Practice Management News Archive

Exclusion of Doctors From Public Health Insurance Up 2007 to 2017

From 2007 to 2017, the number of physicians excluded from Medicare and state public insurance programs increased.

Patient-Reported Outcome Measures May Aid Communication

Usefulness of PROs varies based on how much doctors value, prioritize, and use them.

HIT-Related Stress Linked to Burnout Among Physicians

Odds of burnout up with report of poor/marginal time for documentation, time spent on EHR at home.

Patient Education Can Improve Chronic Disease Management

Improvement seen in patients' ability to manage disease, medical students' ability to educate them.

Many Patients Withhold Information From Clinicians

Reasons for nondisclosure include not wanting to be judged or lectured, being embarrassed.

Burnout, Satisfaction Vary With Age, Sex Among Neurologists

Sex does not independently predict burnout, fatigue, overall quality of life after controlling for age.

Novel Scoring System Can Up Access to Biologics in Psoriasis

DLQI-R allows more patients to achieve threshold for becoming candidates for biologic treatment.

Patients Hospitalized for COPD Rarely Receive Pulmonary Rehab

Elderly, those living 10 miles from facility, those with lower SES less likely to receive pulmonary rehab.

Harms Identified With Nonoperative Management of Appendicitis

Higher likelihood of readmission, developing abscess; more follow-up needed in year after admission.

AMA to Collect Data on Suicide Among Doctors-in-Training

Administration hopes to identify the systemic factors that contribute to this problem.

Pharmacist-Led Effort Cuts Inappropriate Prescriptions in Older Adults

Intervention included educational deprescribing information to patients, physicians.

One-Third of Peds Medication Errors Due to Usability Issues

EHR usability issues contribute to 36% of med errors; 18.8% may have caused harm.

Coordinated Care Needed for Cancer Survivors, Caregivers

Efforts needed in implementing routine assessments of needs, facilitating personalized referrals.

Trump Administration Finalizes Birth Control Coverage Opt-Out

A birth control coverage opt-out for employers was finalized by the Trump administration on Wednesday.

Nurses With Bachelor's Degree Feel More Prepared

Gaps in quality, safety competencies between bachelor's, associate degree nursing grads increase.

Black, Low-Income Women May Not Report Barriers to Care

Black women, women living in poverty, and those with higher levels of distrust are less likely to report barriers to timely screening mammography.

Trump Administration Announces Plan to Cut Drug Prices

HHS study shows Medicare pays 80 percent more than other countries for certain prescription drugs

Gap Found in Pneumoccal Vaccine Recommendations Among Primary Care Clinicians

While primary care physicians overwhelmingly recommend pneumococcal vaccines, there is a gap in their knowledge of how to implement related vaccine recommendations.

Guidelines Outlined to Ease Peds Transition to Adult Health Care

Recommendations developed in realms of infrastructure, education, payment, research.

Poor Experience With PCP Linked to Hospitalization in CKD

Risk of hospitalization up for Hispanic patients with lower scores on Ambulatory Care Experiences Survey.

Simple Clinical Assessment in ED Best for Predicting Mortality

Agreement between formalized triage assessment and simple clinical assessment was poor.

Recommendations Developed to Verify Nasogastric Tube Placement in Children

Recommendations include clinician education, use of gastric pH measurement, radiographs.

Job Market for Nephrologists Continuing to Improve

The job market for new nephrologists is continuing to improve, and most fellows would recommend nephrology to medical students or residents.

Merge Between Aetna and CVS Health Approved

A $69 billion merger between health insurer Aetna and pharmacy manager CVS Health has been approved, according to the US.Justice Department.

FDA Approves Marketing of First User-Fitted Hearing Aid

Bose Hearing Aid is user-fitted device for people 18 and older with mild-to-moderate hearing loss.

3/4 of Adult Day Services Centers Keep Advance Directives on Hand

Documentation of advance directives more common in Northeast, among small adult day services centers.

Second Opinion at NCI Center Valuable for Breast CA Patients

Almost 43% of those presenting to NCI center for second opinion have change in diagnosis.

More Non-Elderly Americans Uninsured in 2017 vs 2016

More than 700,000 Americans uninsured in 2017 vs 2016, despite broad economic improvement.

AAP Provides Recommendations for Teen Drivers, Parents

Parents should be reminded that their driving and behavior will shape the behavior of their teen drivers.

Implementing EMRs Affects Time Spent With Patients in Clinic

Even after return to pre-EMR efficiency, more time spent on documentation, less on patient interaction.

Practices Should Set Rules for Staff Social Media Use

Staff social media accounts should be strictly personal, with no info about patients or employees.

Guidelines Updated for Adult Congenital Heart Disease

New classification system intended to capture complexity of anatomy and physiology of ACHD.

