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Why Do Doctors Still Carry Pagers?

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Seeing a pager in today’s technologically evolved world is like spotting a hand-cranked car engine. In an era where the cell phone has replaced virtually every item in an old Radio Shack catalog, what’s the point of sticking with a device that hasn’t evolved in 20-odd years?

For physicians, the answer is that an anachronistic messaging system may still be best. Even though pager use has dropped from 61 million users in 1994 to less than six million today, hospital employees are helping to keep this seemingly redundant device from obsolescence for two reasons. In an urgent-care situation, they may be more reliable than cell phone reception. Second, hospitals are in no hurry to upgrade telecommunications.

“The feeling has been that in hospitals where the walls are shielded due to MRIs, cells phone aren’t universal,” says Fred Pelzman, M.D., an internist affiliated with New York-Presbyterian Hospital. “And hospitals will just tell you, ‘We use pagers.’ Cost is probably a factor in that.”

By some estimates, more than 90 percent of hospitals in the country use a telecommunications system based around pagers. Typically, a patient, nurse, or physician will phone a number designated for an urgent response; a dispatch center will take the message, then contact the on-call physician. The physician gets a page and returns the call.

It sounds inefficient, and it is. One survey shows that doctors waste up to 45 minutes a day using a relay system. But according to Pelzman, having a dedicated cell phone for messages wouldn’t be quite the same. “You have a pager when a patient is unstable. When a pager goes off, your instinct is to immediately respond. I don’t know you’d get that same kind of jolt if someone left a voicemail.” Compared to cell phones, pagers don’t need recharging—only batteries that need to be changed every few months. They also can be relied upon in cases of a natural disaster cutting off cell towers because they don't use over-crowded mobile phone networks.

Some hospitals are exploring alternative messaging systems like Vocera, a voice-operated badge that allows for near-instant consultations. But for Pelzman and many physicians, the distinctive beep of a pager would be a hard stimulus to leave behind. “When my pager goes off in the middle of the night, I’m wide awake,” he says. “It’s ingrained in my DNA.”

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Karen Bleier, AFP/Getty Images
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Medicine
Bill and Melinda Gates Will Repay Nigeria's $76 Million Polio-Fighting Loan
Karen Bleier, AFP/Getty Images
Karen Bleier, AFP/Getty Images

Not long after announcing a $100 million donation to find a cure for Alzheimer's disease, Bill and Melinda Gates have agreed to pay off Japan's $76 million loan to Nigeria to stamp out polio, Quartz reports.

Polio has been eradicated in most countries around the world, but it's still present in Nigeria, as well as in Afghanistan and Pakistan. In 2008, according to The Conversation, Nigeria accounted for 86 percent of all polio cases in Africa. This high number was thanks in part to low immunization rates and calls from extremists to boycott polio vaccinations out of fear that they were tainted with anti-fertility steroids.

National and international campaigns were launched to lower polio rates in Nigeria, and in 2014 the nation received the loan from Japan to boost disease-fighting efforts. Progress has been made since then, with no new cases of polio reported in Nigeria in 2017. Two children had contracted polio in 2016, two years after Nigeria's last known case.

Nigeria's loan repayments to Japan were slated to begin in 2018. The Bill & Melinda Gates Foundation agreed to cover the costs after Nigeria met its goal of "achieving more than 80 percent vaccination coverage in at least one round each year in very high risk areas across 80 percent of the country's local government areas," Quartz reports. The loan will be repaid over the next 20 years.

While the Gates Foundation is lending a hand to Nigeria, the Associated Press reports that health officials in Pakistan's eastern Punjab province recently launched a new chapter in the nation's ongoing struggle against the disease. Health workers will engage in a week-long, door-to-door vaccination campaign, though efforts like this are risky due to threats from the Taliban and other militant groups, who view vaccinations as a Western conspiracy and believe they sterilize children. Anti-polio efforts in Pakistan also suffered after the CIA used vaccinations as a cover to get DNA samples from the Bin Laden compound.

[h/t Quartz]

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George Mayerle, U.S. National Library of Medicine // Public Domain
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Design
This 1907 Vision Test Was Designed for People of All Nationalities
George Mayerle, U.S. National Library of Medicine // Public Domain
George Mayerle, U.S. National Library of Medicine // Public Domain

At the turn of the 20th century, San Francisco was a diverse place. In fact, Angel Island Immigration Station, located on an island in the San Francisco Bay, was known as the “Ellis Island of the West,” processing some 300,000 people coming to the U.S. in the early 1900s. George Mayerle, a German optometrist working in the city at the time, encountered this diversity of languages and cultures every day in his practice. So in the 1890s, Mayerle created what was billed as “the only [eye] chart published that can be used by people of any nationality,” as The Public Domain Review alerts us.

Anticipating the difficulty immigrants, like those from China or Russia, would face when trying to read a vision test made solely with Roman letters for English-speaking readers, he designed a test that included multiple scripts. For his patients that were illiterate, he included symbols. It features two different styles of Roman scripts for English-speaking and European readers, and characters in Cyrillic, Hebrew, Japanese, and Chinese scripts as well as drawings of dogs, cats, and eyes designed to test the vision of children and others who couldn't read.

The chart, published in 1907 and measuring 22 inches by 28 inches, was double-sided, featuring black text on a white background on one side and white text on a black background on the other. According to Stephen P. Rice, an American studies professor at Ramapo College of New Jersey, there are other facets of the chart designed to test for a wide range of vision issues, including astigmatism and color vision.

As he explains in the 2012 history of the National Library of Medicine’s collections, Hidden Treasure [PDF], the worldly angle was partly a marketing strategy on Mayerle’s part. (He told fellow optometrists that the design “makes a good impression and convinces the patient of your professional expertness.”)

But that doesn’t make it a less valuable historical object. As Rice writes, “the ‘international’ chart is an artifact of an immigrant nation—produced by a German optician in a polyglot city where West met East (and which was then undergoing massive rebuilding after the 1906 earthquake)—and of a globalizing economy.”

These days, you probably won’t find a doctor who still uses Mayerle’s chart. But some century-old vision tests are still in use today. Shinobu Ishihara’s design for a visual test for colorblindness—those familiar circles filled with colored dots that form numbers in the center—were first sold internationally in 1917, and they remain the most popular way to identify deficiencies in color vision.

[h/t The Public Domain Review]

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