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How widespread is physician suicide? What are the warning signs that colleagues
should not ignore? What more can the healthcare community do to help
practitioners who are at risk? This month’s survey provides some answers.
This edition of the Jackson & Coker Industry Report examines a reality that many
professionals in the healthcare industry might wish to ignore: physician
suicide. But the hard, cold facts are what they are.
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Yearly, from 300-400 physicians successfully commit suicide, according to an
article that recently appeared in Newsweek magazine entitled “Doctors
Who Kill Themselves” (04/28/08). This statistic does not include the number of
attempted suicides, often among female physicians. The article concludes:
“The unsettling truth is that doctors have the highest rate of suicide of any
profession.”
It’s not like the healthcare community is unaware of this tragic circumstance
that ends the lives of so many productive practitioners. If you Google
“physician suicide,” dozens of articles and professional studies pop up that
discuss some aspect of physician depression and suicide. Here are some
intriguing titles:
“Doctor kills self after malpractice verdict”
“Physician suicide: Risk Factors and Prevention”
“Female Physicians Face Higher Suicide Rate”
“Physician Suicide and Drug Abuse”
“Taking Their Own Lives—the High Rate of Physician Suicide”
“Physician Suicide: Searching for Answers”
“Encouraging Treatment in Depressed Medical Professionals.”
The healthcare community acknowledges the grim statistics, but a key question
remains: Is enough being done in terms of preventative measures? That question
prompted us to commission a Special Report on the subject prepared by our
research team, along with launching our latest survey: “Raising Awareness
Concerning Physician Suicide.”
The comments of survey respondents are particularly illuminative of the likely
causes of suicidal behavior, reasons why persons at risk are hesitant to seek
help, and steps that can be taken to address the problem more effectively.
Physician suicide is a sobering topic—but one that deserves the spotlight of
reasoned and compassionate attention by all those in the healthcare community.
Cordially,
Calvin Bruce
Managing Editor
Health Plans Embrace Retail Clinics
Source: Managed Care
Date: 03/01/2008
For time-constrained consumers with minor healthcare needs, retail clinics are becoming a fast-growing phenomenon as an alternative to primary care practices. Usually located in grocery stores, large retailers like Target, and other commercial spaces, retail clinics are an easy way for individuals to receive quick outpatient medical care in the span of about 15 minutes. For a small fee, consumers can access cures for very simple medical procedures like ear infections, strep throat, and poison ivy. Many clinics do not even have a full-time physician on hand. For more serious medical conditions, the clinics advise their patients to visit either a traditional doctor's office or else an emergency room. Insurance companies are jumping on the bandwagon and covering their customers' visits to these clinics as a cheap and easy solution to overburdened physician's offices and ERs.
At the beginning of 2007 there were just 150 retail clinics in the United States, and as of March 2008, this number has risen to over 900. With companies like Wal-Mart hoping to open 2,000 retail clinics in their existing stores within 7 years, these figures are expected to rise dramatically. As the new generation of healthcare seekers are increasingly accustomed to the consumer mentality, quick in-and-out health services for minor procedures are becoming more desirable. According to a 2008 Deloitte Survey of Health Care Consumers, 16 percent of American consumers claim to have used a retail clinic in the last year, and 34 percent of those said they would visit one again. Forty-eight percent of consumers said they would visit a clinic if the nurse practitioner were connected to a physician's office in the local area.
Some doctors are concerned that the rise of retail clinics will result in "fragmented care," and there are concerns about the quality of services that these for-profit offices can provide. Nevertheless, the traditional model of healthcare will need to adjust its practices to accommodate for this rapidly growing trend.
