Category Archives: Nurses

Is there really a looming doctor shortage?

Share

Question markSome 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

Share

US to fund $840 million initiative to improve patient care and lower costs

Share

All interested clinicians are invited to participate in the initiative.

stethoscope doctor's bag chest x-rayUS 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;
  • Improving the coordination of patient care by primary care providers, specialists, and the broader medical community; and
  • Using electronic health records on a daily basis to examine data on quality and efficiency.

To learn more about the the initiative go here.

Share

Are nurse practitioners, physician assistants encroaching on specialists’ turf?

Share

One of the hopes embedded in the health law was to expand the role of nurse practitioners and physician assistants in addressing the nation’s shortage of primary care providers. But a new study questions whether that’s actually happening in doctors’ offices.

Mid-level providers – PAs and NPs – “are doing invasive procedures and surgery. I’m not sure they were trained to do that.”

Of the more than 4 million procedures office-based nurse practitioners and physician assistants independently billed more than 5,000 times in a year to Medicare – a list including radiological exams, setting casts and injecting anesthetic agents – more than half were for  dermatological surgeries. Continue reading

Share

Health Care Job Growth Not Accelerating | Altarum Institute

Share

Health Care Job Growth Not Accelerating

AUGUST 8, 2014

Physician and Nurse Pushing GurneyANN ARBOR, MI — Health care gained a modest 7,000 jobs in July, bringing the 2014 year-to-date monthly average down to 18,000, very close to the monthly average for all of 2013.  This low net figure masks above-average growth in ambulatory care and job losses in hospitals. The health share of total employment fell from 10.61% to 10.60%, down from the high of 10.66% last seen in December 2012, and the lowest figure since October 2010.

via Health Care Job Growth Not Accelerating | Altarum Institute.

Share

Report sparks fight over future of doctor training programs

Share

doctors-300By Julie Rovner
KHN 

A high-level report recommending sweeping changes in how the government distributes $15 billion annually to subsidize the training of doctors has brought out the sharp scalpels of those who would be most immediately affected.

The reaction also raises questions about the sensitive politics involved in redistributing a large pot of money that now goes disproportionately to teaching hospitals in the Northeast U.S. All of the changes recommended would have to be made by Congress. Continue reading

Share

Panel recommends sweeping changes to doctor training system

Share

An expert panel recommended Tuesday completely overhauling the way government pays for the training of doctors, saying the current $15 billion system is failing to produce the medical workforce the nation needs.

“We recognize we are recommending substantial change,” said health economist and former Medicare Administrator Gail Wilensky, co-chairwoman of the nonpartisanInstitute of Medicine panel that produced the report. “We think it’s key to justifying the continued use of public funds.” Continue reading

Share

Health system not doing enough to protect patients, experts

Share

Physician and Nurse Pushing Gurneyby Marshall Allen
ProPublica

WASHINGTON, D.C. — The health care community is not doing enough to track and prevent widespread harm to patients, and preventable deaths and injuries in hospitals and other settings will continue unless Congress takes action, medical experts said today on Capitol Hill.

“Our collective action in patient safety pales in comparison to the magnitude of the problem,” said Dr. Peter Pronovost, senior vice president for patient safety and quality at Johns Hopkins Medicine. “We need to say that harm is preventable and not tolerable.” Continue reading

Share

Nurses delaying retirement – study

Share

Woman_doctor_surgeonBy Shefali Luthra
KHN / JULY 16TH, 2014

Despite predictions of an impending nurse shortage, the current number of working registered nurses has surpassed expectations in part due to the number of baby-boomer RNs delaying retirement, a study by the RAND Corp. found.

The study, published online Wednesday by Health Affairs, notes that the RN workforce, rather than peaking in 2012 at 2.2 million – as the researchers predicted a decade ago – reached 2.7 million that year and has continued growing.

