Medical illustration is both an art and a science. But it can have a huge cultural impact, too, as medical student and illustrator Chidiebere Ibe discovered when his illustration of a pregnant Black woman and her fetus went viral in 2021.

The image was groundbreaking precisely because it shouldn’t have been. People have a wide range of skin colors, and everyone develops medical conditions; it’s common sense that medical illustrations should feature a diverse range of bodies.

Yet a 2018 study found that only 4.5% of the images in medical textbooks feature darker skin tones. The lack of diversity in medical illustration can be dangerous. In dermatology, for instance, the scarcity of visual representations of skin conditions on darker complexions can lead to misdiagnosis. And for people of color, the dearth of images depicting conditions in non-white people could prompt them to ignore their symptoms and put off seeking medical attention.

When Ibe began teaching himself medical illustration in 2020, the then-24-year-old from Nigeria’s Ebonyi State was looking for a way to combine his artistic talent with the dream of becoming a doctor. He worked on a borrowed laptop that he plugged in at his church, where the power supply was steadier than at his home an hour away.

The success of his images ultimately helped Ibe crowdfund his medical education. Meanwhile, his work led to the creation of Illustrate Change, a library of BIPOC (Black, Indigenous, and people of color) medical illustrations created by the Association of Medical Illustrators with support from Johnson & Johnson and Deloitte. He is the chief illustrator of the Journal of Global Neurosurgery and has published a book on the importance of diverse visual representation in medicine, all while continuing his studies in medicine at Copperbelt University in Kitwe, Zambia.

This interview has been edited for length and clarity.

When you started doing medical illustrations, was it with the intent of adding diversity?

No. When I started, I didn’t know anything about medical illustrations. It’s through the process of learning that I realized they didn’t represent people of color or Black people.

How did that lack of diversity influence your ability to learn medical illustrations?

I didn’t have any formal training on how to create medical illustrations. And to be able to teach yourself, you need good references to guide you through. I didn’t have them. So everything I drew was off my imagination. I would go and create these images and show my mentor. He offered guidance, but the lack of model resources was a big struggle.

For example, I would create a surgical procedure and maybe I wanted to show how the blood clots [look] on Black people. But I wouldn’t know how to represent it on a Black person because the illustrations I saw were all on white people.

Is that true even as a medical student? Does a mostly Black classroom of future African doctors learn medical symptoms on images of white people? 

I would say that that is actually the case, yes. For instance, I took a course in pathology and realized that all the slides that were used in lecturing were skin diseases on white people. And I keep asking myself: Our patients, the majority of them are Black people, yet the resources to get them treated are white-centered; how does [the same disease] look like on Black people?

I realized that it was really a problem in Africa: in our textbooks, our lecture materials, our laboratories. For example, we have these mannequins in laboratories, and they are white. I really hope that in no distant time people will understand that this is a problem in health care in Africa. We can all work assiduously in addressing this issue.

The field of medical illustration is relatively small. How has your work been perceived within it?

I’m just about four years in as an illustrator, so my wealth of experience wouldn’t be comparable to someone who has been doing this for 50 years. For me, every day has really been a day to Excellerate my illustrations, to make them more accurate, to put in all the tiny details from research.

I’ve had people who are very supportive, who suggest areas to focus on. I’ve also had people come into my inbox and say, “I think next time you could consider making the design better based on these notes, and maybe you consider taking away the smile [on the people you draw].” So of course I am open to learning, and that is the beauty of being an illustrator, because your work out there is not just for you.

With such a large need for diverse medical illustrations, how do you choose what to work on?

There are two ways I do that.

One, I pay attention to my followers and my audience. Sometimes people of color make comments on my posts, for instance someone who has PCOS or endometriosis, or someone who has a child with Down syndrome and doesn’t feel seen. I want to create illustrations that I know represent the community of people who are actually following me.

And the second way is about research, because what I do is ask, “What are the prevalent diseases in Africa? And how many of these diseases have been accurately represented?” So then I am going to create them.

