Last month the Wall Street Journal had an article on the shortage of residencies for medical students currently enrolled at U.S. medical schools. Turns out the feds, who have primary authority for funding residency programs through Medicare, have frozen funding since 1997. Meanwhile, an aging population and mandates of the Affordable Care Act will continue to create demand for trained physicians. Lets hope this gets worked out soon.
The Wall Street Journal has an extensive article on the growing debate over the scope of practice for physician assistants and other mid-level practitioners. My experience is that a good PA or Nurse Practitioner can add great value to a physician’s professional productivity and personal quality of life. The Kentucky Medical Association is being cautious on the expanded use of PAs, saying they want to work with the PA community on developing a model for “”physician-led, patient-centered medical teams”. Amen to that. Get it down quick though. We are going to need a lot of bright minds and caring hearts at all levels to meet the growing demand created by the Affordable Care Act. Then the next big trick will be to ensure that M.D.s, P.A.s and N.P.s are all compensated fairly.
Press control.alt, delete to take back that diagnosis.
Venture capitalist Vinod Khosla writes that technology will largely replace the diagnosis currently performed by physicians. Khosla asserts that these rapidly progressing developments will actually free up physicians to spend more time with their patients and perform their work better.
Khosla also says that while computers and technology do the analytics that can lead to more accurate diagnosis and treatment, those physicians that can oversee this process with empathy and a good bedside manner will be the ones that flourish in this brave new world.
Dr. Marty Makary has a good piece in the Wall Street Journal comparing the harm caused to society by medical errors and airplane accidents. He says medicine needs to follow the practices put in place by aviation to reduce the amount of medical errors. In short, medicine needs to do a better job of learning from mistakes and encouraging greater transparency and accountability when dealing with medical errors.
Think your practice is too small to escape scrutiny and sanctions for HIPAA violations? Better think again.
In April, the HHS Office for Civil Rights (OCR) levied a fine in the amount of $100,000 against a five physician cardiac surgery group located in Phoenix for potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules. Evidently, the surgical practice used a web based appointment system and the names of patients were being posted online for all the world to see.
In addition to the fine, the group was required to implement policies and procedures to ensure that patients’ protected health information is adequately safeguarded.
In announcing the fine, HHS OCR struck an aggressive posture. “This case is significant because it highlights a multi-year, continuing failure on the part of this provider to comply with the requirements of the Privacy and Security Rules,” said Leon Rodriguez, director of OCR. “We hope that health care providers pay careful attention to this resolution agreement and understand that the HIPAA Privacy and Security Rules have been in place for many years, and OCR expects full compliance no matter the size of a (medical practice).”
So, if you don’t have HIPAA policies in place, do it soon. The feds won’t be very sympathetic to an argument that your practice is too small to comply with HIPAA.
Dan Primack of Fortune magazine has a post today on his blog, Term Sheet, about how one prominent venture capital firm is shutting down its investments in healthcare. This is not good sign.
The firm, Scale Venture Partners, cites the challenges of getting new drug submissions through the FDA as the basis for its actions.
A vibrant interest in healthcare by venture capital and private equity is critical to advancements in new therapies and devices. Government policies that chill investments in these areas are a problem and should be changed.
The Wall Street Journal has an interesting article today on how physicians deal with the complicated issue of pain management for patients.
One doctor quoted in the article says that between 15% and 20% of patients fake their pain or aren’t in as much pain as they say. Other patients are dependent on opoid painkillers or exagerate their pain in order to avoid work.
Faced with patients that overstate their pain, physicians must make some difficult decisions, including just saying no to a request for another painkiller prescription.
It a good article, even for physicians treating the milions of patients out there with very real and debilitating pain. Go give it a read.
During the summer travel season, I will usually get a few calls from doctor clients who have responded to a medical emergency while on an airplane. If the patient doesn’t make it or later develops severe complications, the doctors are concerned that they may have incurred liability for providing care. They need not worry. Good Samaritan laws provide a shield from liability when a doctor happens upon an accident or ill person and volunteers to provide care without compensation.
Yesterday, the New York Times had a piece on just how much the airline industry actually relies on the medical community to come to the aid of fellow passengers in emergency situations. Some doctors interviewed even pack drugs and other items and equipment so they are prepared in case they are called upon for professional assistance.
Its an interesting read so go check it out. And pack accordingly for that trip to the beach this summer.
In the wake of the spectacular work of Navy SEALS to locate and kill Osama Bin Laden, the training regimen and methods of that elite group have received quite a bit of attention.
Now researchers who recently presented their findings at Harvard Medical School are saying that the type of resiliency in the face of constant stress that is taught to Navy SEALs can also benefit medical students and residents during their training.
According to their findings, researchers say that emotional resiliency can be taught and the effects of chronic stress reversed. The best predictor of immunity to stress, is a strong social support network. Optimism (including faith in a higher cause or power), perseverance (work ethic), responsibility and integrity also count.
For my money, our nation’s doctors are just as good as our Navy SEALS at the work they are asked to do. But if borrowing from the outstanding training methods of the military’s elite units will make doctors even better, medical schools and residency programs should take heed and adopt them.