27,235 --> 03:28:29,337 LEARNERS, SO THEY NEED TO THINK 5651 03:28:29,337 --> 03:28:30,572 IT'S RELEVANCE, AND THEY NEED TO 5652 03:28:30,572 --> 03:28:32,440 THINK IT WILL BE APPLYING TO 5653 03:28:32,440 --> 03:28:34,142 THEIR PRACTICE, AND SO THAT'S 5654 03:28:34,142 --> 03:28:38,880 THE FIRST STEP. 5655 03:28:38,880 --> 03:28:40,682 AFTER THAT, YOU HAVE TO 5656 03:28:40,682 --> 03:28:42,884 CONSTRUCT EDUCATIONAL PROGRAMS 5657 03:28:42,884 --> 03:28:49,057 THAT WILL BE ABLE TO BE ALIGNED 5658 03:28:49,057 --> 03:28:51,660 WITH SOMEBODY IN A BUSY 5659 03:28:51,660 --> 03:28:53,028 PRACTICE, THINGS THAT ARE 5660 03:28:53,028 --> 03:28:55,564 RELATIVELY SHORT, MAY BE 5661 03:28:55,564 --> 03:28:56,731 ASYNCHRONOUS, SO AS OPPOSED -- 5662 03:28:56,731 --> 03:29:02,904 YOU KNOW, NO ONE IS GOING TO GO 5663 03:29:02,904 --> 03:29:07,943 TO AN IN-PERSON FIVE-DAY 5664 03:29:07,943 --> 03:29:09,177 CONFERENCE ON A RARE DISEASE, 5665 03:29:09,177 --> 03:29:10,145 THEY JUST DON'T HAVE THE 5666 03:29:10,145 --> 03:29:11,313 BANDWIDTH. 5667 03:29:11,313 --> 03:29:11,880 PARTICULARLY WHEN YOU'RE OUT 5668 03:29:11,880 --> 03:29:12,781 THERE IN PRIVATE PRACTICE, YOU 5669 03:29:12,781 --> 03:29:14,816 DON'T MAKE ANY MONEY WHEN YOU DO 5670 03:29:14,816 --> 03:29:16,184 CME BECAUSE YOU'RE NOT SEEING 5671 03:29:16,184 --> 03:29:16,451 PATIENTS. 5672 03:29:16,451 --> 03:29:19,120 SO IT HAS TO BE ABLE TO FIT IN 5673 03:29:19,120 --> 03:29:21,823 TO THEIR -- SORT OF THEIR -- THE 5674 03:29:21,823 --> 03:29:28,997 LIFE OF THEIR WORK. 5675 03:29:28,997 --> 03:29:30,865 BUT THE FIRST STEP IS FOR THEM 5676 03:29:30,865 --> 03:29:32,300 TO RECOGNIZE THE IMPORTANCE OF 5677 03:29:32,300 --> 03:29:33,735 GAINING THE KNOWLEDGE IN THE 5678 03:29:33,735 --> 03:29:34,903 FIRST PLACE. 5679 03:29:34,903 --> 03:29:38,139 >> I WOULD AGREE WITH DR. HAFTEL 5680 03:29:38,139 --> 03:29:39,674 IN THAT, YOU KNOW, IT NEEDS TO 5681 03:29:39,674 --> 03:29:40,475 BE RELEVANT. 5682 03:29:40,475 --> 03:29:48,083 FOR EXAMPLE, MY DAUGHTER SEES 5683 03:29:48,083 --> 03:29:49,384 LYMPHADEMA RATHER FREQUENTLY AND 5684 03:29:49,384 --> 03:29:50,151 AS A RESULT, SHE'S KEEPING UP 5685 03:29:50,151 --> 03:29:51,753 WITH THE LITERATURE AND SHE'S 5686 03:29:51,753 --> 03:29:56,558 KEEPING UP WITH THE MANAGEMENT 5687 03:29:56,558 --> 03:29:57,459 OF LYMPHADEMA. 5688 03:29:57,459 --> 03:29:59,427 MYSELF, I SEE IT RARELY, AND 5689 03:29:59,427 --> 03:30:02,931 THERE'S SO MANY OTHER DISEASES I 5690 03:30:02,931 --> 03:30:05,166 HAVE TO KEEP ON TOP OF IN MY 5691 03:30:05,166 --> 03:30:06,935 PARTICULAR PATIENT POPULATION, 5692 03:30:06,935 --> 03:30:09,437 DIABETES, HYPERTENSION, 5693 03:30:09,437 --> 03:30:11,439 CARDIOVASCULAR DISEASE IS AT THE 5694 03:30:11,439 --> 03:30:12,907 TOP OF MY LIST OF WHAT I NEED TO 5695 03:30:12,907 --> 03:30:13,675 WORRY ABOUT. 5696 03:30:13,675 --> 03:30:15,944 BECAUSE I WORK WITH THE NATIVE 5697 03:30:15,944 --> 03:30:25,587 AMERICAN POPULATION. 5698 03:30:25,587 --> 03:30:26,888 IT NEEDS TO BE COST-EFFECTIVE 5699 03:30:26,888 --> 03:30:28,056 AND IT ALSO NEEDS TO BE 5700 03:30:28,056 --> 03:30:31,559 SOMETHING THAT HAS VALUE. 5701 03:30:31,559 --> 03:30:42,070 ON THE OTHER HAND, INFORMATION 5702 03:30:44,506 --> 03:30:45,974 FROM THIS SESSION WITH THE 5703 03:30:45,974 --> 03:30:47,142 CERTIFICATION COMMITTEE OF THE 5704 03:30:47,142 --> 03:30:48,176 AMERICAN BOARD OF FAMILY 5705 03:30:48,176 --> 03:30:50,045 MEDICINE, MAYBE WE CAN ADD A 5706 03:30:50,045 --> 03:30:52,147 QUESTION OR TWO INTO OUR 5707 03:30:52,147 --> 03:30:56,117 CONTINUING MEDICAL EDUCATION 5708 03:30:56,117 --> 03:30:58,453 CERTIFICATION PROCESS, JUST TO 5709 03:30:58,453 --> 03:31:00,455 MAKE SURE THAT PEOPLE STAY ON 5710 03:31:00,455 --> 03:31:05,493 TOP OF IT, BUT IT REALLY HAS TO 5711 03:31:05,493 --> 03:31:08,330 BE TIMELY AND COST-EFFECTIVE, 5712 03:31:08,330 --> 03:31:12,067 CME DOLLARS THAT ARE PROVIDED TO 5713 03:31:12,067 --> 03:31:15,737 PHYSICIANS ARE VALUABLE, SO THEY 5714 03:31:15,737 --> 03:31:17,472 TEND TO GO WHERE THE MONEY IS 5715 03:31:17,472 --> 03:31:19,040 AT, AS I ALWAYS TEACH MY MEDICAL 5716 03:31:19,040 --> 03:31:26,915 STUDENTS, YOU KNOW, AND COMMON 5717 03:31:26,915 --> 03:31:32,287 PROBLEMS -- HOWEVER, I DO SEE 5718 03:31:32,287 --> 03:31:33,421 THEY'RE REACHING OUT AND 5719 03:31:33,421 --> 03:31:34,255 RECEIVING THE NECESSARY 5720 03:31:34,255 --> 03:31:42,063 EDUCATION. 5721 03:31:42,063 --> 03:31:43,431 >> THANK YOU. 5722 03:31:43,431 --> 03:31:44,632 MIIKKA, I THINK YOU WERE NEXT. 5723 03:31:44,632 --> 03:31:45,700 >> THANK YOU. 5724 03:31:45,700 --> 03:31:46,601 A COUPLE SMALL COMMENTS. 5725 03:31:46,601 --> 03:31:50,972 SOMETHING THAT WE HAVE DONE IN A 5726 03:31:50,972 --> 03:31:52,140 SENSE TO REACH OUT FROM THE 5727 03:31:52,140 --> 03:31:55,176 HOSPITAL TO THE PEDIATRIC AND 5728 03:31:55,176 --> 03:31:55,810 GENERALIST COMMUNITIES IS THAT 5729 03:31:55,810 --> 03:31:57,145 AT LEAST HERE IN BELGIUM, THEY 5730 03:31:57,145 --> 03:32:01,216 TEND TO HAVE FROM TIME TO TIME 5731 03:32:01,216 --> 03:32:05,687 KIND OF AN EVENING SECTION FOR R 5732 03:32:05,687 --> 03:32:08,189 THEM AND THEY LIKE TO HAVE 5733 03:32:08,189 --> 03:32:08,857 DIFFERENT TOPIC. 5734 03:32:08,857 --> 03:32:10,458 SO WE'VE GONE THERE TO TALK 5735 03:32:10,458 --> 03:32:13,762 ABOUT THE PLETHORA IN ONE OF 5736 03:32:13,762 --> 03:32:15,397 THEIR SESSIONS AND THAT WAY 5737 03:32:15,397 --> 03:32:16,231 THOSE WHO ARE INTERESTED GET TO 5738 03:32:16,231 --> 03:32:18,099 KNOW THERE IS A CENTER NEXT TO 5739 03:32:18,099 --> 03:32:19,501 ME, NOT REALLY NEXT, BUT STILL, 5740 03:32:19,501 --> 03:32:22,270 WHERE I CAN REFER THOSE KIND OF 5741 03:32:22,270 --> 03:32:22,570 PATIENTS. 5742 03:32:22,570 --> 03:32:23,972 AND KIND OF WHAT KIND OF 5743 03:32:23,972 --> 03:32:26,040 SYMPTOMS THEY HAVE AND WHEN 5744 03:32:26,040 --> 03:32:27,609 SHOULD I BE ALERTED TO SEND THEM 5745 03:32:27,609 --> 03:32:28,009 THERE. 5746 03:32:28,009 --> 03:32:30,412 SO THAT'S ONE WAY I THINK FOR 5747 03:32:30,412 --> 03:32:32,213 EXPERTS AND ALSO TO COVER BETTER 5748 03:32:32,213 --> 03:32:33,782 THE SURROUNDINGS BECAUSE THAT'S 5749 03:32:33,782 --> 03:32:35,183 OFTEN THE PROBLEM ALSO THAT THEY 5750 03:32:35,183 --> 03:32:36,951 DON'T KNOW THAT THERE'S AN 5751 03:32:36,951 --> 03:32:38,553 EXPERT CENTER BECAUSE THESE ARE 5752 03:32:38,553 --> 03:32:39,854 RARE DISEASES AND THEY DON'T 5753 03:32:39,854 --> 03:32:41,723 KNOW LIKE IT HAS BEEN DISCUSSED 5754 03:32:41,723 --> 03:32:43,591 WHAT THE SYMPTOMS AND SIGNS ARE, 5755 03:32:43,591 --> 03:32:48,530 WHEN SHOULD I PRESID BE THINKINO 5756 03:32:48,530 --> 03:32:51,299 THAT WAS ONE TO SAY IT HAS TO BE 5757 03:32:51,299 --> 03:32:52,734 IN THEIR WORLD, SO WE'D RATHER 5758 03:32:52,734 --> 03:32:54,035 GO TO THEIR MEETING RATHER THAN 5759 03:32:54,035 --> 03:32:55,637 TRYING THEM TO GET TO SOMETHING 5760 03:32:55,637 --> 03:32:58,606 THAT WE WOULD ORGANIZE. 5761 03:32:58,606 --> 03:33:02,477 THEN ONE -- I WAS GOING THROUGH 5762 03:33:02,477 --> 03:33:09,651 THE -- I FOUND AVMs -- THORAX 5763 03:33:09,651 --> 03:33:12,287 BUT LIKE -- BIG GROUP ALREADY, 5764 03:33:12,287 --> 03:33:13,755 IT'S NOT MENTIONED THERE. 5765 03:33:13,755 --> 03:33:16,524 AND THEN AT THE END, THERE WERE 5766 03:33:16,524 --> 03:33:19,360 SOME TYPICAL TYPES OF GENETIC 5767 03:33:19,360 --> 03:33:20,662 DISEASES, WHICH IS EXACTLY THE 5768 03:33:20,662 --> 03:33:22,564 ONES THAT EVERYBODY TALKS, BUT I 5769 03:33:22,564 --> 03:33:26,167 DON'T SEE SIGNALING, AND 5770 03:33:26,167 --> 03:33:27,235 VASCULAR AND LYMPHADEMA MALL FOR 5771 03:33:27,235 --> 03:33:30,104 NATIONS ARE DUE TO ABNORMAL -- 5772 03:33:30,104 --> 03:33:31,506 NOT AS A GROUP THERE. 5773 03:33:31,506 --> 03:33:33,274 METABOLIC DISEASE, THERE ARE 5774 03:33:33,274 --> 03:33:36,110 GENETIC BIGGER STRUCTURAL 5775 03:33:36,110 --> 03:33:38,012 CHANGES, THERE'S INTRACELLULAR 5776 03:33:38,012 --> 03:33:39,013 TRANSPORTERS AND ALL KINDS OF 5777 03:33:39,013 --> 03:33:41,850 OTHER GROUPS, BUT THE WHOLE 5778 03:33:41,850 --> 03:33:44,385 SIGNALING GROUP IS NOT INTEREST. 5779 03:33:44,385 --> 03:33:44,719 THERE. 5780 03:33:44,719 --> 03:33:46,154 SO THAT'S ONE WAY TO TRY TO PUT 5781 03:33:46,154 --> 03:33:47,288 SOMETHING IN. 5782 03:33:47,288 --> 03:33:48,990 AND THEN JUST IF I UNDERSTOOD 5783 03:33:48,990 --> 03:33:50,225 CORRECTLY FROM CHRIS WILSON THAT 5784 03:33:50,225 --> 03:33:52,760 YOU HAD A GUIDELINES PROJECT? 5785 03:33:52,760 --> 03:33:54,295 AND I WAS JUST INTERESTED TO 5786 03:33:54,295 --> 03:33:55,597 HEAR A LITTLE BIT MORE ABOUT 5787 03:33:55,597 --> 03:33:58,166 THAT. 5788 03:33:58,166 --> 03:33:59,934 >> SURE. 5789 03:33:59,934 --> 03:34:02,837 YEAH, SO BASICALLY SEVERAL OF US 5790 03:34:02,837 --> 03:34:04,339 PHYSICAL THERAPIST LEADERS KIND 5791 03:34:04,339 --> 03:34:07,308 OF DID A MODIFIED DELPHI STUDY, 5792 03:34:07,308 --> 03:34:09,143 AND IT WAS BASED OFF A COUPLE 5793 03:34:09,143 --> 03:34:10,545 OTHER DELPHI STUDIES. 5794 03:34:10,545 --> 03:34:12,113 IT SHOULD BE PUBLISHED IN THE 5795 03:34:12,113 --> 03:34:12,947 PHYSICAL THERAPY JOURNAL IN THE 5796 03:34:12,947 --> 03:34:14,949 NEXT COUPLE OF WEEKS, IT JUST 5797 03:34:14,949 --> 03:34:16,451 GOT ACCEPTED FOR PUBLICATION. 5798 03:34:16,451 --> 03:34:17,519 BUT BASICALLY WE DID THREE 5799 03:34:17,519 --> 03:34:19,420 ROUNDS OF THE DELPHI AND ASKED 5800 03:34:19,420 --> 03:34:22,624 EXPERTS IN THE FIELD, BOARD 5801 03:34:22,624 --> 03:34:24,158 CERTIFIED THERAPISTS, LYMPHADEMA 5802 03:34:24,158 --> 03:34:26,828 THERAPISTS, GENERALISTS, EVEN 5803 03:34:26,828 --> 03:34:28,530 SOME STUDENTS, WHAT SHOULD ENTRY 5804 03:34:28,530 --> 03:34:31,466 LEVEL THERAPISTS KNOW ABOUT 5805 03:34:31,466 --> 03:34:32,534 CANCER AND LYMPHADEMA. 5806 03:34:32,534 --> 03:34:34,068 AND BASICALLY WE DID THREE 5807 03:34:34,068 --> 03:34:36,037 ROUNDS OF DELPHI FROM THAT AND 5808 03:34:36,037 --> 03:34:37,472 WHATEVER FLOATED TO THE TOP OF 5809 03:34:37,472 --> 03:34:39,941 THAT, THAT WAS WHAT WE PUBLISHED 5810 03:34:39,941 --> 03:34:41,342 IN OUR GUIDELINES. 5811 03:34:41,342 --> 03:34:42,877 SO IT'S WORKED OUT REALLY, 5812 03:34:42,877 --> 03:34:43,978 REALLY WELL. 5813 03:34:43,978 --> 03:34:46,347 AND WE'RE HONORED TO BE 5814 03:34:46,347 --> 03:34:49,117 RECOGNIZED FOR PEER REVIEWED 5815 03:34:49,117 --> 03:34:50,518 PUBLICATION AND NOW WE HAVE KIND 5816 03:34:50,518 --> 03:34:52,053 OF A CORE DOCUMENT THAT WE CAN 5817 03:34:52,053 --> 03:34:53,988 TAKE TO INSURANCE COMPANIES, 5818 03:34:53,988 --> 03:34:56,357 ACCREDITING AGENCIES, AND THEN 5819 03:34:56,357 --> 03:35:00,428 THOSE WHO ARE WRITING THE 5820 03:35:00,428 --> 03:35:01,062 MEDICAL EXAM CON AT THE PRESENT 5821 03:35:01,062 --> 03:35:05,900 TIME OCONTENT OUTLINE SOWE CAN T 5822 03:35:05,900 --> 03:35:07,402 OUR CLINICIANS TELL US OUR 5823 03:35:07,402 --> 03:35:09,170 STUDENTS NEED TO KNOW BEFORE 5824 03:35:09,170 --> 03:35:11,606 THEY LEAVE AND GO OUT INTO THE 5825 03:35:11,606 --> 03:35:12,106 GREAT BIG WORLD. 