Category Archives: Doctors

Error: You have no payments from Pharma

Share

Data GlobeDoctors checking a soon-to-be-unveiled federal website that will publicly list drug company payments are encountering error messages if they have not accepted industry money.

by Charles Ornstein
ProPublica

The federal government has a word for physicians who don’t have financial relationships with pharmaceutical and medical device manufacturers: “Error.”

This week, the government began allowing doctors to log into a secure website to check the payments attributed to them by drug and device makers.

Doctors who were expecting the site to clearly confirm that they don’t have relationships with pharmaceutical companies have met with a surprise.

This information will be made public later this year under the Physician Payment Sunshine Act, a part of the 2010 Affordable Care Act.

In advance, if doctors believe the material about them is wrong, they can contest it.

But early reports suggest the new site has some glitches. Doctors say it is taking them as long as an hour, sometimes longer, to verify their identities and log in. (Because the information is not yet public, doctors have to go through several steps to prove they are who they say they are.)

Once they get that far, doctors who were expecting the site to clearly reflect that they don’t have relationships with pharmaceutical companies have met with a surprise.

“You have the following errors on the page,” the Open Payments website tells them. “There are no results that match the specified search criteria.” Continue reading

Share

Docs slam recertification rules. Call them a waste of time.

Share

This KHN story also ran in .

Many specialists are balking at what they say are onerous new rules to get recertified, warning the demands will force some physicians out of practice at a time when the nation faces a shortage.

Doctors say the new requirements have made maintaining specialty certifications a process that never ends.

Younger doctors already retake the arduous certification exam every seven to 10 years to keep their credential, long considered the gold standard of expertise.

“I’m at an age where, if anybody does anything to force me to participate, I’d say ‘adios.’ I’d retire. It’s not worth it for me.”

But physicians of all ages must now complete a complex set of requirements every two to three years, or risk losing their certification.

Supporters contend the new process will ensure doctors incorporate the latest medical advances into their practices, but many critics dismiss it as meaningless, expensive and a waste of time. 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

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

Painkiller prescribing varies widely state-by-state

Share

 VitalSigns

Icon: Mortor and pestleEach day, 46 people die from an overdose of prescription painkillers in the US.

Icon: Pill bottleHealth care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.

Icon: U.S. map10 of highest prescribing states for painkillers are in the South.

 

Health care providers in some states prescribed far more painkillers than those in other states in 2012.

 

  • Southern states had the most prescriptions per person for painkillers, especially Alabama, Tennessee, and West Virginia.
  • The Northeast, especially Maine and New Hampshire, had the most prescriptions per person for long-acting and high-dose painkillers.
  • Nearly 22 times as many prescriptions were written for oxymorphone (a specific type of painkiller) in Tennessee as were written in Minnesota.

What might be causing this?

  • Health care providers in different parts of the country don’t agree on when to use prescription painkillers and how much to prescribe.
  • Some of the increased demand for prescription painkillers is from people who use them nonmedically (using drugs without a prescription or just for the high they cause), sell them, or get them from multiple prescribers at the same time.
  • Many states report problems with for-profit, high-volume pain clinics (so-called “pill mills”) that prescribe large quantities of painkillers to people who don’t need them medically.

Some states have more painkiller prescriptions per person than others.

Some states have more painkiller prescriptions per person than others.

SOURCE: IMS, National Prescription Audit (NPATM), 2012.

To learn more go here.

Share

Employer health costs forecast to accelerate in 2015

Share

$100-dollar bill inside a capsuleBy Jay Hancock
KHN

Health costs will accelerate next year, but changes in how people buy care will help keep them from attaining the speed of several years ago, PricewaterhouseCoopers says in a new report.

The prediction, based on interviews and modeling, splits the difference between hopes that costs will stay tame and fears that they’re off to the races after having been slow since the 2008 financial crisis.

“This is not an immediate return to double-digit growth rates,” says Ben Isgur, a director in PwC’s Health Research Institute. However, he adds, “what we’re seeing for 2015 will be our first uptick in some time.” Continue reading

Share

Insurers push back against growing cost of cancer treatments

Share

 This KHN story also ran in .

Some cancer patients and their insurers are seeing their bills for chemotherapy jump sharply, reflecting increased drug prices and hospitals’ push to buy oncologists’ practices and then bill at higher rates.

