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Hospitals find success in slashing health disparities
A coalition of health care organizations is highlighting how collecting patients' demographic data, expanding cultural competency training and diversifying health leadership can help reduce care disparities. For example, New York-Presbyterian Hospital started an initiative to improve care for patients in the largely Hispanic neighborhoods of Washington Heights and Inwood in New York City. The effort included a four-hour training program for health professionals to help address patients' cultural, language and literacy needs. "The cultural competency training provides background information in terms of the various ethnicities and religions and groups that we see predominantly," said J. Emilio Carrillo, MD, MPH, vice president for community health at New York-Presbyterian. "However, we are making it very clear that we ascribe to a patient-centered, cross-cultural approach." Whatever ethnic or racial background a patient is from, "people are trained to respond to them as an indiv [Read more]
Guidelines focus on newly diagnosed HIV patients
Worried that too few people with HIV receive the care they need, infectious diseases experts have issued guidelines calling on physicians to ensure that newly diagnosed patients start treatment and adhere to life-long drug regimens. The recommendations were developed by a panel of 31 HIV experts on behalf of the International Assn. of Physicians in AIDS Care. They were published online March 5 in Annals of Internal Medicine. The guidelines urge health professionals to monitor the entry of patients they diagnose with HIV into treatment programs. After the initial visit for such programs, nurses or other staff members periodically should call patients to ensure that they are properly taking their medications. Adherence also can be monitored through systems that alert physicians when a patient does not pick up his or her prescriptions, said Larry W. Chang, MD, MPH, co-author of the guidelines and an assistant professor of Medicine at Johns Hopkins University School of Medicine in [Read more]
Medicare overhauls patient claims statements
Medicare has redesigned the claims and benefits statements that are sent to enrollees on a quarterly basis, with the goal of clarifying a document that has been criticized as impenetrable to many patients. Some of the changes to the Medicare summary notices include descriptions of medical services that are deemed more consumer-friendly, larger fonts and definitions of all the terms that Medicare uses on the forms. The notice also is reformatted around a snapshot of the beneficiary's current deductible status, a list of health professionals they saw during the quarter, and information about whether their claims were approved or denied. Critics of the Medicare claims system have complained that beneficiaries often don't realize that claims for their services have been rejected, making the process of appealing those decisions more difficult. The Centers for Medicare & Medicaid Services said the clearer forms will make it easier for patients to launch appeals if they think the denial [Read more]
Medical students show gains in empathy are short-lived after training
The actor wore goggles smeared with petroleum jelly to simulate poor vision and earplugs to replicate hearing loss. He portrayed an elderly patient being admitted to a long-term, assisted-care facility and fired questions at another actor playing the facility's assistant manager. The two had trouble communicating. While the patient wanted to know about the center's schedule, food service and what to do in an emergency, the assistant manager wanted to focus on rules. It was a brief, 10-minute performance, but it had a strong impact on the 370 first-year medical and pharmacy students who saw it. The students showed increased signs of empathy after watching and discussing the skit, but the results were not sustained, said a study in the Feb. 10 American Journal of Pharmaceutical Education. Still, the results are encouraging, said Mohammadreza Hojat, PhD, study co-author and research professor of psychiatry and human behavior at Thomas Jefferson University Jefferson Medical Col [Read more]
Asthma risk increases for overweight and obese youths
When treating overweight and obese youths, physicians should keep in mind that an elevated body-mass index increases one's likelihood of having asthma, said the lead author of a recent study. But the extent to which weight impacts a patient's risk of developing the disease depends, in part, on the individual's ethnicity or race, said Mary Helen Black, PhD. She is a research scientist bio-statisticianin the Dept. of Research and Evaluation at Kaiser Permanente Southern California in Pasadena, Calif. Among youths, the odds of having current asthma are greatest for blacks, according to a study published online Jan. 17 in the journal Obesity. The study, co-written by Black, defines people with current asthma as those diagnosed with the condition in the past year and who have at least one asthma-specific medication on their medical records. Black youths were nearly twice as likely to have current asthma compared with whites of the same age. But when researchers grouped participants [Read more]
Revised MCAT places broader expectations on students
The Medical College Admission Test is being redesigned to ensure that medical school applicants have a broad education that enables them to communicate well with patients, understand the many social and behavioral factors that affect health and ULTIMATEly become better doctors, says the Assn. of American Medical Colleges. The goal is to expand what is expected of prospective physicians, with the hope of attracting a wider variety of medical school applicants, said AAMC President and CEO Darrell G. Kirch, MD. "We're recognizing in this test that being a good doctor is not just about understanding science, but it is also about understanding people," he said. Starting in 2015, the MCAT will include two new sections: Knowledge of psychological, social and biological foundations of behavior. Critical analysis and reasoning skills. The writing portion will be eliminated, and the overall exam time will increase to about 6½ hours. The current test takes about 4½ hours an [Read more]
Texas doctor indicted in $375 million health care fraud scheme
The Justice Dept. has charged a Texas physician with bilking the government to the tune of nearly $375 million in what it says is the single-largest health fraud scheme exposed in the nation's history. Emergency physician Jacques Roy, MD, is accused of recruiting fake patients to sign for medical treatments he never provided, then billing Medicare and Medicaid for the care. Dr. Roy, 54, owned and operated Dallas-based Medistat Group Associates P.A., an association of health professionals that provided home health certifications and patient home visits, according to the Justice Dept. Between January 2006 and November 2011, Medistat certified more Medicare beneficiaries than any other medical practice in the country, the Justice Dept said in a statement. These certifications allegedly resulted in $350 million being billed to Medicare and more than $24 million being billed to Medicaid by Medistat and associated home health agencies for care that never was provided. "The conduct c [Read more]
Type 1 diabetes may develop more slowly than thought
Recent data showing that type 1 diabetes progresses more slowly than formerly thought is expected to help physicians better manage the condition in their patients, according to the lead author of a recent study. Traditionally, it was believed that the production of insulin by beta cells completely ceased in people with advanced type 1 diabetes, said Denise L. Faustman, MD, PhD, director of the Immunobiology Laboratory at Massachusetts General Hospital in Boston. But a study in the March Diabetes Care shows that the pancreas continues to function and produce insulin at some level even decades after the onset of type 1 diabetes. Dr. Faustman was lead author of the study. Determining how much insulin a diabetic patient is producing, regardless of how small an amount, will help physicians better regulate the individual's blood glucose levels and delay the potential development of medical complications, Dr. Faustman said. Such complications include cardiovascular problems, neuropat [Read more]
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