Interpreter Services Critical for Emergency Care

Authors recommend professional interpreter when practical if patient has limited English proficiency.

Actigraphy May Overestimate Sleep in ICU Setting

Wide ranges of sleep quality and quantity with use of actigraphy among critically ill patients in ICU.

Dozens of Medical Groups Join Forces to Improve Diagnoses

Diagnostic error is the most common cause of medical errors that patients report.

EPA Plan Will Maintain Carbon Emissions From Power Plants

Inadequate regulation of carbon pollution will likely have current, future consequences for human health.

Scribes Improve Physician Workflow, Patient Interaction

Scribes lower EHR documentation burden for doctors and increase time spent interacting with patients.

Tips for Advising Patients Living in Highly Polluted Settings

Guidance focuses on Americans posted in overseas settings with high ambient levels of air pollution.

Gender Wage Gap Facts: What the 2018 Salary Survey Reveals

Is the gender wage gap among NPs and PAs shrinking? We analyzed the results of the past 5 salary surveys to find out.

Physicians Need Training for Mass Casualty Incidents

Training includes protocols for the actual incident and self-awareness and care afterwards.

Recommendations Issued for Enhancing ICU Diagnostic Safety

Include enhancing recognition of potential errors, increasing teamwork, patient-centeredness.

Medicaid Benefits for Addiction Treatment Expanded After ACA

Decreases in states imposing annual service limits, requiring preauthorization for services.

Nurse-Led Call After Discharge Doesn't Cut Peds Urgent Care

One-time nurse-led call does not lower reutilization of urgent care services after pediatric discharge.

Fifteen Genetic Determinants of Fracture Identified

All determinants also associated with bone mineral density, which showed causal effect on fracture.

Docs, Consumers Agree on Benefits of Virtual Care

But physician adoption of virtual care technologies is low; few plan to add video visit capability.

Social Determinants Linked to Provision of Primary Care

Strong link for social complexity with primary care indicators for prevention, chronic disease management.

Better Training Needed to Boost LGBTQ Patient Health Care

Issues raised at AMA discussion include knowledge gaps for transgender women, screening guidelines.

PSA Testing Not Recommended for Prostate Cancer Screening

Odds of choosing screening up for men with family history, African descent, low socioeconomic status.

Patient Distressed by Overturn of California End of Life Option Act

Patient with ALS describes assisted death as last element of control, while losing control over his body.

Poor, Non-English Speaking Cancer Patients Need Support

Serving patients' specific needs, such as referral to socioeconomic support, can improve care.

Adding Pharmacist to Team Can Improve Patient Outcomes

Pharmacist roles include helping with insulin treatment, virtual consults, diabetes management.

Mindfulness Training Acceptable Among Surgical Interns

Mindfulness-based stress reduction integrated into personal, professional settings over 12 months.

Medicare, Med Advantage Health Care Use Differs Regionally

Variation in skilled nursing facility, hospital care up in Medicare Advantage vs traditional Medicare.

No Meaningful Increase in Physician Compensation Last Year

Average change in median compensation 1.2% in 2017 for all medical specialties.

High, Low Carbohydrate Diets Linked to Increased Mortality

Increase in mortality when carbohydrates were exchanged for animal-derived fat or protein.

Medical Practices Should Address Negative Online Reviews

Staff can learn from negative reviews by acknowledging patterns and seeking solutions.

Laryngeal Tube Insertion Beats Endotracheal Intubation in OHCA

And, 30-day functional outcomes similar with supraglottic airway device or tracheal intubation.

Prescription Drug Monitoring Program May Not Cut Opioid Use

No significant reduction in percentage of patients prescribed opioids after general surgery.

Computer-Aided Colonoscopy Reliably Identifies Small Polyps

Diagnosing, but leaving these polyps can save time and, likely, costs.

Medicaid Expansion Linked to Increase in Diabetes Prescription Fills

Fills for insulin and newer medications increased by 40 and 39%, respectively.

Similar Outcomes for Rural, Urban Cancer Patients in SWOG Trials

Few differences between rural, urban patients in cancer outcomes with uniform access to cancer care.

USPSTF Updates Guidance for Cervical Cancer Screening

Cytology recommended every 3 years from age 21; different screening options from age 30 to 65.

WPSI Recommends Annual Urinary Incontinence Screening

Due to limited evidence, other experts urge caution in implementing guideline for women.

Pennsylvania Case Could Affect Evidence for Malpractice Defense

Appeals center on relevance of consent, known risks and complications presented at trial.

Two Strategies for Preventing Diabetes in Minority Patients

Physicians can stress the factors in a patient's control and change messaging about the condition.

Primary Care Provider Burnout Rate Low in Small Practices

In survey of independent practices in NYC, higher adaptive reserve linked to lower odds of burnout.