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From Red to Green
Source: Hospitals & Health Networks
Date: 04/22/2008
Employing nearly 5 million workers, U.S. hospitals are big operations that stay open 24 hours a day, seven days a week with lights on, kitchens running, and trash piles growing around the clock. Collectively, hospitals burn 600 BTUs of energy each year at a cost of over $5 billion, and they generate millions of tons of garbage with the majority of that being highly toxic waste. “Going green” has become an ethical, regulatory, and economic imperative for U.S. hospitals and thanks to a new initiative, Practice Greenhealth, it is getting easier for hospitals to be ecologically responsible.
Congress passed the Medical Waste Tracking Act in 1988 in response to incidents in which large amounts of medical waste washed ashore in New York and New Jersey. Three years later, hospitals were responding. Many were monitoring waste bags, winnowing energy consumption, phasing out polystyrene products, recycling, and experimenting with eco-friendly waste disposal technologies. Unfortunately, these trends did not catch on with a majority of hospitals. Due to high federal costs of waste tracking and medical waste disposal, many hospitals built incinerators and started burning everything. These incinerators had huge impacts in lowering the quality of air and water in surrounding areas.
In 1997, the EPA began enforcing stringent air emissions standards for hospitals and their medical waste incinerators, vowing to cut mercury, particulates, hydrogen chloride and dioxin pollution by 90 percent. The EPA also joined with the American Hospital Association and formed Hospitals for a Healthy Environment (H2E). Since then, thousands of clinics and health care facilities have joined H2E, and 80 percent of U.S. hospitals have implemented some form of waste reduction policy. Currently, nineteen health care facilities have been built in the U.S. and British Columbia to meet the standards of the U.S. Green Building Council.
As a successor to H2E, Practice Greenhealth offers the educational resources of H2E but also makes available its guide for safe, efficient, environmentally friendly design, construction and operations, “The Green Guide for Health Care,” plus a promising new approach to major savings in electricity procurement through the Internet-based reverse auction technology of the Healthcare Clean Energy Exchange.
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Leavitt Pitches Urgency, Tougher Stance on Value-Driven Healthcare
Source: Healthcare Finance News
Date: 04/24/2008
The Department of Health and Human Services’ continued efforts to drive transparency into the U.S. healthcare system will not wane in the concluding months of the Bush Administration. HHS Secretary Michael Leavitt, speaking at the Fifth Annual World Health Care Congress event on April 23rd in Washington, announced his intentions to proceed with the plans for change in the healthcare system with “a continued sense of urgency.”
One of the initiatives that Leavitt will continue to push is the consolidation of all healthcare quality standards used across its agencies. The HHS intends to publish these standards and make them available for market-wide use. HHS is also testing an initiative involving competitive bidding for bundled services, beginning with a Medicaid demo that officials hope to expand. The value-driven healthcare plan depends on “healthcare IT adoption to record quality measures and aggregate and provide cost and quality information to consumers,” but adoption is not nearly as widespread in small physician practices as Leavitt would hope. Still, in his final 272 days left as HHS secretary, Leavitt has no intentions of slowing down his crusade for change in the healthcare system.
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Some Operators Closing Retail Clinics, Scaling Back Expansion Plans
Source: Medical News Today
Date: 05/08/2008
Walk-in health clinics at pharmacies, supermarkets and retailers are not doing as well as they once did according to a Wall Street Journal report, even though the numbers of such clinics have grown steadily over the past few years. There are currently 963 retail clinics in the U.S., compared with only 125 in 1995. Some retail clinic operators are starting to notice the shifting trend and scaling back. At least 69 clinics in 15 states have been closed, and others are scaling back expansion plans. Part of the problem is that financiers for many of the clinics did not appreciate how complex and costly such clinics are to operate, and patient acceptance of the clinics has been slow. Clinics have been spending a large percentage of resources on marketing to increase awareness. Some clinics, however, are still doing well. Walgreen’s, for example, plans to add 240 new health clinics this year.
