Category Archives: Doctors and Nurses

Humana and Northwest Physicians Network form accountable care partnership


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.”


Dueling recommendations about need for pelvic exams leaves women confused


Question marksBy Sandra G. Boodman

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


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


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


Teamwork key to reducing diagnostic errors, report


By Julie Appleby

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
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Under pressure, hospitals push physicians to improve their bedside manners


PrintBy Shefali Luthra

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


New tool helps you check on doctors’ licensure info


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 ( draws data from the FSMB’s Physician Data Center, the nation’s most comprehensive database of physician licensure and disciplinary information. Continue reading


Yelp! adds medical quality data to its ratings


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


Is getting a second opinion worth it?


Second opinions often sought but value is not yet proven

By Michelle Andrews

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


Even in nursing, men earn more than women


woman_doctor_surgeon_bigBy Julie Rovner

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


Washington Center for Nursing picks new executive director


Sofia_AragonFrom the Washington Center for Nursing

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


Ebola-infected nurse contends Dallas hospital violated her privacy


by Charles Ornstein ProPublica

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.

“I love you guys,” Pham says, wiping away tears.

“We love you Nina,” the doctor replies.

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


New Mexico’s nurse hotline touted as a model for other states


red-telephoneBy Christine Vestal

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.

In April, the U.S. Centers for Disease Control and Prevention (CDC) will recommend New Mexico’s advice line as a national model that other states adopt during an emergency preparedness summit in Atlanta. Continue reading