HFAP updates standards relating to telemedicine credentialing and privileging.
ACUTE CARE
________________________________________
01.00.06 Governing Body Responsibilities – Revision of Standard
Effective Immediately
03.00.07 Telemedicine Privileging Provisions – New Standard
Effective Immediately
03.00.08 Telemedicine Privileging Provisions Through Distant Site – New Standard
Effective Immediately
03.01.09 Bylaws – Granting of Privileges – Revision of Standard
Effective Immediately
CRITICAL ACCESS
________________________________________
01.00.08 CEO Appointment – Standard Revision
Effective Immediately
05.00.14 Telemedicine Privileging Provisions Through Distant Site Hospital Agreement – New Standard
Effective Immediately
05.00.15 Telemedicine Privileging Provisions Through Distant Site Entity Agreement – New Standard
Effective Immediately
12.00.24 Diagnosis & Treatment Review – New Standard
Effective Immediately
For more information, visit HFAP's website:
http://www.hfap.org/manualupdates.aspx
Thursday, September 29, 2011
Wednesday, September 21, 2011
NYT: Withdrawal of Database on Doctors Is Protested
DUFF WILSON -- September 15, 2011
Three journalism organizations on Thursday protested a decision by the Obama administration to remove a database of physician discipline and malpractice actions from the Web.
The National Practitioner Data Bank, created in 1986, is used by state medical boards, insurers and hospitals. The “public use file” of the data bank, with physician names and addresses deleted, has provided valuable information for many years to researchers and reporters investigating oversight of doctors, trends in disciplinary actions and malpractice awards.
On Sept. 1, responding to a complaint from Dr. Robert T. Tenny, a neurosurgeon in Kansas, the Health Resources and Services Administration, an agency of the Department of Health and Human Services, removed the public use file from its Web site, said an agency spokesman, Martin A. Kramer. The agency also wrote a reporter a letter to warn he could be liable for $11,000 or more in civil fines for violating a confidentiality provision of the federal law. Both actions outraged journalism groups.
“Reporters across the country have used the public use file to write stories that have exposed serious lapses in the oversight of doctors that have put patients at risk,” Charles Ornstein, president of the Association of Health Care Journalists and a reporter for ProPublica, an investigative newsroom, said in an interview. “Their stories have led to new legislation, additional levels of transparency in various states, and kept medical boards focused on issues of patient safety.”
Two other national journalism organizations, Investigative Reporters and Editors and the Society of Professional Journalists, joined the health reporters’ group in a letter to Mary K. Wakefield, administrator of the federal office. “If anything, the agency erred on the side of physician privacy,” they wrote.
Mr. Kramer said the agency, contacted by a doctor, had become concerned that a Kansas City reporter obtained information from the full data bank, not just its public use file.
“We have in the past sent letters like this, but it is the first time in our knowledge one has gone to a journalist,” Mr. Kramer said.
That concern and the letter, though, were made moot when the reporter explained that he had been getting information from the public use file, Mr. Kramer said. “That’s the end of that,” he said.
Nonetheless the agency is reviewing the public use file and may change it to further assure confidentiality before placing it back on the Web, he said, adding that he hoped it would be public again within six months.
“We are going to do everything we can to get the data back up in a public use file as quickly as we possibly can,” Mr. Kramer said. “We want to make sure the public, researchers and reporters have access to all the information that we can legally make available.”
Mr. Kramer said he could not speculate about how the public use file would be changed. He said the agency was still reviewing complaints made by the journalist organizations.
The Kansas City Star, despite the letter to its reporter, published its article on Sept. 3, titled, “Doctors With Histories of Alleged Malpractice Often Go Undisciplined.”
“To see whether other doctors with long malpractice payment histories are practicing in Kansas and Missouri, The Star analyzed thousands of records in the National Practitioner Data Bank,” the article said. It found 21 doctors had at least 10 malpractice payments but had never been disciplined by the states.
Mr. Ornstein said the Star reporter, Alan Bavley, like many others across the country, had performed broad research of courts, state agencies and hospital actions, “allowing them to connect the dots” to individual doctors. But he said the federal database itself did not reveal identities.
Other recent notable articles based partly on the database have appeared in The Duluth News Tribune in Minnesota and The St. Louis Post-Dispatch, which published a series last year titled, “Who Protects the Patients?”
Three journalism organizations on Thursday protested a decision by the Obama administration to remove a database of physician discipline and malpractice actions from the Web.
The National Practitioner Data Bank, created in 1986, is used by state medical boards, insurers and hospitals. The “public use file” of the data bank, with physician names and addresses deleted, has provided valuable information for many years to researchers and reporters investigating oversight of doctors, trends in disciplinary actions and malpractice awards.
On Sept. 1, responding to a complaint from Dr. Robert T. Tenny, a neurosurgeon in Kansas, the Health Resources and Services Administration, an agency of the Department of Health and Human Services, removed the public use file from its Web site, said an agency spokesman, Martin A. Kramer. The agency also wrote a reporter a letter to warn he could be liable for $11,000 or more in civil fines for violating a confidentiality provision of the federal law. Both actions outraged journalism groups.
“Reporters across the country have used the public use file to write stories that have exposed serious lapses in the oversight of doctors that have put patients at risk,” Charles Ornstein, president of the Association of Health Care Journalists and a reporter for ProPublica, an investigative newsroom, said in an interview. “Their stories have led to new legislation, additional levels of transparency in various states, and kept medical boards focused on issues of patient safety.”
