Shortage Notion Challenged; Check Your Coverage; Physicians' ACO Views

STAT

77 - The percentage of physicians who say they are pessimistic about the future of medicine.

Source: The Physician Foundation's 2012 Biennial Physician Survey

QUOTABLES

Payment Uncertainty

"Physician practices need a stable, predictable Medicare payment system to allow them to make sound, long-term decisions to invest in their practices, position themselves for the future, and provide the highest quality care to the Medicare patients they serve."

Susan L. Turney, MD, president and CEO of the Medical Group Management Association, in a statement following the Congressional decision to delay the Medicare pay cut, under the sustainable growth rate formula, until 2014.

Shortage Notion Challenged

"If we include the impact of diverting a fraction of patient appointments to nonphysician professionals or of addressing some of the demand through electronic communication channels, the predicted physician shortage essentially evaporates."

Linda V. Green, Sergei Savin, and Yina Lu, authors of the report "Primary Care Physician Shortages Could Be Eliminated Through Use Of Teams, Nonphysicians, And Electronic Communication" published in the January 2013 edition of Health Affairs.

Prevent Plagiarism

While there is no perfect way to guarantee your content won't get copied, there are several ways to reduce your risk of being plagiarized, C. Noel Henley, an orthopedic hand surgeon and contributor to Practice Notes recently wrote. For starters, be faster and better than those who might steal from you. "Repurposing your own material will let you produce more material faster," Henley wrote. "Turn an existing blog post or article into a video, which is harder to copy and steal." For more ideas on preventing plagiarism, visit http://bit.ly/plagiarism_prevention.

Check Your Coverage

Have you looked at your disability coverage lately? If you are more than 10 years or even five years into your practice, chances are a lot has changed. And putting off reviewing and revising your policy could put you at serious risk for underpayment when you need it most, Jeffrey D. Brunken, president and chairman of the board of The MGIS Companies, Inc., a provider of insurance products and services specifically for physicians, recently warned in Practice Notes. Ready to start checking? Start by making sure the contract clearly defines disability so that your medical specialty is protected. For more, visit http://bit.ly/doc_disability_coverage.

Physicians' ACO Views

A recent report based on a three-part technology survey, "Healthcare Information Technology: Trends and Transformations," by EHR vendor Greenway Medical Technologies, which included questions answered by about 200 practice-based physicians, sheds light on physicians' shifting attitudes about partnerships with other health organizations. More than 20 percent of those physicians surveyed said they have already chosen at least one ACO partner and nearly 60 percent indicated that they are considering an ACO partnership. Additionally, nearly 50 percent of physicians surveyed would align with or seek direct employment with a larger health system if Medicare/Medicaid reimbursements are lowered.

Small Breaches, Big Consequences

The Hospice of North Idaho recently agreed to pay $50,000 to settle potential HIPAA violations in what HHS said is "the first HIPAA breach settlement" involving fewer than 500 patients. "This action sends a strong message to the healthcare industry that, regardless of size, covered entities must take action and will be held accountable for safeguarding their patients' health information," HHS Office for Civil Rights Director Leon Rodriguez said in a press release. The Health Information Technology for Economic and Clinical Health (HITECH) Breach Notification Rule requires covered entities to report an impermissible use or disclosure of protected health information of 500 individuals or more to the secretary of HHS and the media within 60 days after the discovery of the breach. However, smaller breaches affecting fewer than 500 individuals must be reported to the secretary annually.

Healthy Bump?

MedXSafe, a new smartphone application that allows patients to "bump" phones to share STD-free status in a HIPAA-compliant fashion, is causing quite a stir in the healthcare community. The app is the brainchild of physician Michael Nusbaum, surgery chief at Morristown Medical Center in Morristown, N.J., whose goal was to get sexually active college students (and other adults) to communicate honestly about STDs and to get tested. While Nusbaum warns "there's no 100 percent way to prevent STDs," the app is designed to curtail their spread. One caveat: The app only says a person is STD free as of a certain test date. "It can take months for HIV to show up on a test," Renee Williams, executive director of SAFE, a nonprofit organization dedicated to abstinence education, told ABC News Radio, suggesting that the app may even encourage high-risk behaviors among young people.

Cultural Care Barriers

Although the population of Latino Americans is estimated to nearly double between now and 2050 - going from 16 percent to 30 percent of the U.S. population - the quality of healthcare they receive is not always up to par. A number of barriers, including lack of insurance, different cultural beliefs, language, and mistrust, can prevent Latino patients from receiving the same high-quality care as their peers, according to a recent article in American Family Physician. To overcome some of these barriers, authors suggest physicians explore the use of alternative therapies, and make an effort to be sensitive to Latino cultural values of "simpatia" (kindness), "personalismo" (relationship), "respeto" (respect), and "modestia" (modesty).

Overseeing Doctor Not Liable for PA Actions

A recent court ruling reinforces that supervising physicians are not liable for improper actions of their physician assistants (PAs). The Vermont Supreme Court ruled that a physician overseeing a PA who prescribed opiates improperly is not subject to disciplinary actions. The ruling upholds a 2012 decision by the Vermont Board of Medical Practice, which found that the physician wasn't answerable for a PA, American Medical News reported. Had the court ruled the other way, some believe physicians might have shied away from supervising PAs. "Physicians' licenses would have been at stake for physician assistants' conduct, even though in this case the board found the doctor had done everything he was supposed to do while supervising the PA," Madeleine Mongan, Vermont Medical Society deputy executive vice president, told American Medical News.

Patients: Help for Making Tough Decisions

Looking for a great site to recommend to your patients? Researchers from the UCSF-affiliated San Francisco VA Medical Center, University of California San Francisco, and the Veterans Health Research Institute have launched a website to help people make difficult medical decisions. The PREPARE website, available at Prepareforyourcare.org, provides concrete examples through videos and other mechanisms on how to identify what is most important in life, how to communicate that with family and friends and doctors, and how to make informed medical decisions.

U.S. PCP Physician IT Progress

Primary-care physicians in the United States and other countries are making inroads on health information technology use, but barriers remain, the Commonwealth Fund reported in a recent survey of 8,500 primary-care physicians in ten countries - the United States, the United Kingdom, Switzerland, the Netherlands, Germany, Australia, Norway, Canada, France, and New Zealand - published online Nov. 15 in Health Affairs. Here are some of the key findings noted by American Medical News:

• Nearly 70 percent of U.S. physicians reported that they were using EHRs in 2012, compared to 46 percent in 2009.

• Multifunctional IT use continues to progress more slowly in these two countries: Just 27 percent of U.S. doctors and 10 percent of Canadian practices reported having such capacities in their systems.

• Although the study said electronic access to records by patients is growing, primary-care doctors in the surveyed countries have not made as much progress on exchanging data with physicians outside of their practices. Only 31 percent of U.S. primary-care physicians said they did this.

This article originally appeared in the March 2013 issue of Physicians Practice.