Have doctors forgotten about infectious diseases?
Dr. Neil W. Schluger's main area of academic interest has been in tuberculosis, including clinical trials, molecular epidemiology, development and evaluation of diagnostics, and human host immune responses. He is the principal investigator at Columbia University for the Tuberculosis Trials Consortium, a CDC-funded collaboration in clinical trials in which patients are enrolled in trials of treatment of latent tuberculosis infection and active tuberculosis disease. In addition, Dr. Schluger has led studies examining the transmission dynamics of tuberculosis in New York City, using tools of molecular epidemiology. He has a long standing interest in the development and evaluation of new tools for the diagnosis of tuberculosis.
More recently, in addition to his studies in tuberculosis, he has led clinical trials for the use of retinoids in the treatment of emphysema and for the use of interferon gamma in the treatment of idiopathic pulmonary fibrosis.
Question: Have doctors forgotten about infectious diseases?
Neil Schluger: It certainly was true 15 years ago that there were very few physicians in the United States who felt comfortable taking care of tuberculosis patients because TB had become quite uncommon, and then in the late ‘80s and early ‘90s when it came back there was sort of a resurgence of interest in TB and historically it’s an interesting medical condition. So much of the history of medicine actually flowed through tuberculosis so people were interested for that reason, but most tuberculosis patients are cared for in the public sector in public health clinics. One certainly can’t make a living taking care of TB patients the same way you could giving Botox or doing weight-loss operations or things like that uh.. but even more serious things like cancer and heart disease are just infinitely more common in the United States. And patients with TB as I mentioned often are at the margins of society, often uninsured. It’s really in general I think part of the public health system’s responsibility to care for most of these patients.
Recorded on: 04/25/2008
When tuberculosis became uncommon in the U.S., the number of specialists declined, too, Schluger says.
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