Two other national journalism organizations, Investigative Reporters and Editors and the Society of Professional Journalists, joined the health reporters’ group in a letter to Mary K. Wakefield, administrator of the federal office. “If anything, the agency erred on the side of physician privacy,” they wrote.
Mr. Kramer said the agency, contacted by a doctor, had become concerned that a Kansas City reporter obtained information from the full data bank, not just its public use file.
“We have in the past sent letters like this, but it is the first time in our knowledge one has gone to a journalist,” Mr. Kramer said.
That concern and the letter, though, were made moot when the reporter explained that he had been getting information from the public use file, Mr. Kramer said. “That’s the end of that,” he said.
Nonetheless the agency is reviewing the public use file and may change it to further assure confidentiality before placing it back on the Web, he said, adding that he hoped it would be public again within six months.
“We are going to do everything we can to get the data back up in a public use file as quickly as we possibly can,” Mr. Kramer said. “We want to make sure the public, researchers and reporters have access to all the information that we can legally make available.”
Mr. Kramer said he could not speculate about how the public use file would be changed. He said the agency was still reviewing complaints made by the journalist organizations.
The Kansas City Star, despite the letter to its reporter, published its article on Sept. 3, titled, “Doctors With Histories of Alleged Malpractice Often Go Undisciplined.”
“To see whether other doctors with long malpractice payment histories are practicing in Kansas and Missouri, The Star analyzed thousands of records in the National Practitioner Data Bank,” the article said. It found 21 doctors had at least 10 malpractice payments but had never been disciplined by the states.
Mr. Ornstein said the Star reporter, Alan Bavley, like many others across the country, had performed broad research of courts, state agencies and hospital actions, “allowing them to connect the dots” to individual doctors. But he said the federal database itself did not reveal identities.
Other recent notable articles based partly on the database have appeared in The Duluth News Tribune in Minnesota and The St. Louis Post-Dispatch, which published a series last year titled, “Who Protects the Patients?”
Tuesday, September 20, 2011
American-Statesman: New state law bans anonymous complaints against physicians
Karen M. Cheung – September 20, 2011
Following the fallout of two Winkler County whistle-blowing nurses who lost their jobs, a new Texas law that goes into effect this month bars the Texas Medical Board from considering anonymous complaints against physicians.
Adjusting the complaint process, House Bill 680 requires the Medical Board know the identity of those persons filing complaints, including pharmaceutical companies and insurers, while keeping those identities confidential, reports the American-Statesman.
The Texas rule follows the case of two Winkler County Memorial Hospital nurses Anne Mitchell and Vickilyn Galle, who in 2009 sent an anonymous ethics complaint about physician Rolando Arafiles Jr. to the Texas Medical Board, accusing him of dangerous practices. Winkler County Sheriff Robert L. Roberts Jr. and friend to Dr. Arafiles identified the two nurses, which resulted in the nurses losing their jobs and indictment. Charges were dropped against Galle before trial, and Mitchell was found not guilty. The Medical Board put the physician on probation, and the Sheriff was found guilty of retaliation.
"Though I do not know if the Winkler County nurses would have filed their complaints if they had to attach their names, the new law would keep their names confidential," said State Rep. Donna Howard (D-Austin) in the article.
Supporters and critics of the legislation argue how widespread its effects could be. Anonymous complaints make up 4 percent of the 6,849 complaints the Texas Medical Board received last year, according to the article. Patient safety advocates say that maintaining anonymity ensures protection from retaliation, while provider supporters say banning anonymous sources ensures valid complaints.
For full article:
http://www.statesman.com/news/texas-politics/new-law-bans-anonymous-complaints-about-doctors-1865789.html
Following the fallout of two Winkler County whistle-blowing nurses who lost their jobs, a new Texas law that goes into effect this month bars the Texas Medical Board from considering anonymous complaints against physicians.
Adjusting the complaint process, House Bill 680 requires the Medical Board know the identity of those persons filing complaints, including pharmaceutical companies and insurers, while keeping those identities confidential, reports the American-Statesman.
The Texas rule follows the case of two Winkler County Memorial Hospital nurses Anne Mitchell and Vickilyn Galle, who in 2009 sent an anonymous ethics complaint about physician Rolando Arafiles Jr. to the Texas Medical Board, accusing him of dangerous practices. Winkler County Sheriff Robert L. Roberts Jr. and friend to Dr. Arafiles identified the two nurses, which resulted in the nurses losing their jobs and indictment. Charges were dropped against Galle before trial, and Mitchell was found not guilty. The Medical Board put the physician on probation, and the Sheriff was found guilty of retaliation.
"Though I do not know if the Winkler County nurses would have filed their complaints if they had to attach their names, the new law would keep their names confidential," said State Rep. Donna Howard (D-Austin) in the article.
Supporters and critics of the legislation argue how widespread its effects could be. Anonymous complaints make up 4 percent of the 6,849 complaints the Texas Medical Board received last year, according to the article. Patient safety advocates say that maintaining anonymity ensures protection from retaliation, while provider supporters say banning anonymous sources ensures valid complaints.
