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Medicine decries nurse doctorate exam being touted as equal to physician testing
Physician leaders say a new doctor of nursing practice certification exam is being wrongly compared with testing that physicians take. And they fear that patients may be misled into believing nurses who pass the exam share the same qualifications as physicians. Last fall, the National Board of Medical Examiners began offering the voluntary DNP test, based in part on Step 3 of the U.S. Medical Licensing Examination. Step 3 is the final stage in the physician testing series. In January, the Council for the Advancement of Comprehensive Care -- a nonprofit nursing group that contracted with the NBME to develop the exam -- announced the results of the first DNP certification test, with 50% of candidates receiving passing scores. In its announcement, the CACC said the exam "was comparable in content, similar in format and measured the same set of competencies and applied similar performance standards as Step 3 of the USMLE, which is administered to physicians as one component of qualif [Read more]
California physicians push to end Medicaid prior approval
California's budget crisis is leading Gov. Arnold Schwarzenegger to consider massive health care cuts, but the California Medical Assn. has another suggestion -- end treatment authorization review for Medicaid services and save hundreds of millions of dollars. The state's Medicaid treatment authorization program requires physicians to obtain prior approval for certain prescriptions and treatments. The mandate applies to a minority of procedures -- perhaps 15% overall, said Doug Robins, chief of the California Dept. of Health Care Services' Utilization Management Division. The state in 2001 reviewed 9% of Medicaid claims, including 10% of Medicaid prescriptions, 1.4% of inpatient care and 0.4% of physician services, according to a 2003 report by the California HealthCare Foundation, an independent philanthropy committed to improving the way health care is delivered and financed in California. Robins did not provide more current estimates. CMA Trustee Ted Mazer, MD, said the progra [Read more]
5 answers to your recession questions: Tips to keep your practice solvent
The financial questions physicians previously asked consultants were focused on ways to optimize revenue. Now those same questions are being asked so practices can keep from closing their doors. "The recession is fortunate for my practice. I seem to be very busy," said Jamie Claypool, president and founder of J. Claypool Associates, a practice management consulting firm based in Spicewood, Texas. Claypool and other consultants say once-hypotheticals have become real dilemmas for their client physicians as financial solvency has become harder to maintain. "If you're already in a tight economy, making a bad decision can push you over the edge," said Judy Capko, author and founder of her own consulting business based in Thousand Oaks, Calif. The questions physicians are asking haven't changed, but have become more urgent, said Keith Borglum, a medical practice management consultant based in Santa Rosa, Calif. Here are the questions practice management consultants say they h [Read more]
Drug czar pushes Rx monitoring for all states
In his first major speech since his appointment as the so-called drug czar, R. Gil Kerlikowske reaffirmed the Office of National Drug Control Policy's push to expand prescription drug monitoring programs to all 50 states. Kerlikowske, the former police chief of Seattle, delivered an address at the May 20 National Methamphetamine and Pharmaceutical Initiative meeting in Nashville, Tenn. He said it is "essential" that prescription drug monitoring programs are in place across the country. "Just as law enforcement needs to learn from health professionals about addiction and abuse to help us do our jobs, so too must the health community learn from law enforcement about the public safety consequences of excessive prescriptions and the reality of doctor shopping," Kerlikowske said in his address. The American Medical Association supports the expansion of prescription drug monitoring programs as a way of assisting physicians in identifying patients in need of help, rather than for [Read more]
More practices refusing to accept credit cards from patients
Even as patients increasingly are paying for care out of their own pockets, more practices are stopping them from doing so with one of the most-used items in their wallets: credit cards. A third of physician practices did not accept credit cards as of April, up 5 points from 28% last year, according to SK&A Information Services. The company, which aggregates data on physician practices for pharmaceutical and device manufacturing companies, did a telephone survey of 202,650 physician offices nationwide at the behest of an undisclosed credit-card company client. SK&A said a specialty's interest in accepting credit cards seems to be linked with its reliance on patient self-pay and the age of its patient base. The highest acceptance rate was in plastic surgery, with 91% of practices open to plastic payments. Pathology, at 21%, had the lowest acceptance rate. Family physicians had a credit card acceptance rate of 71.9%; internists, 53.1%; and geriatricians, 32%, according to SK&A. [Read more]
Surgical team briefings may improve patient safety
Preoperative briefings involving all members of a surgical team can decrease disruptions and miscommunications during a procedure and may improve patient safety, according to a study in the June Journal of the American College of Surgeons ( The study, conducted at the Mayo Clinic in Rochester, Minn., found that briefings resulted in fewer miscommunications -- 1.17 versus 2.5 per operation. During the meetings, each member of a surgical team reports his or her plan for the pending operation and asks questions or raises issues. "Briefings get everyone together, and they get their minds wrapped around this particular case," said co-investigator Thoralf M. Sundt III, MD, a professor of surgery in Mayo's division of cardiovascular surgery. "I'm convinced they make it safer for patients." The briefing protocol was pilot-tested during 16 of Dr. Sundt's operations. The cardiac-specific protocol was designed with the input of 5 [Read more]
Medical office buildings buffered from real estate slide
Medical office buildings are turning out to be a bright spot in an otherwise dismal real estate market. "There are a lot of great investment opportunities out there," said Steven Brezny, MD, a family physician in Powell, Ohio, who put in an offer this month on a 4,500-square-foot office building he intends to use as a new home for his practice. The medical office building market has long been characterized by stability rather than extreme highs or lows. In a world where flat is the new up, that is attracting a lot of attention from physicians as well as more traditional real estate investors. For instance, a pair of papers published in the May 4 and May 25 Industry Insights, issued by the investment banking firm Cain Brothers, said now is a good time for health systems to sell real estate assets if they need cash. For buyers, these types of investments were less risky than they had been in the past. "We do think the timing is still good," said Tim Schier, author of one of t [Read more]
Physicians question Obama in White House town hall
Washington President Obama fielded questions about health reform from several physicians, including the newly inaugurated president of the American Medical Association, during a June 24 televised town hall meeting at the White House ( "When you spoke to us last week, you said that we entered the medical profession not to be bean counters, not to be paper pushers, but to be healers. And we totally agree," said AMA President J. James Rohack, MD, referencing Obama's June 15 address at the AMA Annual Meeting. "How are you going to assure the American public that medical decisions will still be between the patient and the physician, and not some bureaucracy that will make decisions on cost and not really what the patient needs?" Obama replied by mounting another defense of his controversial proposal to offer a national public plan insurance option that will c [Read more]
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