NPs as independent PCPs...has the future just arrived?

From the FierceHealthcare article:

CareFirst BlueCross BlueShield (CareFirst) today announced that, effective immediately, it will permit nurse practitioners (NPs) to participate in its health care provider networks as independent primary care providers. Previously, CareFirst permitted NPs to participate in its networks, but they were only permitted to practice independently of physicians in certain medically underserved areas with limited access to primary care physicians.

Click here to access the article.

NAAMECC transforms into NAMEC

The North American Association of Medical Education and Communication Companies (NAAMECC) recently changed its name to the National Association of Medical Education Companies (NAMEC).  Click here to access their website.

Academic Medicine Supplement - Free!

September 2010 - Volume 85 - Supplement, A Snapshot of Medical Student Education in the United States and Canada: Reports from 128 Schools

Happy Halloween!

Erik, you've hardly changed at all! 

A lost art?

From the New York Times article "Physician Revives a Dying Art: The Physical":

He is out to save the physical exam because it seems to be wasting away, he says, in an era of CT, ultrasound, M.R.I., countless lab tests and doctor visits that whip by like speed dates. Who has not felt slighted by a stethoscope applied through the shirt, or a millisecond peek into the throat?

Some doctors would gladly let the exam go, claiming that much of it has been rendered obsolete by technology and that there are better ways to spend their time with patients. Some admit they do the exam almost as a token gesture, only because patients expect it.

Medical schools in the United States have let the exam slide, Dr. Verghese says, noting that over time he has encountered more and more interns and residents who do not know how to test a patient’s reflexes or palpate a spleen.

Click here to access the NYT article.  As my stepfather, who was a large animal veterinarian, always taught me...H&P, H&P, H&P!

October issue of Health Affairs now online

This issue is packed with a number of articles on health reform and comparative effectiveness research.  Click here to access the TOC (sub. req.).

Health care fraud?

From the New York Times article "Side Effects May Include Lawsuits":

FOR decades, antipsychotic drugs were a niche product. Today, they’re the top-selling class of pharmaceuticals in America, generating annual revenue of about $14.6 billion and surpassing sales of even blockbusters like heart-protective statins.
...
Anointed with names like Abilify and Geodon, the drugs were given to a broad swath of patients, from preschoolers to octogenarians. Today, more than a half-million youths take antipsychotic drugs, and fully one-quarter of nursing-home residents have used them. Yet recent government warnings say the drugs may be fatal to some older patients and have unknown effects on children.
...
Such marketing, according to analysts and court documents, included payments, gifts, meals and trips for doctors, biased studies, ghostwritten medical journal articles, promotional conference appearances, and payments for postgraduate medical education that encourages a pro-drug outlook among doctors. All of these are tools that federal investigators say companies have used to exaggerate benefits, play down risks and promote off-label uses, meaning those the F.D.A. hasn’t approved.
...
Over the next year, the government is adding at least 15 prosecutors and 100 investigators to pursue health care fraud.

Click here to access the NYT article.

To mammogram or not to mammogram?

From the New York Times article "Mammograms' Value in Cancer Fight at Issue":

Starting in their 40s or 50s, most women in this country faithfully get a mammogram every year, as recommended by health officials. But the study suggests that the decision about whether to have the screening test may now be a close call.
...
Previous studies of mammograms, done decades ago, found they reduced the breast cancer death rate by 15 to 25 percent, a meaningful amount. But that was when treatment was much less effective.
...
The study, published Thursday in The New England Journal of Medicine, looked at what happened in Norway before and after 1996, when the country began rolling out mammograms for women ages 50 to 69 along with special breast cancer teams to treat all women with breast cancer.

Click here to access the NYT article. Click here to access the NEJM article.

September 2010 Issue of the ACCME Report now available

Click here to access.

AMA PRA Booklet 2010 now available

Click here to check it out.

NCHS data on prescription drug use

Key findings from this report:

• Over the last 10 years, the percentage of Americans who took at least one prescription drug in the past month increased from 44% to 48%. The use of two or more drugs increased from 25% to 31%. The use of five or more drugs increased from 6% to 11%.
• In 2007–2008, 1 out of every 5 children and 9 out of 10 older Americans reported using at least one prescription drug in the past month.
• Those who were without a regular place for health care, health insurance, or prescription drug benefit had less prescription drug use compared with those who had these benefits.
• The most commonly used types of drugs included: asthma medicines for children, central nervous system stimulants for adolescents, antidepressants for middle-aged adults, and cholesterol lowering drugs for older Americans.

Click here to access the report. Click here to access Pharmalot's take on this report.

Board certification and quality of care

From the ABMS news release:

A new study on the quality of physician care provides evidence of the benefit of specialty board certification and suggests the necessity of continuous professional development programs, such as the American Board of Medical Specialties Maintenance of Certification® (ABMS MOC®) program.
...
The study also found two other important quality distinctions relevant to the general population of physicians in the United States:

•Specialty board certification was associated with lower mortality and shorter stays.
•Physician performance declined over time, with mortality rates and length of stays increasing with the number of years since graduation from medical school. The study was authored by John Norcini, CEO of Foundation for Advancement of International Medical Education and Research, a Philadelphia-based not-for-profit.

Click here to access the ABMS news release. Click here to access the Health Affairs article published on the aforementioned study (subscription required).

C-section rate of 30.5%!?!

Yep...check out the article "Contemporary cesarean delivery practice in the United States" just published in the American Journal of Obstetrics & Gynecology by clicking here.

Break out the popcorn...coming to a theater near y'all...soon

Hat tip to Pharmalot.

Simon's Cat in the Box (not to be confused with Jack)

Hat tip to Sue P.

Medical errors and disclosure

From Dr. Chen's New York Times column:

Despite the best efforts of health care professionals, bad things can happen in hospitals. Up until more recently, when errors occurred, the scenario that played out was always the same. Clinicians, devastated but fearful of litigation, would shut down. Patients and their families, grieving but desperate to make sense of the event, would find that their doctors and nurses were no longer responsive or available. Eventually, the most important relationship in health care, that between patient and doctor, would cede to the most adversarial one, that between plaintiff and defendant.
...
“Everybody worries that disclosure will lead to liability going through the roof,” said Dr. Allen Kachalia, lead author and an assistant professor of medicine at Harvard Medical School. “But here’s one institution that set up their disclosure program privately and independently, helped their patients avoid using the courts and tort system, and did not sustain the skyrocketing claims and costs that others might have predicted.”

Click here to access Dr. Chen's column. Click here to access "Liability Claims and Costs Before and After Implementation of a Medical Error Disclosure Program" (abstract) in the Annals of Internal Medicine.

"Change Board Recertification"

Have y'all heard of this group?  If not, click here to check it out.  Interesting...

AMA publishes info on malpractice claims for 2007-2008

 Can you guess which specialty is sued most often?  Click here to access AMA's press release on this report.

MA gift ban law intact?

Click here to read the Wall Street Journal's Health Blog's posting on this bill.

Nurse fired because of Facebook posting