DNR Orders Linked to Increased Mortality in Older Adults

Early vs late DNR tied to shorter median length of stay in hospitalized adults aged 65 years and older.

6 Factors Related to Inclusion in Health Care Workplace Identified

Presence of discrimination, the silent witness, effectiveness of leadership can help assess inclusion.

Dermatologist Intervention Tied to Better Sun Protection

Short intervention associated with more sunscreen use, improved patient satisfaction.

Perspectives on USPSTF AF Screening Recommendation

Physicians weigh in on the need to develop a screening strategy.

Few Older Homeless Adults Make Advance Care Plans

Most have potential surrogates for decision making but have not discussed or documented ACP wishes.

Insurance Status Tied to Higher Self-Perceived Poor/Fair Health

Underinsured and never insured adults more likely to report poor/fair health.

AMA Adopts Policy to Advance Gender Equity in Medicine

AMA House of Delegates has adopted policy to study, act for, advocate gender equity in medicine.

USPSTF: Insufficient Evidence to Screen for Atrial Fibrillation

US Preventive Services Task Force says benefit unclear in asymptomatic, older patients.

Resource Use Greater for More Severe Pediatric Appendicitis

Findings suggest need for reimbursement to have severity adjustment, especially in underserved areas.

AHA Introduces Heart Failure Certification Program

Program for heart failure management and implementation of clinical practice guidelines.

FDA Warns of the Dangers of 'Vaginal Rejuvenation'

Numerous cases of vaginal burns or scarring have been linked to the procedures.

Diabetes Diagnosis May Impact Health Behaviors of Family

Small changes in health behaviors seen for partners of those newly diagnosed with diabetes.

Embezzlement Not Uncommon in Medical Practices

Employees should undergo detailed background checks; practices should have zero-tolerance for theft.

Risk of CRC, Non-CRC Death Increases With Positive Fecal Hemoglobin Test

Positive guaiac fecal occult blood test result linked to increased risk of death from circulatory, respiratory, other diseases.

More Youths With Hypertension Using 2017 AAP Guidelines

Weighted net estimated increase of 795,000 US youths being reclassified as having hypertension.

2001 to 2015 Saw Decline in Self-Employment in Health Care

Gap in earnings between self-employed and employed health care professionals also decreased.

Authors Explore Overdiagnosis in Cancer Screening

Standardized definition, guidance on estimation may facilitate understanding of overdiagnosis.

PCPs Often Not Meeting Needs of Seniors With Chronic Conditions

Eight-six percent of PCPs feel unable to adequately address needs of patients with multiple chronic conditions

WHO Calls for Renewed Effort to Combat Chronic Disease

Commission makes 6 recommendations to meet 2030 goals for non-communicable diseases

AMA Adopts Policy to Cut Sugar Sweetened Drink Consumption

Policy supports evidence-based strategies such as excise taxes, adding warning labels

AMA Calls for Electronic Health Record Training

Association says medical students, residents should undergo training with evaluative feedback.

Ethics of Genealogy Data Use for Solving Crimes Discussed

Ethical discussion relates to issues of informed consent, privacy, and justice

AMA: Docs Declare Drug Shortages Public Health Emergency

AMA calls for greater manufacturer transparency in order to prepare for disasters, mitigate shortages.

Prenatal Pediatric Visit Recommended for Expectant Families

Visit provides unique opportunity to address relationship between family and pediatric practice.

New Guidelines Increase Melanoma Staging Reproducibility

Greater reproducibility and higher concordance for melanoma staging with implementation of AJCC 8

USPSTF Favors Osteoporosis Screening to Prevent Fracture

Screening with bone measurement recommended for women aged 65, younger women at risk

Presence of Nurse Practitioners Growing in Primary Care

Findings from 2008 to 2016 in both rural and nonrural practices.

Vertical Mergers Could Be Challenging for Primary Care

Vertical level mergers, which incorporate not just health care providers, but also insurers, retailers, and PBMs, could pose challenges in primary care.

AMA Vows to Improve Access for Physicians Seeking Mental Health Care

New policy recommends state licensing boards to only inquire about current conditions

High Costs for Diagnosis, Care of Nonalcoholic Fatty Liver Disease

Costs were significantly higher than total annual costs per matched control with similar comorbidities.

USPSTF Advises PCPs to Screen Adults for Unhealthy Alcohol Use

Screening, counseling advised for adults, including pregnant women; evidence lacking for teens

ACS Updates Colorectal Cancer Screening to Start at Age 45

Average-risk adults aged 45 should undergo high-sensitivity stool-based test, structural exam

Recommendations Developed for Improving Women's Health Care

Recommendations focus on policies to improve health outcomes, including training for clinicians

CDC: No Change in Level of Uninsured in US in 2017

Five percent of children uninsured in 2017, 41.3 and 55.0% had public and private coverage.

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