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Health reform law anniversary draws praises and renewed vows for repeal
Washington -- As the one-year anniversary of President Obama's signing the Patient Protection and Affordable Care Act into law arrived, policymakers and observers used the occasion to issue reminders of what they see to be at stake in the health system reform debate. The week of March 21 gave both sides the opportunity to renew their positions on the reform law, which was enacted March 23, 2010, after a long and bitter legislative contest. The administration started out the week by launching the "Better Benefits, Better Health Initiative," a public information campaign. Although most of the major reforms in the law will not launch until 2014, the White House is promoting some of the protections and coverage expansions that already have occurred. Each day of the week, the administration and other reform law advocates planned numerous events focusing on the positive effects the reforms have had. "One year into the health care law, you, your family and your small business may be [Read more]
Poor communication found between primary care and emergency doctors
Improving communication between primary care and emergency physicians won't be easy, but it could be fostered through changes in electronic medical records, payment incentives and liability reform, a study suggests. After talking to 21 doctors in each specialty, researchers found spotty communication and poor coordination between the two groups. When physicians in the two specialties don't talk, patients can receive duplicative or misapplied treatments and may be admitted for unnecessary emergency care, according to a February study that the Center for Studying Health System Change conducted for the National Institute of Health Care Reform, a nonpartisan health policy research group ( Poor communication also means that primary care physicians don't get the chance to talk to patients about when it is appropriate to use an emergency department, and they don't have a chance to learn if their lack of office availability may drive patients to an [Read more]
Physician empathy may mean better patient outcomes
Having empathy for patients isn't something physicians should do just to be nice. A study suggests that it also leads to better outcomes and should be seen as a key component of physician competence. In what is believed to be the first scientific analysis to link empathy with patient outcomes, researchers found that physicians with high empathy had patients with significantly greater control over their diabetes than patients of physicians with low empathy scores. The findings are in the March issue of Academic Medicine ( The 29 physicians who participated in the study completed the Jefferson Scale of Empathy, which assessed how empathetic they were to patients. Researchers then looked at A1c and LDL results for 891 diabetics whom the doctors treated. Among patients who had doctors with high empathy scores, 56% had an A1c test result below 7% and 59% had an LDL test below 100. Among doctors with low empathy scores, 40% of diabetics had an A1c [Read more]
House bills would lift ban on physician-owned hospitals
Washington -- House lawmakers have introduced two pieces of legislation that would rescind a provision in the health system reform statute designed to stop the spread of physician-owned hospitals. Separate bills introduced by Reps. Doc Hastings (R, Wash.) and Sam Johnson (R, Texas) would repeal Section 6001 of the Patient Protection and Affordable Care Act. The provision barred new physician-owned hospitals from obtaining Medicare certification starting Jan. 1, and it placed strict limits on existing hospitals that seek to expand their footprints or take on new physician investors beyond where they were at the time of the law's enactment. Physician hospital advocates said the move was crippling to an industry that provides high-quality, specialized care to millions of patients. Physician Hospitals of America, which represents many of the facilities, said the issue goes beyond the 275 doctor-owned hospitals that are in operation. "Much-needed expansion projects were halted at o [Read more]
Medical oaths less of a moral compass for physicians
Most physicians take part in a medical school oath ceremony, but few believe that the rite of passage has strongly shaped their sense of professionalism, according to an article published March 14 in Archives of Internal Medicine. Nearly 80% of 1,032 practicing physicians surveyed in 2009 said they took part in a medical school oath ceremony using the original or modified version of the Hippocratic Oath, the Osteopathic Oath, the Prayer of Maimonides or the Declaration of Geneva. However, only 26% said the oath they took significantly influenced their practice of medicine or provided moral guidance in their medical careers ( "These data suggest that for most physicians, the taking of the oath is not a pivotal, meaningful, signal event, but just something that happens," said Farr A. Curlin, MD, co-author of the article. "Some people take it really seriously, and are looking to take it seriously. Others just see it as one more ri [Read more]
Growing number of hospitals ban hiring smokers
More hospitals are refusing to hire smokers. Not all states allow this, and some anti-tobacco activists are uncomfortable with this trend. "We hope that people will be encouraged to quit smoking and quit using nicotine products and build a healthy life for themselves," said Julie Uehara, spokeswoman for Summa Health System in Akron, Ohio, which implemented a nicotine-free hiring policy in January. No studies show how many hospitals have banned hiring smokers. However, more hospitals have reported instituting such restrictions. For example: * ProMedica, which owns several hospitals in Michigan and Ohio. * St. Francis Medical Center in Cape Girardeau, Mo. * Crittenton Hospital Medical Center in Rochester, Mich. These institutions have been smoke-free for years, and the restrictive policies follow the Cleveland Clinic, which in 2007 became one of the first health care institutions to stop hiring smokers. Though some nonhospital employers have reported saving m [Read more]
35% of orthopedic imaging costs stem from defensive medicine
Nearly 20% of imaging tests ordered by Pennsylvania orthopedic surgeons were for defensive purposes, according to a new study examining testing decisions of 72 surgeons. The study, presented Feb. 16 at an American Academy of Orthopaedic Surgeons conference, found that defensive testing accounted for 35% of all imaging costs for surveyed surgeons. The most common defensive test ordered was an MRI, a more costly test that contributed to higher imaging expenses, the study said. In the survey, members of the Pennsylvania Orthopaedic Society were asked to record a series of imaging decisions and note whether tests were for clinical care or defensive reasons. Test decisions were recorded for 2,068 patients. The many lawsuits that hinge on claims that doctors should have ordered more diagnostic testing are probably the driving force behind the defensive tests, said John Flynn, MD, associate chief of orthopedic surgery at Children's Hospital of Philadelphia. The hospital's researchers [Read more]
Health plans face suits challenging collection of
Three class-action lawsuits fighting health plans' efforts to collect so-called overpayments on behalf of self-insured companies are pending in federal court, including one against UnitedHealth Group. The lawsuits could have implications for physicians who are the target of the same kind of collections, even though the plaintiffs are chiropractors. The most recent suit was filed Jan. 24 in U.S. District Court in New Jersey on behalf of two Ohio chiropractic clinics and the Ohio State Chiropractic Assn. The Council of State Chiropractic Assns. joined the lawsuit against UnitedHealth as plaintiffs Feb. 8. The lawsuit against UnitedHealth also names Health Net of the Northeast, which UnitedHealth acquired in December 2009, as a defendant. UnitedHealth has not filed a response to the lawsuit, but company spokeswoman Cheryl Randolph said in a statement, "We believe this claim is without merit and intend to defend ourselves vigorously." The plaintiffs' law firm, New York City- [Read more]
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