For full article:
http://www.statesman.com/news/texas-politics/new-law-bans-anonymous-complaints-about-doctors-1865789.html
Monday, September 19, 2011
Medscape Medical News: Top Performing Hospitals Listed in Joint Commission Report
Mark Crane, September 15, 2011
Small and rural hospitals headed the list of top performing hospitals in using evidence-based processes closely linked to positive patient outcomes, according to the Joint Commission's annual report on quality and safety, Improving America's Hospitals.
The 405 hospitals identified as attaining excellence in accountability measure performance for 2010 represent approximately 14% of Joint Commission–accredited hospitals. The top performers were the most diligent in following best-practice protocols, such as giving aspirin to a person who is having a heart attack on arrival at the hospital, or the use of corticosteroids in children admitted with asthma, said the report, which was issued this week.
The nation's most highly regarded hospitals (the Mayo Clinic in Rochester, Minnesota; Johns Hopkins in Baltimore, Maryland; Massachusetts General Hospital in Boston; and the Cleveland Clinic in Ohio) were not included among the top performers. The list also did not include a single hospital in New York City or the most prominent facilities in Chicago and Houston.
Hospital performance nationwide continued to improve in using evidence-based treatments related to 22 accountability measures for heart attack, heart failure, pneumonia, surgical care, and children's asthma care.
In 2002, hospitals achieved 81.8% composite performance to perform care processes related to accountability measures. In 2010, hospitals achieved 96.6% composite performance, a 9-year improvement of almost 15 percentage points, the report found. More than 9 in 10 hospitals had scores of at least 90%, which is more than 4 times the figure of 9 years ago. The top performing hospitals all had scores of 95% or better.
"While the data across the annual report show impressive gains in hospital quality..., further improvements can still be made," Joint Commission President Mark R. Chassin, MD, MPH, said in a news release. "By following evidence-based care processes, hospitals can improve the quality of care they provide and meet national mandates regarding performance."
Hospitals had relatively low performance on providing fibrinolytic therapy within 30 minutes of arrival to patients having heart attacks (only 60.5% of hospitals achieved 90% compliance or better), and on providing antibiotics to immunocompetent intensive care unit patients with pneumonia (only 77.2% of hospitals achieved 90% compliance or better).
The list of top performers included a disproportionate share of small and rural hospitals, as well as 20 Veterans Affairs Medical Centers. "It is certainly true that larger hospitals, particularly if they are reporting on more measures than smaller hospitals, have a lot more work to do," Dr. Chassin told reporters during a conference call yesterday. "But on the other hand, they have more resources than small hospitals to do that. It may be a question of priority setting.
"I hope [the list] is both a wake-up call to the larger hospitals to put more resources into these types of programs, and a recognition that a small, rural hospital can do an excellent job," he said.
Starting in January, Joint Commission–accredited hospitals will be required to meet an 85% composite compliance target rate for performance on accountability measures. Some 121 hospitals would not pass that mark based on their 2010 scores.
"They know who they are," Dr. Chassin said. "We'll see if they have heeded the warning."
Small and rural hospitals headed the list of top performing hospitals in using evidence-based processes closely linked to positive patient outcomes, according to the Joint Commission's annual report on quality and safety, Improving America's Hospitals.
The 405 hospitals identified as attaining excellence in accountability measure performance for 2010 represent approximately 14% of Joint Commission–accredited hospitals. The top performers were the most diligent in following best-practice protocols, such as giving aspirin to a person who is having a heart attack on arrival at the hospital, or the use of corticosteroids in children admitted with asthma, said the report, which was issued this week.
The nation's most highly regarded hospitals (the Mayo Clinic in Rochester, Minnesota; Johns Hopkins in Baltimore, Maryland; Massachusetts General Hospital in Boston; and the Cleveland Clinic in Ohio) were not included among the top performers. The list also did not include a single hospital in New York City or the most prominent facilities in Chicago and Houston.
Hospital performance nationwide continued to improve in using evidence-based treatments related to 22 accountability measures for heart attack, heart failure, pneumonia, surgical care, and children's asthma care.
In 2002, hospitals achieved 81.8% composite performance to perform care processes related to accountability measures. In 2010, hospitals achieved 96.6% composite performance, a 9-year improvement of almost 15 percentage points, the report found. More than 9 in 10 hospitals had scores of at least 90%, which is more than 4 times the figure of 9 years ago. The top performing hospitals all had scores of 95% or better.
"While the data across the annual report show impressive gains in hospital quality..., further improvements can still be made," Joint Commission President Mark R. Chassin, MD, MPH, said in a news release. "By following evidence-based care processes, hospitals can improve the quality of care they provide and meet national mandates regarding performance."
Hospitals had relatively low performance on providing fibrinolytic therapy within 30 minutes of arrival to patients having heart attacks (only 60.5% of hospitals achieved 90% compliance or better), and on providing antibiotics to immunocompetent intensive care unit patients with pneumonia (only 77.2% of hospitals achieved 90% compliance or better).
The list of top performers included a disproportionate share of small and rural hospitals, as well as 20 Veterans Affairs Medical Centers. "It is certainly true that larger hospitals, particularly if they are reporting on more measures than smaller hospitals, have a lot more work to do," Dr. Chassin told reporters during a conference call yesterday. "But on the other hand, they have more resources than small hospitals to do that. It may be a question of priority setting.
"I hope [the list] is both a wake-up call to the larger hospitals to put more resources into these types of programs, and a recognition that a small, rural hospital can do an excellent job," he said.
