Category Archives: Doctors and Nurses

Primary care doctors often don’t help patients manage depression, study

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Doctor simpleBy Michelle Andrews
Kaiser Health News

Although primary care doctors frequently see patients with depression, they typically do less to help those patients manage it than they do for patients with other chronic conditions such as diabetes, asthma or congestive heart failure, a recent study found.

That is important because research has found that it can be good for patients’ health when physician practices have procedures in place to identify and provide targeted services to patients with chronic conditions and to encourage patients to get involved in actively managing their own care.

But physicians were less likely to use those “care-management processes” with patients who have depression than with those who had other chronic conditions, according to the study in the March edition of the journal Health Affairs. Continue reading

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It’s not just doctors and nurses, patients need to wash their hands, too

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Hygiene. Cleaning Hands. Washing hands.

By Shefali Luthra
Kaiser Health News

Encouraging doctors and nurses to wash their hands frequently has always been considered an easy and effective way to curb the spread of infection in hospitals and other health facilities.

But a new research letter published Monday in JAMA Internal Medicine points to another key group of people who aren’t always keeping their hands so clean and, it turns out, probably should: patients.

Researchers focused on inner-city Detroit and examined patients who went from hospitals to post-acute care facilities — places like rehabilitation centers, skilled-nursing facilities, hospice and long-term care hospitals.

They found that almost one in four adults who left the hospital had on their hands a superbug: a virus, bacteria or another kind of microbe that resists multiple kinds of medicine. While in post-acute care, about 10 percent of patients picked up another superbug. Of those who had superbugs, 67 percent still had them upon being discharged, even if they hadn’t gotten sick.

These findings add to a growing body of research about hand hygiene and the patient’s role in infection transmission, and speak to an underlying problem with health care facilities — they can increase the odds of getting sick. The paper’s authors suggest it highlights a potential, so far underused strategy for addressing that concern: getting patients to wash their hands. Continue reading

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Pediatricians offer a ‘medical home’ for your child

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Pediatricians Know Children’s Medical History Well and Provide Comprehensive Care

McCabe_Liana_2014Guest column by Liana McCabe, MD
Contributing writer

As the mother of two young children and a pediatrician, I understand and appreciate how challenging it can be to coordinate health care for a child, especially for parents who also work outside the home or have other responsibilities. To make caring for children and their families easier, we strive to provide comprehensive pediatric services and have our office be your child’s ‘medical home.’

Your pediatrician can do it for you

Aided by an electronic medical record, which includes your child’s allergies, medical history and immunization records, a pediatrician is able to provide the most informed, safe and effective treatment options, unlike a clinic that may not be able to easily obtain your child’s personal health information.

Consistency is also key to proper health care

The importance of a long-term relationship with a pediatrician from the newborn years until adulthood – both for the patient and for the parent who is looking for guidance in navigating the sometimes challenging world of parenting – cannot be understated.

With every visit, phone call or secure email, the pediatrician is learning about your child’s health care needs, enabling the physician to make decisions with complete knowledge and information. This is why children’s health care is ideally delivered or coordinated through the child’s ‘medical home,’ the office of the primary-care pediatrician.

Pediatricians provide comprehensive care

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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
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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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