Wednesday, October 28, 2009

Census Estimates Predict Doctor Shortage and Younger Workforce

According to an article in Medscape Medical News, US Census Bureau estimates are predicting a younger physican workforce as new doctors replace the large number of current doctors that are expected to reach retirement age over the next 10 years. The Census is also estimating a workforce shortage that is larger than predictions based on data from the American Medical Association's Physician Masterfile.

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

Question of the Week: Telemedicine

Today we're launching a "Question of the Week" on the NAMSS Blog. Each week, we will feature a new poll on an issue facing MSPs. This will allow you to get a pulse on what your colleagues think, and on practices that are implemented in other facilities.

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:

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

Friday, October 23, 2009

Doctor Responsible for Treating Octuplets' Mom Ejected from the Society of Reproductive Medicine

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:,0,4363432.story.

Source: Los Angeles Times

Wednesday, October 21, 2009

House Votes to Exempt Small Groups from FTC "Red Flag" Rules

On Tuesday, the House voted to exempt small businesses from the Federal Trade Commission's "red flag" rules by a unanimous vote of 400 to 0.

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.

Source: BNA

Thursday, October 15, 2009

NPDB Reporting Guidance Available

The Medical Staff, Credentialing, and Peer Review Discussion List of the American Health Lawyers Association recently discussed whether or not the termination of a physician making misstatements and failing to make required disclosures about an insurance gap requires NPDB reporting.

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

Visit the New NAMSS Website!

The new NAMSS website has officially launched today!

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

American Board of Pediatrics Announces Pediatrics-Anesthesiology Program

The American Board of Pediatrics (ABP) has approved a new combined Pediatrics-Anesthesiology training program. The following description is taken from ABP's website:

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

Study Compares Board Certification Requirements Among Physician Multi-Specialty Organizations

An independent study performed by The Associated Industries of Florida Service Corporation (AIFSC) has compared multi-specialty board requirements for both certification and re-certification. The study shows that the requirements of the three national certification organizations are generally equivalent.

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

Senate Finance Committee Passes Health Reform Bill

This afternoon, the Senate Finance Committee voted 14-9 in support of the Committee's health reform overhaul bill.

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.

Source: CQ

Are Hospitals Ready for Expanded Coverage?

The answer is "yes," according to Dr. William Jessee, President and CEO of the Medical Group Management Association (MGMA). In an article in Modern Physician, Dr. Jessee supports the initiative to expand healthcare coverage but wonders whether or not the current payment structure and medical workforce is ready to take on the greater patient load.

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
(Free subscription required to view article)

Thursday, October 1, 2009

TJC Releases Telemedicine Revisions to Hospital Standards

The Joint Commission (TJC) has released revisions to the Leadership and Medical Staff chapters of the Hospital Standards in order to comply with CMS requirements for deeming authority.

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

TJC Accreditation Requirements Available for Pre-Publication Review

The Joint Commission has released the 2010 standards revisions for pre-publication review. Revisions for all accreditation programs will be available online until December 1, 2009.

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