Starting in January, Joint Commission–accredited hospitals will be required to meet an 85% composite compliance target rate for performance on accountability measures. Some 121 hospitals would not pass that mark based on their 2010 scores.
"They know who they are," Dr. Chassin said. "We'll see if they have heeded the warning."
Friday, September 16, 2011
HealthLeaders Media: Overhaul of Physician Education System Recommended
Cheryl Clark, September 12, 2011
The nation's system for training physicians is in dramatic need of a complete overhaul to adequately provide future patient care, says a report from the Josiah Macy Jr. Foundation, which issued 14 recommendations to make that happen.
"Although notable changes have occurred in graduate medical education (GME) over the past decade, including the introduction of a competency-based framework and limitations on duty hours, many people feel that much broader reforms are needed to keep pace," says the 39-member panel that authored the report.
The panel, consisting of physicians and surgeons as well as medical school deans and faculty members, said the nation will be short more than 100,000 doctors by the middle of the next decade, in part because of the current system's entrenched ways of educating and assuring the quality of the physician workforce.
"Unless we in academic medicine are self-critical and show a willingness to change, the political and public support for graduate medical education will disappear," warns Macy President George Thibault, MD, in a statement. "This is a huge enterprise built on tradition, but the system has to change to be more responsive to public needs."
One of panel’s key recommendations is that medical education should shift from gauging competency by months and years of training to actual measurements of individual physicians' readiness for independent practice. This is because medical school residents "vary significantly in how quickly they achieve competency, yet the current system of training all residents for a fixed duration fails to recognize or accommodate this reality."
The panel also prioritizes its recommendation to diversify training sites from traditional teaching hospitals to federally qualified and school-based health centers "and to expand content related to professionalism, population medicine, and team-based practice.”
A third key recommendation is for educational institutions to eliminate historic boundaries so that other health provider professions can learn with their physician colleagues. "This will require revising regulations that now prevent supervision across specialties or professions," the group says.
The panel also wants to require a period of "monitored independence" during GME to confirm each physician's readiness for independent practice. "Program directors and teaching faculty express widespread concern that residents are not given sufficient opportunity to act independently within the present teaching environment and are consequently less well prepared for practice," the statement says.
The report lists four trends that make a major shift in medical training necessary:
1. New approaches to physician practice are necessary to meet the needs of an aging population, as the number of people 65 and older will double by 2020. This population will live longer with more chronic, cognitive, and functional issues and will be more racially and culturally diverse.
2. Care continues to move outside the hospital to the home, clinics, and other community settings, and care providers are assuming new roles to meet these needs. The Affordable Care Act's directives will accelerate this trend, giving 32 million more people health coverage. This influx will require trainees to be "prepared to work in different organizations and sites of care, and in teams of health professionals."
3. Trainees must enter practice trained to use new healthcare technologies safely and efficiently. "Advances in medical diagnostics, therapeutics, and information technology can significantly improve health outcomes. However, we have fallen short in consistently using technology optimally to improve the quality and efficiency of healthcare," the panel writes.
4. The next generation of physicians must help lower costs and be more efficient. "Physicians in training must understand the financial implications of their patient management decisions, and their training must include new and efficient models of care so that they will be prepared to practice cost-effective medicine and be responsible stewards of resources while providing high-quality patient care," the report says.
However, to change the graduate medical system, medical educators face many obstacles, including the growing tension between work-hour restrictions and competition for curricular time and non-educational tasks. Another important obstacle is the difficulty in persuading sufficient numbers of medical students to choose primary care.
"In the past decade, the number of residents in subspecialty training has risen five times faster than the number of residents in the core specialties (those representing primary board certification). The number of residents expected to practice primary care has declined by more than 10%," the report notes.
The panel was chaired by Debra Weinstein, MD, Massachusetts General Hospital, and Vice President for Graduate Medical Education for Partners Healthcare System, Inc.
The nation's system for training physicians is in dramatic need of a complete overhaul to adequately provide future patient care, says a report from the Josiah Macy Jr. Foundation, which issued 14 recommendations to make that happen.
"Although notable changes have occurred in graduate medical education (GME) over the past decade, including the introduction of a competency-based framework and limitations on duty hours, many people feel that much broader reforms are needed to keep pace," says the 39-member panel that authored the report.
The panel, consisting of physicians and surgeons as well as medical school deans and faculty members, said the nation will be short more than 100,000 doctors by the middle of the next decade, in part because of the current system's entrenched ways of educating and assuring the quality of the physician workforce.
"Unless we in academic medicine are self-critical and show a willingness to change, the political and public support for graduate medical education will disappear," warns Macy President George Thibault, MD, in a statement. "This is a huge enterprise built on tradition, but the system has to change to be more responsive to public needs."
One of panel’s key recommendations is that medical education should shift from gauging competency by months and years of training to actual measurements of individual physicians' readiness for independent practice. This is because medical school residents "vary significantly in how quickly they achieve competency, yet the current system of training all residents for a fixed duration fails to recognize or accommodate this reality."
The panel also prioritizes its recommendation to diversify training sites from traditional teaching hospitals to federally qualified and school-based health centers "and to expand content related to professionalism, population medicine, and team-based practice.”