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Eastern and Western Medicine Come Together at New San Diego Center
Source: BusinessWire.com
Date: 04/14/2008
A brand new, state-of-the-art medical facility for integrative care of arthritis and autoimmune disorders has recently opened in San Diego, California. The Institute for Specialized Medicine is the first medical center of its kind to be opened in the San Diego area. The institution was founded by Dr. Alexander Shikhman, who is also the medical director for Restorative Remedies, a newly developed nutraceutical company in San Diego. The Institute for Specialized Medicine’s main objective is to use all possible treatment methods available, including Western medicine, historic Eastern medicine, and a patient-centered approach from Europe.
The facility was designed with aging Baby Boomers in mind. The institute specializes in helping people who suffer from “arthritis, inflammatory and metabolic disorders, autoimmune diseases, and immune system issues driven by foods and chronic infections.” A recent study showed that by the year 2030, the average Baby Boomer will be suffering from diabetes, cardiac disease, and arthritis. The institute has been designed to provide patients with individualized therapy programs that combine Eastern and Western medical practices for an all encompassing health treatment. The facility provides specialists in every field ranging from dieticians and nutritionists to physical therapists, from orthopedic surgeons to acupuncturists.
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Sarbanes-Oxley on the Not-for-Profit Horizon
Source: Trustee Magazine
Date: 04/01/2008
The Sarbanes-Oxley Act is currently setting its sights on not-for-profit hospitals to change the way they report profits and losses. This “Sarbanes Creep” is occurring at a time when focus is shifting from financial compliance to corporate compliance on issues of quality, finance, billing, coding and safety. Not-for-profit hospitals, such as Beth Israel Deaconess Medical Center in Boston, are being held accountable for including losses from bad debts and other sources as part of charity care calculations in past financial reports.
While this new world of heightened scrutiny on the role of boards and corporate governance has led to changes ranging from slight to vast restructuring, nearly all not-for-profit hospital boards have taken action and are, at the very least, investigating what they must do in order to become compliant with Sarbanes-Oxley. Most agree that the Sarbanes-Oxley enforcement lodged against not-for-profit organizations will not be nearly as pervasive, costly, and time-consuming as the federal regulations against corporations and for-profit businesses, as small not-for-profits simply do not have the resources to comply with such demands.
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A Team Approach to Cost Commitment
Source: Healthcare Financial Management
Date: 04/01/2008
Hospitals across the country have been developing new techniques and methods for cutting costs while keeping the volume of patients high and avoiding rising expenses. In several cases, clinicians are turning to finance agencies for strategies to reduce labor expenses and supply chain costs. For example, Bristol Hospital in Bristol, Connecticut, recently turned to a finance company for assistance in reducing expenses without cutting FTEs while maintaining a commitment to high-quality care. So far the results have been positive, as last year Bristol saw over 2,000 more patients than in the previous year, and patient and employee satisfaction have been improving as well.
A recent survey of healthcare finance specialists, HFMA’s Healthcare Finance Outlook 2008-2013, concluded that cost control is the biggest challenge facing healthcare CFOs and other executives. According to the report, labor expenses, such as salaries and benefits, make up the largest component of a hospital’s costs. This is fueled by a lack of talent (nurses and other healthcare professionals) and constantly increasing benefit costs. Managing labor and supply costs also rank among the top 10 challenges to healthcare executives, according to the report.
Collaborations between healthcare facilities and financial agencies have tried to combat these challenges while primarily focusing on quality improvement. In the majority of cases, the teaming of healthcare and finance has resulted in enhanced productivity, lowered agency and overtime costs, and employee satisfaction. Effective collaborative efforts between hospital staffs and their finance departments can reduce labor costs which subsequently can enable a hospital to successfully provide high-quality patient care and augment the hospital’s bottom line.
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Is the Medicine You Depend On Made in a Place You Trust?