5826 03:35:12,106 --> 03:35:13,508 >> MANAGEMENT GUIDELINES AND 5827 03:35:13,508 --> 03:35:15,577 DIFFERENT TYPES OF LYMPHATIC -- 5828 03:35:15,577 --> 03:35:16,544 OR LYMPHADEMAS EVEN? 5829 03:35:16,544 --> 03:35:18,112 >> IT DIDN'T -- SO THAT WAS 5830 03:35:18,112 --> 03:35:19,180 ACTUALLY PROBABLY ONE OF THE 5831 03:35:19,180 --> 03:35:20,982 MOST INTERESTING PARTS, BECAUSE 5832 03:35:20,982 --> 03:35:26,387 WE ACTUALLY -- EVERY -- IT WAS 5833 03:35:26,387 --> 03:35:27,288 DETERMINED BY THE GROUP THAT THE 5834 03:35:27,288 --> 03:35:28,489 DATA SAID THAT EVERY STUDENT 5835 03:35:28,489 --> 03:35:31,426 NEEDS TO KNOW WHAT LYMPHADEMA 5836 03:35:31,426 --> 03:35:33,361 IS, HOW TO SCREEN FOR IT, HOW TO 5837 03:35:33,361 --> 03:35:35,997 DIAGNOSE IT, AND THEN HOW TO 5838 03:35:35,997 --> 03:35:37,365 REFER. 5839 03:35:37,365 --> 03:35:39,667 BUT IT WAS ABOUT 50/50, HALF OF 5840 03:35:39,667 --> 03:35:42,203 OUR CLINICIAN RESPONDENTS SAID 5841 03:35:42,203 --> 03:35:43,338 YES, EVERY PHYSICAL THERAPIST 5842 03:35:43,338 --> 03:35:47,775 NEEDS TO KNOW HOW TO DO BASIC 5843 03:35:47,775 --> 03:35:49,978 LYMPHADEMA MANAGEMENT, YOU KNOW, 5844 03:35:49,978 --> 03:35:50,812 COMPREHENSIVE DEACON JESSTIVE 5845 03:35:50,812 --> 03:35:57,185 THERAP DECONGESTIVE 5846 03:35:57,185 --> 03:35:58,453 THERAPY. 5847 03:35:58,453 --> 03:36:01,155 THE OTHER SAID ABSOLUTELY NOT, 5848 03:36:01,155 --> 03:36:03,925 THAT IS AN ADVANCED SKILL, THERE 5849 03:36:03,925 --> 03:36:05,693 WAS A BIG PART OF THE AUDIENCE 5850 03:36:05,693 --> 03:36:06,694 THAT VEMENTLY SAID NO, THAT'S 5851 03:36:06,694 --> 03:36:10,231 NOT ENTRY LEVEL, SORRY. 5852 03:36:10,231 --> 03:36:10,598 GREAT QUESTION. 5853 03:36:10,598 --> 03:36:17,605 THANK YOU. 5854 03:36:17,605 --> 03:36:18,172 >> CLAIRE. 5855 03:36:18,172 --> 03:36:20,241 >> I HAVE A COMMENT DUE TO THE 5856 03:36:20,241 --> 03:36:21,009 FIRST COMMENT ON SHARING THE 5857 03:36:21,009 --> 03:36:23,444 INFORMATION. 5858 03:36:23,444 --> 03:36:26,180 I WAS NEW TO LEXINGTON 20 YEARS 5859 03:36:26,180 --> 03:36:29,117 AGO, AND I HAD STARTED GETTING 5860 03:36:29,117 --> 03:36:30,084 INTERESTED IN LYMPHADEMA 5861 03:36:30,084 --> 03:36:34,155 MANAGEMENT FROM A PREVIOUS 5862 03:36:34,155 --> 03:36:35,890 HOSPITAL, AND THIS WAS A MUCH 5863 03:36:35,890 --> 03:36:36,891 BIGGER FACILITY WITHIN A 5864 03:36:36,891 --> 03:36:39,060 HOSPITAL SYSTEM, AND TO 5865 03:36:39,060 --> 03:36:42,130 INITIALLY, I GOT STARTED SHARING 5866 03:36:42,130 --> 03:36:43,631 INFORMATION ABOUT WHAT I WAS 5867 03:36:43,631 --> 03:36:45,133 DOING AT A TUMOR BOARD, AND I 5868 03:36:45,133 --> 03:36:48,236 GOT TO MEET THE PHYSICIANS AND 5869 03:36:48,236 --> 03:36:50,171 SAID HEY, I'M NEW, THIS IS WHAT 5870 03:36:50,171 --> 03:36:53,107 I'M DOING, YOU KNOW, SEND ME 5871 03:36:53,107 --> 03:36:54,208 PATIENTS, I KNOW YOU MUST HAVE 5872 03:36:54,208 --> 03:36:55,743 SOME PATIENTS WITH LYMPHADEMA, 5873 03:36:55,743 --> 03:37:01,616 AND IT GOT STARTED THAT WAY. 5874 03:37:01,616 --> 03:37:03,951 SO NOW WHEN I AM INVOLVED IN ANY 5875 03:37:03,951 --> 03:37:07,255 CLINICAL PRACTICE GUIDELINE, 5876 03:37:07,255 --> 03:37:09,357 WRITING OR THIS CONSENSUS 5877 03:37:09,357 --> 03:37:11,192 DOCUMENT ONCE IT'S PUBLISHED, MY 5878 03:37:11,192 --> 03:37:12,527 PHYSICIANS ARE ALL ASKING ME, 5879 03:37:12,527 --> 03:37:14,362 BRING ME THE EVIDENCE, BRING TO 5880 03:37:14,362 --> 03:37:16,698 ME, YOU KNOW, SHOW ME, SO I'LL 5881 03:37:16,698 --> 03:37:18,166 JUST SAY -- I'LL CALL THEM AND 5882 03:37:18,166 --> 03:37:20,468 SAY CAN I COME AND SHARE THIS? 5883 03:37:20,468 --> 03:37:22,203 SO I'LL TURN UP AT A TUMOR BOARD 5884 03:37:22,203 --> 03:37:23,271 AND HAVE FIVE OR 10 MINUTES AT 5885 03:37:23,271 --> 03:37:25,273 THE BEGINNING TO SAY, OKAY, THIS 5886 03:37:25,273 --> 03:37:26,541 IS THE MOST IMPORTANT EVIDENCE 5887 03:37:26,541 --> 03:37:28,643 YOU NEED TO BE AWARE OF THIS, 5888 03:37:28,643 --> 03:37:30,511 THIS IS WHAT WE'VE FOUND. 5889 03:37:30,511 --> 03:37:35,850 SO I'M SHARING IT THAT WAY. 5890 03:37:35,850 --> 03:37:37,618 I'M ALSO INVOLVED IN SHARING IT 5891 03:37:37,618 --> 03:37:40,455 WITHIN OUR STATE PHYSICAL 5892 03:37:40,455 --> 03:37:42,657 THERAPY ASSOCIATION, SO WHEN WE 5893 03:37:42,657 --> 03:37:44,625 HAVE A NEW CLINICAL PRACTICE 5894 03:37:44,625 --> 03:37:47,562 GUIDELINE, I'LL ASK TO GO TO THE 5895 03:37:47,562 --> 03:37:50,131 FALL OR SPRING MEETING AND SHARE 5896 03:37:50,131 --> 03:37:51,432 THE UPDATES THERE. 5897 03:37:51,432 --> 03:37:55,803 JUST TO MAKE PEOPLE AWARE WITHIN 5898 03:37:55,803 --> 03:37:59,107 OUR COMMUNITY, WE DO HAVE 5899 03:37:59,107 --> 03:38:02,210 SMALLER GROUPS GETTING TOGETHER, 5900 03:38:02,210 --> 03:38:02,977 PHYSICAL THERAPISTS. 5901 03:38:02,977 --> 03:38:05,980 IT'S NOT SO MUCH THE LYMPHADEMA 5902 03:38:05,980 --> 03:38:07,915 THERAPISTS YET, THAT'S GOING TO 5903 03:38:07,915 --> 03:38:09,183 BE HAPPENING WITHIN OUR SYSTEM. 5904 03:38:09,183 --> 03:38:12,820 OUR HOSPITAL SYSTEM. 5905 03:38:12,820 --> 03:38:14,555 BUT WITHIN THE PHYSICAL 5906 03:38:14,555 --> 03:38:16,057 THERAPISTS WITHIN KENTUCKY, WE 5907 03:38:16,057 --> 03:38:18,526 DO GET TOGETHER AND SHARE 5908 03:38:18,526 --> 03:38:20,361 INFORMATION AND UPDATE ON 5909 03:38:20,361 --> 03:38:21,229 CLINICAL PRACTICE GUIDELINES AS 5910 03:38:21,229 --> 03:38:22,997 WE CAN. 5911 03:38:22,997 --> 03:38:24,699 AND THEN NATIONALLY, WE HAVE 5912 03:38:24,699 --> 03:38:26,000 LIKE CHRIS SAID EARLIER, WE HAVE 5913 03:38:26,000 --> 03:38:30,605 THE COMBINED SECTION MEETING AND 5914 03:38:30,605 --> 03:38:33,307 WE'D ALWAYS DO AN UPDATE ON THE 5915 03:38:33,307 --> 03:38:34,876 CLINICAL PRACTICE GUIDELINE AND 5916 03:38:34,876 --> 03:38:36,377 A TWO-HOUR EDUCATION SESSION. 5917 03:38:36,377 --> 03:38:37,812 SO WITHIN PHYSICAL THERAPY, WE 5918 03:38:37,812 --> 03:38:41,315 ARE TRYING TO GET INFORMATION 5919 03:38:41,315 --> 03:38:43,284 OUT ON NEW CONSENSUS DOCUMENTS 5920 03:38:43,284 --> 03:38:45,052 AS WELL AS CLINICAL PRACTICE 5921 03:38:45,052 --> 03:38:47,488 GUIDELINES. 5922 03:38:47,488 --> 03:38:50,324 SO IT'S GETTING THE WORD OUT. 5923 03:38:50,324 --> 03:38:51,859 >> THANK YOU. 5924 03:38:51,859 --> 03:38:52,860 PAULA, I THINK YOU HAVE YOUR 5925 03:38:52,860 --> 03:38:54,996 HAND UP. 5926 03:38:54,996 --> 03:38:56,264 >> OH, PERFECT. 5927 03:38:56,264 --> 03:38:58,232 I'VE BEEN TRYING TO GET MY VIDEO 5928 03:38:58,232 --> 03:39:01,369 UNLOCKED BY THE HOST BUT SINCE 5929 03:39:01,369 --> 03:39:03,204 I'M NOT -- IF YOU GUYS CAN 5930 03:39:03,204 --> 03:39:04,505 UNLOCK MY VIDEO, I WILL SHARE 5931 03:39:04,505 --> 03:39:05,039 VIDEO. 5932 03:39:05,039 --> 03:39:06,641 THANK YOU ALL FOR THIS WONDERFUL 5933 03:39:06,641 --> 03:39:07,141 DISCUSSION. 5934 03:39:07,141 --> 03:39:07,842 I LOVE IT. 5935 03:39:07,842 --> 03:39:09,877 CHRIS, CAN I ASK A QUESTION? 5936 03:39:09,877 --> 03:39:12,280 I KNOW IT WAS MORE FOCUSED TO 5937 03:39:12,280 --> 03:39:12,613 ONCOLOGY. 5938 03:39:12,613 --> 03:39:14,615 DID YOU GET ANY RESPONSES BACK 5939 03:39:14,615 --> 03:39:16,551 OR ANYBODY ELSE IN THE PHYSICAL 5940 03:39:16,551 --> 03:39:19,654 THERAPY SPACE HERE ON THIS CALL 5941 03:39:19,654 --> 03:39:21,289 WHERE IT'S THE IMPORTANCE OF THE 5942 03:39:21,289 --> 03:39:22,623 LYMPHATICS ITSELF, NOT 5943 03:39:22,623 --> 03:39:26,360 NECESSARILY DRILLING IT INTO THE 5944 03:39:26,360 --> 03:39:29,130 NEEDS OF BEING ABLE TO DO THE 5945 03:39:29,130 --> 03:39:29,730 MANAGEMENT, BUT IT'S A LITTLE 5946 03:39:29,730 --> 03:39:32,066 BIT LIKE PULLING IT BACK AND 5947 03:39:32,066 --> 03:39:33,701 JUST UNDERSTANDING IT BETTER AND 5948 03:39:33,701 --> 03:39:35,770 IN THEIR DIFFERENT SPACES, THEY 5949 03:39:35,770 --> 03:39:37,505 HAVE A GOOD EDUCATIONAL 5950 03:39:37,505 --> 03:39:39,373 UNDERSTANDING COMING OUT AS A PT 5951 03:39:39,373 --> 03:39:42,043 OF HOW THE LYMPHATICS ARE GOING 5952 03:39:42,043 --> 03:39:42,910 TO -- WE CAN USE THE LYMPHATICS 5953 03:39:42,910 --> 03:39:46,113 AS PHYSICAL THERAPISTS TO HELP 5954 03:39:46,113 --> 03:39:53,621 OUR PATIENTS FOR WHOLE WO HOST F 5955 03:39:53,621 --> 03:39:56,691 PROBLEMS, POST SURGICAL, INJURY, 5956 03:39:56,691 --> 03:39:58,993 NOT THAT LYMPHATICS HAS SUCH AN 5957 03:39:58,993 --> 03:40:00,027 IMPAIRMENT WHERE IT'S DEVELOPING 5958 03:40:00,027 --> 03:40:01,028 LYMPHADEMA, BUT DID ANY OF THAT 5959 03:40:01,028 --> 03:40:02,663 COME UP TO BETTER UNDERSTANDING 5960 03:40:02,663 --> 03:40:05,199 THE IMPORTANCE OF TRAINING OUR 5961 03:40:05,199 --> 03:40:07,034 PTs ON THE LYMPHATICS, 5962 03:40:07,034 --> 03:40:07,935 LYMPHATIC FUNCTIONING AND HOW WE 5963 03:40:07,935 --> 03:40:09,003 CAN USE IT BETTER? 5964 03:40:09,003 --> 03:40:10,805 >> I THINK THERE WAS AT LEAST 5965 03:40:10,805 --> 03:40:13,507 INHERENT TO OUR DOCUMENT WAS A 5966 03:40:13,507 --> 03:40:15,776 BASIC UNDERSTANDING OF LYMPHATIC 5967 03:40:15,776 --> 03:40:18,045 ANATOMY AND PHYSIOLOGY AND 5968 03:40:18,045 --> 03:40:20,214 FUNCTION, AND HOW THINGS DO 5969 03:40:20,214 --> 03:40:22,049 WORK, AND I KNOW THAT AT LEAST 5970 03:40:22,049 --> 03:40:24,018 FOR THE PROGRAMS THAT I'M 5971 03:40:24,018 --> 03:40:26,854 FAMILIAR WITH, THAT IS EMBEDDED 5972 03:40:26,854 --> 03:40:30,124 FAIRLY STRONGLY INTO ENTRY LEVEL 5973 03:40:30,124 --> 03:40:31,525 PROGRAMS, SO I'M PRETTY 5974 03:40:31,525 --> 03:40:33,294 CONFIDENT THAT THE STUDENTS ARE 5975 03:40:33,294 --> 03:40:34,262 KNOWING THAT PART. 5976 03:40:34,262 --> 03:40:35,596 I THINK AGAIN IT PROBABLY FALLS 5977 03:40:35,596 --> 03:40:36,898 IN LINE WITH JUST LIKE THE 5978 03:40:36,898 --> 03:40:38,399 CLINICAL END OF THINGS, JUST 5979 03:40:38,399 --> 03:40:40,067 LIKE THE CLINICIAN SAID, OH, 5980 03:40:40,067 --> 03:40:42,136 YEAH, I HAVE A CANCER REHAB 5981 03:40:42,136 --> 03:40:44,538 PROGRAM BECAUSE I HAVE 5982 03:40:44,538 --> 03:40:46,908 LYMPHADEMA, I THINK A LOT OF EP 5983 03:40:46,908 --> 03:40:48,576 TRI LEVEL PROGRAMS ALSO FEEL THE 5984 03:40:48,576 --> 03:40:54,582 SAME WAY, IT'S LIKE, OH, YEAH, 5985 03:40:54,582 --> 03:40:56,250 I -- I TEACH LYMPHADEMA SO I'M 5986 03:40:56,250 --> 03:40:57,618 TEACHING CANCER REHAB. 5987 03:40:57,618 --> 03:40:58,953 OR KIND OF TELLING THEM A LITTLE 5988 03:40:58,953 --> 03:41:01,956 BIT ABOUT KIND OF WHAT A 5989 03:41:01,956 --> 03:41:04,725 CERTIFIED LYMPHATIC THERAPIST 5990 03:41:04,725 --> 03:41:06,260 DOES IS ENOUGH AND WE'VE KIND OF 5991 03:41:06,260 --> 03:41:11,232 SAID THAT, -- YOU NEED TO DO 5992 03:41:11,232 --> 03:41:11,966 THAT DEPTH AND BREADTH, BUT I 5993 03:41:11,966 --> 03:41:16,671 GOT THE IMPRESSION THAT MOST OF 5994 03:41:16,671 --> 03:41:19,740 THE PROGRAMS I'M INVOLVED IN 5995 03:41:19,740 --> 03:41:22,243 HAVE SOME BASIC KNOWLEDGE OF 5996 03:41:22,243 --> 03:41:22,543 LYMPHATICS. 