Category Archives: Doctors

Plan will keep White Center’s Greenbridge Public Health Center open

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greenbridgeA partnership between City of Seattle and Planned Parenthood will allow the White Center Public Health Center at Greenbridge to remain open, King County Executive Dow Constantine said Monday.

The White Center clinic, which serves West Seattle, Burien, SeaTac, Tukwila, and Des Moines, was under threat of closing due to cut backs in state and federal funding.

Under the new partnership, Planned Parenthood of the Great Northwest will provide family planning services at the facility, while Public Health continues to provide Women, Infant and Children (WIC) and Maternity Support services for the next two years.

Seattle Mayor Ed Murray has committed $400,000 in 2015 to help keep Greenbridge open and preserve a variety of public health services.

Key details of the partnership include: Continue reading

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

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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

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Health Care For $4: Are You Ready For Walmart To Be Your Doctor?

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Walmart logoAfter years of “Will they or won’t they?” discussion, Walmart is making its long-awaited move into delivering primary care: The retailer has quietly opened a half-dozen primary care clinics across South Carolina and Texas, and plans to launch six more before January.

via Health Care For $4: Are You Ready For Walmart To Be Your Doctor?.

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Health Care Job Growth Not Accelerating | Altarum Institute

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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.

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California university fast tracks primary care docs

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3yrmedschool

UC Davis medical student Ngabo Nzigira with a patient (Photo: Andrew Nixon/Capital Public Radio)

By Pauline Bartolone, Capital Public Radio
KHN / AUGUST 7TH

Some doctors in the state of California will soon be able to practice after three years of medical school instead of the traditional four.

The American Medical Association is providing seed money for the effort in the form of a $1 million, five-year grant to the University of California at Davis.

In a traditional medical school, Nzigira wouldn’t be in a clinic until his third year.  In this accelerated course, students can shave up to $60,000 off their education debt. Still, Nzigira initially had hesitations.

“I thought ‘Oh man, you want me to put the intensity and stress that is medical school in four years, you want me to condense it down to three years? I’m not sure about that,’” Nzigira says. But, after learning more, he became convinced it was a good path for him. Continue reading

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Vermont moves towards single-payer health insurance

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VermontBy Michael Ollove
Stateline

BERLIN, Vermont – Dr. Marvin Malek has been yearning and advocating for a publicly financed, single-payer health care system for at least two decades.

Now, as Vermont stands on the threshold of being the first state to launch such a plan, he’s confessing to trepidation.

Some believe that if the Vermont experiment is successful, other states could follow. In Canada, they note, single-payer started in one province and then spread across the country.

“I am pretty damn nervous,” he confided before bounding off for rounds at the Vermont Central Medical Center, still clutching the bicycle helmet he wore on his ride to work. Continue reading

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Suspicious HIV drug prescriptions abound in Medicare

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propublica thumbnailThe inspector general of the U.S. Department of Health and Human Services finds Medicare spent tens of millions of dollars in 2012 for HIV drugs there’s little evidence patients needed. A 77-year-old woman with no record of HIV got $33,500 of medication.

By Charles Ornstein
ProPublica

Medicare spent more than $30 million in 2012 on questionable HIV medication costs, the inspector general of the U.S. Department of Health and Human Services said in a report set for release Wednesday.

The report offers a litany of possible fraud schemes, all paid for by Medicare’s prescription drug program known as Part D.

Among the most egregious:

In Detroit, a 77-year-old woman purportedly filled $33,500 worth of prescriptions for 10 different HIV medications. But there’s no record she had HIV or that she had visited the doctors who wrote the scripts.

A 48-year-old in Miami went to 28 different pharmacies to pick up HIV drugs worth nearly $200,000, almost 10 times what average patients get in a year. The prescriptions were supposedly written by 16 health providers, an unusually high number.

And on a single day, a third patient received $17,500 of HIV drugs — and none the rest of the year. She got more than twice the recommended dose of five HIV drug ingredients. Continue reading

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Seeking cheaper care, patients take online bids from doctors

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This KHN story also ran in wapo.

Francisco Velazco couldn’t wait any longer. For several years, the 35-year-old Seattle handyman had searched for an orthopedic surgeon who would reconstruct the torn ligament in his knee for a price he could afford.

Out of work because of the pain and unable to scrape together $15,000 – the cheapest option he could find in Seattle – Velazco turned to an unconventional and controversial option: an online medical auction site called Medibid, which largely operates outside the confines of traditional health insurance.