A third key recommendation is for educational institutions to eliminate historic boundaries so that other health provider professions can learn with their physician colleagues. "This will require revising regulations that now prevent supervision across specialties or professions," the group says.
The panel also wants to require a period of "monitored independence" during GME to confirm each physician's readiness for independent practice. "Program directors and teaching faculty express widespread concern that residents are not given sufficient opportunity to act independently within the present teaching environment and are consequently less well prepared for practice," the statement says.
The report lists four trends that make a major shift in medical training necessary:
1. New approaches to physician practice are necessary to meet the needs of an aging population, as the number of people 65 and older will double by 2020. This population will live longer with more chronic, cognitive, and functional issues and will be more racially and culturally diverse.
2. Care continues to move outside the hospital to the home, clinics, and other community settings, and care providers are assuming new roles to meet these needs. The Affordable Care Act's directives will accelerate this trend, giving 32 million more people health coverage. This influx will require trainees to be "prepared to work in different organizations and sites of care, and in teams of health professionals."
3. Trainees must enter practice trained to use new healthcare technologies safely and efficiently. "Advances in medical diagnostics, therapeutics, and information technology can significantly improve health outcomes. However, we have fallen short in consistently using technology optimally to improve the quality and efficiency of healthcare," the panel writes.
4. The next generation of physicians must help lower costs and be more efficient. "Physicians in training must understand the financial implications of their patient management decisions, and their training must include new and efficient models of care so that they will be prepared to practice cost-effective medicine and be responsible stewards of resources while providing high-quality patient care," the report says.
However, to change the graduate medical system, medical educators face many obstacles, including the growing tension between work-hour restrictions and competition for curricular time and non-educational tasks. Another important obstacle is the difficulty in persuading sufficient numbers of medical students to choose primary care.
"In the past decade, the number of residents in subspecialty training has risen five times faster than the number of residents in the core specialties (those representing primary board certification). The number of residents expected to practice primary care has declined by more than 10%," the report notes.
The panel was chaired by Debra Weinstein, MD, Massachusetts General Hospital, and Vice President for Graduate Medical Education for Partners Healthcare System, Inc.
Friday, September 9, 2011
From Samueli Institute's 2010 Complementary and Alternative Medicine Survey of Hospitals
More hospitals (42 percent) offered complementary and alternative medicine (CAM) last year than in 2007 (37 percent), according to a survey by Health Forum and the Samueli Institute. Hospitals cited patient demand (78 percent), evidence of effectiveness (74 percent), and practitioner availability (58 percent) as reasons for offering CAM services. Report (.pdf)
http://www.siib.org/news/2468-SIIB/version/default/part/AttachmentData/data/CAM%20Survey%20FINAL.pdf
http://www.siib.org/news/2468-SIIB/version/default/part/AttachmentData/data/CAM%20Survey%20FINAL.pdf
Medscape.com: Board Certification Varies With Demographics, Education
Specific demographic and educational factors are associated with board certification of physicians. These include race and education debt, according to a study published in the September 7 issue of JAMA.
Certification by an American Board of Medical Specialties member board is an important credential, and it is becoming increasingly common. Previous studies have shown better outcomes in patients who are in the care of board-certified physicians, and health maintenance organizations, hospitals, and insurance plans use board certification as an evaluation tool for physicians.
Donna B. Jeffe, PhD, and Dorothy A. Andriole, MD, both from Washington University School of Medicine, St Louis, Missouri, investigated how demographic, medical school, and graduate medical education were associated with American Board of Medical Specialties board certification. They conducted a retrospective study of a national cohort of 42,440 medical students who graduated from US medical schools between 1997 and 2000. Participants were followed up through March 2, 2009.
Of the participants, 37,054 (87.3%) were board certified. The researchers found that board certification was associated with first-attempt passing scores in the highest percentile (compared with those who failed on the first attempt) on US Medical Licensing Examination Step 2 Clinical Knowledge. This trend held true in all physician categories. The lowest adjusted odds ratio (AOR) was found in emergency medicine (87.4% vs 73.6%; AOR, 1.82; 95% confidence interval [CI], 1.03 - 3.20). The highest was found for radiology (98.1% vs 74.9%; AOR, 13.19; 95% CI, 5.55 - 31.32).
Participants who self-identified as underrepresented racial/ethnic minorities had a lower likelihood of being board-certified — a trend that held for every physician category except family medicine. The percentage in pediatrics was 83.5% (vs 95.6% of whites; AOR, 0.44; 95% CI, 0.33 - 0.58). In other nongeneralist specialties, the percentage was 71.5% (vs 83.7% in whites; AOR, 0.79; 95% CI, 0.64 - 0.96).
Increased debt also had an effect. Among obstetrics/gynecology specialists, every $50,000 stepped increase in debt was associated with a lower likelihood of board certification (AOR, 0.89; 95% CI, 0.83 - 0.96) compared with those who had no debt. The reverse was true among family medicine specialists (ie, family practitioners with higher educational debt were more likely to be board certified; AOR, 1.13; 95% CI, 1.01 - 1.26).
The authors noted that the observational nature of the study makes it impossible to assign causal associations, and longer follow-up times may increase the rates of board certification. The results also cannot be applied to osteopathic physicians or students at international medical schools.
"Nevertheless, our findings can inform an understanding of factors contributing to US medical school graduates' advancement along the medical education continuum to board certification, an outcome of interest for medical school graduates, their patients, and the relevant professional organizations involved in undergraduate medical education, [graduate medical education], and board certification," the authors write.
