Practice Management News Archive

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.

Nurses' Overtime Can Negatively Affect Collaborative Practice

Findings tied to both frequency of overtime and length of overtime hours in acute care setting

Whole Body CT Not Linked to Reduced Mortality in Blunt Trauma

No significant difference in mortality for those undergoing whole body CT vs selective CT approach

CDC reports lack of sleep in majority of school children

Nearly 75% of high school students are not getting enough sleep.

24-Hour clinics could provide sustainable primary care

Some believe clinics offering 24-hour primary care may facilitate the quality of patient care.

Practice patterns differ in university vs nonuniversity-based residency surgeons

Nonuniversity-based residency-trained surgeons and university-based residency-trained surgeons have distinct practice patterns.

Some stresses lead female physicians to leave medicine

Practicing after childbirth, wage gaps, and additional work from home are some of the factors that cause burnout in female physicians.

Hot tea consumption may reduce the risk of glaucoma

Individuals who consume hot tea daily may have a lower risk of developing glaucoma.

Characteristics in transgender individuals may lead to more HIV tests

More tests might be administered to transgender individuals who are female, black, or sex workers.

Americans consume less than recommended fruits, vegetables

Lowest US consumption rates for fruits in vegetables found in males, young adults, and impoverished adults.

US surgical residents have high stress, burnout levels

US Surgical residents have severe stress and high burnout levels during general training.

Law upheld requiring HIV-infected adults to tell sexual partners of their status

The Ohio Supreme Court has unanimously upheld the constitutionality of a law requiring HIV-infected individuals to tell their sexual partners of their illness.

FDA: Some liquid pharmaceuticals recalled due to possible bacterial contamination

The FDA has announced a recall of liquid pharmaceutical products because of possible bacterial contamination that could cause severe infections.

AMA calls for transparency in drug pricing

The American Medical Association adopted new policies on drug pricing to protect patients.

Strategies to help physicians plan for retirement

Crafting a debt management plan that includes loan repayment with building retirement savings is crucial for doctors starting their career path.

Guidelines proposed on substance abuse in nurses

Health care facilities should provide education to nurses and other employees relating to alcohol and drug use, and promote safe, supportive drug-free workplaces.

Patients report satisfaction with telehealth primary care visits

All patients reported overall satisfaction with video visits and most reported being interested in continuing use of video visits as an alternative to in-person visits.

AAFP proposes primary care-based payment model

The American Academy of Family Physicians has submitted a detailed plan in response to a request for proposals from the Physician-Focused Payment Model Technical Advisory Committee.

Pharmacy chains continue to develop primary care venues

Retail medical sites like CVS and Walmart have established primary care clinics, which are staffed by nurse practitioners and physician assistants.

Second opinion results in a different diagnosis for 1 in 5 patients

The data showed that 21% of cases received final diagnoses that were distinctly different than referral diagnoses.

Nurse practitioners could meet the need for house calls to elderly

Nurse practitioners made more than 1.3 million home visits nationwide in 2013.

ACA increased coverage and access for patients with chronic illness

Researchers found that nearly 1 in 7 of those with a chronic disease still lack coverage.

Clinician burnout negatively affects health care quality and safety

Healthcare provider burnout was negatively linked to quality and safety of health care.

Primary care clinician volume tied to quality of diabetes care

Higher ambulatory volume was linked to lower quality of care and quality increased with higher diabetes-specific volume.

Tips for addressing negative reviews in patient care

Doctor's responses should demonstrate willingness to take action to address the complaint.

NCCPA survey results show PA certification continues to increase

The biggest challenges for recently certified PAs are the lack of clinical PA opportunities for recent graduates and the lack of clinical PA opportunities in a geographic area.

National PA Week 2016 honors the profession's growing influence

The AAPA celebrates National PA Week from October 6-12, 2016.

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