And how do you go about creating them? 

After the research, what I do is I look at the concept sketch, then I look for a suitable model. I sketch the outline, start coloring, ensure the anatomy is correct, and when that’s done I export the image, review the text, the labeling, and the anatomy in general.

I also think about the experience of patients who are going through the disease and see an image of it on Google. So for example, while it’s OK to create an image of a patient who is in pain, what about giving people hope through the illustration, by giving it a smile?

Did you ever expect your illustrations would go viral like they did?

I actually don’t know anyone who expects to be famous or go viral. I never expected it. And so for me, it was a shocker to see my work on LinkedIn have 5 million impressions, and about 3 million on Instagram, and the rest. And I think it’s just more reason to be humble and to work harder.

How has your work changed since your work has become more popular?

The older you get in a particular field the more patient you are, is what I noticed in the course of my learning. When I started I was so eager to get the work out that I would go too quickly, but in the course of learning I realized that patience is everything. So now I really take my time to do the research, my outlines, my painting and all of that. Also because I understand that my work is really out there, so I need to be sure it is very accurate.

Your work started a conversation about diversity in medical images. How do you think that discussion is changing the field?

In accurate times there’s been an increase in resources out there. There’s a project [Illustrate Change] that I worked on in which we’ve built a library of diverse illustrations, and people are already collaborating and are already coming together to Excellerate access. We partnered with Johnson & Johnson and Deloitte to create one of the biggest libraries of diverse illustrations out there, and so you see that collectively, many institutions or systems are now working together to Excellerate access to these resources. And these things were not there before my images went viral.

And secondly, I’ve also seen more illustrators who are also focused on creating more diverse illustrations. I feel that is a great asset and I’m sure that in the next three years or so that if a research is conducted around the number of diverse images, that will be an increase.

You are also helping train a new class of medical illustrators out of Africa. 

Some of the problems we have in Africa are due to lack of mentorship and empowerment. Medical illustration is actually a very small niche, and because it is small, that also affects the number of diverse images that we see out there. So my idea is, why not train more people who are willing to do the same thing so we can have more Black illustrations?

You are still pursuing training as a physician. How do you plan to combine your practice with your work as a medical illustrator? 

I had to still pursue my dream of being a doctor, because that’s where I find my ultimate joy and my ultimate fulfillment. And also to Excellerate my skill in illustrations, I needed to go to medical school. They’re not like two different things entirely. I am a doctor-to-be and I am also drawing things that are medically inclined. It is a beautiful experience that you can use your art to change lives, and use illustrations to change the perspective of people.

As a doctor, my life wouldn’t just be centered around the hospital; I would have some free time and I can make drawings of my daily cases, so I think there is really going to be a good balance there.

From a diagnostic perspective, what is the benefit of your body of images? 

Medical students will one day become doctors and it matters what they are being trained with. It matters what kind of resources they get exposed to. Imagine here in Africa, if medical students aren’t exposed to — let’s say — skin conditions on Black people, how do you expect them to treat patients that come to them with that skin condition? An accurate representation ensures that the patients are treated accurately.

And I think ultimately it also helps patients to feel seen, because as much as they’re trying to Excellerate health care outcomes, you also want to ensure that patients feel confident coming to the doctor.

Are your images being included in textbooks?

I don’t have access to organizations that publish medical textbooks globally, but I believe that people who have access to my illustrations do. So this is where collaboration comes in and people are like, “So can we review our textbook and what we’re doing? And can we ensure that more diverse images are being included?” I’m also aware of physicians who have printed my illustrations and hung them on their offices. That is really a great approach. That’s really fantastic. But I’m looking forward to seeing these images in textbooks.

And you have your own book. 

I published my book, titled “Beyond Skin.” The idea behind the book is that if only physicians could look beyond the skin of patients, we would have an equitable health care system. So it’s a moral call to physicians to treat every patient fairly and rightly. And it is also the book that contains my journey as an illustrator.

What do you think is the ultimate goal of your illustration work?

