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Patients won’t ask physicians to come clean on hand-washing
The vast majority of patients have never asked a physician or other health professional if they washed their hands before a physical exam or medical procedure, said a survey released in September. Only 21% of patients have asked about hand hygiene in the hospital, and just 17% have inquired about hand-washing at their doctor’s office, said the nationwide online survey of 1,020 U.S. adults. Fewer than 10% of patients said they ask “frequently” or “all the time.” The low rate of hand-hygiene quizzing comes despite widespread use of hospital signage encouraging such questions, as well as educational videos and urging from the Centers for Disease Control and Prevention, the Joint Commission and others. Compliance with hand-hygiene guidelines is difficult to measure accurately and varies widely. The CDC says the hand-washing rate in hospitals hovers around 50%. Poor hand hygiene is a leading contributor to the estimated 1.7 million health care-associated infections that occu [Read more]
Insurers begin using standardized consumer guides
Health plans now are providing more consumer-friendly summaries of the insurance coverage they offer patients. The 2010 health system reform law required insurers to detail coverage using uniform documents and standardized definitions to explain patient benefits and cost-sharing responsibilities. Sept. 23 was the official deadline for health plans to begin using the new documentation. The summary of benefits and coverage form contains key information beneficiaries need during health plan enrollment periods, said Dept. of Health and Human Services Secretary Kathleen Sebelius during a Sept. 24 conference call with reporters. The document, which she likened to a food nutrition label, tells patients what they need to know when comparing insurance plans without having to read through dozens of pages of fine print and footnotes. “Americans shouldn’t have to make a decision as important as picking a health plan for themselves and their family or their employees without having all [Read more]
Patients seek strong say in how their data are used
A study in the September-October issue of Annals of Family Medicine shows that even patients who are generally comfortable with their data being shared electronically want to be in control of how that information is shared. Researchers from Weill Cornell Medical College in New York surveyed 170 patients from the Hudson Valley in New York. They found that 78% wish they could explicitly approve the sharing of all types of information, and most prefer restricting information by clinician (83%), visit (81%) or information type (88%). However, two-thirds of those surveyed said they supported the idea of sharing health information. The Statewide Health Information Network for New York (SHIN-NY) requires patients to opt into having their information shared, and all patients surveyed are covered under that network. All-or-nothing opt-ins do not allow patients to select which information is shared or with whom. Lead author Rainu Kaushal, MD. MPH, director of the Center for Healthcare I [Read more]
Congress extends visa waiver program for IMGs
A program that provides incentives for international medical graduates to practice in rural areas where physicians are scarce is set to get a three-year extension. On Sept. 13, the House of Representatives voted 412-3 to approve legislation to continue the Conrad State 30 J-1 Visa Waiver Program through Sept. 30, 2015. Advocates of the program in organized medicine say passage of the bill is a victory, but they would like to see more than an extension. “We are pleased the program has been reauthorized and would like the program to be permanent,” said Elizabeth Lietz, spokeswoman for the American Hospital Assn. IMGs represent about a quarter of the U.S. physician work force, including practicing physicians and physicians-in-training. Initiated in 1994, the Conrad 30 program allows IMGs to stay in the U.S. after completing their medical training if they agree to work at least three years in a medically under-served community. Without the waiver, physicians who train in the U [Read more]
Physicians sue insurer over payment denials
In the latest battle among doctors and insurers over what constitutes “medically necessary” treatment, the Los Angeles County Medical Assn. is suing Health Net, claiming that the plan routinely denies payment for lifesaving health care services. The medical association is asking a judge to immediately block the insurer’s payment practices, which doctors say includes a faulty set of criteria used to define medical necessity. Health Net is irreparably harming the doctor-patient relationship and keeping physicians from ensuring that their patients receive appropriate care, said Rocky Delgadillo, the association’s CEO. “Doctors and the patients that they serve are being hurt by Health Net defining medical necessity by its own terms and by its own people,” he said. “It’s another case of insurers putting profit over patients and denying care simply because the care is expensive.” Health Net said in a statement that it carefully follows the guidelines established by [Read more]
ROTC-type primary care scholarships proposed
A bill introduced by Rep. Jim McDermott, MD (D, Wash.) seeks to add thousands of new primary care doctors to the work force by establishing a program that would pay for a student’s medical school education in return for several years of service as a primary care doctor in a medically under-served area. Dr. McDermott said his RDOCS program, or the Restoring the Doctors of Our Country through Scholarships Act of 2012, follows the model of ROTC programs, which pay college expenses for students who commit to be trained as reserve officers in the U.S. military. Most of the funding for the new program would come from the federal government, but states would administer it for participating medical students attending state medical schools. In exchange for scholarship funds, students would conduct their residencies in primary care and serve as primary care physicians in under-served areas of their respective states for five years. The nation is facing a projected shortage of 45,000 doct [Read more]
Substance abuse among U.S. military declared a public health crisis
Rising rates of alcohol and prescription drug use among the nation’s armed forces have become a public health crisis that could negatively affect service members’ abilities to perform their duties, said an Institute of Medicine report issued Sept. 17. In 2008, 47% of active duty personnel reported binge drinking at least once in the previous month, up from 35% in 1998. Between 2002 and 2008, misuse of prescription medication in the past 30 days increased from 2% to 11% of active service members, the IOM report said. Contributing to the problem are outdated military policies on preventing and treating substance use disorders, according to the IOM. “Many of these policies had been drafted more than 10 years previously and had not been revised to reflect emerging knowledge,” the report said. Other challenges include patients avoiding care for substance-use disorders due, in part, to concerns about being penalized, and limited training in addiction and psychiatry among phy [Read more]
Hospitalist project reports success in improving ED patient flow
Assigning a hospitalist and an allied health professional to patients admitted to a facility but waiting in the emergency department for a bed improved patient flow through the hospital and saved it more than a half-million dollars, according to a study in the September Journal of Hospital Medicine. “The emergency department is not something that I thought was my purview, but now I think there is a role for an internist-hospitalist,” said Smitha R. Chadaga, MD, the lead author, who launched a hospitalist program for the ED in 2009 at Denver Health, a 477-bed academic safety net hospital in Denver. “And it’s a great opportunity.” Patient boarding in the emergency department has been a longtime concern of several medical societies. The American Medical Association supports collaboration between organized medical staff and emergency department staff to address the issue. The American College of Emergency Physicians generally is behind initiatives that move admitted patient [Read more]
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