Source: Los Angeles Times
Date: 03/30/2008
In mid-March of this year, batches of a Chinese-made medicine were recalled worldwide for causing hundreds of allergic reactions and at least 19 deaths in the United States alone. The drug was a blood thinner named heparin used most commonly to prevent clots for patients during surgery or for those with heart trouble. The Food and Drug Administration discovered that some of the ingredients used to produce heparin had been contaminated with the chemical oversulfated chondroitin sulfate. This man-made drug acts similarly as the blood-thinning effects of heparin but is significantly cheaper to produce.
The problem is that the F.D.A. has no regulations that require drug companies to make known where their prescription medicines are produced. The billion-dollar pharmaceutical industry obviously benefits from producing medicines in countries with lower costs. Although the heparin case is still under investigation, it is at least a possibility that a Chinese supplier replaced the heparin ingredients with the deadly but cheaper chemical in an effort to increase the total profit.
As a result, patients are left with an undesired level of distrust and fear, though in many cases, as with heparin, refusing a vital treatment is simply not an option.
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Women Increasingly Fill Medical Director Role
Source: Managed Care Magazine
Date: 02/01/2008
According to a survey conducted by the American College of Physician Executives (ACPE) and Cejka Search, there has been a 30 percent increase in the share of physician executive jobs held by women in the last 10 years. In 1997, 10 percent of physician executive jobs were held by women, while in 2007, that number rose to 13 percent. Many women get into physician executive positions through the medical director role. In 2007, 17 percent of medical directors were women, up from 16 percent in 2005 and 12 percent in 1997.
Average pay for physician executives has also increased 7.5 percent according to the survey, from $240,000 in 2005 to $258,000 in 2007. Of the 7,796 ACPE members who received the survey, 27 percent responded to produce these results.
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Employment & Compensation
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Accident Highlights Long Hours for Doctors in Training
Source: Chicago Journal
Date: 10/12/2005
Questions surrounding overworked residents continue to be a problem for hospitals across the country. In September 2005, an Illinois court ruled that Rush-Presbyterian-St. Luke's Medical Center was not liable for damages when a resident crashed his car following a 30-hour shift at the hospital, seriously injuring another motorist. Though the court was careful to draw a line saying that hospitals are not responsible for injuries caused by overworked physicians and residents, the Accreditation Council for Graduate Medical Education in 2003 developed standards outlining acceptable working conditions for residents in U.S. hospitals.
According to the ACGME, all hospital residents are prevented from working more than 80 hours a week (calculated over a 4-week period) and more than 30 hours in a given shift and are required to have at least 10 hours between shifts and at least 1 day off a week. Yet though these standards are in place, many residents admit that they are not following regulations and working more hours than they are allowed. Other residents are complaining that the regulations prevent them from performing all of their duties sufficiently.
The American Medical Student Association argues that the regulations are not restrictive enough, and the group is lobbying the federal government in order to install national regulations that are protected by law.
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Reality Check for Joining a Group
Source: Unique Opportunities
Date: 04/01/2008
When jumping into a practice out of medical school and residency, there are many considerations that a newly certified physician needs to consider before signing any contracts.
Location is a primary concern, as any physician needs to decide if a different city or rural area would be an acceptable place to live for the next 25 or 30 years. Finding out all of the details of a practice - including financial data, doctor-physician assistant ratios, number of patients served, the potential for future salary raises and bonuses, and patient satisfaction levels - should be a major priority as well. Going into the practice during office hours can be a useful way to tell whether or not everything is going smoothly. Speaking to non-physician employees or even patients can be a great way to learn inside information about how the practice is functioning.
Overall, joining a practice can turn into a serious commitment, and new physicians need to do serious research in order to determine whether the practice will be a good fit. Asking a lot of questions to several different parties is one of the best ways to accomplish this. Additionally, financial and other information on the practice can be retrieved from online databases like the Medical Group Management Association (http://www.mgma.com) and the National Society of Certified Healthcare Business Consultants (http://www.nschbc.com).
