Category Archives: Doctors and Nurses

Nurses Ranked No. 1 for Honesty and Ethics (again), Gallup Poll

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Nurses have topped Gallup’s Honesty and Ethics ranking every year but one since they were added to the list in 1999.

With an 85% honesty and ethics rating  nurses have no serious competition atop the Gallup ranking this year.

Pharmacists and medical doctors constitute the next tier, with about two-thirds of Americans viewing each highly, followed by high school teachers at 60% and police officers at 56%.

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Jobs for medical scribes rise, but standards lag

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EscribanoBy Lisa Gillespie
KHN

A national campaign for electronic health records is driving business for at least 20 companies with thousands of workers ready to help stressed doctors log the details of their patients’ care — for a price.

Nearly 1 in 5 physicians now employ medical scribes, many provided by a vendor, who join doctors and patients in examination rooms.

Regulation and training are not rigorous. Scribes are not licensed.

They enter relevant information about patients’ ailments and doctors’ advice into a computer, the preferred successor to jotting notes on a clipboard as doctors universally once did.

The U.S. has 15,000 scribes today and their numbers will reach 100,000 by 2020, estimates ScribeAmerica, the largest competitor in the business. After buying three rivals this year, it employs 10,000 scribes working in 1,200 locations.

Regulation and training are not rigorous. Scribes are not licensed. About a third of them are certified and that’s voluntary, according to the sole professional body for scribes. The American College of Scribe Specialists was created by ScribeAmerica’s founders in 2010.

“This is literally an exploding industry, filling a perceived gap, but there is no regulation or oversight at all,” said George Gellert, regional chief medical informatics officer at Christus Santa Rosa Health System in San Antonio, which uses scribes. Continue reading

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For abortion providers, a constant barrage of personalized harassment

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Logo_plannedparenthoodby Nina Martin
ProPublica.

Since 1993, 11 people have been killed in abortion-related attacks 2014 doctors, clinic staff, and last week, a police officer and two visitors in the line of fire at a Planned Parenthood clinic in Colorado Springs.

While the investigation continues into the shooter’s background and motives, David Cohen, a law professor at Drexel University, says that stalking and harassment pose a much more common threat to abortion providers and their families.

For their May 2015 book “Living in the Crosshairs: The Untold Stories of Anti-Abortion Terrorism,” Cohen and co-author Krysten Connon interviewed 87 providers in 34 states 2014 clinic owners, doctors, and other employees.

ProPublica spoke with Cohen about their findings; the interview was edited for clarity and length.

Nina Martin: How did you come to write your book? Continue reading

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Humana and Northwest Physicians Network form accountable care partnership

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Screen Shot 2015-10-14 at 8.44.31 AMNorthwest Physicians Network and the insurer Humana have signed an accountable care agreement that will provide Humana Medicare Advantage members access to the network’s physicians.

Northwest Physicians Network (NPN) is an independent physicians association with more than 500 providers and 200 ancillary facilities located throughout the Puget Sound region.

Humana executives said the accountable care model, which focuses on chronic disease management and wellness and which rewards providers for improved performance, is designed to control costs, improve quality and enhance the patient experience.

“Humana is excited to work with NPN to continue delivering value-based health care to our Medicare Advantage members in the Puget Sound region,” said Catherine Field, Intermountain Vice President for Senior Products at Humana. “This model is designed to foster high-quality healthcare, lower costs and provide a more patient-centric healthcare system.”

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Dueling recommendations about need for pelvic exams leaves women confused

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Question marksBy Sandra G. Boodman
KHN

It’s the latest battle over screening: Should healthy women skip annual pelvic exams?

controversial recommendation last year by the American College of Physicians, which represents the nation’s internists, strongly urged that doctors stop routinely performing the invasive exam on women without symptoms and who are not pregnant.

Citing 60 years of research, the ACP found no evidence that the screening, performed about 63 million times annually at a cost of approximately $2.6 billion, detects cancer or other serious conditions.

The exam, researchers reported, did cause harm: One-third of women reported discomfort, pain, embarrassment or anxiety — leading some to avoid care altogether.

For roughly 1 percent of women, a suspicious finding triggered a cascade of anxiety-provoking interventions — including tests and surgery, which carry a risk of complications for conditions that nearly always turned out to be benign.

The controversy underscores the difficulty of changing long-established clinical practice and raises questions about the role of payment in shaping physician behavior.

The American College of Obstetricians and Gynecologists (ACOG) fired back. Despite what the group acknowledged was a lack of evidence that “supports or refutes” the exam, ACOG strongly endorsed it, citing the “clinical experiences of gynecologists.”

Patients expect it, the group said, and the screening builds trust, reassures women and encourages them to discuss sensitive matters such as sexual dysfunction. A decision about whether to undergo the exam should be made by doctors and patients, ACOG concluded.

These dueling recommendations leave women in the unenviable position of sorting out what to do. Continue reading

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Bill would require drug companies to report their payments to nurses and physician assistants

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Twenty-dollar bill in a pill bottleBy 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.

Companies have so far released more than 15 million payment records, covering August 2013 to December 2014. Continue reading

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Teamwork key to reducing diagnostic errors, report

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By Julie Appleby
KHN

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.

Photo courtesy of Sanja Gjenero
Continue reading

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Under pressure, hospitals push physicians to improve their bedside manners

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PrintBy Shefali Luthra
KHN/CNN

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

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New tool helps you check on doctors’ licensure info

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Screen Shot 2015-08-20 at 12.46.16 PMFrom the FSMB

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

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Yelp! adds medical quality data to its ratings

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yelp-logoStay 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.

Screen Shot 2015-08-06 at 9.47.38 AMPatients 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

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Is getting a second opinion worth it?

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Second opinions often sought but value is not yet proven

By Michelle Andrews
KHN

Dye with Yes, No and Maybe of the three visible sidesActress 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

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Even in nursing, men earn more than women

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woman_doctor_surgeon_bigBy Julie Rovner
KHN

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

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