5997 03:41:22,543 --> 03:41:24,078 >> AND I THINK WE PROBABLY JUST 5998 03:41:24,078 --> 03:41:26,013 HAVE TO GROW FROM IT, BECAUSE 5999 03:41:26,013 --> 03:41:27,048 THE GENERAL INFORMATION I KEEP 6000 03:41:27,048 --> 03:41:28,249 GETTING FROM STUDENTS COMING 6001 03:41:28,249 --> 03:41:31,185 FROM DIFFERENT PROGRAMS IS, THEY 6002 03:41:31,185 --> 03:41:32,386 ONLY RECALL A LITTLE BIT OF 6003 03:41:32,386 --> 03:41:34,522 INFORMATION IN AN HOUR OR HALF A 6004 03:41:34,522 --> 03:41:37,258 DAY, AND IT'S NOT BEING YOU HID 6005 03:41:37,258 --> 03:41:39,560 IT THERE WHERE IT KIND OF LIKE, 6006 03:41:39,560 --> 03:41:41,629 HEY, EVERYONE, WE WANT TO CHECK 6007 03:41:41,629 --> 03:41:43,064 THAT BOX, FOR THEIR PROGRAM AND 6008 03:41:43,064 --> 03:41:44,598 IT NOT TO SAY THAT WILL THEIR 6009 03:41:44,598 --> 03:41:46,000 PROGRAM IS INSUFFICIENT. 6010 03:41:46,000 --> 03:41:48,002 IT JUST WE HAVE LEARNED OVER THE 6011 03:41:48,002 --> 03:41:50,738 LAST DECADE WHERE WE ARE MISSING 6012 03:41:50,738 --> 03:41:51,172 OPPORTUNITIES. 6013 03:41:51,172 --> 03:41:52,940 AND PATIENTS CAN GET BETTER 6014 03:41:52,940 --> 03:41:54,842 FASTER THE MORE CLINICIANS ARE 6015 03:41:54,842 --> 03:41:57,511 AWARE OF WHAT THEY -- I KNOW 6016 03:41:57,511 --> 03:42:02,283 WE'VE HAD THIS CONVERSATION -- 6017 03:42:02,283 --> 03:42:03,517 HOW DO WE GET THE CLINICIANS TO 6018 03:42:03,517 --> 03:42:04,652 UNDERSTAND WHAT THEY DON'T KNOW 6019 03:42:04,652 --> 03:42:07,021 AND IT GOING TO OPEN UP THEIR 6020 03:42:07,021 --> 03:42:09,423 MINDS AT BEING BETTER WITH WHAT 6021 03:42:09,423 --> 03:42:12,159 THEY PROVIDE AS PHYSICIANS, AND 6022 03:42:12,159 --> 03:42:12,827 REFERRALS, A LOT OF THIS HAS TO 6023 03:42:12,827 --> 03:42:13,961 BE REFERRALS TOO. 6024 03:42:13,961 --> 03:42:14,762 THANK YOU. 6025 03:42:14,762 --> 03:42:20,034 >> BETSY. 6026 03:42:20,034 --> 03:42:22,103 >> JUST A COMMENT. 6027 03:42:22,103 --> 03:42:23,104 PAULA, I APPRECIATE YOUR 6028 03:42:23,104 --> 03:42:24,205 PERSPECTIVE BECAUSE REALLY WE 6029 03:42:24,205 --> 03:42:30,177 NEED TO LOOK AT IT AS IT EDEMA 6030 03:42:30,177 --> 03:42:30,945 MANAGEMENT. 6031 03:42:30,945 --> 03:42:32,847 IN TREATING EVEN OUR ORTHOPEDIC 6032 03:42:32,847 --> 03:42:33,547 PATIENTS, BUT I THINK WE'RE 6033 03:42:33,547 --> 03:42:34,782 GOING TO CONTINUE TO FACE 6034 03:42:34,782 --> 03:42:36,017 BARRIERS THERE AND I THINK THIS 6035 03:42:36,017 --> 03:42:37,051 GOES BACK TO -- I THINK IT WAS A 6036 03:42:37,051 --> 03:42:39,587 COMMENT THAT HILLARY MADE BEFORE 6037 03:42:39,587 --> 03:42:41,655 WAS WE HAVE TO IDENTIFY THE GAPS 6038 03:42:41,655 --> 03:42:42,390 FIRST AND SO WE HAVE THIS WHOLE 6039 03:42:42,390 --> 03:42:45,359 POPULATION OF EXISTING PROVIDERS 6040 03:42:45,359 --> 03:42:46,794 OUT IN THE CLINIC WHO DON'T SEE 6041 03:42:46,794 --> 03:42:50,865 VALUE IN THAT AND DON'T 6042 03:42:50,865 --> 03:42:51,699 NECESSARILY UNDERSTAND TO THAT 6043 03:42:51,699 --> 03:42:53,234 LEVEL OF DEPTH, SO TO HAVE OUR 6044 03:42:53,234 --> 03:42:54,869 STUDENTS COME IN AND SAY I THINK 6045 03:42:54,869 --> 03:42:56,437 THIS IS WHAT WE SHOULD DO AND I 6046 03:42:56,437 --> 03:42:57,605 THINK JUST BRINGS A DIFFERENT 6047 03:42:57,605 --> 03:43:00,775 LAYER OF COMPLEXITY TO THAT 6048 03:43:00,775 --> 03:43:02,676 CLINICAL ENVIRONMENT, SO I AM 6049 03:43:02,676 --> 03:43:04,045 NOT AT ALL BEING PESSIMISTIC 6050 03:43:04,045 --> 03:43:06,147 ABOUT IT, BUT I THINK IT'S THE 6051 03:43:06,147 --> 03:43:06,947 REALITY OF THE ENVIRONMENT THAT 6052 03:43:06,947 --> 03:43:07,448 WE FACE. 6053 03:43:07,448 --> 03:43:09,950 I KNOW MANY OF US WITHIN THE 6054 03:43:09,950 --> 03:43:11,419 SPACE TALK ABOUT HOW DO WE 6055 03:43:11,419 --> 03:43:13,788 TRANSLATE THIS TO ORTHOPEDICS OR 6056 03:43:13,788 --> 03:43:15,489 SOME OF THE OTHER POPULATIONS 6057 03:43:15,489 --> 03:43:16,223 THAT WE'RE REGULARLY SEEING 6058 03:43:16,223 --> 03:43:20,561 WHERE WE CAN SAFELY UTILIZE THE 6059 03:43:20,561 --> 03:43:22,863 INTERVENTIONS WE'RE DOING FOR 6060 03:43:22,863 --> 03:43:24,365 LYMPHADEMA PATIENTS BUT I THINK 6061 03:43:24,365 --> 03:43:26,033 THERE'S ALWAYS THIS -- YOU'RE 6062 03:43:26,033 --> 03:43:27,968 THE LYMPHADEMA PROVIDERS, RIGHT, 6063 03:43:27,968 --> 03:43:29,103 WE'RE A WHOLE DIFFERENT SUBSET 6064 03:43:29,103 --> 03:43:30,638 OF CLINICIANS EVEN THOUGH WE 6065 03:43:30,638 --> 03:43:31,539 SHOULD BE ABLE TO BE CONSIDERING 6066 03:43:31,539 --> 03:43:33,474 ALL OF THE IMPAIRMENTS AND 6067 03:43:33,474 --> 03:43:34,809 FUNCTIONAL LIMITATIONS OF OUR 6068 03:43:34,809 --> 03:43:36,110 PATIENT, IRREGARDLESS OF THE 6069 03:43:36,110 --> 03:43:37,278 ETIOLOGY AND WHO'S MOST 6070 03:43:37,278 --> 03:43:37,978 QUALIFIED. 6071 03:43:37,978 --> 03:43:40,081 SO I THINK IT'S SORT OF A BIGGER 6072 03:43:40,081 --> 03:43:42,616 ELEPHANT IN THE ROOM THAN EVEN 6073 03:43:42,616 --> 03:43:43,884 JUST WORKING WITH THE PATIENTS 6074 03:43:43,884 --> 03:43:45,953 WHO HAVE A CLEAR ETIOLOGY FOR 6075 03:43:45,953 --> 03:43:47,288 THAT. 6076 03:43:47,288 --> 03:43:48,389 >> CHRIS. 6077 03:43:48,389 --> 03:43:50,124 >> YES. 6078 03:43:50,124 --> 03:43:53,627 SO JUST ANOTHER THOUGHT FOR 6079 03:43:53,627 --> 03:43:57,631 DISCUSSION. 6080 03:43:57,631 --> 03:43:58,866 TAKING THIS FROM THE PAYMENT END 6081 03:43:58,866 --> 03:44:00,201 OF THINGS, I THINK ONE OF THE 6082 03:44:00,201 --> 03:44:01,635 OTHER BIG CHALLENGES WE RUN INTO 6083 03:44:01,635 --> 03:44:03,337 JUST LIKE ACCREDITING AGENCIES 6084 03:44:03,337 --> 03:44:04,672 KIND OF DICTATE A LOT OF WHAT 6085 03:44:04,672 --> 03:44:06,507 THE PROGRAMS WILL DO, WHAT THE 6086 03:44:06,507 --> 03:44:10,077 CLINICIANS WILL DO IS DICTATE IT 6087 03:44:10,077 --> 03:44:10,978 BY WHAT THEY'RE PAID FOR. 6088 03:44:10,978 --> 03:44:12,346 AND RIGHT NOW REALLY THE 6089 03:44:12,346 --> 03:44:15,316 RESEARCH IS SHOWING THAT THINGS 6090 03:44:15,316 --> 03:44:16,917 LIKE THE PROSPECTIVE 6091 03:44:16,917 --> 03:44:19,620 SURVEILLANCE MODEL FOR BREAST 6092 03:44:19,620 --> 03:44:20,254 CANCER-RELATED LYMPHADEMA IS 6093 03:44:20,254 --> 03:44:21,755 REALLY, REALLY HELPFUL. 6094 03:44:21,755 --> 03:44:23,858 LET'S CATCH IT EARLY, GIVE IT A 6095 03:44:23,858 --> 03:44:27,261 FEW VISITS, MAYBE WAITING FOR 6096 03:44:27,261 --> 03:44:29,063 SOMETHING TO FESTER, AND ONE OF 6097 03:44:29,063 --> 03:44:31,098 THE BARRIERS AT LEAST FROM A 6098 03:44:31,098 --> 03:44:33,200 THERAPY PERSPECTIVE WAS THE 6099 03:44:33,200 --> 03:44:36,103 INITIAL REQUIREMENT FOR A 6100 03:44:36,103 --> 03:44:37,671 PRESCRIPTION TO COME SEE A 6101 03:44:37,671 --> 03:44:39,640 PHYSICAL THERAPIST, EVEN FOR A 6102 03:44:39,640 --> 03:44:42,476 BASIC CONSULTATION. 6103 03:44:42,476 --> 03:44:44,745 AND NOW THE LEGISLATIVE THINGS 6104 03:44:44,745 --> 03:44:49,450 HAVE SHIFTED A LITTLE BIT TO 6105 03:44:49,450 --> 03:44:50,918 WHERE PEOPLE CAN GO SEE A 6106 03:44:50,918 --> 03:44:51,852 PHYSICAL THERAPIST WITHOUT 6107 03:44:51,852 --> 03:44:55,256 NEEDING A PRESCRIPTION IN ALL 6108 03:44:55,256 --> 03:44:56,790 JURISDICTIONS AND IT REALLY DOES 6109 03:44:56,790 --> 03:44:58,759 FALL TO EVERYONE IN THAT 6110 03:44:58,759 --> 03:45:00,461 SURVIVOR SHIP TO BE SCREENING 6111 03:45:00,461 --> 03:45:02,029 FOR THESE THINGS, AND AGAIN, 6112 03:45:02,029 --> 03:45:04,431 MAYBE DOING PURPOSEFUL 6113 03:45:04,431 --> 03:45:05,432 SCREENINGS THROUGH SOMETHING 6114 03:45:05,432 --> 03:45:10,871 LIKE THE MODEL THAT'S PUBLISHED. 6115 03:45:10,871 --> 03:45:12,106 AND THE PROBLEM I THINK IS THE 6116 03:45:12,106 --> 03:45:13,707 INSURANCE COMPANIES ARE NOT 6117 03:45:13,707 --> 03:45:16,410 THERE YET. 6118 03:45:16,410 --> 03:45:18,512 THEY'RE NOT THERE KIND OF TO 6119 03:45:18,512 --> 03:45:20,014 SAY, OH, YEAH, WE KNOW THIS 6120 03:45:20,014 --> 03:45:23,117 PERSON IS AT FAIRLY HIGH RISK OF 6121 03:45:23,117 --> 03:45:24,685 DEVELOPING LYMPHADEMA, WE DO 6122 03:45:24,685 --> 03:45:26,187 WANT THEM TO SEE SOMEONE EVERY 6123 03:45:26,187 --> 03:45:27,621 SIX MONTHS OR EVERY THREE MONTHS 6124 03:45:27,621 --> 03:45:29,790 OR HOWEVER LONG THE GUIDELINES 6125 03:45:29,790 --> 03:45:34,128 SAY, BUT THAT CONFUSES THE 6126 03:45:34,128 --> 03:45:34,995 INSURANCE COMPANIES. 6127 03:45:34,995 --> 03:45:37,231 I KIND OF EQUATE IT A LOT TO 6128 03:45:37,231 --> 03:45:39,433 WHEN I'M SPEAKING TO PUBLIC 6129 03:45:39,433 --> 03:45:41,702 AUDIENCES IS KIND OF LIKE THE 6130 03:45:41,702 --> 03:45:44,104 DENTIST MODEL. 6131 03:45:44,104 --> 03:45:47,174 MY DENTIST WON'T LET ME LEAVE 6132 03:45:47,174 --> 03:45:48,943 THE OFFICE WITHOUT SCHEDULING 6133 03:45:48,943 --> 03:45:49,910 ANOTHER 6 MONTH APPOINTMENT. 6134 03:45:49,910 --> 03:45:52,746 NOW THEY PROBABLY WILL LET ME 6135 03:45:52,746 --> 03:45:53,881 LEAVE BUT YOU GET THE IDEA, WHEN 6136 03:45:53,881 --> 03:45:55,349 WE'RE DOING THAT FOR THE TEETH 6137 03:45:55,349 --> 03:45:57,818 WHERE I DON'T HAVE A HUGE RISK 6138 03:45:57,818 --> 03:46:01,388 FOR CAVITIES, BUT WE'RE NOT 6139 03:46:01,388 --> 03:46:05,092 NECESSARILY FOR PEOPLE 6140 03:46:05,092 --> 03:46:05,859 DEVELOPING LYMPHADEMA YET FROM 6141 03:46:05,859 --> 03:46:07,027 AN INSURANCE COMPANY STANDPOINT. 6142 03:46:07,027 --> 03:46:10,231 >> CHRIS, I AGREE WITH THAT, BUT 6143 03:46:10,231 --> 03:46:11,465 THERE IS A FLY IN THE OINTMENT 6144 03:46:11,465 --> 03:46:14,235 WHICH IS THAT MOST PEOPLE SEE 6145 03:46:14,235 --> 03:46:15,569 DENTISTS OUTSIDE OF THE REALM OF 6146 03:46:15,569 --> 03:46:16,637 INSURANCE COVERAGE OR MINIMAL, 6147 03:46:16,637 --> 03:46:19,206 AND THE PROBLEM WITH THE 6148 03:46:19,206 --> 03:46:20,207 INSURANCE COMPANIES IS THAT THEY 6149 03:46:20,207 --> 03:46:21,842 HAVE NOT REALLY EMBRACED 6150 03:46:21,842 --> 03:46:23,010 PREVENTIVE STRATEGIES. 6151 03:46:23,010 --> 03:46:25,446 THEY DON'T WANT IT BECAUSE THEY 6152 03:46:25,446 --> 03:46:27,481 KNOW THAT PEOPLE CHANGE THEIR 6153 03:46:27,481 --> 03:46:29,450 INSURERS WITH ENOUGH REGULARITY 6154 03:46:29,450 --> 03:46:30,484 THAT THEY'RE GOING TO PAY FOR 6155 03:46:30,484 --> 03:46:32,453 SOMETHING THAT IS GOING TO 6156 03:46:32,453 --> 03:46:35,656 BENEFIT ANOTHER RECIPIENT AND SO 6157 03:46:35,656 --> 03:46:38,025 THAT'S WHERE WE GET INTO TROUBLE 6158 03:46:38,025 --> 03:46:41,195 WITH TRYING TO INVOKE PREVENTION 6159 03:46:41,195 --> 03:46:42,329 TO MINIMIZE PROBLEMS. 6160 03:46:42,329 --> 03:46:43,697 >> I AGREE. 6161 03:46:43,697 --> 03:46:45,399 I DON'T HAVE THE AWBS. 6162 03:46:45,399 --> 03:46:47,735 I JUST HAVE THE QUESTIONS. 6163 03:46:47,735 --> 03:46:48,669 >> SARAH. 6164 03:46:48,669 --> 03:46:50,170 >> I DON'T KNOW IF THIS FIT 6165 03:46:50,170 --> 03:46:51,572 HERE, BUT CHRIS BROUGHT UP THE 6166 03:46:51,572 --> 03:46:52,473 IDEA OF SURVEILLANCE. 