Patients say, “‘I’ve been treated with Herceptin for breast cancer for several years and it was always $5,000 for the drug and suddenly it’s $16,000 — and I was in the same room with the same doctor same nurse and the same length of time’,” said Dr. Donald Fischer, chief medical officer for Highmark, the largest health plan in Pennsylvania. Continue reading

Share

FAQ on ACOs: Accountable Care Organizations, explained

Share

Boeing-logo-2Some non-union Boeing workers will now be able to get care through an “accountable care organization” run by UW Medicine and Providence Health and Services/Swedish. But what are accountable care organizations, or ACOs, anyway? Here’s a primer.

Accountable care organizations are practically a footnote in the health law, but advocates say they’ll be critical to holding down the cost of care while improving quality

By Jenny Gold
KHN Staff Writer
APR 16, 2014

One of the main ways the Affordable Care Act seeks to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks which coordinate patient care and become eligible for bonuses when they deliver that care more efficiently.

A doctor walking through a mazeThe law takes a carrot-and-stick approach by encouraging the formation of Accountable Care Organizations (ACOs) in the Medicare program. Providers make more if they keep their patients healthy. About four million Medicare beneficiaries are now in an ACO, and, combined with the private sector, more than 428 provider groups have already signed up.

An estimated 14 percent of the U.S. population is now being served by an ACO. You may even be in one and not know it.

While ACOs are touted as a way to help fix an inefficient payment system that rewards more, not better, care, some economists warn they could lead to greater consolidation in the health care industry, which could allow some providers to charge more if they’re the only game in town.  

ACOs have become one of the most talked about new ideas in Obamacare. Here are answers to some of the more common questions about how they work:  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

Patients lose when doctors can’t do good physical exams

Share

A middle-aged aged man admitted to a Seattle emergency room for the third time in six weeks displays the classic signs of liver cirrhosis for which he has been repeatedly treated, including swollen legs and a distended abdomen. But a veteran doctor spots a telltale indicator of a different disease: rapid inward pulsations just beneath the man’s right ear.

Red stethoscope By Sandra G. Boodman

This KHN story was produced in collaboration withwapo

Doctors at a Northern California hospital, concerned that a 40-year-old woman with sky-high blood pressure and confusion might have a blood clot, order a CT scan of her lungs. To their surprise, the scan reveals not a clot but large cancers in both breasts that have spread throughout her body.

Had they done a simple physical exam of the woman’s chest, they would have been able to feel the tumors. So would the doctors who saw her during several hospitalizations over the previous two years, when the cancer might have been more easily treated. Continue reading

Share

FDA cuts recommended starting dose for sleeping pill Lunesta from 3 mg to 1 mg

Share

Alert Icon with Exclamation Point!The U.S. Food and Drug Administration (FDA) is warning that the insomnia drug Lunesta (eszopiclone) can cause next-day impairment of driving and other activities that require alertness.

As a result, the agency has decreased the recommended starting dose of Lunesta to 1 mg at bedtime.

Health care professionals should follow the new dosing recommendations when starting patients on Lunesta, the FDA said.

Continue reading

Share

What surge? Primary care system holding up well so far under Obamacare

Share

doctors-300By Phil Galewitz
KHN
May 12, 2014

This KHN story was produced in collaboration with 

The headlines were ominous: Good luck finding a doctor under Obamacare. Not enough doctors for newly insured. Obamacare, doctor shortage could crash health system.

Despite these dire predictions, the nation’s primary care system is handling the increased number of insured patients without major problems so far, according to interviews with community health centers, large physician practices and insurers nationwide. Continue reading

Share

Patient education tops physician training for diabetes control – study

Share

Glucometer showing a blood sugar of 105People with diabetes who received counseling at clinic appointments had a 49 percent greater likelihood of achieving long term blood glucose control than patients that did not receive counseling. 

Physician training about managing diabetes seemed to be ineffective at helping patients control their glucose levels, whether or not patients received counseling.

By Valerie DeBenedette
Health Behavior News Service

Teaching people with diabetes how to control their blood glucose levels helps them achieve better results, finds a new study in Ethnicity and Disease.

Surprisingly, providing intensive training to physicians of diabetes patients did not help patients achieve blood glucose control. Continue reading

Share