The four-year-old online service links patients seeking non-emergency care with doctors and facilities that offer it, much the way Priceline unites travelers and hotels. Continue reading

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A doctor’s perspective on ACA exchange plans

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 This story is part of a partnership that includes WNPR , NPR and Kaiser Health News.]

On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. Gerard, an internist, checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way.

For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80.

And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates.

I don’t think most physicians know what they’re being reimbursed.

That’s not something he’s willing to accept.

“I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,” Gerard says. “You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.”

Three insurers offered plans on Connecticut’s ACA marketplace in 2014and Gerard is only accepting one. He won’t say which, but he will say it pays the highest rate to doctors.

“I don’t think most physicians know what they’re being reimbursed. Only when they start seeing some of those rates come through will they realize how low the rates are they agreed to.”

Gerard’s decision to reject two plans is something officials in Connecticut are concerned about. Continue reading

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What’s been the local impact of the Affordable Care Act?

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California congressman Rep. Henry Waxman, a Democrat, has released a report detailing the impact of the Affordable Care Act broken down by congressional district.

Below are details from the report on the health law’s impact in the 7th district, represented by Congressman Jim McDermott, a strong supporter of the law, and the 8th district, represented by Congressman David Reichert, who has voted repeatedly to repeal the law.

For information about other districts go here.

In District  7 – Jim McDermottScreen Shot 2014-08-01 at 8.47.35 AM

As a result of the law:

  • There are 27,000 district residents who were previously uninsured now have health coverage because of the Affordable Care Act.
  • Overall, the number of uninsured district residents has declined by 35%.
  • Approximately 13,300 individuals purchased coverage through the new health insurance marketplace.
  • 31,700 enrolled in Medicaid
  • 7,600 young adults were able to retain coverage through their parents’ plans.
  • For more than 79% of the individuals enrolled in the health insurance marketplace, financial assistance was available that substantially reduced the cost of coverage – in many cases to less than $100 per month.
  • 295,000 individuals in the district – including 42,000 children and 132,000 women – now have health insurance that covers preventive services without any co-pays, coinsurance, or deductible.
  • 5,700 seniors in the district received Medicare Part D prescription drug discounts worth $8.9 million.
  • 94,000 seniors in the district are now eligible for Medicare preventive services without paying any co-pays, coinsurance, or deductible
  • 279,000 individuals in the district are protected by ACA provisions that prevent insurance companies from spending more than 20% of their premiums on profits and administrative overhead.
  • Because of these protections, over 5,700 individuals in the district received approximately $250,000 in insurance company rebates
  • Up to 26,000 children in the district with preexisting health conditions can no longer be denied coverage by health insurers.
  • 279,000 individuals in the district now have insurance that cannot place annual or lifetime limits on their coverage.

District 8 – Dave ReichertScreen Shot 2014-08-01 at 8.48.16 AM

  • 28,000 district residents who were previously uninsured now have health coverage.
  • Overall, the number of uninsured district residents has declined by 35%.
  • Approximately 13,900 individuals purchased coverage through the new health insurance marketplace
  • 33,000 enrolled in Medicaid
  • 5,400 young adults were able to retain coverage through their parents’ plans.
  • For more than 79% of the individuals enrolled in the health insurance marketplace, financial assistance was available that substantially reduced the cost of coverage – in many cases to less than $100 per month.
  • 286,000 individuals in the district – including 63,000 children and 114,000 women – now have health insurance that covers preventive services without any co-pays, coinsurance, or deductible.
  • 6,900 seniors in the district received Medicare Part D prescription drug discounts worth $9.9 million.
  • 100,000 seniors in the district are now eligible for Medicare preventive services without paying any co-pays, coinsurance, or deductible.
  • 252,000 individuals in the district are protected by ACA provisions that prevent insurance companies from spending more than 20% of their premiums on profits and administrative overhead.
  • Because of these protections, over 6,900 individuals in the district received approximately $240,000 in insurance company rebates.
  • Up to 42,000 children in the district with preexisting health conditions can no longer be denied coverage by health insurers.
  • 252,000 individuals in the district now have insurance that cannot place annual or lifetime limits on their coverage.

 

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Report sparks fight over future of doctor training programs

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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

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Panel recommends sweeping changes to doctor training system

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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

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Error: You have no payments from Pharma

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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

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

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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

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Health system not doing enough to protect patients, experts

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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

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