It is to ensure that these images are in textbooks, and see that we do not use the skin as a basis for treatment, and this can be a result of accurate representation. And also, I long to see more people doing the same thing that I do, because it’s not about me, I want to see people be passionate about issues like this.

You were initially drawn to medical illustration as an artist. Do you still do other types of art? 

I don’t do any other type of art anymore. This is obviously now my art.

ThePRTree New Delhi [India], August 21: In a groundbreaking move set to revolutionize the medical coding industry, 369Hub Ventures Private Limited and(AAPC) have joined forces as "International Regional Growth Partners". This partnership, officially established on August 18th, 2023, in Delhi, aims to provide an all-encompassing ecosystem that empowers students and professionals in the healthcare and medical coding sectors.

Empowering the Future of Medical Coding: A Transformative Partnership 369Hub Ventures Private Limited, a rapidly growing organization with a global footprint, has now established its presence in India and is focused on catering to the healthcare and medical coding industry. With a vision to empower individuals through comprehensive training and resources, 369Hub Ventures is committed to creating an ecosystem that not only educates but also equips participants with the necessary skills to excel in the ever-evolving medical coding landscape.

Collaborating with the highly respected AAPC, 369Hub Ventures has taken a giant leap towards achieving this vision. AAPC, as the largest education and credentialing organization for medical coders, billers, auditors, and related professionals, brings its expertise and ethical standards to this partnership. All members of AAPC adhere to a strict Code of Ethics, ensuring the highest levels of professionalism, integrity, and ethical behavior. A Comprehensive Ecosystem for Success

The cornerstone of this partnership is the creation of an end-to-end ecosystem that prepares individuals for success in the medical coding field. The ecosystem includes a range of offerings aimed at equipping students and professionals with the necessary skills and knowledge. This comprehensive ecosystem encompasses: * CPC Training by AAPC: A course that imparts fundamental medical coding skills for professional services and prepares participants for AAPC's CPC exam.

* Books: Access to educational materials that support learning and understanding of coding practices. * Membership in the Ecosystem: Benefit from networking opportunities, learning from industry experts, free webinars, product discounts, enhanced earning potential with certifications, and access to job-finding resources.

* test (Dual Attempt): A preparation program for the CPC test that provides dual attempts, increasing the chances of success. * Practicode (Internship Module): An innovative internship module designed by AAPC, allowing participants to apply their coding skills in real-world scenarios.

* Codify Tool (3 weeks): A focused program that sharpens participants' coding skills, ensuring they are ready for the challenges of the industry. Placing over 15,000 Students and Professionals: Bridging the Skills Gap

The partnership's impact goes beyond education and training. With a commitment to supporting career growth, 369Hub Ventures and its group are determined to place over 15,000 students and professionals within the medical coding industry. This strategic move aligns with the growing demand for skilled medical coders and ensures a seamless transition from education to employment. A Commitment to Excellence and Transparency

The partnership between 369Hub Ventures and AAPC is built on a foundation of trust, transparency, and excellence. The collaborative efforts are dedicated to delivering the most trusted, straightforward, and effective ecosystem for learning and professional development. By providing access to industry experts, cutting-edge tools, and a supportive community, the partnership ensures that individuals embarking on a medical coding career are well-equipped for success. A Bright Future for Medical Coding

As the medical coding industry continues to evolve and grow, the partnership between 369Hub Ventures and AAPC is poised to play a pivotal role in shaping its future. Through innovative training, hands-on experiences, and a commitment to ethical standards, this partnership is set to elevate the skills and capabilities of aspiring medical coders, contributing to the overall efficiency and effectiveness of the healthcare industry. (Disclaimer: The above press release has been provided by ThePRTree. ANI will not be responsible in any way for the content of the same)

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)

Even with extensive caregiving experience, Patti LaFleur was unprepared for the crisis that hit in April 2021, when her mother, Linda LaTurner, fell out of a chair and broke her hip.