The study was supported by the National Institutes of Health National Institute of General Medical Sciences. The authors received travel funds from the National Institutes of Health for meeting attendance. One author received an honorarium and travel reimbursement from the University of Cincinnati supporting a lecture on MD-PhD programs and their graduates.
JAMA. 2011;306:961-970.
Jim Kling, September 6, 2011
http://www.medscape.com/viewarticle/749172?sssdmh=dm1.716474&src=nldne
Certification by an American Board of Medical Specialties member board is an important credential, and it is becoming increasingly common. Previous studies have shown better outcomes in patients who are in the care of board-certified physicians, and health maintenance organizations, hospitals, and insurance plans use board certification as an evaluation tool for physicians.
Donna B. Jeffe, PhD, and Dorothy A. Andriole, MD, both from Washington University School of Medicine, St Louis, Missouri, investigated how demographic, medical school, and graduate medical education were associated with American Board of Medical Specialties board certification. They conducted a retrospective study of a national cohort of 42,440 medical students who graduated from US medical schools between 1997 and 2000. Participants were followed up through March 2, 2009.
Of the participants, 37,054 (87.3%) were board certified. The researchers found that board certification was associated with first-attempt passing scores in the highest percentile (compared with those who failed on the first attempt) on US Medical Licensing Examination Step 2 Clinical Knowledge. This trend held true in all physician categories. The lowest adjusted odds ratio (AOR) was found in emergency medicine (87.4% vs 73.6%; AOR, 1.82; 95% confidence interval [CI], 1.03 - 3.20). The highest was found for radiology (98.1% vs 74.9%; AOR, 13.19; 95% CI, 5.55 - 31.32).
Participants who self-identified as underrepresented racial/ethnic minorities had a lower likelihood of being board-certified — a trend that held for every physician category except family medicine. The percentage in pediatrics was 83.5% (vs 95.6% of whites; AOR, 0.44; 95% CI, 0.33 - 0.58). In other nongeneralist specialties, the percentage was 71.5% (vs 83.7% in whites; AOR, 0.79; 95% CI, 0.64 - 0.96).
Increased debt also had an effect. Among obstetrics/gynecology specialists, every $50,000 stepped increase in debt was associated with a lower likelihood of board certification (AOR, 0.89; 95% CI, 0.83 - 0.96) compared with those who had no debt. The reverse was true among family medicine specialists (ie, family practitioners with higher educational debt were more likely to be board certified; AOR, 1.13; 95% CI, 1.01 - 1.26).
The authors noted that the observational nature of the study makes it impossible to assign causal associations, and longer follow-up times may increase the rates of board certification. The results also cannot be applied to osteopathic physicians or students at international medical schools.
"Nevertheless, our findings can inform an understanding of factors contributing to US medical school graduates' advancement along the medical education continuum to board certification, an outcome of interest for medical school graduates, their patients, and the relevant professional organizations involved in undergraduate medical education, [graduate medical education], and board certification," the authors write.
The study was supported by the National Institutes of Health National Institute of General Medical Sciences. The authors received travel funds from the National Institutes of Health for meeting attendance. One author received an honorarium and travel reimbursement from the University of Cincinnati supporting a lecture on MD-PhD programs and their graduates.
JAMA. 2011;306:961-970.
Jim Kling, September 6, 2011
http://www.medscape.com/viewarticle/749172?sssdmh=dm1.716474&src=nldne
Tuesday, September 6, 2011
Alert: NIMS Guideline for the Credentialing of Personnel
The purpose of this NIMS Alert is to announce the availability of the NIMS Guideline for the Credentialing of Personnel.
The NIMS Guideline for the Credentialing of Personnel (Guideline) is now final and available for use. The Guideline provides guidance on credentialing for Federal, State, Tribal and Local Personnel, as well as for persons affiliated with Critical Infrastructure and Key Resources, voluntary and not-for-profit response organizations. This Guideline was developed with the participation of stakeholders from key sectors of our society, and builds on the doctrine established in NIMS Guide 0002 NATIONAL CREDENTIALING DEFINITION AND CRITERIA dated March 27, 2007. The Guideline addresses the full range of responders who may be called upon and need to establish their legitimacy through proof of Identity, Qualification/Affiliation and Authorization to deploy.
The Guideline and the NIMS Guide 0002 can be found at the NIMS Resource Center at the following URLs:
The Guideline - http://www.fema.gov/emergency/nims/ResourceMngmnt.shtm#item3
The NIMS Guide 0002 - http://www.fema.gov/pdf/emergency/nims/ng_0002.pdf
For more information on NIMS visit: www.fema.gov/emergency/nims
All questions can be directed to the NIC via e-mail: FEMA-NIMS@dhs.gov or via telephone: 202.646.3850.
• NIMS Alert 02-11 Guidelines for the Credentialing of Personnel.pdf
The NIMS Guideline for the Credentialing of Personnel (Guideline) is now final and available for use. The Guideline provides guidance on credentialing for Federal, State, Tribal and Local Personnel, as well as for persons affiliated with Critical Infrastructure and Key Resources, voluntary and not-for-profit response organizations. This Guideline was developed with the participation of stakeholders from key sectors of our society, and builds on the doctrine established in NIMS Guide 0002 NATIONAL CREDENTIALING DEFINITION AND CRITERIA dated March 27, 2007. The Guideline addresses the full range of responders who may be called upon and need to establish their legitimacy through proof of Identity, Qualification/Affiliation and Authorization to deploy.