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Part-Time Doctors
Source: American Medical News
Date: 05/05/2008
Results of a March survey of members of the American Medical Group Association showed that the proportion of doctors engaged in part-time work has gone from 13 percent in 2005 to 19 percent in 2007. Survey respondents included forty-three groups who gave several different reasons for requesting abbreviated schedules, including the onset of academic research or teaching (<3%), administrative or leadership duties (25%), family responsibilities including pregnancy (80%), health issues (7%), and retirement preparation (33%), along with various unrelated professional or personal pursuits (53%).
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Judge Strikes Down Cap on Malpractice Suit Awards
Source: Atlanta Journal-Constitution
Date: 05/01/2008
A Fulton County Judge decided that Georgia’s legislative cap of $350,000 for noneconomic damages in medical malpractice cases is unconstitutional because it provides too much protection for the medical profession. Due to the cap, people injured by doctors have less protection under the law than those injured by other things such as manufacturers’ products (for which there is no legal cap on noneconomic damages).
The case under review involved a 60-year-old retiree who fell from a ladder and was left a quadriplegic due to injuries to his neck and spine that were missed by doctors. The $350,000 cap was approved as part of tort reforms in 2005. Another part of those reforms was struck down in 2006 when the Georgia Supreme Court ruled that defendants couldn’t decide where malpractice cases were tried. If upheld, the decision could undercut a number of the state’s tort reform laws.
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Baby Boomer Time Bomb: Too Many Aging Patients, Too Few Geriatricians
Source: American Medical News
Date: 05/05/2008
The number of doctors specializing in geriatrics is declining. There are approximately 7,100 geriatricians in the U.S. today. That number is 22% lower than the number of geriatricians in 2000. This is related to the larger trend of the decline in U.S. medical graduates interested in family and general practice. If this decline continues, there will not be enough geriatricians to handle the 78 million baby boomers who will begin to turn 65 in 2011, and by 2030, there will only be an estimated 8,000 geriatricians, but the country will need 36,000. A lower rate of pay is the biggest thing keeping most doctors from entering the specialty. The Institute of Medicine suggested an increase in geriatric education across the board in the health care workforce and raising reimbursement for senior citizens’ care to offset the lack of the specialty. The AMA is also promoting more geriatric training and preventions of Medicare funding cuts which make the reimbursement problem worse. Medical graduates must spend an extra year of training to learn about the specialty, and that is hard to justify when those students are looking at a lack of proportionate reimbursement after they have finished training.
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Canada's Health System Draws Mixed Reviews From Psychiatrists
Source: Psychiatric News
Date: 05/02/2008
In the continuing debate about socialized healthcare at the national level, psychiatrists in Canada give differing opinions about the viability of such a system.
Many Canadian psychiatrists are proud of their universal coverage and are appalled that doctors in America are forced to turn away patients who are unable to pay for much-needed medical services. Psychiatrists in the Canadian system also see themselves as more autonomous than their American counterparts, as treatment options do not need approval from insurance companies or other third parties. When patients need a particular treatment, say an expensive medication, doctors in a socialized system prescribe options based on need, not financial availability. Further, with the elimination of multiple third-party providers, significant red tape is removed and billing is straightforward and standardized.
While many in the field of psychiatry appreciate the Canadian system, others find the socialized system frustrating. There is a serious lack of hospital beds, to the point where patients are dying in emergency department waiting rooms or visiting the United States for care. With increased costs associated with universal healthcare, there is a substantial personnel shortage, particularly in terms of support staff. Some Canadian psychiatric hospitals have entire floors that are unoccupied because there is not enough funding to cover employee salaries. One critic of the Canadian system estimates that there is a current shortage of 26,000 doctors throughout the entire country. Some Canadian patients are forced to wait upwards of 4 months or longer for psychiatric outpatient care.
With these pros and cons in mind, there is still a thriving debate about whether universal healthcare is a feasible solution to America's health care woes. From a psychiatrist's perspective, it is unclear whether or not a Canadian-style system has a future in this country.