LaTurner, 71, had been diagnosed with early-onset dementia seven years before. For two years, she’d been living with LaFleur, who managed insulin injections for her mother’s Type 1 diabetes, helped her shower and dress, dealt with her incontinence and made sure she was eating well.

In the hospital after her mother’s hip replacement, LaFleur was told her mother would never walk again. When LaTurner came home, two emergency medical technicians brought her on a stretcher into the living room, put her on the bed LaFleur had set up, and wished the daughter well.

That was the extent of the help LaFleur received upon her mother’s discharge.

She didn’t know how to change her mother’s diapers or dress her, since at that point, LaTurner could barely move. She didn’t know how to turn her mother, who was spending all day in bed, to avoid bedsores. Even after an occupational therapist visited several days later, LaFleur continued to face caretaking tasks she wasn’t sure how to handle.

“It’s already extremely challenging to be a caregiver for someone living with dementia,” said LaFleur, who lives in Auburn, Washington, a Seattle suburb. Her mother died in March 2022.

“The lack of training in how to care for my mother,” she added, “just made an impossible job even more impossible.”

A new proposal from the Centers for Medicare & Medicaid Services addresses this often-lamented failure to support family, friends and neighbors who care for frail, ill, and disabled older adults. For the first time, it would authorize Medicare payments to health care professionals to train informal caregivers who manage medications, assist loved ones with activities such as toileting and dressing, and oversee the use of medical equipment.

The proposal, which covers both individual and group training, is a long-overdue recognition of the role informal caregivers — also known as family caregivers — play in protecting the health and well-being of older adults. About 42 million Americans provided unpaid care to people 50 and older in 2020, according to a much-cited report.

“We know from our research that nearly 6 in 10 family caregivers assist with medical and nursing tasks such as injections, tube feedings and changing catheters,” said Jason Resendez, president and CEO of the National Alliance for Caregiving.

But fewer than 30% of caregivers have conversations with health professionals about how to help loved ones, he said.

Even fewer caregivers for older adults — only 7% — report receiving training related to tasks they perform, according to a June 2019 report in JAMA Internal Medicine.

Nancy LeaMond, chief advocacy and engagement officer for AARP, experienced this gap firsthand when she spent six years at home caring for her husband, who had amyotrophic lateral sclerosis, a neurological condition also known as Lou Gehrig’s disease. Although she hired health aides, they weren’t certified to operate the feeding tube her husband needed at the end of his life and couldn’t show LeaMond how to use it. Instead, she and her sons turned to the internet and trained themselves by watching videos.

“Until very recently,” she told me, “there’s been very little attention to the role of family caregivers and the need to support caregivers so they can be an effective part of the health delivery system.”

Several details of CMS’s proposal have yet to be finalized. Notably, CMS has asked for public comments on who should be considered a family caregiver for the purposes of training and how often training should be delivered.

(If you’d like to let CMS know what you think about its caregiving training proposal, you can comment on the CMS site until 2 p.m. Sept. 11. The expectation is that Medicare will start paying for caregiver training next year, and caregivers should start asking for it then.)

Advocates said they favor a broad definition of caregiver.

Since often several people perform these tasks, training should be available to more than one person, Resendez suggested. And since people are sometimes reimbursed by family members for their assistance, being unpaid shouldn’t be a requirement, suggested Anne Tumlinson, founder and chief executive officer of ATI Advisory, a consulting firm in aging and disability policy.

As for the frequency of training, a one-size-fits-all approach isn’t appropriate given the varied needs of older adults and the varied skills of people who assist them, said Sharmila Sandhu, vice president of regulatory affairs at the American Occupational Therapy Association. Some caregivers may need a single session when a loved one is discharged from a hospital or a rehabilitation facility. Others may need ongoing training as conditions such as heart failure or dementia progress and new complications occur, said Kim Karr, who manages payment policy for AOTA.