The Guideline and the NIMS Guide 0002 can be found at the NIMS Resource Center at the following URLs:
The Guideline - http://www.fema.gov/emergency/nims/ResourceMngmnt.shtm#item3
The NIMS Guide 0002 - http://www.fema.gov/pdf/emergency/nims/ng_0002.pdf
For more information on NIMS visit: www.fema.gov/emergency/nims
All questions can be directed to the NIC via e-mail: FEMA-NIMS@dhs.gov or via telephone: 202.646.3850.
• NIMS Alert 02-11 Guidelines for the Credentialing of Personnel.pdf
Friday, September 2, 2011
IDFPR: State Revokes Licenses of Health Care Workers Convicted of Sex Crimes or Crimes against Patients
CHICAGO – Earlier today, the Illinois Department of Financial and Professional Regulation (IDFPR) revoked the licenses of 11 health care workers who have been convicted of sex offenses or violent crimes against their patients. These revocations are required by a new law signed by Governor Quinn last month. HB 1271 (Public Act 97-0156) provides that the professional license of any health care worker who has been convicted of a sex offense or of a violent crime against their patients is permanently revoked without a hearing and further provides that sex offenders cannot be licensed as health care workers in Illinois.
“The State takes its responsibilities to protect our residents seriously,” said Brent E. Adams, Secretary of Financial and Professional Regulation. “This new law establishes tough outcomes that are intended to shield Illinois patients from health care workers who have been convicted of sex offenses and certain violent crimes.”
While many health care workers are covered by the new law, regulations will be proposed to specifically list all the types of health care workers that are covered by the law. The law also lists most of the crimes requiring permanent revocation, but regulations will be proposed to make clear all the crimes that trigger permanent revocation. These proposed regulations will be filed later this year.
Each health care worker whose license was revoked today appears below, along with the city at which he/she was licensed, and the crime that triggered the permanent revocation.
“The State takes its responsibilities to protect our residents seriously,” said Brent E. Adams, Secretary of Financial and Professional Regulation. “This new law establishes tough outcomes that are intended to shield Illinois patients from health care workers who have been convicted of sex offenses and certain violent crimes.”
While many health care workers are covered by the new law, regulations will be proposed to specifically list all the types of health care workers that are covered by the law. The law also lists most of the crimes requiring permanent revocation, but regulations will be proposed to make clear all the crimes that trigger permanent revocation. These proposed regulations will be filed later this year.
Each health care worker whose license was revoked today appears below, along with the city at which he/she was licensed, and the crime that triggered the permanent revocation.
For Missouri Members: Upcoming Change in State Law
DIFP: New state law allows consumers to learn more about their physicians
Also gives state regulators more tools against dangerous doctors
Jefferson City, Mo. - Under a new state law, Missouri consumers can now learn more about the educational history of their doctors. House Bill 265, signed by Gov. Jay Nixon, took effect yesterday and allows the State Board of Registration for the Healing Arts to release extensive information about licensed doctors for the first time. The board's website now allows consumers to learn about medical and professional schools attended by physicians, as well as any specialties or board certifications.
In addition, more information will soon be available to the public: Under the law, any future information submitted to the board may be released if it pertains to discipline by another government agency or court-ordered limitations on a doctor's practice.
"This law is a significant step toward better transparency for patients in Missouri," said John M. Huff, director of the Missouri Department of Insurance, Financial Institutions and Professional Registration. "We always encourage consumers to learn as much as they can about the professionals they're doing business with, and that's especially important in a doctor-patient relationship."
House Bill 265 also gives more authority to the board to discipline doctors who violate the law. The board can now:
More effectively seek an immediate suspension of a physician's license when the board believes the doctor is a danger to patients;
Streamline the process for discipline of doctors;
Move cases more quickly through the state Administrative Hearing Commission, which conducts hearings related to the discipline of doctors; and
Discipline doctors for alcohol dependency, being on a sex offender registry or failing to cooperate with board investigations.
Consumers who would like to learn more about their physicians can use the licensee search feature on the board's website at pr.mo.gov, or they can contact the board by phone at 573-751-0098.
About the Missouri Department of Insurance, Financial Institutions & Professional Registration
The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department's seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.
August 29, 2011
Also gives state regulators more tools against dangerous doctors
Jefferson City, Mo. - Under a new state law, Missouri consumers can now learn more about the educational history of their doctors. House Bill 265, signed by Gov. Jay Nixon, took effect yesterday and allows the State Board of Registration for the Healing Arts to release extensive information about licensed doctors for the first time. The board's website now allows consumers to learn about medical and professional schools attended by physicians, as well as any specialties or board certifications.
In addition, more information will soon be available to the public: Under the law, any future information submitted to the board may be released if it pertains to discipline by another government agency or court-ordered limitations on a doctor's practice.
"This law is a significant step toward better transparency for patients in Missouri," said John M. Huff, director of the Missouri Department of Insurance, Financial Institutions and Professional Registration. "We always encourage consumers to learn as much as they can about the professionals they're doing business with, and that's especially important in a doctor-patient relationship."