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Opening of Nation’s 2nd Depression Center Gets National Network Under Way
Source: WebWire.com
Date: 04/16/2008
Inspired by cancer centers and heart centers across the United States, a new wave of medical centers is developing to deal with depression, bipolar disease, and other psychiatric diseases. The Depression Center at the University of Colorado Denver School of Medicine will open in August and will stand alongside the University of Michigan Depression Center, the nation’s only other depression facility. Both institutions hope to form a national network as other centers are built in the future.
Work at the Colorado center will focus on treatment options, research, and education surrounding what the World Health Organization calls “one of the most disabling human illnesses.” With donations as large as $13 million from a variety of individuals and organizations, the Colorado center hopes to live up to its ambitious mission statement: “To improve the quality, effectiveness, and availability of depression and bipolar diagnosis, treatment, and prevention so patients can lead better lives.”
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Payer & Reimbursement Issues
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Experts Predict Trouble for Providers under Medicare Billing Crackdown
Source: Healthcare Finance News
Date: 04/24/2008
Coding experts claim those who do not prepare for the upcoming federal crackdown on Medicare billing could be facing a number of serious consequences including six-figure bills, referrals to fraud enforcers, and even possible jail time. The Centers for Medicare and Medicaid Services will be looking at the nation’s errant Medicare billing beginning this fall. In 2006, Recovery Audit Contractors (RAC) recovered over $304 million, and the CMS intends to continue the audits based on this success.
Admittedly, audits are not conducted on an unbiased basis, but compliance is the recommendation of seasoned professional billing coders. The CMS are predicted to “have a field day” when the audits begin. The offered advice is to listen to coders, not billing and records software, and document properly in order to avoid being a target. Experts say to watch billing profiles and not to cluster around one level of a code. The new RAC program is capable of asking doctors and hospitals to provide documentation for Medicare billing as far back as 2007.
The Ohio State University Medical Center is already in preparation for these audit requests, having put together a task force of doctors, hospital managers, IT experts, and others to help with the audit letters, which could be delivered several times per week. A private audit would allow a hospital time to find documentation errors and possibly correct them with Medicare before the RAC audits begin. In addition, health care providers who find their own errors and report them ahead of time will have a better opportunity to negotiate the associated fines.
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Insurers Rush to Fill States’ Medicaid Needs
Source: Managed Care
Date: 04/01/2008
Medicaid managed care programs are much better now than they were in the 1990s. Now plans are attempting to expand Medicaid business, and states are placing more and more patients in managed care to control costs. Aetna showed an interest in Medicaid as a means for growth in August 2007 when it acquired Schaller Anderson, a Medicaid-focused company with more than 600,000 enrollees. Medicaid generates a good deal of business, with more than 45 million active members and federal and state governments spending more than $310 billion on the service. Managed care contracts between governments and health plans can be set up in several different ways, and there are more than 300 managed care plans in the U.S.
Pure plays, which are “multistate, investor-owned Medicaid-only” programs, have grown particularly in recent years. These programs include those offered by AmeriGroup, Centene, Molina, and WellCare. In 2006, those companies had 1.5 million new members due to managed care expansion in Georgia, Ohio, and Texas.
The push to convert Medicaid recipients to managed care is coming from both for-profit and not-for-profit plans. In 2006, 40 percent of all Medicaid members were in comprehensive plans. In spite of this growth, problems have come up in the relationships between state governments and the plans. JAMA produced a study in October of 2007 stating that Medicaid managed care enrollees do not receive the same level of care quality that is received by commercial managed care enrollees, but these findings have been somewhat disputed, and states’ monitoring of the plans can make a big difference in meeting performance requirements.
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Congress Passes Bill to Bar Bias Based on Genes
Source: The New York Times
Date: 05/02/2008
A bill recently passed by Congress will grant privacy protection for individuals who undergo genetic testing as a predictor of certain medical conditions. With a 95 to 0 Senate vote and a 414 to 1 House vote, Congress has recognized that genetic discrimination is a major obstacle to making genetic testing a mainstream reality for health care.