6167 03:46:52,473 --> 03:46:53,707 WHEN I THINK ABOUT THE BREAST 6168 03:46:53,707 --> 03:46:54,975 CANCER POPULATION, THERE'S SO 6169 03:46:54,975 --> 03:46:57,711 MUCH FOCUS ON DE-ESCALATION OF 6170 03:46:57,711 --> 03:46:59,313 THERAPY, AND THE REALITY IS, IS 6171 03:46:59,313 --> 03:47:00,347 THAT MANY OF THE PATIENTS MIGHT 6172 03:47:00,347 --> 03:47:02,416 BE TREATED WITH NO CHEMOTHERAPY 6173 03:47:02,416 --> 03:47:05,919 OR MINIMAL RADIATION THERAPY OR 6174 03:47:05,919 --> 03:47:07,121 ORAL CHEMOTHERAPIES, AND MANY OF 6175 03:47:07,121 --> 03:47:08,956 THE VISITS POSTOPERATIVELY ARE 6176 03:47:08,956 --> 03:47:10,224 HAPPENING VIRTUALLY. 6177 03:47:10,224 --> 03:47:12,059 AND SO HOW DO YOU FOLLOW THESE 6178 03:47:12,059 --> 03:47:13,761 PATIENTS TO COME BACK WHEN 6179 03:47:13,761 --> 03:47:16,530 YOU'RE TRYING TO DO THAT 6180 03:47:16,530 --> 03:47:17,998 PROSPECTIVE SURVEILLANCE MODEL 6181 03:47:17,998 --> 03:47:19,466 WITH NO OTHER REASON TO COME 6182 03:47:19,466 --> 03:47:21,735 BACK AND THEY MIGHT BE ABLE TO 6183 03:47:21,735 --> 03:47:22,936 DO A VIDEO VISIT TO SATISFY 6184 03:47:22,936 --> 03:47:24,905 THOSE FOLLOW-UP VISIT. 6185 03:47:24,905 --> 03:47:26,740 SO AS WE MOVE INTO THIS REALM OF 6186 03:47:26,740 --> 03:47:27,708 VIRTUAL CARE AND WE ALREADY KNOW 6187 03:47:27,708 --> 03:47:29,143 WE HAVE SIGNIFICANT 6188 03:47:29,143 --> 03:47:30,210 HETEROGENEITY IN THE TECHNOLOGY 6189 03:47:30,210 --> 03:47:32,746 USED TO DIAGNOSE LYMPHADEMA AND 6190 03:47:32,746 --> 03:47:35,382 NO ONE AGREES, WHERE DO WE GO IN 6191 03:47:35,382 --> 03:47:36,784 THE SETTING OF TELEHEALTH AND 6192 03:47:36,784 --> 03:47:38,218 VIRTUAL MEDICINE, WHERE WE'RE 6193 03:47:38,218 --> 03:47:40,587 ALL MOVING TO, AND HOW DO WE 6194 03:47:40,587 --> 03:47:41,422 FOLLOW THESE PATIENTS GOING 6195 03:47:41,422 --> 03:47:41,722 FORWARD? 6196 03:47:41,722 --> 03:47:43,123 WE DON'T HAVE A GOOD STRATEGY 6197 03:47:43,123 --> 03:47:43,657 FOR THAT. 6198 03:47:43,657 --> 03:47:45,259 IT WOULD HAVE TO BE SOMETHING 6199 03:47:45,259 --> 03:47:47,628 THAT IS PATIENT-DIRECTED AND 6200 03:47:47,628 --> 03:47:48,228 PATIENT-USED BECAUSE RIGHT NOW 6201 03:47:48,228 --> 03:47:49,797 ALL OF OUR SURVEILLANCE TOOLS 6202 03:47:49,797 --> 03:47:52,433 REQUIRE AN IN-PERSON VISIT. 6203 03:47:52,433 --> 03:47:54,134 >> GOOD POINT. 6204 03:47:54,134 --> 03:47:54,768 GOOD POINT. 6205 03:47:54,768 --> 03:47:56,603 I'D LIKE TO -- I DON'T SEE ANY 6206 03:47:56,603 --> 03:47:57,604 HANDS RAISED RIGHT AT THE 6207 03:47:57,604 --> 03:48:00,674 MOMENT, SO I'D LIKE TORE BROADEN 6208 03:48:00,674 --> 03:48:03,344 THIS DISCUSSION TO A TANGENTIAL 6209 03:48:03,344 --> 03:48:03,544 AREA. 6210 03:48:03,544 --> 03:48:05,045 WE'VE TALKED A LOT DURING THE 6211 03:48:05,045 --> 03:48:09,917 COURSE OF THE DAY ABOUT 6212 03:48:09,917 --> 03:48:10,818 EMBRACING POPULATIONS OF 6213 03:48:10,818 --> 03:48:12,119 PRACTITIONERS THAT ARE ALREADY 6214 03:48:12,119 --> 03:48:14,588 FORMALLY TRAINED THAT ARE OUT IN 6215 03:48:14,588 --> 03:48:17,658 THEIR SETTING PURSUING THEIR 6216 03:48:17,658 --> 03:48:20,861 CAREERS AND ARE PRACTICING WITH 6217 03:48:20,861 --> 03:48:22,796 THE KNOWLEDGE ARMAMENTARIUM THAT 6218 03:48:22,796 --> 03:48:24,732 THEY HAVE. 6219 03:48:24,732 --> 03:48:26,700 SO ACKNOWLEDGING, FOR EXAMPLE, 6220 03:48:26,700 --> 03:48:29,870 THAT MOST OF THE LYMPHATIC 6221 03:48:29,870 --> 03:48:30,738 PRESENTATIONS IN PEDIATRICS WILL 6222 03:48:30,738 --> 03:48:33,574 BE RELATIVELY UNCOMMON, 6223 03:48:33,574 --> 03:48:36,143 ACKNOWLEDGING THE FACT THAT 6224 03:48:36,143 --> 03:48:37,344 WITHIN THIS DOMAIN, THERE ARE 6225 03:48:37,344 --> 03:48:39,947 UNCOMMON CONDITIONS LIKE LAM AND 6226 03:48:39,947 --> 03:48:43,884 VASCULAR MALFORMATIONS IN ADULTS 6227 03:48:43,884 --> 03:48:45,519 AND PROTEIN -- I ALSO WANT TO 6228 03:48:45,519 --> 03:48:48,622 ACKNOWLEDGE THAT OUR CHARGE 6229 03:48:48,622 --> 03:48:51,725 EMBRACES TWO VERY COMMON MEDICAL 6230 03:48:51,725 --> 03:48:53,093 CONDITIONS, LYMPHADEMA OR LET'S 6231 03:48:53,093 --> 03:49:01,301 SAY CHRONIC EDEMA, AND LIPEDEMA, 6232 03:49:01,301 --> 03:49:07,307 ESTIMATED AT AFFECTING BETWEEN T 6233 03:49:07,307 --> 03:49:10,210 POPULATION, IN POPULATIONS SUCH 6234 03:49:10,210 --> 03:49:12,780 AS THE UNITED STATES, SOME OF 6235 03:49:12,780 --> 03:49:14,314 THOSE OBSERVATIONS WERE MADE IN 6236 03:49:14,314 --> 03:49:14,615 GERMANY. 6237 03:49:14,615 --> 03:49:16,917 THE NUMBERS FOR CHRONIC EDEMA GO 6238 03:49:16,917 --> 03:49:19,153 UP TO ABOUT 10 MILLION AS 6239 03:49:19,153 --> 03:49:20,921 ESTIMATES IN THE UNITED STATES. 6240 03:49:20,921 --> 03:49:24,691 SO THE QUESTION I WOULD LIKE TO 6241 03:49:24,691 --> 03:49:31,131 PUT IN FRONT OF THE PANEL IS, 6242 03:49:31,131 --> 03:49:33,367 HOW DO WE BEGIN TO GET THE 6243 03:49:33,367 --> 03:49:35,969 MESSAGE THAT NESTED IN WHAT YOU 6244 03:49:35,969 --> 03:49:37,604 DON'T KNOW BUT WHAT YOU NEED TO 6245 03:49:37,604 --> 03:49:38,372 KNOW ARE SOME COMMON PROBLEMS 6246 03:49:38,372 --> 03:49:39,606 YOU MAY BE OVERLOOKING IN YOUR 6247 03:49:39,606 --> 03:49:41,508 PATIENT POPULATION AND/OR 6248 03:49:41,508 --> 03:49:42,743 PERHAPS DON'T HAVE THE RESOURCES 6249 03:49:42,743 --> 03:49:46,513 TO KNOW HOW TO FACILITATE THEIR 6250 03:49:46,513 --> 03:49:47,981 CARE WITHIN THE BROADER MEDICAL 6251 03:49:47,981 --> 03:49:48,816 NETWORK. 6252 03:49:48,816 --> 03:49:50,918 ANY COMMENTS FROM ANYBODY ON 6253 03:49:50,918 --> 03:50:00,294 THAT? 6254 03:50:00,294 --> 03:50:02,596 NO SOLUTIONS. 6255 03:50:02,596 --> 03:50:03,130 >> LISA. 6256 03:50:03,130 --> 03:50:06,333 THANK YOU. 6257 03:50:06,333 --> 03:50:12,673 >> IN IS NOT A PERFECT SOLUTION 6258 03:50:12,673 --> 03:50:14,908 BUT ONE EXAMPLE FOR THOSE TYPES 6259 03:50:14,908 --> 03:50:19,880 OF CONDITIONS OR CHALLENGES, THE 6260 03:50:19,880 --> 03:50:27,421 RARE BUT -- CONDITIONS OR -- 6261 03:50:27,421 --> 03:50:28,188 CLINICAL FINDINGS, FOR EXAMPLE, 6262 03:50:28,188 --> 03:50:30,257 THAT YOU WANT TO TRAIN FOR BUT 6263 03:50:30,257 --> 03:50:35,696 IT'S HARD TO DO THAT IN AN 6264 03:50:35,696 --> 03:50:36,597 ACTIVE CLINICAL -- EVEN AN 6265 03:50:36,597 --> 03:50:37,764 ACTIVE CLINICAL ENVIRONMENT, 6266 03:50:37,764 --> 03:50:41,635 VERY BUSY ONE, IS SIMULATION. 6267 03:50:41,635 --> 03:50:44,004 WE DO THAT QUITE OFTEN. 6268 03:50:44,004 --> 03:50:45,606 SIMULATION HAS BECOME UBIQUITOUS 6269 03:50:45,606 --> 03:50:50,978 ACROSS HEALTH PROFESSIONS FOR 6270 03:50:50,978 --> 03:50:54,615 VERY COMPLEX CASES AND REASONS 6271 03:50:54,615 --> 03:50:59,953 AND ENVIRONMENTS TO EVEN SIMPLE 6272 03:50:59,953 --> 03:51:00,187 ONES. 6273 03:51:00,187 --> 03:51:03,323 SO I WONDER, WORKING WITH THE 6274 03:51:03,323 --> 03:51:04,358 SIMULATIONISTS OR THOSE 6275 03:51:04,358 --> 03:51:05,626 EDUCATORS WHO WORK IN 6276 03:51:05,626 --> 03:51:07,961 SIMULATION, USE SIMULATION, 6277 03:51:07,961 --> 03:51:09,062 THERE ARE NOW FORMAL 6278 03:51:09,062 --> 03:51:10,330 ORGANIZATIONS WHO KIND OF LEAD 6279 03:51:10,330 --> 03:51:13,867 AND DEVELOP AND DO RESEARCH IN 6280 03:51:13,867 --> 03:51:16,703 SIMULATION-BASED EDUCATION TO 6281 03:51:16,703 --> 03:51:20,841 KIND OF IDENTIFY HOW OUR -- IS 6282 03:51:20,841 --> 03:51:23,143 THIS BEING ADDRESSED THROUGH 6283 03:51:23,143 --> 03:51:24,378 THEIR CURRENT SIMULATION 6284 03:51:24,378 --> 03:51:27,748 PROGRAM, SIMULATION EDUCATION, 6285 03:51:27,748 --> 03:51:30,284 HOW CAN IT BE FURTHER ADDRESSED, 6286 03:51:30,284 --> 03:51:31,485 WHERE ARE THERE GAPS AND 6287 03:51:31,485 --> 03:51:33,220 OPPORTUNITIES, TO BRING IT IN TO 6288 03:51:33,220 --> 03:51:34,988 THOSE CLINICAL LEARNS 6289 03:51:34,988 --> 03:51:36,456 EXPERIENCES. 6290 03:51:36,456 --> 03:51:37,157 AGAIN, ACROSS PROFESSIONS. 6291 03:51:37,157 --> 03:51:39,226 SO IT'S JUST ONE -- ANOTHER 6292 03:51:39,226 --> 03:51:40,594 SPACE THAT I DON'T KNOW IF IT'S 6293 03:51:40,594 --> 03:51:42,863 COME UP TODAY OR NOT, BUT THE 6294 03:51:42,863 --> 03:51:45,399 SIMULATION SPACE MIGHT BE 6295 03:51:45,399 --> 03:51:47,668 ANOTHER OPPORTUNITY HERE. 6296 03:51:47,668 --> 03:51:49,403 AND WHILE I'M NOT MUTED IF YOU 6297 03:51:49,403 --> 03:51:52,105 DON'T MIND, I DID PUT IT IN THE 6298 03:51:52,105 --> 03:51:55,676 CHAT JUST A MOMENT AGO, THERE 6299 03:51:55,676 --> 03:51:56,977 WERE CONVERSATIONS ABOUT CME AND 6300 03:51:56,977 --> 03:51:58,412 ABOUT ASSESSMENT AND IT JUST 6301 03:51:58,412 --> 03:52:00,147 REMINDED ME OF LONGITUDAL 6302 03:52:00,147 --> 03:52:01,081 ASSESSMENTS. 6303 03:52:01,081 --> 03:52:02,182 SO THE VAST MAJORITY OF THE 6304 03:52:02,182 --> 03:52:04,184 BOARDS NOW HAVE MOVED TO 6305 03:52:04,184 --> 03:52:07,354 LONGITUDAL ASSESSMENT, AND 6306 03:52:07,354 --> 03:52:08,689 MEANING THAT THOSE CLINICIANS 6307 03:52:08,689 --> 03:52:12,326 ARE GETTING QUESTIONS THROUGHOUT 6308 03:52:12,326 --> 03:52:13,894 THE YEAR, AND RESPONDING TO 6309 03:52:13,894 --> 03:52:17,965 THOSE QUESTIONS, THEY'RE GETTING 6310 03:52:17,965 --> 03:52:18,865 CONTINUING EDUCATION CREDITS FOR 6311 03:52:18,865 --> 03:52:21,301 DOING THAT TYPE OF WORK IN MOST 6312 03:52:21,301 --> 03:52:23,003 CASES FOR DOING THE -- FOR 6313 03:52:23,003 --> 03:52:25,205 STAYING CURRENT, STAYING ON TOP 6314 03:52:25,205 --> 03:52:27,240 OF THEIR OWN LEARNING, IN ONE 6315 03:52:27,240 --> 03:52:30,944 WAY, THIS IS JUST ONE EXAMPLE, 6316 03:52:30,944 --> 03:52:33,547 BUT ENSURING THAT THE BOARDS ARE 6317 03:52:33,547 --> 03:52:38,251 INTEGRATING RELEVANT -- THIS 6318 03:52:38,251 --> 03:52:39,353 INFORMATION INTO THOSE 6319 03:52:39,353 --> 03:52:40,988 ASSESSMENTS MIGHT BE ANOTHER 6320 03:52:40,988 --> 03:52:42,823 FORWARD PATH TOO. 6321 03:52:42,823 --> 03:52:44,458 SO JUST A LITTLE ADDITIONAL 6322 03:52:44,458 --> 03:52:46,059 COMPLEX TO THE NOTE I PUT IN THE 6323 03:52:46,059 --> 03:52:46,259 CHAT. 6324 03:52:46,259 --> 03:52:47,027 >> THANK YOU, THAT'S GREAT. 6325 03:52:47,027 --> 03:52:48,228 I WANT TO DOVETAIL ON THE 6326 03:52:48,228 --> 03:52:49,930 QUESTION THAT I ASKED, MAYBE 6327 03:52:49,930 --> 03:52:51,064 MAKE IT MORE DIRECTED AND I 6328 03:52:51,064 --> 03:52:55,035 THINK THIS HAS TO -- WILL BE 6329 03:52:55,035 --> 03:52:59,306 DIRECTED SPECIFICALLY TO CARLOS 6330 03:52:59,306 --> 03:53:01,508 AND HILLARY, RECOGNIZING THAT 6331 03:53:01,508 --> 03:53:04,111 BUSY PRACTITIONERS THAT ARE DOG 6332 03:53:04,111 --> 03:53:05,879 PRIMARY CARE IN THE COMMUNITY 6333 03:53:05,879 --> 03:53:09,750 HAVE TO CARVE OUT TIME FOR CME, 6334 03:53:09,750 --> 03:53:11,151 BUT ALSO ACKNOWLEDGING THAT THE 6335 03:53:11,151 --> 03:53:12,653 BIG ACADEMIES AND ORGANIZATIONS 6336 03:53:12,653 --> 03:53:14,588 DO HAVE ANNUAL MEETINGS. 