By Charles Ornstein ProPublica, Oct. 8, 2015, 11 a.m. This story was co-published with NPR’s Shots blog.
A bill proposed Wednesday by two U.S. senators would require drugmakers and medical device manufacturers to publicly disclose their payments to nurse practitioners and physician assistants for promotional talks, consulting, meals and other interactions.
The legislation would close a loophole in the Physician Payment Sunshine Act, which requires companies to report such payments to doctors, dentists, chiropractors, optometrists and podiatrists.
Almost every American will experience a medical diagnostic error, but the problem has taken a back seat to other patient safety concerns, an influential panel said in a report out today calling for widespread changes.
Diagnostic errors — defined as inaccurate or delayed diagnoses — account for an estimated 10 percent of patient deaths, hundreds of thousands of adverse events in hospitals each year and are a leading cause of paid medical malpractice claims, a blue ribbon panel of the Institute of Medicine (IOM) said in its report.
A doctor’s training hasn’t historically focused on sensitivity. And too often while juggling heavy workloads and high stress, they can be viewed as brusque, condescending or inconsiderate.
A 2011 study, for instance, found barely more than half of recently hospitalized patients said they experienced compassion when getting health care, despite widespread agreement among doctors and patients that kindness is valuable and important.
But payment initiatives and increasing patient expectations are slowly forcing changes, encouraging doctors to be better listeners and more sensitive to patients’ needs. Continue reading →
The Federation of State Medical Boards (FSMB) has launched a free online resource to provide consumers with important background information on the more than 900,000 actively licensed physicians in the United States, including whether or not a physician has been disciplined by a state medical board.
The Docinfo physician search tool (www.docinfo.org) draws data from the FSMB’s Physician Data Center, the nation’s most comprehensive database of physician licensure and disciplinary information. Continue reading →
Stay far, far away’ and other things gleaned from Yelp health reviews
By Charles Ornstein ProPublica, Aug. 6, 2015, 5 a.m. This story was co-published with NPR’s Shots blog.
Dental patients really don’t like Western Dental. Not its Anaheim, California clinic: “I hate this place!!!” one reviewer wrote on the rating site Yelp. Or one of its locations in Phoenix: “Learn from my terrible experience and stay far, far away.”
In fact, the chain of low-cost dental clinics, which has more Yelp reviews than any other health provider, has been repeatedly, often brutally, panned in some 3,000 online critiques 2014379 include the word “horrible.” Its average rating: 1.8 out of five stars.
Patients on Yelp aren’t fans of the ubiquitous lab testing company Quest Diagnostics either. The word “rude” appeared in 13 percent of its 2,500 reviews (average 2.7 stars). “It’s like the seventh level of hell,” one reviewer wrote of a Quest lab in Greenbrae, California.
Indeed, doctors and health professionals everywhere could learn a valuable lesson from the archives of Yelp: Your officious personality or brusque office staff can sink your reputation even if your professional skills are just fine.
“Rudest office staff ever. Also incompetent. I will settle for rude & competent or polite & incompetent. But both rude & incompetent is unacceptable,” wrote one Yelp reviewer of a New York internist.
ProPublica and Yelp recently agreed to a partnership, which will allow information from ProPublica’s interactive health databases to begin appearing on Yelp’s health provider pages.
In addition to reading about consumers’ experiences with hospitals, nursing homes and doctors, Yelp users will see objective data about how the providers’ practice patterns compare to their peers. Continue reading →
Second opinions often sought but value is not yet proven
By Michelle Andrews KHN
Actress Rita Wilson, who was diagnosed with breast cancer and underwent a double mastectomy recently, told People magazine last month that she expects to make a full recovery “because I caught this early, have excellent doctors and because I got a second opinion.”
When confronted with the diagnosis of a serious illness or confusing treatment options, everyone agrees it can be useful to seek out another perspective. Even if the second physician agrees with the first one, knowing that can provide clarity and peace of mind.
A second set of eyes, however, may identify information that was missed or misinterpreted the first time. A study that reviewed existing published research found that 10 to 62 percent of second opinions resulted in major changes to diagnoses or recommended treatments.
Another study that examined nearly 6,800 second opinions provided by Best Doctors, a second-opinion service available as an employee benefit at some companies, found that more than 40 percent of second opinions resulted in diagnostic or treatment changes.
But here’s the rub: While it’s clear that second opinions can help individual patients make better medical decisions, there’s little hard data showing that second opinions lead to better health results overall. Continue reading →
Women outnumber men in the nursing profession by more than 10 to 1. But men still earn more, a new study finds.
The report in this week’s Journal of the American Medical Association found that even after controlling for age, race, marital status and children in the home, males in nursing out-earned females by nearly $7,700 per year in outpatient settings and nearly $3,900 in hospitals.
Even as men flowed into nursing over the past decades, the pay gap did not narrow over the years studied: 1988 to 2013.
