Good morning! In today's issue, read about how some Americans are considering paying for their medical costs out-of-pocket instead of using health insurance, as premiums continue to rise.

Also, AAFP has released new information on the responsible use of artificial intelligence in primary care.

The American Academy of Family Physicians and Rock Health have released a whitepaper outlining a road map for the responsible integration of AI into primary care. The report emphasizes AI's potential to enhance patient outcomes by reducing administrative burdens and improving decision-making. Dr. Steven Waldren, AAFP's CMIO, highlights the urgency of AI adoption due to rapid technological advancements and the need to address administrative challenges in health care. However, challenges such as data interoperability and risk assessment remain significant barriers to AI implementation.

A study led by Dr. Jiyoung Ahn of the NYU Grossman School of Medicine found a significant link between poor dental health and an increased risk of pancreatic cancer. The research identified 27 oral bacteria and fungi that together raise the risk of pancreatic cancer by more than threefold, surpassing the risk associated with smoking. The study, which analyzed 122,000 oral wash samples, highlights the importance of oral health in preventing systemic disease.

Data showed that 43.3% of patients ages 65 and older with rheumatic conditions received at least one opioid prescription in 2021, with about 20% receiving prescriptions for 90 days or more, researchers reported at the American College of Rheumatology's annual meeting. About two-thirds of high-dose prescriptions were written by non-rheumatologists. Data came from the ACR's RISE registry and Medicare records.

Two studies in the journal Influenza and Other Respiratory Viruses highlight the significant burden of respiratory syncytial virus in primary care. One study found an incidence of 62.8 cases per 1,000 children in primary care settings before the COVID-19 pandemic, with the highest rates among the youngest children. Another study found that 13.2% of adults 60 and older had RSV, with a similar burden to that of influenza.

Survey data presented at the Menopause Society's annual meeting showed that 94% of perimenopausal and menopausal women in a study experienced digestive health issues. Bloating, constipation, stomach pain and acid reflux were common, and about half of participants sought professional help.

As health insurance premiums are expected to rise, some Americans are considering paying for medical care out-of-pocket, without insurance. Experts note that while paying cash can be cheaper for predictable, low-cost services, it does not count toward deductibles or out-of-pocket limits, potentially leaving individuals vulnerable to high medical bills in emergencies.

Intermountain Health plans to build a stand-alone children's hospital in Las Vegas, the first in the city, to address the need for specialized pediatric care. The $1 billion facility will be built on the University of Nevada Las Vegas Reid Research Campus, with construction starting in 2026 and completion expected by the end of 2029.

Sen. Rand Paul, R-Ky., proposed forming a bipartisan commission to address expiring Affordable Care Act subsidies, which are the central issue in the ongoing government shutdown. Paul suggested that the government could reopen for a month while the commission works on solutions.

Canada is at risk of losing its measles elimination status after a year of continuous transmission, with more than 5,000 cases reported this year. The US also faces the loss of its status amid ongoing outbreaks in multiple states. The Pan American Health Organization will review the elimination status of several countries, including the US, next month.

Daylight saving time ends Sunday in most of the US, and health experts suggest exposure to morning sunlight to help reset the body's circadian rhythm. "More light in the morning and less at night is key to keeping that rhythm on schedule -- all the instruments in sync," said Jamie Zeitzer, co-director of Stanford's Center for Sleep and Circadian Sciences.