6337 03:53:14,588 --> 03:53:18,392 ARE THERE OPPORTUNITIES TO 6338 03:53:18,392 --> 03:53:20,894 INTRODUCE SOME CME AROUND THESE 6339 03:53:20,894 --> 03:53:22,229 TOPICS IN THESE ANNUAL MEETINGS 6340 03:53:22,229 --> 03:53:25,298 THAT OCCUR AN IF SO, HOW DO WE 6341 03:53:25,298 --> 03:53:30,237 HELP TO FACILITATE THAT SO WE 6342 03:53:30,237 --> 03:53:30,904 BEGIN TO ADDRESS THE POPULATION 6343 03:53:30,904 --> 03:53:31,505 OF HEALTHCARE PROVIDERS THAT 6344 03:53:31,505 --> 03:53:32,639 WE'RE TRYING TO REACH, WHO AGAIN 6345 03:53:32,639 --> 03:53:34,374 MAY NOT KNOW THAT THIS IS 6346 03:53:34,374 --> 03:53:36,677 SOMETHING THAT THEY WANT OR 6347 03:53:36,677 --> 03:53:46,787 NEED? 6348 03:53:48,789 --> 03:53:51,124 THE AVFM DOESN'T PUT ON ANY 6349 03:53:51,124 --> 03:53:52,759 NATIONAL CONFERENCES HOWEVER THE 6350 03:53:52,759 --> 03:53:53,326 AMERICAN ACADEMY OF FAMILY 6351 03:53:53,326 --> 03:53:55,028 PHYSICIANS DOES DO A BIG ANNUAL 6352 03:53:55,028 --> 03:53:55,328 CONFERENCE. 6353 03:53:55,328 --> 03:53:58,398 THE NEXT ONE IS GOING TO BE IN 6354 03:53:58,398 --> 03:53:59,299 PHOENIX, AS A MATTER OF FACT. 6355 03:53:59,299 --> 03:54:02,669 BUT ONE WAY TO GET ON TO THE 6356 03:54:02,669 --> 03:54:04,237 CURRICULUM OF THAT NATIONAL 6357 03:54:04,237 --> 03:54:14,181 CONFERENCE IS TO APPLY TO THE 6358 03:54:14,181 --> 03:54:15,148 EDUCATION COMMISSION TO FOR 6359 03:54:15,148 --> 03:54:16,283 EXAMPLE GET ON NEXT YEAR'S 6360 03:54:16,283 --> 03:54:17,951 SCHEDULE AND HAVE A PRESENTATION 6361 03:54:17,951 --> 03:54:21,221 ON EDEMA THERE. 6362 03:54:21,221 --> 03:54:23,156 IT'S JUST AN APPLICATION PROCESS 6363 03:54:23,156 --> 03:54:32,032 THROUGH THE AAFP, AND YOU'LL 6364 03:54:32,032 --> 03:54:33,266 PROBABLY HAVE SOME INTEREST 6365 03:54:33,266 --> 03:54:35,535 BECAUSE A LOT OF US FAMILY DOCS 6366 03:54:35,535 --> 03:54:37,337 WANT TO KEEP ABREAST OF WHAT'S 6367 03:54:37,337 --> 03:54:38,205 HAPPENING AND EVEN IF WE DON'T 6368 03:54:38,205 --> 03:54:42,109 SEE IT THAT OFTEN, IT'S 6369 03:54:42,109 --> 03:54:47,214 SOMETHING WE CAN CATCH UP ON, 6370 03:54:47,214 --> 03:54:50,884 THEY'LL PRESENT THEMSELVES TO A 6371 03:54:50,884 --> 03:54:56,990 SEMINAR OR A LECTURE ON 6372 03:54:56,990 --> 03:54:57,357 LYMPHADEMA. 6373 03:54:57,357 --> 03:55:00,494 SO I WOULD SUGGEST GETTING IN 6374 03:55:00,494 --> 03:55:02,529 CONTACT WITH THE AMERICAN 6375 03:55:02,529 --> 03:55:04,030 ACADEMY OF FAMILY PHYSICIANS CME 6376 03:55:04,030 --> 03:55:04,297 COMMITTEE. 6377 03:55:04,297 --> 03:55:05,265 >> WONDERFUL. 6378 03:55:05,265 --> 03:55:10,370 HILLARY? 6379 03:55:10,370 --> 03:55:13,607 SORRY, YOU'RE MUTED. 6380 03:55:13,607 --> 03:55:14,007 >> SORRY. 6381 03:55:14,007 --> 03:55:18,645 WE RUN A VERY LARGE MEETING 6382 03:55:18,645 --> 03:55:22,449 EVERY YEAR, AND THERE'S A WHOLE 6383 03:55:22,449 --> 03:55:26,820 PROPOSAL PROCESS, THERE'S A 6384 03:55:26,820 --> 03:55:29,222 COUPLE MECHANISMS TO GET 6385 03:55:29,222 --> 03:55:30,490 SOMETHING INCLUDED THERE. 6386 03:55:30,490 --> 03:55:36,196 FIRST OFF, IT HAS TO BE OF 6387 03:55:36,196 --> 03:55:39,332 IMPORTANCE TO A LARGE PORTION OF 6388 03:55:39,332 --> 03:55:40,534 THE PEOPLE ATTENDING. 6389 03:55:40,534 --> 03:55:42,369 SO AGAIN, THAT GETS BACK TO THE 6390 03:55:42,369 --> 03:55:45,939 DATA AND THE ADVOCACY PART OF 6391 03:55:45,939 --> 03:55:48,341 THIS. 6392 03:55:48,341 --> 03:55:53,046 SECOND, IT CAN BE BUNDLED IN 6393 03:55:53,046 --> 03:55:57,984 WITH SOMETHING LESS COMMON BUT 6394 03:55:57,984 --> 03:55:59,519 IMPORTANT DISEASES, SUGGEST MAY 6395 03:55:59,519 --> 03:56:00,854 MISS IN YOUR PRACTICE, SOMETHING 6396 03:56:00,854 --> 03:56:02,322 THAT'S CLINICALLY RELEVANT, THAT 6397 03:56:02,322 --> 03:56:03,523 IT'S IMPORTANT, THAT YOU 6398 03:56:03,523 --> 03:56:04,958 WOULDN'T WANT TO MISS IT, SO YOU 6399 03:56:04,958 --> 03:56:11,298 CAN GET A COLLABORATIVE SORT OF 6400 03:56:11,298 --> 03:56:13,900 PRESENTATION. 6401 03:56:13,900 --> 03:56:14,901 THE THIRD IS THAT ALL OF OUR 6402 03:56:14,901 --> 03:56:18,071 SECTIONS AND COMMITTEES SPONSOR 6403 03:56:18,071 --> 03:56:19,639 A PROGRAM WITHIN THE BODY OF OUR 6404 03:56:19,639 --> 03:56:27,514 MEETING. 6405 03:56:27,514 --> 03:56:30,016 GENETICS OR -- IF THEY WERE 6406 03:56:30,016 --> 03:56:31,885 WILLING TO ALLOCATE A PORTION OF 6407 03:56:31,885 --> 03:56:34,287 THEIR PROGRAM TO EDUCATION ABOUT 6408 03:56:34,287 --> 03:56:38,358 THIS TOPIC, THAT THEY CHOOSE 6409 03:56:38,358 --> 03:56:40,360 WHAT IS THEIR CONTENT, SO AS 6410 03:56:40,360 --> 03:56:43,930 OPPOSED TO THE NATIONAL THE 6411 03:56:43,930 --> 03:56:45,131 COMMITTEE FOR THE GENERAL 6412 03:56:45,131 --> 03:56:46,132 PROGRAM, SO THAT WOULD BE 6413 03:56:46,132 --> 03:56:46,533 ANOTHER VEHICLE. 6414 03:56:46,533 --> 03:56:54,474 SO WHAT YOU NEED IS A CHAMPION. 6415 03:56:54,474 --> 03:56:55,108 TO DO THAT. 6416 03:56:55,108 --> 03:56:57,210 SO CERTAINLY FROM OUR 6417 03:56:57,210 --> 03:56:57,844 PERSPECTIVE, ACCESSIBLE TO THE 6418 03:56:57,844 --> 03:56:59,746 12 TO 15,000 PEDIATRICIANS THAT 6419 03:56:59,746 --> 03:57:01,314 ARE GOING TO GO TO THE MEETING. 6420 03:57:01,314 --> 03:57:03,783 >> EXACTLY. 6421 03:57:03,783 --> 03:57:05,118 THAT'S EXACTLY THE KIND OF INPUT 6422 03:57:05,118 --> 03:57:10,257 WE WERE HOPING TO GET. 6423 03:57:10,257 --> 03:57:11,591 RELEVANT AS TO WHAT IS BEFORE 6424 03:57:11,591 --> 03:57:11,758 US. 6425 03:57:11,758 --> 03:57:12,826 JOEL, I THINK YOU HAVE YOUR HAND 6426 03:57:12,826 --> 03:57:22,903 UP. 6427 03:57:25,238 --> 03:57:27,674 >> ONE THING THAT CAME UP BEFORE 6428 03:57:27,674 --> 03:57:28,608 ABOUT LONGITUDINAL ASSESSMENTS, 6429 03:57:28,608 --> 03:57:29,776 ET CETERA, IN PULMONARY, THERE'S 6430 03:57:29,776 --> 03:57:32,512 A PROBLEM THEY HAVE DURING 6431 03:57:32,512 --> 03:57:37,050 COVID, AND THAT IS THAT HAPPY 6432 03:57:37,050 --> 03:57:37,851 HYPOXEMIA. 6433 03:57:37,851 --> 03:57:39,085 SO PATIENTS DON'T REALIZE WHAT'S 6434 03:57:39,085 --> 03:57:41,421 GOING ON. 6435 03:57:41,421 --> 03:57:47,027 AND THEY HAVE SATURATIONS IN THE 6436 03:57:47,027 --> 03:57:47,193 70s. 6437 03:57:47,193 --> 03:57:49,162 SO ONE WAY OF APPROACHING IT IS 6438 03:57:49,162 --> 03:57:56,202 BY DIAGNOSTICS. 6439 03:57:56,202 --> 03:57:57,871 SO IN ANY OF THE PROCESSES WE'RE 6440 03:57:57,871 --> 03:57:59,039 DISCUSSING IN LYMPHADEMA, FOR 6441 03:57:59,039 --> 03:58:00,040 EXAMPLE, YOU'RE CONCERNED ABOUT 6442 03:58:00,040 --> 03:58:01,308 SOMETHING DEVELOPING. 6443 03:58:01,308 --> 03:58:03,677 PART OF THE ISSUE IS THE 6444 03:58:03,677 --> 03:58:05,078 DIAGNOSTIC. 6445 03:58:05,078 --> 03:58:08,915 SO WHAT'S HAPPENING NOW IS 6446 03:58:08,915 --> 03:58:10,417 THROUGH NHLBI, WE'RE ABLE TO GET 6447 03:58:10,417 --> 03:58:14,254 AN SBIR TO DEVELOP SOMETHING 6448 03:58:14,254 --> 03:58:15,021 THAT WILL TELL US HOW SOMETHING 6449 03:58:15,021 --> 03:58:18,325 IS DOING, AND THEY'LL SEND IT 6450 03:58:18,325 --> 03:58:20,093 DIRECTLY TO A PHYSICIAN'S 6451 03:58:20,093 --> 03:58:22,395 OFFICE, YOU DON'T HAVE TO SEE 6452 03:58:22,395 --> 03:58:23,730 THE PATIENT, AND THE WAY WE KNOW 6453 03:58:23,730 --> 03:58:25,532 THIS IS RELEVANT IS WE KNOW WHEN 6454 03:58:25,532 --> 03:58:26,967 PATIENT IS HAVING A PROBLEM AND 6455 03:58:26,967 --> 03:58:27,133 NOT. 6456 03:58:27,133 --> 03:58:28,068 AND I THINK THE SAME THING MAY 6457 03:58:28,068 --> 03:58:31,938 BE ABLE TO HELP WITH LYMPHADEMA, 6458 03:58:31,938 --> 03:58:36,643 AND IT MAY BE ABLE TO WORK 6459 03:58:36,643 --> 03:58:36,977 THROUGH NHLBI. 6460 03:58:36,977 --> 03:58:38,645 SO VERY PRACTICAL. 6461 03:58:38,645 --> 03:58:41,481 IT'S A GOOD DIAGNOSTIC OR 6462 03:58:41,481 --> 03:58:43,183 WEARABLE, THIS MAY BE A SOLUTION 6463 03:58:43,183 --> 03:58:47,320 TO ONE OF THE PROBLEMS. 6464 03:58:47,320 --> 03:58:49,189 >> I THINK SOME OF THAT MAY COME 6465 03:58:49,189 --> 03:58:53,626 OUT OF THE ARPA LITE INITIATIVE 6466 03:58:53,626 --> 03:58:54,461 THAT IS RECEIVING LETTERS OF 6467 03:58:54,461 --> 03:58:55,862 INTENT THIS VERY WEEK, SO WITHIN 6468 03:58:55,862 --> 03:58:57,263 THE NEXT FIVE YEARS, MAYBE WE 6469 03:58:57,263 --> 03:58:58,798 WILL HAVE SOMETHING THAT NHLBI 6470 03:58:58,798 --> 03:59:01,768 CAN PARTNER WITH FOR THAT KIND 6471 03:59:01,768 --> 03:59:02,402 OF DISSEMINATION. 6472 03:59:02,402 --> 03:59:03,903 >> YOU CAN ALSO DO IT WITH A 6473 03:59:03,903 --> 03:59:05,638 COMPANY. 6474 03:59:05,638 --> 03:59:07,407 SBIR ALLOWS YOU TO DEVELOP A 6475 03:59:07,407 --> 03:59:09,009 COMPANY THAT WILL BE FUNDED FOR 6476 03:59:09,009 --> 03:59:12,145 DOING SOMETHING LIKE THIS. 6477 03:59:12,145 --> 03:59:15,682 SO IF THEY HAD A GOOD IDEA FOR A 6478 03:59:15,682 --> 03:59:16,716 DIAGNOSTIC AND YOU HAVE SOMEBODY 6479 03:59:16,716 --> 03:59:18,251 IN PRACTICE THAT WANTS TO DO 6480 03:59:18,251 --> 03:59:19,252 THIS AS PART OF A COMPANY, ET 6481 03:59:19,252 --> 03:59:21,087 CETERA, AS LONG AS IT'S LEGAL, 6482 03:59:21,087 --> 03:59:23,423 THIS MAY BE A SOLUTION THAT YOU 6483 03:59:23,423 --> 03:59:25,625 CAN DO NOW. 6484 03:59:25,625 --> 03:59:26,860 >> MAYBE WE NEED TO ADVERTISE TO 6485 03:59:26,860 --> 03:59:30,296 ALL THE ARPA APPLICANTS WHO 6486 03:59:30,296 --> 03:59:32,265 DON'T GET FUNDING, IF THEY CAN 6487 03:59:32,265 --> 03:59:35,101 DO IT THROUGH SBIR INSTEAD. 6488 03:59:35,101 --> 03:59:39,272 THAT'S WONDERFUL. 6489 03:59:39,272 --> 03:59:40,306 THAT'S A GREAT SUGGESTION. 6490 03:59:40,306 --> 03:59:42,008 I DON'T SEE ANY HANDS UP AT THE 6491 03:59:42,008 --> 03:59:42,242 MOMENT. 6492 03:59:42,242 --> 03:59:43,643 THIS MAY BE A GOOD OPPORTUNITY 6493 03:59:43,643 --> 03:59:47,547 TO ASK ONE OF OUR PATIENT 6494 03:59:47,547 --> 03:59:50,483 REPRESENTATIVES ON THE 6495 03:59:50,483 --> 03:59:51,384 COMMISSION IF YOU HAVE ANY 6496 03:59:51,384 --> 03:59:52,085 THOUGHTS OR COMMENTS OR 6497 03:59:52,085 --> 03:59:55,422 QUESTIONS FOR THIS PANEL FROM 6498 03:59:55,422 --> 04:00:04,531 THE PATIENT PERSPECTIVE. 6499 04:00:04,531 --> 04:00:11,538 VOLUNTEERS? 6500 04:00:11,538 --> 04:00:12,939 >> I SEE JEFF'S HAND. 6501 04:00:12,939 --> 04:00:14,507 >> OKAY, JEFF. 6502 04:00:14,507 --> 04:00:18,311 WE WANT TO HEAR FROM YOU TOO. 6503 04:00:18,311 --> 04:00:20,346 >> I WAS GOING TO LET YOUR 6504 04:00:20,346 --> 04:00:22,148 SOLICITATION STAND BEFORE I 6505 04:00:22,148 --> 04:00:22,549 JUMPED IN. 6506 04:00:22,549 --> 04:00:23,616 >> LET'S GO AHEAD. 6507 04:00:23,616 --> 04:00:25,318 I DIDN'T SEE A HAND RAISED, SO 6508 04:00:25,318 --> 04:00:27,854 LET'S GO. 6509 04:00:27,854 --> 04:00:29,956 >> SO THIS HAS BEEN SUPER 6510 04:00:29,956 --> 04:00:30,623 USEFUL. 6511 04:00:30,623 --> 04:00:32,892 ONE OF THE THINGS THAT THE 6512 04:00:32,892 --> 04:00:35,895 COMMISSION IS INTERESTED IN IS 6513 04:00:35,895 --> 04:00:39,299 HOW DO WE QUANTIFY PROGRESS 6514 04:00:39,299 --> 04:00:41,267 TOWARD THE GOALS -- THE 6515 04:00:41,267 --> 04:00:41,701 COMMISSION'S GOALS? 