Wednesday, October 28, 2009
Census estimates predict an increase of young physicians in the 25 - 34 year old age range, based on the number of current first-year residents. However, Census data also shows that the US may face a shortage of up to 200,000 active physicians by 2020, while the AMA Masterfile predicts only 100,000 fewer physicians.
Although the Census and AMA data do not provide a conclusive outlook on the possible physician shortage, we should start preparing just in case. Health reform is expected to increase patient intake as more people will have access to coverage and care. Also, incidents like the H1N1 pandemic have shown the need for a solid workforce as hospitals face higher admission rates.
Another interesting aspect of this article is the younger workforce that is expected over the next decade. As MSPs, we will still be charged with identifying competent and qualified providers, but it is our role in medical staff management that may see some changes. With many of the current physicians expected to retire in the coming years, it will be interesting to see how the new generation of doctors will step into the roles of medical staff leadership and governance.
Source: Medscape Medical News
Monday, October 26, 2009
This week's topic is telemedicine. The following article from Scripps Howard News Service includes comments from several health experts who believe that although telemedicine is addressed in health reform proposals, the government is not making enough of an investment in this technology. (Link to article: http://www.scrippsnews.com/content/telemedicine-getting-short-shrift-congress-health-care-reforms)
We all know that telemedicine can expand access to care, especially in rural areas. However, we also know that there is still debate over how credentialing of telemedicine providers should be handled. Recently, The Joint Commission amended its credentialing by proxy standards in order to comply with the CMS Conditions of Participation, which currently do not recognize this practice.
So this week's question is, how does your facility currently perform credentialing for telemedicine providers? Vote in the poll to the right, and feel free to discuss your views on the issue in the comment field below.
We are also looking for other "Questions of the Week." If there is a topic or question you would like to see on the NAMSS Blog, e-mail your idea to firstname.lastname@example.org.
Friday, October 23, 2009
It wasn't so many months ago when hospitals and Ethics Committees across the country were discussing the issue of in vitro fertilization. Today a decision was made by the American Society of Reproductive Medicine in the case of Dr. Michael Kamrava. Dr. Kamrava was responsible for treating Nadya Suleman, who had octuplets in 2009.
Dr. Kamrava's case focuses on the question of how many embryos should be implanted into a woman during in vitro fertilization. Dr. Kamrava had a history of implanting six or more embryos in women other than Suleman.
While Dr. Kamrava is not barred from practice, stripping him of his Society membership is a signal of what the Society will consider ethical regarding embryo limitations.
The full article can be found here:
Source: Los Angeles Times
Wednesday, October 21, 2009
The bill, H.R. 3763, exempts healthcare, legal, and accounting practices with 20 employees or less from "creditor" status under the rules. The "red flag" rules require creditors to implement programs and policies to monitor and combat identity theft by November 1.
The "red flag" rules faced opposition from several professional groups including the American Bar Association and American Medical Association. They felt that the FTC's broad definition of "creditor" included entities that were outside of the Congressional intent of the rules. Under this interpretation, healthcare providers are considered creditors since they defer payment of services until they are reimbursed through a patient's insurer.
Thursday, October 15, 2009
Daryl Gray, Director of the Division of Practitioner Databanks, provided the NPDB's interpretation of the issue. The Data Bank's official guidance can be found here:
Source: Katten Muchin Rosenman LLP
The new website features an updated look and easier navigation. You will also be able to view the latest NAMSS Blog headlines on the homepage.
On the new website, you will be able to access resources such as the Grassroots Advocacy Toolkit and Guide to Grassroots Advocacy to help state associations develop a system for tracking local legislative and regulatory developments.
Visit our new site and let us know what you think:
Wednesday, October 14, 2009
Combined training consists of a coherent educational experience in two or more closely related specialty or subspecialty programs. The educational plan for combined training is approved by the specialty board of each of the specialties to assure that resident physicians completing combined training are eligible for board certification in each of the component specialties. Each specialty or subspecialty program is separately accredited by ACGME through its respective specialty review committee. The curriculum components that comprise the combined training must be taken from those experiences that have been approved by the Residency Review Committees in each of the specialties. The duration of combined training is longer than any one of its component specialty programs standing alone, and shorter than all of its component specialty programs together.
A special agreement exists with the American Board of Anesthesiology (ABA) whereby an applicant may fulfill the training requirements for certification in pediatrics and anesthesiology by completing five years of combined training. An applicant may not take the certifying examination of the ABP until all training requirements in both programs has been successfully completed.
Program requirements and other information can be found here:
Source: American Board of Pediatrics
The groups included in the comparison are: the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), and the American Osteopathic Association's Bureau of Osteopathic Specialists (AOABOS).
The comparison brochure can be found here:
Source: American Association of Physician Specialists, Inc.
Tuesday, October 13, 2009
Sen. Olympia Snowe (R-ME) was the lone Republican to support the bill. She stated that she did not completely support the bill, but felt that urgent action needed to be taken to improve healthcare.
"When history calls, history calls, and I happen to think that the consequences of inaction dictate the urgency of Congress to take every opportunity to demonstrate its capacity to solve the monumental issue of our time," said Snowe in a quote to CQ.
The Senate Finance Committee's bill expands Medicare and creates healthcare insurance marketplaces to provide Americans with greater options for coverage. It does not include the creation of a public plan. The Congressional Budget Office estimates that the plan will cost $829 billion over the next ten years.
The Senate Finance Committee's bill must now be reconciled with the Senate Health, Education, Labor, and Pensions (HELP) Committee's bill before it a proposal is sent to the full Senate for a vote. The Senate Finance bill is considered the more moderate of the two plans.
Dr. Jessee recognizes that work needs to be done in order to provide high-quality, safe care for what will become an increased patient population. However, he believes that facilities will be able to figure out ways to eliminate administrative waste and increase efficiencies in their own settings.
Dr. Jessee's message is a call to all of us to act now and be a part of healthcare reform. Prepare your facility now by exploring more efficient ways to perform the work that you are currently doing. Determine if your facility has a plan to ensure that it has the workforce to handle greater patient intake.
Source: Modern Physician
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Thursday, October 1, 2009
Currently, TJC accepts credentialing and privileging by proxy. CMS currently requires that telemedicine providers be credentialed by both the originating and distant sites. TJC would have allowed the originating site (where the patient is located) to accept the credentials and privileges granted by the distant site (where the provider is located) if the distant site is TJC accredited and complies with the appropriate Medical Staff standards.
TJC has revised its telemedicine standards to comply with the CMS rule, but continues to work with CMS and Congress to accept credentialing by proxy by the distant site.
The revised standard is effective July 15, 2010 and can be found here:
Source: The Joint Commission
Questions from accredited organizations can be submitted to the Standards Interpretation Group at (630) 792-5900 or via the online form.
To review the 2010 revisions, click here:
Source: The Joint Commission