Doctors involved in genetic testing of ordinary citizens have been complaining that many patients are fearful that if their insurance company receives indication that they are more likely to contract a certain disease, their rates will increase. For the thousands of Americans at risk for genetic disorders - conditions like breast and colon cancer, diabetes, and heart disease - this prevents them from receiving adequate medical care to catch these ailments in the earliest stages.
The Genetic Information Nondiscrimination Act specifically prohibits insurance companies from raising premiums or denying coverage to any individual who is genetically predisposed to any medical condition. The bill also includes a fine of up to $300,000 for any employer who makes hiring, firing, or compensation decisions based on genetic information.
There are still many difficult ethical and legal questions surrounding genetic testing, but Congress's recent vote is the first step in clearing up some of the ambiguity associated with this potentially groundbreaking technology.
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Credentialing, Licensure, Quality Management
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U.S. Report Finds Sluggish Increases in Quality of Care
Source: American Medical News
Date: 04/28/2008
According to the fifth annual Agency for Healthcare Research and Quality’s report, the rate of health care quality improvement has slowed dramatically. The report is compiled of federal and state data on more than 200 quality metrics. For the report, the AHRQ compared overall rates of quality improvement and costs and examined progress versus expenses for conditions such as heart disease, cancer, and diabetes mellitus. Other efficiency metrics considered in the report included “trend data on the number and cost of potentially preventable hospitalizations and hospital costs per patient admission.”
According to the report, overall quality at healthcare facilities is improving but is improving at a pace that is frustratingly slow. One suggestion as to why quality care is improving at such a slow rate is a recent hike in cost cutting, though many experts argue that there is no meaningful correlation between cutting costs and improved quality of care because the current reimbursement system is founded in volume.
In order to attain more significant changes, a much larger, coordinated systems approach must be collaboratively instilled. This would readjust the reimbursement model and give physicians and other healthcare professionals the additional time needed to provide quality care. A move to adopt successful quality systems from other professional industries is beginning to gain momentum in health care.
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Disciplinary Action against Physicians Dropped 6% from 2006 to 2007, US Report Finds
Source: Medical News Today
Date: 04/24/2008
State medical boards’ disciplinary action against physicians declined for a third year in a row, decreasing by 6% in the U.S. from 2006 to 2007, according to a report by Public Citizen, cited in the Los Angeles Times. The report states that the rate has fallen 22% since 2004.
The group also ranks states by dividing the number of disciplinary actions by the number of licensed physicians in the state. The state with the highest rate of disciplinary action was Alaska, with 8.33 actions per 1,000 physicians, and the lowest was South Carolina, with 1.18 actions per 1,000 doctors.
According to the report’s author, more funding, staffing, and investigations are necessary to discipline physicians adequately and claimed that the report is proof that too many states allow doctors to endanger patients’ well-being because they do not sufficiently discipline the physicians.
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HHS Seed Money Helps Build Health-Information Networks
Source: Psychiatry News
Date: 04/18/2008
This March, the U.S. Department of Health and Human Services pledged $22.5 million to 9 different health information exchanges (HEIs) to test the feasability of a national online health information network. Specific medical information on each patient will be distributed between the networks in hopes of making all data available whenever and wherever it is needed.
Additionally, up to 1,200 physicians across each of the systems will be given the resources to store patient data using electronic medical records (EMRs). Over the 5-year period, payouts will average about $58,000 per physician or $290,000 per practice.
Other health organizations and agencies are also working hard to make a national health information network a reality.