6516 04:00:41,701 --> 04:00:43,436 SO WHEN WE THINK ABOUT 6517 04:00:43,436 --> 04:00:46,005 EDUCATIONAL IMPERATIVES, WHEN WE 6518 04:00:46,005 --> 04:00:48,208 THINK ABOUT TEACHING SCIENTISTS, 6519 04:00:48,208 --> 04:00:50,543 WHEN WE THINK ABOUT TEACHING 6520 04:00:50,543 --> 04:00:51,711 CLINICIANS, WHEN WE THINK ABOUT 6521 04:00:51,711 --> 04:00:54,147 CONTINUING TO TEACH CLINICIANS 6522 04:00:54,147 --> 04:00:58,251 THROUGH THEIR CAREERS, WHAT ARE 6523 04:00:58,251 --> 04:00:58,852 INSTRUMENTS -- NOT INSTRUMENTS 6524 04:00:58,852 --> 04:01:00,253 MAY NOT BE THE RIGHT WORD, I 6525 04:01:00,253 --> 04:01:02,422 DON'T MEAN SURVEYS, BUT WHAT ARE 6526 04:01:02,422 --> 04:01:04,324 MECHANISMS OR APPROACHES THAT WE 6527 04:01:04,324 --> 04:01:07,060 SHOULD HAVE ON OUR RADAR FOR HOW 6528 04:01:07,060 --> 04:01:10,029 WE CAN QUANTIFY EFFECTIVE 6529 04:01:10,029 --> 04:01:12,966 TEACHING OF THESE THINGS TO 6530 04:01:12,966 --> 04:01:19,839 CLINICIANS AND SCIENTISTS? 6531 04:01:19,839 --> 04:01:22,041 >> GREAT QUESTION. 6532 04:01:22,041 --> 04:01:23,176 ANYBODY WANT TO TAKE A STAB AT 6533 04:01:23,176 --> 04:01:28,882 THAT? 6534 04:01:28,882 --> 04:01:29,215 LISA, PLEASE. 6535 04:01:29,215 --> 04:01:34,621 >> SURE. 6536 04:01:34,621 --> 04:01:36,456 I THINK THERE ARE LIKELY MANY 6537 04:01:36,456 --> 04:01:37,323 WAYS TO MEASURE THAT. 6538 04:01:37,323 --> 04:01:40,293 JUST TO THROW OUT AN EXAMPLE, I 6539 04:01:40,293 --> 04:01:44,397 MENTIONED ACCME, WHICH IS THE 6540 04:01:44,397 --> 04:01:45,965 ACCREDITATION COUNCIL FOR 6541 04:01:45,965 --> 04:01:48,401 CONTINUING EDUCATION, THEY HAVE 6542 04:01:48,401 --> 04:01:50,303 THE PARS SYSTEM WHERE CME 6543 04:01:50,303 --> 04:01:52,405 OFFERINGS ARE ENTERED INTO THAT 6544 04:01:52,405 --> 04:01:56,943 SYSTEM AND TRACKED AND MONITORED 6545 04:01:56,943 --> 04:01:59,078 AND THAT COULD BE -- IT'S NOT 6546 04:01:59,078 --> 04:02:01,047 OUR SYSTEM SO I CAN'T SPEAK FOR 6547 04:02:01,047 --> 04:02:04,150 THEM, BUT THAT IS POTENTIALLY 6548 04:02:04,150 --> 04:02:07,520 ONE OPTION TO IDENTIFY HOW -- 6549 04:02:07,520 --> 04:02:09,722 AND LOOK AT TRENDS OVER THE 6550 04:02:09,722 --> 04:02:12,625 COURSE OF TIME, ARE WE SEEING 6551 04:02:12,625 --> 04:02:14,594 INCREASES IN THE NUMBER OF CME 6552 04:02:14,594 --> 04:02:18,064 ACTIVITIES THAT ARE OFFERED THAT 6553 04:02:18,064 --> 04:02:20,633 ADDRESS LYMPHATICS, LYMPHADEMA 6554 04:02:20,633 --> 04:02:24,037 IN THIS SPACE. 6555 04:02:24,037 --> 04:02:26,406 FOR POSTING THAT LINK. 6556 04:02:26,406 --> 04:02:27,473 WE DO SOMETHING DIFFERENT BUT 6557 04:02:27,473 --> 04:02:32,679 KIND OF SIMILAR ISH, BY ME I 6558 04:02:32,679 --> 04:02:36,516 MEAN THE WAC, WE ALSO -- IT'S 6559 04:02:36,516 --> 04:02:40,553 CALLED THE SCOPEs, WHICH IS AN 6560 04:02:40,553 --> 04:02:40,853 ACRONYM. 6561 04:02:40,853 --> 04:02:43,790 IT HAS TO DO WITH THE 6562 04:02:43,790 --> 04:02:46,092 CURRICULUM, I SHOULD KNOW THE 6563 04:02:46,092 --> 04:02:48,528 FULL ACRONYM AND I'M NOT -- I'M 6564 04:02:48,528 --> 04:02:49,796 BLANKING ON IT AT THE MOMENT. 6565 04:02:49,796 --> 04:02:50,330 IT'S NEW. 6566 04:02:50,330 --> 04:02:51,431 WE ACTUALLY JUST STARTED THAT 6567 04:02:51,431 --> 04:02:53,766 THIS YEAR, BUT IT'S A WAY FOR US 6568 04:02:53,766 --> 04:02:58,471 TO SURVEY ALL OF OUR MEMBER 6569 04:02:58,471 --> 04:02:59,806 SCHOOLS ABOUT THEIR CURRICULAR 6570 04:02:59,806 --> 04:03:00,106 PRACTICES. 6571 04:03:00,106 --> 04:03:01,941 IT'S A PRETTY IN DEPTH SURVEY. 6572 04:03:01,941 --> 04:03:03,109 IT'S OPEN FOR MANY MONTHS 6573 04:03:03,109 --> 04:03:04,277 ACTUALLY, AND IT OPENS IN THE 6574 04:03:04,277 --> 04:03:07,180 FALL, IT CLOSES IN THE -- EARLY 6575 04:03:07,180 --> 04:03:09,916 IN THE NEW YEAR. 6576 04:03:09,916 --> 04:03:11,117 THAT AFFORDS THE OPPORTUNITY FOR 6577 04:03:11,117 --> 04:03:12,619 OUR MEMBER SCHOOLS TO ENTER 6578 04:03:12,619 --> 04:03:13,820 INFORMATION, QUITE A LOT OF 6579 04:03:13,820 --> 04:03:14,420 INFORMATION ABOUT THEIR 6580 04:03:14,420 --> 04:03:16,422 CURRICULAR PRACTICES. 6581 04:03:16,422 --> 04:03:18,458 SO WHAT ARE THEY TEACHING IT, 6582 04:03:18,458 --> 04:03:19,993 HOW ARE THEY TEACHING IT, WHERE 6583 04:03:19,993 --> 04:03:22,362 ARE THEY TEACHING IT, AND A FAIR 6584 04:03:22,362 --> 04:03:23,329 AMOUNT OF DEPTH. 6585 04:03:23,329 --> 04:03:28,368 SO THAT'S ANOTHER OPPORTUNITY TO 6586 04:03:28,368 --> 04:03:30,370 TRACK AND LOOK AT PROGRESS MADE 6587 04:03:30,370 --> 04:03:30,637 OVER TIME. 6588 04:03:30,637 --> 04:03:33,940 SO I JUST WANTED TO MENTION -- 6589 04:03:33,940 --> 04:03:35,975 AND THEN I KIND OF SKIPPED THAT 6590 04:03:35,975 --> 04:03:37,143 IMPORTANT MIDDLE SPACE BUT 6591 04:03:37,143 --> 04:03:38,978 THAT'S THE GME SPACE OR 6592 04:03:38,978 --> 04:03:39,846 RESIDENCY EDUCATION. 6593 04:03:39,846 --> 04:03:42,915 OF COURSE THE ACGME TRACKS AS 6594 04:03:42,915 --> 04:03:46,419 WELL A LOT OF CURRICULAR 6595 04:03:46,419 --> 04:03:48,655 INFORMATION THROUGH THEIR WEB 6596 04:03:48,655 --> 04:03:56,329 EDS SYSTEM OR WEBEDS. 6597 04:03:56,329 --> 04:03:57,730 >> GREAT. 6598 04:03:57,730 --> 04:03:57,930 ALEXA. 6599 04:03:57,930 --> 04:03:59,432 >> HI, EVERYBODY. 6600 04:03:59,432 --> 04:04:00,600 I'M A LYMPHADEMA PATIENT. 6601 04:04:00,600 --> 04:04:01,701 EARLIER WE WERE TALKING ABOUT 6602 04:04:01,701 --> 04:04:03,269 THIS MORNING THE IDEA OF 6603 04:04:03,269 --> 04:04:04,971 MOBILIZING PATIENT ADVOCACY, AND 6604 04:04:04,971 --> 04:04:07,707 AS A PATIENT, IT'S OFTEN REALLY 6605 04:04:07,707 --> 04:04:09,175 INTIMIDATING TO EDUCATE YOUR 6606 04:04:09,175 --> 04:04:11,377 PROVIDERS IF THEY DON'T KNOW 6607 04:04:11,377 --> 04:04:13,012 ABOUT YOUR LYMPHATIC CONDITION. 6608 04:04:13,012 --> 04:04:17,450 DO ANY OF YOU HAVE ANY INSIGHTS 6609 04:04:17,450 --> 04:04:19,052 OR THINGS THAT YOU DO IN YOUR 6610 04:04:19,052 --> 04:04:20,153 ORGANIZATIONS AS FAR AS PATIENT 6611 04:04:20,153 --> 04:04:23,156 EDUCATION FOR EDUCATING THEIR 6612 04:04:23,156 --> 04:04:24,557 CLINICIANS OR CONVERSATION 6613 04:04:24,557 --> 04:04:25,825 GUIDES OR WHAT HAVE BEEN SOME 6614 04:04:25,825 --> 04:04:28,127 WAYS THAT HAVE BEEN EFFECTIVE 6615 04:04:28,127 --> 04:04:29,395 AND NOT INTIMIDATING FOR 6616 04:04:29,395 --> 04:04:31,264 PATIENTS TO ADVOCATE FOR 6617 04:04:31,264 --> 04:04:33,032 THEMSELVES IN THAT SPACE AND 6618 04:04:33,032 --> 04:04:34,901 FEEL EMPOWERED IN DOING SO? 6619 04:04:34,901 --> 04:04:36,102 BECAUSE IT IS KIND OF SCARY 6620 04:04:36,102 --> 04:04:46,279 SOMETIMES. 6621 04:04:47,780 --> 04:04:49,782 >> DOESN'T LOOK LIKE WE HAVE ANY 6622 04:04:49,782 --> 04:04:50,683 TAKERS ON THAT. 6623 04:04:50,683 --> 04:04:51,284 CHRIS, WAS THAT YOU? 6624 04:04:51,284 --> 04:04:52,852 >> YEAH, I CAN SPEAK TO THAT. 6625 04:04:52,852 --> 04:04:53,986 SO ALEXA, THANK YOU FOR THE 6626 04:04:53,986 --> 04:04:54,253 QUESTION. 6627 04:04:54,253 --> 04:04:55,321 AS A MATTER OF FACT, YOU READ MY 6628 04:04:55,321 --> 04:04:55,588 MIND. 6629 04:04:55,588 --> 04:04:56,589 THAT WAS ACTUALLY ONE OF THE 6630 04:04:56,589 --> 04:04:58,558 THINGS THAT I WAS GOING TO BRING 6631 04:04:58,558 --> 04:05:00,293 UP, BUT I DIDN'T WANT TO 6632 04:05:00,293 --> 04:05:02,328 MONOPOLIZE THE CONVERSATION, WAS 6633 04:05:02,328 --> 04:05:04,630 ONE OF THE THINGS THAT WE DO IN 6634 04:05:04,630 --> 04:05:06,299 PHYSICAL THERAPY SCHOOL WHEN 6635 04:05:06,299 --> 04:05:08,901 WE'RE TALKING ABOUT HOW DO WE 6636 04:05:08,901 --> 04:05:10,603 GET CLINICIANS OR EVEN NEW 6637 04:05:10,603 --> 04:05:13,005 STUDENTS WHO'VE NEVER SEEN 6638 04:05:13,005 --> 04:05:13,840 SOMEONE WITH LYMPHADEMA IN THEIR 6639 04:05:13,840 --> 04:05:15,408 WHOLE LIVES BECAUSE THEY'RE 6640 04:05:15,408 --> 04:05:16,476 22 YEARS OLD AN THEY JUST DON'T 6641 04:05:16,476 --> 04:05:19,112 HAVE A LOT OF LIFE EXPERIENCE OR 6642 04:05:19,112 --> 04:05:21,247 CLINICAL EXPERIENCE YET IS 6643 04:05:21,247 --> 04:05:22,348 HAVING SOMEONE COME IN AND JUST 6644 04:05:22,348 --> 04:05:23,616 TELL THEIR STORY. 6645 04:05:23,616 --> 04:05:26,853 AND I THINK MAYBE THERE IS A -- 6646 04:05:26,853 --> 04:05:27,820 PROBABLY THAT LEVEL OF 6647 04:05:27,820 --> 04:05:29,288 INTIMIDATION, BUT HONESTLY, YOU 6648 04:05:29,288 --> 04:05:30,957 KNOW, I THINK IT'S SOMETHING IF 6649 04:05:30,957 --> 04:05:33,359 YOU EVEN JUST REACH OUT TO LOCAL 6650 04:05:33,359 --> 04:05:35,661 HEALTHCARE PROGRAMS, 6651 04:05:35,661 --> 04:05:36,896 INSTITUTIONS, UNIVERSITIES, AND 6652 04:05:36,896 --> 04:05:43,536 THEN REALLY EMPOWERING THE 6653 04:05:43,536 --> 04:05:45,037 LYMPHADEMA PATIENT ADVOCACY 6654 04:05:45,037 --> 04:05:46,406 ORGANIZATIONS TO DO STUFF LIKE 6655 04:05:46,406 --> 04:05:48,474 THAT, CERTAINLY YOU WOULDN'T BE 6656 04:05:48,474 --> 04:05:50,410 NECESSARILY EXPECTED TO KNOW ALL 6657 04:05:50,410 --> 04:05:52,278 THE INS AN OUTS ABOUT 6658 04:05:52,278 --> 04:05:53,346 LYMPHADEMA, BUT FOR THE MOST 6659 04:05:53,346 --> 04:05:54,847 IMPORTANT THING I THINK IS 6660 04:05:54,847 --> 04:05:56,816 REALLY MOTIVATING. 6661 04:05:56,816 --> 04:05:59,552 STUDENTS OR FUTURE CLINICIANS 6662 04:05:59,552 --> 04:06:01,621 THAT, OH, MY GOSH, YES, THIS 6663 04:06:01,621 --> 04:06:02,989 PERSON HAS BEEN DOWN A PATH AND 6664 04:06:02,989 --> 04:06:04,290 THERE ARE SKILLS THAT I CAN DO 6665 04:06:04,290 --> 04:06:06,459 AND LEARN TO HELP THEM WITH 6666 04:06:06,459 --> 04:06:06,893 THAT. 6667 04:06:06,893 --> 04:06:09,462 I THINK EVEN IF IT DOESN'T 6668 04:06:09,462 --> 04:06:10,329 INSPIRE THEM RIGHT AWAY, THEY 6669 04:06:10,329 --> 04:06:13,633 KNOW ABOUT IT AND THEY REALIZE 6670 04:06:13,633 --> 04:06:13,933 IT. 6671 04:06:13,933 --> 04:06:15,168 SO I THINK THE MORE THAT YOU'RE 6672 04:06:15,168 --> 04:06:20,907 KIND OF YOURSELF AND THE MORE 6673 04:06:20,907 --> 04:06:22,308 YOU KIND OF BRING YOUR TRUTH TO 6674 04:06:22,308 --> 04:06:24,577 THE STORIES, AND EVEN IF IT'S 6675 04:06:24,577 --> 04:06:26,679 EMOTIONAL OR IF IT CHALLENGING 6676 04:06:26,679 --> 04:06:27,947 TO DO, SOMETIMES PEOPLE FEEL 6677 04:06:27,947 --> 04:06:30,383 LIKE, OH, I DON'T WANT TO BE 6678 04:06:30,383 --> 04:06:31,250 EMBARRASSED AND CRY ABOUT MY 6679 04:06:31,250 --> 04:06:32,985 STORY IN FRONT OF THE HEALTHCARE 6680 04:06:32,985 --> 04:06:34,353 PROVIDERS, NO, DO IT. 6681 04:06:34,353 --> 04:06:36,823 I SAY LET IT OUT, SHARE YOUR 6682 04:06:36,823 --> 04:06:39,826 WHOLE STORY AND THAT REALLY IS 6683 04:06:39,826 --> 04:06:40,159 IMPACTFUL. 