When possible, training should be delivered in a person’s home rather than at a health care institution, said Donna Benton, director of USC’s Family Caregiver Support Center and the Los Angeles Caregiver Resource Center. All too often, recommendations that caregivers get from health professionals aren’t easy to implement at home and need to be adjusted, she said

Nancy Gross, 72, of Mendham, New Jersey, experienced this when her husband, Jim Kotcho, 77, received a stem cell transplant for leukemia in May 2015. Once Kotcho came home, Gross was responsible for flushing the port that had been implanted in his chest, administering medications through that site, and making sure all the equipment she was using was sterile.

Although a visiting nurse came out and offered education, it wasn’t adequate for the challenges Gross confronted.

“I’m not prone to crying, but when you think your loved one’s life is in your hands and you don’t know what to do,” she said, “that’s unbelievably stressful.”

For her part, Cheryl Brown, 79, of San Bernardino — a caregiver for her husband, Hardy Brown Sr., 80, since he was diagnosed with ALS in 2002 — is skeptical about paying professionals for training. At the time of his diagnosis, doctors gave Hardy five years, at most, to live. But he didn’t accept that prognosis and ended up defying expectations.

Today, Hardy’s mind is fully intact, and he can move his hands and his arms but not the rest of his body. Looking after him is a full-time job for Cheryl, who is also chair of the executive committee of California’s Commission on Aging and a former member of the California State Assembly. She said hiring paid help isn’t an option, given the expense.

And that’s what irritates Cheryl about Medicare’s training proposal.

“What I need is someone who can come into my home and help me,” she told me. “I don’t see how someone like me, who’s been doing this a very long time, would benefit from this. We caregivers do all the work, and the professionals get the money? That makes no sense to me.”

KFF Health News is eager to hear from readers about questions they’d like answered, problems they’ve been having with their care and advice they need in dealing with the health care system. Visit kffhealthnews.org/columnists to submit requests or tips.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling and journalism. 

MIAMI - Paramedics for the City of Marathon carry a drug more common in 1950s MASH units than ambulances in South Florida. It recently helped save a man attacked by a shark and is part of a strategy to sink problems with emergency response in remote areas of the Florida Keys.

Marathon EMS carry three times more drugs, 82, than average ambulances, Captain Joe Forcine said.

It helps the department overcome the island's 2½ hour drive to the nearest trauma center.

"We have an excellent hospital but it doesn't perform surgery," Forcine said. "It doesn't deliver babies. It doesn't work on cardiac patients with a cardiologist on call. So we have to be prepared. What that usually equals to is being able to stretch time and resources. Over time we've learned."

Three months ago, a bull shark attacked spear fisherman Kevin Blanco.

"Everything that could've gone wrong went right in this situation," Blanco's dad Omar said in May after the attack.

Paramedics feared Blanco would bleed out before a helicopter airlifted Kevin to Jackson Memorial South, Forcine said. So, they used a drug few ambulances carry. It's called Tranexamic Acid or TXA, a blood clotting drug given through IV or injected into bone.

Marathon medical leaders trained all 24 paramedics to administer it five years ago. Since then, it has helped save multiple shark attack victims, including Blanco, Forcine said. The drug helped stopped severe bleeding in less than three minutes, Forcine said.

"I have not seen it not work," he added.

Initially, the department wanted TXA to help victims of serious car crashes. 

Forcine read about the drug's use in a combat medical journal. He often reads such material to find tools able to help ease challenges in providing emergency care in remote areas. Even with an air ambulance in the lower Keys and Marathon, winds from the Caribbean and storms limit when and where medical helicopters can respond, Forcine said.

A grant secured by the Monroe County Sheriff bought MRI machines for Marathon EMS ambulances.

"So we can actually look at blood chemistry and see whether or not someone has pitfalls in certain areas that would make us go down an avenue and treat a certain way," Forcine said.

Still, keeping staff is no small concern. The island's cost of living forces 80% of staff to commute from Miami, Forcine said.

"It's hard to attract new people and sometimes when you attract new people they'll leave for more money and stuff like that," Forcine said.

For now, the department is in good shape with enough supplies and people. Marathon EMS will continue to pursue new tools for ambulances, Forcine said.