According to the Census Bureau, men made up about 9 percent of registered nurses in 2011, roughly a three-fold increase from 1970. And even though men were not permitted in nursing programs at some schools until the 1980s, they have overall earned more, just as in society at large.
The biggest disparity was for nurse anesthetists, with men earning $17, 290 more. Continue reading →
The Washington Center for Nursing, the statewide nonprofit nursing workforce center, has selected Sofia Aragon JD, BSN, RN to be its new executive director. Aragon, who was hired after a nationwide search, will begin at WCN on April 1.
As the executive director, Aragon will lead Centers work that focuses on promoting nursing as a desirable career; developing and managing data about the nursing workforce; identifying and disseminating information on best practices in nursing recruitment and retention; and increasing access to all levels of nursing education.
WCN collaborates with stakeholders in workforce development, education and practice in Washington and across the United States to address nursing workforce issues.
Aragon brings a background in health care policy and nursing education and practice, having earned: a Bachelor of Arts degree in economics from the University of Washington in 1994; a Bachelor of Science in Nursing degree from Seattle University in 1997; and her Juris Doctor degree from Loyola University-Chicago School of Law in 2002. Continue reading →
It was a touching scene, meant to buck up a hospital 2013 and a community 2013 shaken when one of its own nurses was infected with the Ebola virus.
Last fall, when Dallas nurse Nina Pham was about to be transferred for treatment from Texas Health Presbyterian Hospital in Dallas to the National Institutes of Health Clinical Center in Maryland, a doctor videotaped her farewell from her hospital bed.
The hospital released the video as it fended off accusations that it did not do enough to protect its staff after a patient who had contracted Ebola in Liberia sought treatment at Texas Health Presbyterian and died.
Now, in an interview with the Dallas Morning News published over the weekend, Pham contends she didn’t give permission for the hospital to record her or to make the video public.
Pham filed a lawsuit Monday against the hospital’s parent company, Texas Health Resources (THR), claiming not only negligence related to her Ebola infection, but violations of her privacy.
A federal patient privacy law, known as HIPAA, prohibits health providers from releasing information about patients without their permission.
“Never once did THR get Nina’s permission to be used as a PR pawn like this,” the suit says. “Never once did THR discuss its purposes or motivations or tell Nina what it was going to do with the information it sought from her. Instead, THR went to this young lady who was not in the position to be making any such decisions, and used her when she was in the darkest moment of her life, all for THR’s own benefit.”
Beyond that, the lawsuit contends, “Nina’s record was grossly and inappropriately accessed by dozens of people throughout the THR system.” Continue reading →
If your infant has a high fever or you’re experiencing an unusual pain in your abdomen and you live in New Mexico, you may want to call the NurseAdvice line before you do anything else.
New Mexico is the only state with a 24/7 registered nurse call center that is free to all residents, whether insured or not. In operation since 2006, it has kept tens of thousands of New Mexicans out of emergency rooms and saved the state more than $68 million in health care expenses.
It has provided a basic form of health care to thousands of uninsured people who have no other access to care. It also has relieved demand on doctors and hospitals in a sparsely populated state where all but a few counties have a severe shortage of health care providers.
On top of that, the statewide call center has generated real-time public health data that has served as an early warning system during epidemics and natural disasters.
Some Experts Dispute Claims Of Looming Doctor Shortage
By Julie Rovner KHN
You hear it so often it’s almost a cliché: The nation is facing a serious shortage of doctors, particularly doctors who practice primary care, in the coming years.
But is that really the case?
Many medical groups, led by the Association of American Medical Colleges, say there’s little doubt. “We think the shortage is going to be close to 130,000 in the next 10 to 12 years,” says Atul Grover, the group’s chief public policy officer.
While few dispute the idea that there will be a growing need for primary care in the coming years, it is not at all clear whether all those primary care services have to be provided by doctors.
But others, particularly health care economists, are less convinced. “Concerns that the nation faces a looming physician shortage, particularly in primary care specialties, are common,” wrote an expert panel of the Institute of Medicine (IOM) in a report on the financing of graduate medical education in July. “The committee did not find credible evidence to support such claims.”Continue reading →
All interested clinicians are invited to participate in the initiative.
US Health and Human Services Secretary Sylvia M. Burwell today announced an initiative that will fund successful applicants who work directly with medical providers to rethink and redesign their practices, moving from systems driven by quantity of care to ones focused on patients’ health outcomes, and coordinated health care systems.
These applicants could include group practices, health care systems, medical provider associations and others.
This effort will help clinicians develop strategies to share, adapt and further improve the quality of care they provide, while holding down costs.
Strategies could include:
Giving doctors better access to patient information, such as information on prescription drug use to help patients take their medications properly;
Expanding the number of ways patients are able communicate with the team of clinicians taking care of them;