6684 04:06:40,159 --> 04:06:42,695 WE DO THAT IN OUR PHYSICAL 6685 04:06:42,695 --> 04:06:44,197 THERAPY PROGRAMS WITH PEOPLE 6686 04:06:44,197 --> 04:06:45,832 WITH A HISTORY OF STROKE, PEOPLE 6687 04:06:45,832 --> 04:06:48,634 WITH SPINAL CORD INJURY, AND 6688 04:06:48,634 --> 04:06:49,969 EMBARRASSINGLY, WE PROBABLY 6689 04:06:49,969 --> 04:06:51,170 DON'T DO IT ENOUGH WITH PEOPLE 6690 04:06:51,170 --> 04:06:52,738 WITH LYMPHADEMA AND IN HINDSIGHT 6691 04:06:52,738 --> 04:06:54,073 AFTER YOUR QUESTION, WE SHOULD, 6692 04:06:54,073 --> 04:06:55,808 BECAUSE I THINK THEIR STORY IS 6693 04:06:55,808 --> 04:06:58,010 IMPORTANT AND IT DOES INSPIRE AT 6694 04:06:58,010 --> 04:06:59,078 LEAST STUDENT PHYSICAL 6695 04:06:59,078 --> 04:07:00,146 THERAPISTS AND CERTAINLY 6696 04:07:00,146 --> 04:07:01,647 HEALTHCARE PROVIDERS TO 6697 04:07:01,647 --> 04:07:02,849 UNDERSTAND THAT THESE FOLKS DO 6698 04:07:02,849 --> 04:07:04,083 HAVE A PATH AND THEY'RE LOOKING 6699 04:07:04,083 --> 04:07:07,119 TO US FOR HELP AND WE NEED TO 6700 04:07:07,119 --> 04:07:08,721 TRAIN OURSELVES TO HELP THEM. 6701 04:07:08,721 --> 04:07:09,722 SO THANK YOU FOR BRINGING THAT 6702 04:07:09,722 --> 04:07:10,356 UP. 6703 04:07:10,356 --> 04:07:11,691 >> GREAT. 6704 04:07:11,691 --> 04:07:12,792 CYNTHIA. 6705 04:07:12,792 --> 04:07:14,494 >> HI, EVERYONE. 6706 04:07:14,494 --> 04:07:16,596 JUST TO GIVE A BRIEF INTRO OF 6707 04:07:16,596 --> 04:07:18,097 MYSELF, MY NAME IS CYNTHIA 6708 04:07:18,097 --> 04:07:20,600 HUDSON, AND I AM A BREAST CANCER 6709 04:07:20,600 --> 04:07:21,000 SURVIVOR. 6710 04:07:21,000 --> 04:07:24,136 I'VE BEEN LIVING WITH LYMPHADEMA 6711 04:07:24,136 --> 04:07:26,806 FOR 25 YEARS, ABOUT, SO I'VE 6712 04:07:26,806 --> 04:07:30,209 SEEN A LOT OF PROGRESS IN THE 6713 04:07:30,209 --> 04:07:34,347 FIELD, BUT I NO LONGER LIKE 6714 04:07:34,347 --> 04:07:36,782 FOLLOW UP WITH AN ONCOLOGIST, I 6715 04:07:36,782 --> 04:07:39,285 HAVEN'T FOR MANY YEARS, AND 6716 04:07:39,285 --> 04:07:41,120 THANK YOU, CHRIS, FOR WHAT YOU 6717 04:07:41,120 --> 04:07:42,955 SAID BECAUSE I HAVE HAD THE 6718 04:07:42,955 --> 04:07:45,124 OPPORTUNITY TO GO TO SPEAK TO 6719 04:07:45,124 --> 04:07:48,227 PHYSICAL THERAPISTS AND THEIR 6720 04:07:48,227 --> 04:07:49,695 COURSES PROBABLY TWO OR THREE 6721 04:07:49,695 --> 04:07:52,098 TIMES, AND IT'S BEEN VERY 6722 04:07:52,098 --> 04:07:54,233 REWARDING FOR ME AND HOPEFULLY 6723 04:07:54,233 --> 04:07:55,535 FOR THEM AS WELL, BUT I'VE NEVER 6724 04:07:55,535 --> 04:07:58,971 THOUGHT TO REACH OUT TO SOME 6725 04:07:58,971 --> 04:08:00,006 PROGRAMS TO VOLUNTEER TO COME 6726 04:08:00,006 --> 04:08:01,173 AND SPEAK. 6727 04:08:01,173 --> 04:08:03,509 I WAS ASKED BECAUSE MY PHYSICAL 6728 04:08:03,509 --> 04:08:05,711 THERAPIST GRADUATED FROM SCHOOL 6729 04:08:05,711 --> 04:08:07,547 AND HER PROFESSOR ASKED HER IF 6730 04:08:07,547 --> 04:08:09,715 SHE KNEW ANYONE THAT WOULD COME 6731 04:08:09,715 --> 04:08:10,650 IN AND SPEAK. 6732 04:08:10,650 --> 04:08:12,652 SO THAT'S SOMETHING THAT I WOULD 6733 04:08:12,652 --> 04:08:14,687 DEFINITELY PUT ON MY LIST TO DO. 6734 04:08:14,687 --> 04:08:20,126 SO ONE OF MY QUESTIONS WAS, 6735 04:08:20,126 --> 04:08:21,627 LET'S JUST GO BACK A LITTLE BIT. 6736 04:08:21,627 --> 04:08:25,298 SO MY LYMPHADEMA WAS VERY OUT OF 6737 04:08:25,298 --> 04:08:25,998 CONTROL. 6738 04:08:25,998 --> 04:08:28,701 I'VE HAD 24 LYMPH NODES REMOVED, 6739 04:08:28,701 --> 04:08:30,903 HAD A MASTECTOMY, RADIATION 6740 04:08:30,903 --> 04:08:33,806 THERAPY, CHEMOTHERAPY, AND SO AT 6741 04:08:33,806 --> 04:08:38,344 THE TIME, I COULDN'T FIND A WAY 6742 04:08:38,344 --> 04:08:40,580 TO TREAT -- A PLACE TO GO TO GET 6743 04:08:40,580 --> 04:08:42,915 TREATED FOR MY LYMPHADEMA. 6744 04:08:42,915 --> 04:08:45,451 I FOUND ONE PLACE IN NEW YORK, 6745 04:08:45,451 --> 04:08:46,886 AND IT WAS VERY EXPENSIVE AND I 6746 04:08:46,886 --> 04:08:48,387 COULD NOT AFFORD IT. 6747 04:08:48,387 --> 04:08:50,623 INSURANCE DIDN'T COVER AT THE 6748 04:08:50,623 --> 04:08:50,823 TIME. 6749 04:08:50,823 --> 04:08:53,960 SO FAST FORWARD, THERE ARE STILL 6750 04:08:53,960 --> 04:08:55,094 CHALLENGES WITH INSURANCE 6751 04:08:55,094 --> 04:08:57,663 COMPANIES AND COVERAGE, AND 6752 04:08:57,663 --> 04:09:01,000 RIGHT NOW I HAVE TO GET GARMENTS 6753 04:09:01,000 --> 04:09:02,301 RENEWED, NEW GARMENTS, AND I 6754 04:09:02,301 --> 04:09:03,502 HAVE TO COME OUT OF POCKET FOR 6755 04:09:03,502 --> 04:09:06,539 IT BECAUSE MY INSURANCE COMPANY 6756 04:09:06,539 --> 04:09:09,508 IS NOT PAYING THE PROVIDER. 6757 04:09:09,508 --> 04:09:10,309 STRAIGHT AWAY. 6758 04:09:10,309 --> 04:09:13,212 SO I HAVE TO WAIT UNTIL THAT 6759 04:09:13,212 --> 04:09:15,047 HAPPENS, WHICH CAN TAKE MONTHS, 6760 04:09:15,047 --> 04:09:16,415 AND I CAN'T WAIT THAT LONG 6761 04:09:16,415 --> 04:09:18,517 BEFORE I HAVE TO GET A NEW 6762 04:09:18,517 --> 04:09:21,053 SLEEVE AND NIGHTTIME GARMENT. 6763 04:09:21,053 --> 04:09:23,856 SO MY QUESTION WAS, ONE, HOW CAN 6764 04:09:23,856 --> 04:09:25,958 I BETTER ADVOCATE FOR 6765 04:09:25,958 --> 04:09:27,460 INDIVIDUALS LIVING WITH 6766 04:09:27,460 --> 04:09:28,861 LYMPHADEMA IN A MORE PUBLIC WAY, 6767 04:09:28,861 --> 04:09:33,733 BECAUSE I FEEL LIKE I DO IN 6768 04:09:33,733 --> 04:09:36,369 TERMS OF LIKE -- I'M PART OF A 6769 04:09:36,369 --> 04:09:38,137 GROUP AT MEMORIAL SLOAN 6770 04:09:38,137 --> 04:09:41,007 KETTERING FOR PEOPLE WITH 6771 04:09:41,007 --> 04:09:41,807 LYMPHADEMA, BUT I THINK THERE 6772 04:09:41,807 --> 04:09:43,609 NEEDS TO BE JUST A GREATER SENSE 6773 04:09:43,609 --> 04:09:46,278 OF PUBLIC AWARENESS ABOUT HOW 6774 04:09:46,278 --> 04:09:48,180 MANY PEOPLE ARE AFFECTED BY 6775 04:09:48,180 --> 04:09:49,915 THIS, AND SO I'M JUST TRYING TO 6776 04:09:49,915 --> 04:09:51,651 THINK OF WAYS THAT I CAN 6777 04:09:51,651 --> 04:09:53,686 ADVOCATE MORE PUBLICLY TO BRING 6778 04:09:53,686 --> 04:09:58,391 ABOUT MORE AWARENESS, AND ALSO 6779 04:09:58,391 --> 04:09:59,558 ADVOCATE TO GET INSURANCE 6780 04:09:59,558 --> 04:10:01,193 COMPANIES TO UNDERSTAND THE 6781 04:10:01,193 --> 04:10:05,464 IMPORTANCE OF MAINTENANCE 6782 04:10:05,464 --> 04:10:08,401 BECAUSE PREVENTION IS VERY 6783 04:10:08,401 --> 04:10:13,406 IMPORTANT, BUT I'VE HAD SEVERAL 6784 04:10:13,406 --> 04:10:14,640 BOUTS OF CELLULITIS OVER THE 6785 04:10:14,640 --> 04:10:16,776 YEARS, TO WHICH MANY OF THE 6786 04:10:16,776 --> 04:10:18,077 TIMES, I'VE HAD TO BE 6787 04:10:18,077 --> 04:10:20,980 HOSPITALIZED, AND SO I KNOW 6788 04:10:20,980 --> 04:10:24,216 THERE WILL BE AT SOME POINT 6789 04:10:24,216 --> 04:10:25,151 ADVANCEMENTS IN WHAT INSURANCE 6790 04:10:25,151 --> 04:10:26,352 COMPANIES ARE COVERING AND HOW 6791 04:10:26,352 --> 04:10:28,554 THEY'RE LOOKING AT THIS 6792 04:10:28,554 --> 04:10:29,555 CONDITION. 6793 04:10:29,555 --> 04:10:31,157 BUT THERE ISN'T AT THE TIME. 6794 04:10:31,157 --> 04:10:34,093 AND FOR SOME PEOPLE LIKE MYSELF 6795 04:10:34,093 --> 04:10:36,195 AT THE TIME, I CAN AFFORD TO GET 6796 04:10:36,195 --> 04:10:37,697 THE SLEEVES AND COME OUT OF 6797 04:10:37,697 --> 04:10:39,065 POCKET, BUT OTHER PEOPLE CAN'T 6798 04:10:39,065 --> 04:10:39,832 DO THAT. 6799 04:10:39,832 --> 04:10:41,267 AND I'VE BEEN IN A SITUATION 6800 04:10:41,267 --> 04:10:43,903 WHERE I COULDN'T DO THAT ONE 6801 04:10:43,903 --> 04:10:46,772 TIME, AND IT WORSENED MY 6802 04:10:46,772 --> 04:10:47,139 LYMPHADEMA. 6803 04:10:47,139 --> 04:10:50,509 SO JUST SOME ADVICE ON BEING A 6804 04:10:50,509 --> 04:10:52,278 BETTER ADVOCATE TO BRING ABOUT 6805 04:10:52,278 --> 04:10:54,714 PUBLIC AWARENESS AND ALSO TO BE 6806 04:10:54,714 --> 04:10:56,916 THE VOICE IN THE EAR OF 6807 04:10:56,916 --> 04:11:00,419 INSURANCE COMPANIES TO LET THEM 6808 04:11:00,419 --> 04:11:02,922 KNOW, YOU KNOW, HOW BAD THIS CAN 6809 04:11:02,922 --> 04:11:04,256 GET FOR INDIVIDUALS THAT ARE 6810 04:11:04,256 --> 04:11:06,158 LIVING WITH IT BECAUSE THEY'RE 6811 04:11:06,158 --> 04:11:13,966 NOT COVERING CERTAIN GARMENTS OR 6812 04:11:13,966 --> 04:11:15,034 CERTAIN OTHER THINGS NEEDED FOR 6813 04:11:15,034 --> 04:11:16,869 MAINTENANCE. 6814 04:11:16,869 --> 04:11:18,270 >> THANKS, CYNTHIA. 6815 04:11:18,270 --> 04:11:19,305 I'M GOING TO GO ON WITH THE 6816 04:11:19,305 --> 04:11:21,240 HANDS RAISED IN A MOMENT, BUT I 6817 04:11:21,240 --> 04:11:23,909 JUST GOT A MESSAGE FROM DR. KIM 6818 04:11:23,909 --> 04:11:25,411 STEELE, WHO IS THE MANAGER OF 6819 04:11:25,411 --> 04:11:28,314 THE ARPA LIGHT PROGRAM FOR 6820 04:11:28,314 --> 04:11:30,683 LYMPHATICS TO TELL US, JOEL, 6821 04:11:30,683 --> 04:11:33,953 THAT THEY ACTUALLY HAVE A 6822 04:11:33,953 --> 04:11:35,621 SOLICITATION FOR SUBMISSIONS 6823 04:11:35,621 --> 04:11:38,924 THROUGH SBIR FOR EXACTLY WHAT 6824 04:11:38,924 --> 04:11:40,493 YOU'RE DISCUSSING, AND I BELIEVE 6825 04:11:40,493 --> 04:11:41,927 SELEN WILL PUT THE LINKS IN THE 6826 04:11:41,927 --> 04:11:42,628 CHAT. 6827 04:11:42,628 --> 04:11:44,663 SO THAT WAS A VERY TIMELY 6828 04:11:44,663 --> 04:11:46,098 COMMENT, JOEL, AND IT GOT AN 6829 04:11:46,098 --> 04:11:47,199 IMMEDIATE RESPONSE. 6830 04:11:47,199 --> 04:11:51,370 SO I'D LIKE TO MOVE ON TO 6831 04:11:51,370 --> 04:11:52,671 MELISSA, I GUESS IS THE NEXT 6832 04:11:52,671 --> 04:11:55,274 HAND UP. 6833 04:11:55,274 --> 04:11:56,408 >> OKAY. 6834 04:11:56,408 --> 04:11:59,011 MY VIDEO WON'T START BECAUSE THE 6835 04:11:59,011 --> 04:12:00,846 HOST HAS STOPPED IT, THIS 6836 04:12:00,846 --> 04:12:01,981 HAPPENED EARLIER AND IF YOU CAN 6837 04:12:01,981 --> 04:12:03,082 HEAR ME -- HERE WE GO. 6838 04:12:03,082 --> 04:12:04,750 NOW YOU CAN SEE ME. 6839 04:12:04,750 --> 04:12:08,154 I JUST WANT TO COMMEND ALEXA AND 6840 04:12:08,154 --> 04:12:09,021 CYNTHIA FOR WHAT THEY'VE DONE, 6841 04:12:09,021 --> 04:12:10,589 AND THE QUESTION CAME UP HOW 6842 04:12:10,589 --> 04:12:12,424 CAN, YOU KNOW, AS A PATIENT, HOW 6843 04:12:12,424 --> 04:12:16,028 CAN YOU EDUCATE A PHYSICIAN YOU 6844 04:12:16,028 --> 04:12:19,231 MAY SEE? 6845 04:12:19,231 --> 04:12:22,635 I CAN RELATE TO THAT AS SOMEONE 6846 04:12:22,635 --> 04:12:24,270 WHO I SUFFER FROM CELIAC 6847 04:12:24,270 --> 04:12:25,704 DISEASE, AND THAT'S THE 6848 04:12:25,704 --> 04:12:26,438 GLUTEN-FREE THING. 6849 04:12:26,438 --> 04:12:30,776 30 YEARS AGO, WHEN IT FIRST 6850 04:12:30,776 --> 04:12:33,546 STARTED UP, NO ONE HAD HEARD OF 6851 04:12:33,546 --> 04:12:33,879 IT. 6852 04:12:33,879 --> 04:12:35,648 WHEN I WENT TO A PHYSICIAN, THEY 6853 04:12:35,648 --> 04:12:36,282 DIDN'T KNOW WHAT I WAS TALKING 6854 04:12:36,282 --> 04:12:36,482 ABOUT. 