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HPV vaccine proposed for teen boys
The Advisory Committee on Immunization Practices voted to recommend the use of a human papillomavirus vaccine for certain males to help prevent the transmission of genital warts caused by HPV types 6 and 11. But doctors have expressed concern that the committee didn't go far enough, cautioning that the lack of a full recommendation could lead to a disparity in vaccination accessibility and add to challenges in inoculating adolescent boys. During an Oct. 21 meeting, ACIP issued a recommendation for the use of Merck's quadrivalent HPV vaccine, Gardasil, for males ages 9 to 26. The action followed the Oct. 16 approval of the drug by the Food and Drug Administration for the prevention of genital warts in males. ACIP, a committee of the Centers for Disease Control and Prevention, gave a permissive recommendation. That means the committee believes Gardasil is an effective vaccine, but it is waiting for data on cost effectiveness and efficacy in preventing precancer in males, said La [Read more]
Orthopedic surgeon prepares to blast into space
Orthopedic surgeon Robert "Bobby" Satcher, MD, PhD, has traded in his scrubs for a space suit. Photo Dr. Satcher and the other five crew members will travel for three days to reach the International Space Station. One of his jobs at the station will be to operate the space shuttle's robotic arms, which "is similar to performing arthroscopic surgery in many ways," he told AAOS Now, a publication of the American Academy of Orthopaedic Surgeons. [Photo courtesy of NASA] The specialist in child and adult bone cancer will leave behind operating rooms and the earth's atmosphere when he lifts off in space shuttle Atlantis, rocketing 5 million miles to the International Space Station. Launch is scheduled for Nov. 16, 2:28 p.m. Eastern time. Dr. Satcher, 44, will be the first orthopedic surgeon to orbit the earth. And he will be No. 23 on NASA's privileged list of American physicians who have become astronauts. "When we get within those last few seconds [of the countdown], I'm sure t [Read more]
Donations to health care institutions drying up
One effect of the recession is that those who usually make charitable contributions to nonprofit hospitals and other health care institutions are keeping a tighter hold on their wallets. An increasing number of pledges are going unfilled, and donated stocks have become less valuable, according to a report issued Oct. 26 by the Assn. for Healthcare Philanthropy. "People are still supporting the institutions they care about, but they are giving less," said AHP President William C. McGinly, PhD. This analysis of data on 220 institutions showed that $8.588 billion was raised during fiscal 2008. This represented an increase of 2.9% from the $8.347 billion donated in fiscal 2007. Inflation, however, was 3.8%. Prior-year increases were 5.6% in 2007 and 11.5% in 2006. The philanthropy group said the report is of particular concern because many institutions closed their 2008 books in September, before the full scale of the economic downturn became apparent. Institutions that wrapped [Read more]
DEA enforces written order requirement for schedule II drugs
Concerned about the diversion of controlled substances in nursing homes, hospice care organizations and long-term-care facilities, the U.S. Drug Enforcement Administration no longer is allowing pharmacies to dispense schedule II drugs based on chart orders. The DEA has taken actions against long-term-care pharmacies in Ohio, Virginia and Wisconsin for violating the Controlled Substances Act. The agency says the federal law requires that, except in emergencies, doctors provide written orders directly to pharmacists. Following an emergency, a written order authorizing the prescription is required within seven days. Pharmacists who fill schedule II orders without a written prescription could face fines or criminal prosecution from the DEA. A letter from the DEA about these requirements is available online (www.ama-assn.org/ama1/pub/upload/mm/399/regulatory-dea-letter.pdf). Traditionally, physicians have given orders for schedule II drugs verbally to nurses who enter them as chart [Read more]
Liability premiums stay stable, but insurers warn this might not last
For the fourth straight year, medical liability insurance premiums have eased nationwide. That's according to the annual Medical Liability Monitor survey, which showed 94% of premiums holding steady or dropping in 2009. Fifty-eight percent of premiums had no change, up from 50% in 2008. Another 36% of premiums fell, down from 43% last year. While those figures are encouraging, physicians and insurance executives say premiums still must shrink from sky-high levels. Insurers expect improvements to continue into next year but are cautious of some potentially unfavorable trends suggesting that results could be short-lived. "It does ease the pain, but the pain is still there because rates are still dramatically higher" than they were before rising in the early 2000s, said Robert D. Francis, chief operating officer of The Doctors Company, a Napa, Calif., physician-owned liability insurer that participated in the survey. Meanwhile, jury awards are climbing steadily, counteracting [Read more]
Physicians sue again to safeguard Pennsylvania's liability fund
Pennsylvania physicians have filed yet another lawsuit in an effort to preserve what's left of the state's medical liability insurance fund after the governor in October approved a $100 million withdrawal to balance the state's budget. Doctors and other health care professionals contribute annually to Mcare, the Medical Care Availability and Reduction of Error Fund, which was authorized under a 2002 tort reform package. State physicians are required to carry $1 million in liability insurance, but the fund subsidizes half of their premiums. Gov. Ed Rendell and state lawmakers have said they plan to use what they contend is excess money in the Mcare pool to fund health care expansions and other budgetary needs. But physicians said the additional funds were meant to cover liability claims still pending in the courts. Those outstanding claims will cost an estimated $1.7 billion, according to the lawsuit filed Oct. 12 by the Pennsylvania Medical Society and state hospitals. Any mon [Read more]
FTC investigating CVS Caremark business practices
The Federal Trade Commission is examining the business dealings of CVS Caremark after getting complaints from several congressmen, pharmacists and patients. At the heart of the complaints is the 2007 merger between CVS and the pharmacy benefit manager Caremark. Critics say the merger may have resulted in a conflict of interest. The FTC was asked to investigate claims that the Caremark branch of the business was making it hard for its members to buy prescription drugs from non-CVS pharmacies. In a statement e-mailed to American Medical News, CVS Caremark acknowledged that it was being investigated but refuted the claims. "The company is not able to predict with certainty the timing, outcome or consequence of the investigation," wrote spokeswoman Carolyn Castel. "However, it remains confident that its business practices and service offerings (which are designed to reduce health care costs and expand consumer choice) are being conducted in compliance with the antitrust laws." [Read more]
Practices lose financial ground as recession outpaces productivity
When faced with payment cuts, physicians traditionally work longer hours or hire additional staff to help keep up revenue. But those strategies have reached their limit, a report from the Medical Group Management Assn. shows. After hitting a peak in 2007, the median revenue a practice collected per full-time-equivalent physician took a 7.8% dive in 2008, according to the MGMA report on multispecialty practices, released in October. While the organization also surveys single-specialty practices, the association views multispecialty practices as a proxy for overall economic trends for outpatient health care. The amount of gross revenue taken in by multispecialty practices per full-time physician steadily increased from $463,637 in 1998 to $690,032 in 2007, as annual productivity gains that often ran into the double digits helped lift revenues, mostly by single-digit percentages. But gross revenue dipped to $637,677 in 2008. "These data demonstrate the trickle-down effect that [Read more]
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