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Physician Practice Management
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Choosing a Medical Malpractice Insurer
Source: Physician’s News Digest
Date: 04/01/2008
Physicians should choose carefully when selecting a medical malpractice insurer. The cheapest insurance is generally not the best, as some insurers offering inexpensive insurance in the 1990s went bankrupt, leaving doctors with little coverage. Now there are more options, including risk retention groups (RRGs), which are member-owned and allow members, who form groups based on specialty, such as physicians, to share risk by pooling resources. Members benefit from profits, which is an incentive to reduce risk.
Whichever form of coverage they choose, doctors should look for corporations that are committed to managing risks and claims. Risk management and continuing education are key to making insurance efficient and has too often been overlooked by doctors in the past. Physicians should also ask about how claims are handled, whether experts and excellent attorneys are provided, and how disputes are typically settled. Physicians need to know that they will have reliable support from the company in the case of a lawsuit. Other pertinent questions involve the financial stability and AM Best rating of the company.
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Physicians Reluctant to Communicate with Patients via E-mail
Source: iHealthBeat.org
Date: 04/23/2008
Even though most U.S. residents wish they could e-mail physicians about non-urgent medical issues such as prescription refills, lab results, and scheduled visits, less than one-third of physicians will use e-mail to communicate with patients. A 2007 study published in the American Journal of Managed Care found that patients able to use secure web contact with their physician were 7 percent to 10 percent less likely to schedule a visit and made 14 percent fewer phone calls to the physician’s office than those that did not use web contact.
Physicians worry that receiving e-mail would increase their workload, put patients in danger of privacy breaches, and raise issues of legal liability if an urgent email was not replied to fast enough. In order for e-mailing to become routine, experts say that physicians must be trained in the risks of technology, confidentiality, and organization, though it is believed that it is only a matter of time before e-mail is a notable part of patient care.
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Practicing Patients
Source: New York Times Magazine
Date: 03/23/2008
A forum for sharing extremely personal medical information online is raising interesting questions about the future of personalized medicine. A website known as PatientsLikeMe allows users with specific medical disorders to publish measurable scientific data about their health problems in order to share experiences with other individuals suffering from similar issues. While providing a personal account of treatment options - including reactions to specific prescriptions - patients hope to help others get the best treatment available.
A major concern surrounding PatientsLikeMe is that users are influenced by unscientific data. The website notes that when an individual user with A.L.S. discovered an unpublished preliminary Italian study citing lithium as a possible treatment option, some 109 users began taking the drug - with their doctors’ consent - without waiting for more serious medical research. Privileged patient data is another concern: instead of making money through advertising, the website hopes to make a profit by selling patient data to pharmaceutical companies. Though all users acknowledge this fact, there are major privacy issues at stake.
Whether the website prospers remains to be seen, but users have been incredibly satisfied with their experiences thus far.
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Changing Drug Labels
Source: WXYZ-TV Detroit
Date: 04/21/2008
As a way to put an end to the confusion felt by some patients, certain leading pharmacy groups are demanding a change in the way prescriptions are labeled. Patients taking numerous prescription drugs at a time often complain that they are unable to identify or distinguish between the bottles and lose track of the different medications. Patients will occasionally forget what a certain medication provides, or they can confuse two drugs with similar sounding names but dangerously different purposes. This is not only a concern for patients but also for the pharmacists filling the prescriptions.
According to the pharmacy groups advocating change, a prescription label should provide the “indication for use” or the reason why someone would take this medication. For example, if a patient suffers from high blood pressure and receives a prescription from their doctor, the label on the prescription should read “take for high blood pressure” or something of that nature. These simple indications would virtually eliminate any miscommunications between the doctor and the pharmacist as well as any confusion on the part of the patient. The hope is to get these changes to the labels state mandated.
The American Medical Association agrees that having the indication on each label is a good thing but argues that it should be optional, not mandatory. They believe that mandatory use indications on a prescription label may violate a patient’s confidentiality agreement. Currently, patients can have the indications of use provided on prescription labels by simply asking their doctor ahead of time. Because there are no regulations for this, however, it is up to the physician to decide how the label actually reads.
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