The trend of nurses delaying retirement accounted for an extra 136,000 RNs in 2012, the study suggests. Continue reading

Share

State disciplines health care providers – July 15 update

Share

Seal_of_WashingtonPeriodically Washington State Department of Health issues an update on disciplinary actions taken against health care providers, including suspensions and revocations of licenses, certifications, or registrations of providers in the state.

The department also suspends the credentials of people who have been prohibited from practicing in other states.

Information about health care providers is also on the agency’s website.

To find this information click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov).

The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998.

This information is also available by calling 360-236-4700.

Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Here is the July 16th update issued by the Washington State Department of Health: Continue reading

Share

New respect for primary care docs?

Share

Blue doctorBy Jay Hancock
KHN Staff Writer
This KHN story also ran in wapo.

BALTIMORE — A few years ago it struck the D.C. region’s biggest medical insurer that the doctors who saw its members most often and knew them best got the smallest piece of the healthcare dollar.

By paying primary care doctors to cut specialist and hospital revenue, CareFirst is helping to alter the medical spoils system.

CareFirst BlueCross BlueShield spent billions on hospital procedures, drugs and specialty physicians to treat sick patients.

Only one dollar in 20 went to the family-care doctors and other primary caregivers trained to keep people healthy.

The company’s move to shift that balance tells a lesser-known story of the Affordable Care Act and efforts to change the health system. Continue reading

Share

After court’s home health aide ruling, fewer state workers to organize

Share

U.S. Supreme CourtBy Jake Grovum
Stateline

The U.S. Supreme Court’s recent ruling in a case brought by home health care aides in Illinois casts doubt on labor agreements between such workers and state governments in nine other states.

It also closes off—or at least complicates—one of labor’s clearest paths to reversing a decades-long trend of declining ranks and shrinking clout.

The petitioners in Harris v. Quinn were home health care aides who did not want to join a union, though a majority of their co-workers had voted to join. Continue reading

Share

School nurses’ role expands with access to students’ online health records

Share

Although the school nurse is a familiar figure, school-based health care is unfamiliar territory to many medical professionals, operating in a largely separate health care universe from other community-based medical services.

Now, as both schools and health care systems seek to ensure that children coping with chronic conditions such as diabetes and asthma get the comprehensive, coordinated care the students need, the schools and health systems are forming partnerships to better integrate their services. Continue reading

Share

When doctors need advice, it might not come from a human

Share

Computer Circuit Board

This story was produced in collaboration with 

Long Island dermatologist Kavita Mariwalla knows well how to treat acne, burns and rashes. But when a patient came in with a potentially disfiguring case of bullous pemphigoid—a rare skin condition that causes large, watery blisters—she was stumped.

The medication doctors usually prescribe for the autoimmune disorder wasn’t available. So she logged in to Modernizing Medicine, a Web-based repository of medical information and insights, for help.

Within seconds, she had the name of another drug that had worked in comparable cases.

“It gives you access to data, and data is king,” she said of Modernizing Medicine. “It’s been very helpful especially in clinically challenging situations.” Continue reading

Share

Want to see a doctor? Get in line.

Share

Stethoscope DoctorBy Jenny Gold
KHN

Need to see a doctor? You may have to wait.

survey of physician practices in 15 metropolitan areas across the country found that the average wait time for a new patient to see a physician in five medical specialties was 18.5 days.

The longest waits were in Boston, where patients wait an average of 72 days to see a dermatologist and 66 days to see a family doctor.

The shortest were in Dallas, where the average wait time is 10.2 days for all specialties, and just 5 days to see a family doctor.

Seattle: 16.5 days for a specialist; 23 days for a family practice doctor.

Continue reading

Share

ER docs give Washington a D+

Share

The American College of Emergency Physicians has given Washington state a “near failing D+” in the its annual state-by-state report card assessing the nation’s emergency services.

Overall the state ranked 35th in the nation, down from its ranking of 19 in the College’s 2009 report, which that year gave Washington a C.

Screen Shot 2014-01-16 at 15.21.58 Continue reading

Share