Category: Physicians

FDA Backs Selling Hearing Aids Over the Counter

UntitledghgThe U.S. Food and Drug Administration (FDA) just announced it is taking steps to make hearing aids available over the counter. The FDA plans to immediately stop enforcing a requirement that patients must have a medical evaluation prior to obtaining a hearing aid. The Agency also hopes its move will stimulate a new category of OTC hearing aid products that cost less.  In this regard, hearing aids will function in a manner similar to reading glasses. The move was likely due to prodding by Senators Elizabeth Warren (D-MA) and Chuck Grassley (R-IA), who recently introduced legislation along these lines.

Opioid Mouth Spray Costs 200 Times More than Patch

become-richThe drug fentanyl — which is up to 50 times stronger than heroin — is available in generic form. It is also a highly addictive street drug, manufactured in back-alley labs and laced in heroin to boost its potency. Fentanyl is used to treat extreme chronic pain that is unresponsive to other opioid pain relievers, such as breakthrough pain cancer patients often suffer. A fentanyl transdermal patch costs from $5 to $12 depending on the dose per hour. A 12 micrograms (mcg) per hour patch retails for about $5 and offers 72 hours of pain relief, whereas the 100 microgram per hour patch is about $12 with GoodRx coupon. Sounds like a bargain; pain-free bliss for $2 to $4 a day. That works out to about $50 to $125 per month.

How Long Should You Have to Wait to See a Doctor?

dogvetwait

How long should you have to wait to see a doctor? Why not just call a doctor?

The patient in the photo was able to get a same-day appointment within 15 minutes of the request and was seen within 10 minutes after arriving. But that is an exception in the United States. A recent article in the American Journal of Managed Care estimated the average physician visit takes two hours (121 minutes). That includes travel time (37 minutes), waiting time (about an hour) and treatment time (10 to 20 minutes). Of course, that’s once you get an appointment.

Fifty Percent Increase in Share of Physicians Owned By Hospitals in Three Years

Confident DoctorsA new survey by the Physicians Advocacy Institute and Avalere Health, a consulting firm, shows a significant increase in the number of physicians leaving independent practice and joining hospital-based health systems:

  • From July 2012 to July 2015, the percent of hospital-employed physicians increased by almost 50 percent, with increases in each six-month period measured over these three years.
  • In 2012, one in four physicians was employed by a hospital.
  • By 2015, 38 percent of physicians were employed by hospitals.

Good or bad? Well, color me skeptical. This acquisition spree is driven by new payment models which seek to reward providers for “accountable” care (which I suppose is better than unaccountable care.) So far, the results of payment reform in Medicare have been trivial.

Is Your Doctor a Happy Camper?

PhysicianIncome2016Physician is arguable the profession with the highest average pay for all those pursuing it. Yes, some doctors lament that investment bankers often earn much more. But investment banker isn’t a profession; it’s a high-paid specialty in the area of banking. The average banker does not enjoy the income the average physician has come to expect.

A ‘Free Health Clinic’ for Montana State Employees

Before he left office, then-Montana Gov. Brian Schweitzer decided Montana’s 11,000 state workers, retirees and their dependents needed an employee health clinic. Before leaving office he had one created without consulting the legislature. For those of you who have not heard of the concept, it’s sort of like the school nurse, except there are doctors and real medical equipment involved. At most employee health clinics, physician visits are either free or involve no cost-sharing. Montana employees aren’t required to use the clinic; they can continue to see their own doctors with the normal cost-sharing.

Accelerated Medical Degree may Boost Primary Care Supply

About six years ago I wrote about the merits of a 3-year medical degree. This involves medical students essentially skipping the rotation that occurs in their fourth year of medical school and beginning residency training. At the time, there were only three universities in the United States and Canada that offered a program that allowed doctors to begin residency after only three years of medical school. Now there are about a dozen according to Robert Grossman and Steven Abramson, writing in the Wall Street Journal.  Nearly one-third of medical schools have (or are) considering ways to speed up medical training programs.  Is probably a good idea.

Electronic Health Records Software Often Written without Doctors’ Input

We’ve written in the past about health information technology, including a doctor’s impression of electronic medical records (EMRs) and physicians declining satisfaction with EMRs.

A recent study found out why EMRs are so frustrating for physicians: the software is often written without doctors’ input.

 

“Current guidelines and industry standards suggest that new EHR software should be tested by at least 15 end users with a clinical background to make sure they are usable and safe before they get federal certification.

But a new study finds that many certified products did not actually conduct this user testing, or did so without clinical testers.”

That raises another question. Can you imagine Microsoft or a hardware/software developer at Apple beta testing new products on only 15 users?  Furthermore, isn’t it beyond imagination that managers at Apple or Microsoft would ever say, “Hey, let’s not bother with testing this on 15 people, that’s just a waste of time.”

 

Physicians Relatively Happy with Their Careers

How happy are physicians with their careers?

In a recent survey of 1001 physicians,

• About 84% said they like being a physician.
• Nearly as many were happy with their choice of specialty.
• Yet, two-thirds said they used to enjoy being a physician much more than they do today.

More than half do not regret anything about their choice of a career path. However, one-in-five would choose a career outside of medicine if they could go back and do it all over again.

What bugs doctors?

• Four-in-ten believe there is too much interference by third-parties;
• Nearly 14% believe their ability to practice independently is slipping.
• Nearly three-quarters have no interest in becoming a patient-centered medical home.

About 10% are working in a direct-pay practice, while 43% are considering it. Yet, nearly 40% believe high deductible health plans and cost-sharing are a barrier to good health care for their patients.

Most docs are workaholics

• Only one-quarter work fewer than 40 hours per week,
• About 46% work more than 50 hours per week.
• Understandably, 70 percent don’t have as much personal time as they wish they had.

Only about half believe they have a good work/life balance. Just over half do not believe they can afford to sacrifice income to work less.

Physicians Report Declining Satisfaction with EHRs

This post is excerpted from an article, Physicians Report Declining Satisfaction with EHRs, from the American Academy of Family Physicians. The report was sent to us by Dr. Larry Pivnick, who authored a report on electronic health records.

“During the past decade, America’s physicians — particularly, family physicians — have invested lots of money and countless hours in implementing electronic health record (EHR) systems. Some physicians eagerly dived into the EHR pond; others were pushed by government initiatives, such as meaningful use, that were intended to spur technology uptake but that have become increasingly burdensome to physicians.”

[I]n 2010, 61 percent of respondents said they were “satisfied” or “very satisfied” with their EHRs, compared with just 34 percent in 2014.
Of physicians who responded to the 2014 survey,

  •  55 percent said it was difficult or very difficult to use their EHR to improve efficiency,
  •  72 percent said it was difficult or very difficult to use their EHR to decrease workload,
  •  54 percent indicated that their EHR system increased their total operating costs, and
  •  43 percent said they had not yet overcome productivity challenges associated with implementation of their EHR.

“From the physicians’ perspective, it appears that the significant investment in EHR system(s) over the past few years in the United States is failing to offer significant returns. Far from helping physicians to operate efficiently and have more time to spend with patients, the opposite appears to be the case.”

Source: Physicians Use of EHR Systems 2014