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15% of surgeons struggle with alcohol problems
More than one in seven surgeons struggle with alcohol abuse or dependence, says a study in the February Archives of Surgery. Researchers conducted an anonymous survey of 7,194 members of the American College of Surgeons and found that 15.4% of respondents had a score on the World Health Organization's Alcohol Use Disorders Identification Test that indicated alcohol abuse or dependence. The test originally was used to identify alcohol problems among Dept. of Veterans Affairs patients and is now used by institutions throughout the U.S. The study found that rates of alcohol abuse or dependence were almost twice as high among female surgeons, at 25.6% compared with 13.9% for men. Rates also were higher among younger surgeons, those without children and those who reported being in an unhappy relationship, the study said. The higher incidence among women may be due to greater societal expectations, said Michael Oreskovich, MD, lead study author and clinical professor of psychiatry a [Read more]
Vermont adjusts path toward universal coverage
Vermont is making significant progress toward implementing its own health insurance exchange, but transforming that marketplace into a truly universal health care program could prove to be very difficult, judging by recent compromises on the issue by Gov. Peter Shumlin. The Vermont House of Representatives on Feb. 24 adopted a measure to implement a state health insurance exchange. The bill passed by a 2-1 ratio and heads next to the Vermont Senate for consideration. Shumlin has announced his support for the measure. Also, the five-member body that state lawmakers created last year to implement the state's universal health care program soon is expected to choose mandatory minimum health benefits for insurers operating in its exchange as well as for many plans outside the exchange. The national health system reform law requires states to operate their own health insurance exchanges by 2014. If a state does not establish such an insurance marketplace, the federal government will [Read more]
Male newborn circumcision rate falls to lowest level
The proportion of newborn boys circumcised in U.S. community hospitals is at its lowest level, 54.5%, since the federal government starting tracking the statistic in 1993. The rate has fallen from its peak of 62.7% in 1999, when the American Academy of Pediatrics adopted a neutral position on the procedure. However, the academy's stance, which many credit as a factor in the decline of circumcision, is being revisited in light of new evidence about the potential health benefits of circumcision. Since the AAP took its position, evidence has mounted that links higher prevalence of circumcision to lower rates of penile cancer, urinary tract infections, phimosis, balanitis and meatitis, as well as HIV and other sexually transmitted diseases. "I don't doubt that the academy's position is influential," said Douglas S. Diekema, MD, MPH, a member of the academy's Task Force on Circumcision that is re-examining the policy. "When the neutral policy came out, more pediatricians changed th [Read more]
Medicare contractors rejecting pay for some legitimate services
A government watchdog's audit of improper payment determinations for Medicare services showed that contractors had denied payments for some valid services in 2010. The Centers for Medicare & Medicaid Services uses contractors to manage a comprehensive error-rate testing program that determines the frequency of improper payments in Medicare fee-for-service. In 2010, that error rate was 10.5% and represented an estimated $34.3 billion in improper payments, according to a February report by the Dept. of Health and Human Services Office of Inspector General. However, a review of those audits showed that the error rate would have been lower if contractors had taken extra steps to obtain records showing that billed services were medically necessary. "Additional efforts to obtain missing documentation could more clearly reflect the true status of improper payments" in the error rate estimate, the OIG said. The error rate in 2010 would have been 10.2%, a total of nearly $1 billion less i [Read more]
Patient room notes, pop quizzes boost hand hygiene
A note on the white boards in hospital patients' rooms saying, "I like clean hands," can result in higher rates of hand-washing among health professionals, but a sign in the staff lounge urging hand-hygiene compliance probably will not make a difference. These are among the findings of a rapid intervention-testing process used at seven hospitals in the Sentara Healthcare system, headquartered in Norfolk, Va., that pushed the hand-hygiene compliance rate to 92.5%. The nationwide hand-washing rate has hovered around 50%, depending on the study and measurement used. Like many health systems, Sentara finds itself under pressure to improve hand-hygiene compliance rates that have been linked to nosocomial infections. Rates of such infections are being publicly reported, and many insurers withhold payment for treating some infections acquired in the hospital. Sentara already had easily accessible sinks and sanitizer foam, yet a revised audit process had shown its compliance rate at a [Read more]
NHSC provides $9 million for medical students to go into primary care
Seventy-seven fourth-year medical students will receive $9.1 million in loan repayments for participating in a new National Health Service Corps program aimed at encouraging more young people to go into primary care. Dept. of Health and Human Services Secretary Kathleen Sebelius announced the awards for the Students to Service Loan Repayment Program at a Los Angeles community health center on Feb. 13. "This new program is an innovative approach to encouraging more medical students to work as primary care doctors," she said. The Health Resources and Services Administration estimates that 17,722 primary care professionals are needed in medically under-served areas to meet a target of having one primary care professional for every 2,000 U.S. residents. Students in the pilot program, funded through the Patient Protection and Affordable Care Act, will receive up to $30,000 annually for four years. In exchange, they must agree to practice at least 40 hours a week for three years [Read more]
Doctors play key role in sustaining weight loss among teen girls
Physicians can help overweight adolescent girls lose weight and keep it off by identifying lifestyle habits that need improvement and encouraging their efforts, a study says. "Some primary care physicians don't think they have a lot of influence over patients because they have such a short period of time to meet with them, but they do have a very powerful presence in the lives of teenagers and their families," said lead study author Lynn L. DeBar, PhD, MPH, clinical psychologist and behavioral health researcher at the Kaiser Permanente Center for Health Research in Portland, Ore. "By just encouraging a healthy lifestyle among their patients, they make a difference." Teenage girls who participated in a six-month program that included weekly peer meetings and consultations with their primary care physician had a lower body mass index and better self-esteem than females who did not take part in the program, said a study posted online Feb. 13 in Pediatrics. DeBar recommends that p [Read more]
AT&T to operate AMA's online physician platform
Under what is being described as a "collaborative agreement," AT&T will take ownership and control over the American Medical Association's physician platform, integrating it with the company's health information exchange. The platform currently operates under the name Amagine, but it will be merged into AT&T's Healthcare Community Online when the changeover is complete. The two platforms run on technology created by Covisint, a division of Detroit-based technology company CompuWare. The AMA will continue to serve as a collaborative partner, offering physician outreach, input into new content and guidance on new solutions. Financial terms of the agreement were not disclosed. The merging of products is expected to be completed by the end of 2012. The AT&T Healthcare Community Online was launched in 2010 as a health information exchange. Since then, new tools and applications have been added for its users, which are mainly large health care organizations. Randall Porter, assistan [Read more]
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