6855 04:12:36,482 --> 04:12:37,583 SO MY LOCAL SUPPORT GROUP, AND 6856 04:12:37,583 --> 04:12:39,685 THIS COULD BE SOMETHING THAT 6857 04:12:39,685 --> 04:12:41,487 SMALLER SUPPORT GROUPS COULD DO, 6858 04:12:41,487 --> 04:12:42,988 DECIDED TO SEND INFORMATION 6859 04:12:42,988 --> 04:12:45,658 PACKETS TO BASICALLY ALL THE 6860 04:12:45,658 --> 04:12:47,893 RELEVANT PHYSICIANS IN THE 6861 04:12:47,893 --> 04:12:49,995 GREATER HOUSTON AREA, AND WE 6862 04:12:49,995 --> 04:12:52,164 NOTICED WITHIN THE FIRST TWO 6863 04:12:52,164 --> 04:12:54,667 YEARS, WE WERE FLOODED WITH NEW 6864 04:12:54,667 --> 04:12:55,868 MEMBERS WHO CAME IN AND THEY 6865 04:12:55,868 --> 04:12:58,871 WERE REFERRED BY -- OR HAD HEARD 6866 04:12:58,871 --> 04:13:00,739 ABOUT US FROM SOME OF THE 6867 04:13:00,739 --> 04:13:02,074 PHYSICIANS THAT WERE ON OUR HIT 6868 04:13:02,074 --> 04:13:04,076 LIST THAT HAD BEEN COMPLETELY 6869 04:13:04,076 --> 04:13:05,411 UNAWARE OF WHAT WE WERE. 6870 04:13:05,411 --> 04:13:07,847 SO I DON'T KNOW IF SOME KIND OF 6871 04:13:07,847 --> 04:13:08,414 A CAMPAIGN LIKE THAT, IT 6872 04:13:08,414 --> 04:13:09,982 WOULDN'T HAVE TO BE MAILING 6873 04:13:09,982 --> 04:13:11,550 PACKAGES, YOU KNOW, PAPER, BUT 6874 04:13:11,550 --> 04:13:14,453 MAYBE EMAILS OR SOMETHING LIKE 6875 04:13:14,453 --> 04:13:16,055 THAT, TO -- JUST TO EDUCATE THE 6876 04:13:16,055 --> 04:13:18,057 ONES YOU KNOW ABOUT, BECAUSE 6877 04:13:18,057 --> 04:13:22,061 EVERY TIME YOU VISIT A PHYSICIAN 6878 04:13:22,061 --> 04:13:23,095 OR ANOTHER PRACTITIONER, PUT 6879 04:13:23,095 --> 04:13:26,065 THEIR NAME ON A LIST AND SEND 6880 04:13:26,065 --> 04:13:26,932 SOMETHING TO THEM? 6881 04:13:26,932 --> 04:13:29,101 I DON'T KNOW. 6882 04:13:29,101 --> 04:13:30,603 IT SEEMED TO WORK FOR US. 6883 04:13:30,603 --> 04:13:32,805 >> IT SOUNDS LIKE A GREAT IDEA 6884 04:13:32,805 --> 04:13:35,107 AND A LOT OF WORK, RIGHT? 6885 04:13:35,107 --> 04:13:36,609 >> IT WAS, BUT IT WAS 6886 04:13:36,609 --> 04:13:38,277 WORTHWHILE. 6887 04:13:38,277 --> 04:13:39,245 >> ABSOLUTELY. 6888 04:13:39,245 --> 04:13:41,347 I SEE WE'RE EDGING UP ON THE END 6889 04:13:41,347 --> 04:13:44,250 OF OUR ALLOTTED TIME FOR THIS 6890 04:13:44,250 --> 04:13:45,517 PANEL, SO I WANT YOU TO BE 6891 04:13:45,517 --> 04:13:47,152 THINKING ABOUT LAST COMMENTS OR 6892 04:13:47,152 --> 04:13:47,486 QUESTIONS. 6893 04:13:47,486 --> 04:13:49,555 I DO HAVE A HAND UP FROM BETSY. 6894 04:13:49,555 --> 04:13:52,057 MAYBE WE CAN TURN TO YOU NEXT. 6895 04:13:52,057 --> 04:13:53,492 >> YEAH, JUST A QUICK COMMENT. 6896 04:13:53,492 --> 04:13:56,295 I JUST WANTED TO ACKNOWLEDGE, 6897 04:13:56,295 --> 04:13:58,297 CYNTHIA HAD SORT OF SOME ACTION 6898 04:13:58,297 --> 04:13:59,632 ITEMS, I THINK, WITH HER 6899 04:13:59,632 --> 04:14:01,967 COMMENT, AND I THINK IN TERMS OF 6900 04:14:01,967 --> 04:14:03,903 REIMBURSEMENT, AND CERTAINLY I'M 6901 04:14:03,903 --> 04:14:04,837 NOT AN EXPERT IN THAT REALM, BUT 6902 04:14:04,837 --> 04:14:06,438 MY HOPE IS WITH THE PASSAGE OF 6903 04:14:06,438 --> 04:14:07,773 THE LYMPHADEMA TREATMENT ACT, 6904 04:14:07,773 --> 04:14:09,408 AND WITH ACTION BY THE CENTERS 6905 04:14:09,408 --> 04:14:10,943 OF MEDICARE AND MEDICAID, I'M 6906 04:14:10,943 --> 04:14:12,378 NOT SURE WHO YOUR INSURANCE 6907 04:14:12,378 --> 04:14:15,681 PROVIDER IS, BUT WE GENERALLY 6908 04:14:15,681 --> 04:14:18,017 SEE PRIVATE PAYORS FOLLOW SUIT 6909 04:14:18,017 --> 04:14:19,618 ONCE MEDICARE AND MEDICAID AND 6910 04:14:19,618 --> 04:14:21,820 SOMETIMES I'VE ACTUALLY SEEN 6911 04:14:21,820 --> 04:14:24,657 ESPECIALLY COUPLE TOM GARMENTS 6912 04:14:24,657 --> 04:14:28,794 WRITTEN AS SPECIFIC EXCLUSION, 6913 04:14:28,794 --> 04:14:29,828 SO INTERESTING TO DO SOME 6914 04:14:29,828 --> 04:14:31,297 RESEARCH AND POTENTIALLY GET 6915 04:14:31,297 --> 04:14:31,797 SOME OF YOUR HEALTHCARE 6916 04:14:31,797 --> 04:14:35,434 PROVIDERS TO BE ABLE TO 6917 04:14:35,434 --> 04:14:36,835 WRITE SOME LETTERS ON YOUR 6918 04:14:36,835 --> 04:14:38,570 BEHALF TO ADVOCATE FOR WHAT 6919 04:14:38,570 --> 04:14:39,571 REALLY HAPPENS IN TERMS OF THE 6920 04:14:39,571 --> 04:14:42,975 COST TO THEM AS A PROVIDER, IF 6921 04:14:42,975 --> 04:14:44,143 YOU'RE NOT IN ADEQUATE 6922 04:14:44,143 --> 04:14:45,744 COMPRESSION, IT'S PLACING YOU AT 6923 04:14:45,744 --> 04:14:47,846 HIGHER RISK FOR CELLULITIS, 6924 04:14:47,846 --> 04:14:48,714 INFECTION OR RECURRENCE OF THOSE 6925 04:14:48,714 --> 04:14:49,481 TYPES OF THINGS. 6926 04:14:49,481 --> 04:14:52,084 SO I THINK THAT UTILIZING THOSE 6927 04:14:52,084 --> 04:14:53,819 PROVIDERS TO HELP YOU ADVOCATE. 6928 04:14:53,819 --> 04:14:55,220 I THINK IN TERMS OF OTHER WAYS 6929 04:14:55,220 --> 04:14:57,856 TO GET YOUR MESSAGE OUT, I'M 6930 04:14:57,856 --> 04:15:00,225 FINDING THAT INDIVIDUALS WHO ARE 6931 04:15:00,225 --> 04:15:01,460 WILLING TO SHARE THEIR LIVES IN 6932 04:15:01,460 --> 04:15:03,329 A SOCIAL MEDIA FORMAT ABOUT WHAT 6933 04:15:03,329 --> 04:15:05,030 IT MEANS TO BE LIVING WITH 6934 04:15:05,030 --> 04:15:06,131 LYMPHADEMA, SHARING YOUR LIVED 6935 04:15:06,131 --> 04:15:07,800 EXPERIENCE IN THAT FORMAT 6936 04:15:07,800 --> 04:15:11,136 THROUGH TIK TOK OR INSTAGRAM IS 6937 04:15:11,136 --> 04:15:13,172 REALLY IMPACTFUL, AND ALLOWING 6938 04:15:13,172 --> 04:15:14,206 PROVIDERS AS WELL AS THE GREATER 6939 04:15:14,206 --> 04:15:16,608 COMMUNITY TO UNDERSTAND JUST 6940 04:15:16,608 --> 04:15:17,943 WHAT THAT REALLY MEANS IN TERMS 6941 04:15:17,943 --> 04:15:19,778 OF HOW MUCH TIME IT TAKES TO 6942 04:15:19,778 --> 04:15:21,547 CARE FOR THAT AFFECTED LIMB AND 6943 04:15:21,547 --> 04:15:23,349 HOW IT MAY OR MAY NOT BE 6944 04:15:23,349 --> 04:15:24,850 IMPACTING YOUR DAY TO DAY LIFE. 6945 04:15:24,850 --> 04:15:26,852 I HAVE FOUND TO BE REALLY 6946 04:15:26,852 --> 04:15:27,720 IMPACTFUL. 6947 04:15:27,720 --> 04:15:28,387 I'VE SHARED IT WITH STUDENTS SO 6948 04:15:28,387 --> 04:15:29,655 THAT THEY CAN HAVE A GREATER 6949 04:15:29,655 --> 04:15:31,390 APPRECIATION WHEN WE'RE NOT ABLE 6950 04:15:31,390 --> 04:15:32,992 TO BRING PATIENTS IN, BUT I 6951 04:15:32,992 --> 04:15:35,861 THINK THE MORE WE CAN BE SORT OF 6952 04:15:35,861 --> 04:15:37,429 PUBLIC FACING -- IT'S ONE THING 6953 04:15:37,429 --> 04:15:38,998 FOR US AS PROVIDERS TO SHARE 6954 04:15:38,998 --> 04:15:40,366 THAT, BUT I DO THINK THE IMPACT 6955 04:15:40,366 --> 04:15:41,734 FROM FIRSTHAND LIVED EXPERIENCES 6956 04:15:41,734 --> 04:15:44,603 IS SO HELPFUL, BECAUSE I DO 6957 04:15:44,603 --> 04:15:46,071 THINK FROM A PERSPECTIVE OF 6958 04:15:46,071 --> 04:15:47,639 HEALTHCARE, WE'RE ALL BUSY, 6959 04:15:47,639 --> 04:15:48,974 WE'RE BEING FORCED TO LIMIT OUR 6960 04:15:48,974 --> 04:15:50,909 AMOUNT OF TIME WITH PATIENTS 6961 04:15:50,909 --> 04:15:52,111 BECAUSE OF CHALLENGES WITH 6962 04:15:52,111 --> 04:15:53,946 PAYMENT AND REIMBURSEMENT, BUT I 6963 04:15:53,946 --> 04:15:55,881 THINK IT HELPS US TO REMEMBER 6964 04:15:55,881 --> 04:15:58,350 THAT THERE'S A PERSON BEHIND 6965 04:15:58,350 --> 04:16:00,285 THAT STORY, AND THAT IT IMPACTS 6966 04:16:00,285 --> 04:16:02,488 EACH PERSON AT A VERY INDIVIDUAL 6967 04:16:02,488 --> 04:16:05,224 LEVEL AND FORCES US TO 6968 04:16:05,224 --> 04:16:07,159 RE-EVALUATE AS A PROVIDER WHY AM 6969 04:16:07,159 --> 04:16:08,894 I HERE, AND WE'RE REALLY HERE TO 6970 04:16:08,894 --> 04:16:11,497 BE ABLE TO IMPROVE AN 6971 04:16:11,497 --> 04:16:13,032 INDIVIDUAL'S QUALITY OF LIFE, 6972 04:16:13,032 --> 04:16:14,166 WALK WITH YOU ON THAT PATH. 6973 04:16:14,166 --> 04:16:15,000 SO IF YOU'RE SOMEONE WHO WOULD 6974 04:16:15,000 --> 04:16:16,735 BE INTERESTED IN THAT 6975 04:16:16,735 --> 04:16:18,871 PUBLIC-FACING EXPERIENCE, I 6976 04:16:18,871 --> 04:16:20,539 THINK THERE'S A LOT OF VALUE AND 6977 04:16:20,539 --> 04:16:22,307 I'VE LEARNED A LOT FROM MY 6978 04:16:22,307 --> 04:16:23,909 PATIENTS AND AT LEAST BEING ON 6979 04:16:23,909 --> 04:16:25,978 SOME OF THOSE SOCIAL MEDIA PAGES 6980 04:16:25,978 --> 04:16:26,979 AND APPRECIATE HOW PEOPLE ARE 6981 04:16:26,979 --> 04:16:28,347 SHARING THEIR LIVES IN THAT 6982 04:16:28,347 --> 04:16:28,580 FORMAT. 6983 04:16:28,580 --> 04:16:32,351 >> THOSE ARE GREAT POINTS. 6984 04:16:32,351 --> 04:16:36,989 WE HAVE LOOK LIKE FOUR MINUTES. 6985 04:16:36,989 --> 04:16:38,791 I WONDER IF ANYBODY HAS A 6986 04:16:38,791 --> 04:16:39,658 BURNING LAST STATEMENT OR 6987 04:16:39,658 --> 04:16:44,363 QUESTION? 6988 04:16:44,363 --> 04:16:45,931 WE REALLY APPRECIATE EVERYBODY'S 6989 04:16:45,931 --> 04:16:46,432 INPUT TODAY. 6990 04:16:46,432 --> 04:16:48,834 IT'S BEEN VERY ILLUMINATING TO 6991 04:16:48,834 --> 04:16:50,769 HEAR THE DIFFERENT VANTAGE 6992 04:16:50,769 --> 04:16:51,770 POINTS FROM WHICH WE COME TO 6993 04:16:51,770 --> 04:16:53,005 THIS SUBJECT MATTER, AND I HOPE 6994 04:16:53,005 --> 04:16:56,341 THAT WE AS A COMMISSION CAN TAKE 6995 04:16:56,341 --> 04:16:58,510 INTO ACTION MANY OF THE IDEAS 6996 04:16:58,510 --> 04:17:05,384 THAT WE HEARD ABOUT TODAY. 6997 04:17:05,384 --> 04:17:06,652 WE REALLY APPRECIATE KNOWING THE 6998 04:17:06,652 --> 04:17:08,020 STATS OF OUR STAKEHOLDERS OF 6999 04:17:08,020 --> 04:17:09,555 WHICH YOU ARE ALL VERY IMPORTANT 7000 04:17:09,555 --> 04:17:10,155 REPRESENTATIVES, SO THANK YOU 7001 04:17:10,155 --> 04:17:12,624 VERY MUCH FOR YOUR INPUT ON 7002 04:17:12,624 --> 04:17:14,827 THIS, AND WE ENCOURAGE YOUR 7003 04:17:14,827 --> 04:17:17,062 CONTINUED INPUT AS THIS 7004 04:17:17,062 --> 04:17:18,330 COMMISSION MOVES FORWARD WITH 7005 04:17:18,330 --> 04:17:19,965 ITS DELIBERATIONS. 7006 04:17:19,965 --> 04:17:24,570 SO THANKS VERY MUCH. 7007 04:17:24,570 --> 04:17:29,541 BUYBYE, EVERYONE. 7008 04:17:29,541 --> 04:17:30,442 >> THANK YOU, EVERYONE. 7009 04:17:30,442 --> 04:17:31,477 I WOULD LIKE TO SAY THANK YOU TO 7010 04:17:31,477 --> 04:17:34,012 ALL THE PANELISTS TODAY, AND WE 7011 04:17:34,012 --> 04:17:37,583 WOULD LIKE TO -- NHLBI WOULD 7012 04:17:37,583 --> 04:17:38,917 LIKE TO THANK YOU, AND IF YOU 7013 04:17:38,917 --> 04:17:41,019 HAVE ANY OTHER THINGS THAT COMES 7014 04:17:41,019 --> 04:17:42,688 TO YOUR MIND THAT PERTAINS TO 7015 04:17:42,688 --> 04:17:44,456 OUR DISCUSSIONS TODAY, PLEASE 7016 04:17:44,456 --> 04:17:45,457 SEND TO MY WAY. 7017 04:17:45,457 --> 04:17:48,660 WE ARE GOING TO SHARE IT WITH 7018 04:17:48,660 --> 04:17:50,562 THE NCLD, AND THANK YOU TO 7019 04:17:50,562 --> 04:17:52,231 EVERYONE WHO WAS LISTENING ON 7020 04:17:52,231 --> 04:17:54,266 NIH VIDEOCAST AS WELL. 7021 04:17:54,266 --> 04:17:56,135 YOUR FEEDBACK IS VERY VALUABLE 7022 04:17:56,135 --> 04:17:59,304 AND WE ARE RECORDING THEM TOO. 7023 04:17:59,304 --> 04:18:02,541 AND ANY QUESTIONS, PLEASE 7024 04:18:02,541 --> 04:18:04,977 DON'T -- OR CONCERNS, PLEASE 7025 04:18:04,977 --> 04:18:06,578 DON'T HESITATE TO SEND TO OUR 7026 04:18:06,578 --> 04:18:06,912 WAY. 7027 04:18:06,912 --> 04:18:08,947 AND WITH THAT, WE ARE GOING TO 7028 04:18:08,947 --> 04:18:12,217 ADJOURN THE CLOSED SESSION AND 7029 04:18:12,217 --> 04:18:14,386 THE NCLD MEMBERS SHOULD STAY FOR 7030 04:18:14,386 --> 04:18:15,754 THE -- SORRY, WE ARE ADJOURNING 7031 04:18:15,754 --> 04:18:17,022 THE OPEN SESSION AND WE ARE 7032 04:18:17,022 --> 04:18:18,524 GOING TO PROCEED TO THE CLOSED 7033 04:18:18,524 --> 04:18:19,591 SESSION. 7034 04:18:19,591 --> 04:18:29,591 HAVE A GOOD AFTERNOON.