House Bill 265 also gives more authority to the board to discipline doctors who violate the law. The board can now:
More effectively seek an immediate suspension of a physician's license when the board believes the doctor is a danger to patients;
Streamline the process for discipline of doctors;
Move cases more quickly through the state Administrative Hearing Commission, which conducts hearings related to the discipline of doctors; and
Discipline doctors for alcohol dependency, being on a sex offender registry or failing to cooperate with board investigations.
Consumers who would like to learn more about their physicians can use the licensee search feature on the board's website at pr.mo.gov, or they can contact the board by phone at 573-751-0098.
About the Missouri Department of Insurance, Financial Institutions & Professional Registration
The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department's seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.
August 29, 2011
Thursday, September 1, 2011
H&HN: Mobile Apps That Bring Patients to Your Door
Mobile medical applications may get all the attention, but apps that effectively market your hospital to patients may be equally important
The explosion of mobile applications has been one of the biggest health IT stories of 2011, and with good reason: Mobile apps can offer hospitals and doctors portable versions of medical devices and instant access to stores of medical research. And at a time when cost pressures are forcing providers to envision a care delivery process that can serve patients with fewer inpatient interactions, mobile apps also offer a way to reach those ends.
Lately, though, I've been coming across an increasing number of examples of how hospitals are harnessing the power of mobile applications beyond the clinical setting as a way to connect with potential patients and offer them real-time, valuable information on where to go for their care in a pinch.
For instance, Baptist Health in South Florida now offers patients real-time information on wait times for physicians at its urgent care centers and emergency rooms. For its efforts, Baptist Health received a 2011 Most Wired Innovator Award, and my colleague, H&HN Senior Editor for Data and Research, Suzanna Hoppszallern, recently talked to Baptist Health's Petter Melau, the project lead for the mobile app initiative. Melau said the service has been extremely popular; within two days of the app launching, 1,000 users signed up. Melau added that the application also has helped users clarify the difference between services offered by Baptist Health's urgent care facilities and its emergency rooms, a critical distinction in an era of overcrowded EDs.
And industry momentum for mobile apps is definitely quickening. Earlier this week, Carolinas Health System, a 30-hospital system based in Charlotte announced the rollout of a new, free mobile app that allows patients to find locations, check wait times or even search for physicians via their location and specialty.
Beyond the advantages these types of mobile apps offer patients, many IT experts are convinced that if current usage trends continue, it won't be long before smart phones will supplant web-based browsers as the chief access point for online information. For H&HN Daily, for instance, roughly 20 percent of our daily readers access the publication via their phone and not a traditional browser. And on a personal level, I'm a huge fan of the mobile sites in Chicago that allow me to check train and bus times on the go. In other words, in a few years time patients will view mobile apps with real-time information not as an added amenity but as an expected service.
By Haydn Bush August 31, 2011
The explosion of mobile applications has been one of the biggest health IT stories of 2011, and with good reason: Mobile apps can offer hospitals and doctors portable versions of medical devices and instant access to stores of medical research. And at a time when cost pressures are forcing providers to envision a care delivery process that can serve patients with fewer inpatient interactions, mobile apps also offer a way to reach those ends.
Lately, though, I've been coming across an increasing number of examples of how hospitals are harnessing the power of mobile applications beyond the clinical setting as a way to connect with potential patients and offer them real-time, valuable information on where to go for their care in a pinch.
For instance, Baptist Health in South Florida now offers patients real-time information on wait times for physicians at its urgent care centers and emergency rooms. For its efforts, Baptist Health received a 2011 Most Wired Innovator Award, and my colleague, H&HN Senior Editor for Data and Research, Suzanna Hoppszallern, recently talked to Baptist Health's Petter Melau, the project lead for the mobile app initiative. Melau said the service has been extremely popular; within two days of the app launching, 1,000 users signed up. Melau added that the application also has helped users clarify the difference between services offered by Baptist Health's urgent care facilities and its emergency rooms, a critical distinction in an era of overcrowded EDs.
And industry momentum for mobile apps is definitely quickening. Earlier this week, Carolinas Health System, a 30-hospital system based in Charlotte announced the rollout of a new, free mobile app that allows patients to find locations, check wait times or even search for physicians via their location and specialty.
Beyond the advantages these types of mobile apps offer patients, many IT experts are convinced that if current usage trends continue, it won't be long before smart phones will supplant web-based browsers as the chief access point for online information. For H&HN Daily, for instance, roughly 20 percent of our daily readers access the publication via their phone and not a traditional browser. And on a personal level, I'm a huge fan of the mobile sites in Chicago that allow me to check train and bus times on the go. In other words, in a few years time patients will view mobile apps with real-time information not as an added amenity but as an expected service.
By Haydn Bush August 31, 2011
Medscape Medical News: Hospitals Begin to Reopen in the Aftermath of Irene
Woes Left in Hurricane's Wake Are Enormous
East Coast hospitals that had evacuated their patients before Hurricane Irene struck during the weekend have begun to admit them again as diminished winds continue to blow northward in the form of Tropical Storm Irene.
In New York City, for example, Staten Island University Hospital reopened its doors last night, as did Palisades Medical Center in North Bergen, New Jersey. However, nobody has given the all-clear sign just yet. St. Clare's Hospital in Sussex, New Jersey, is discharging or transferring 14 patients today because of a malfunctioning emergency generator, said a hospital spokesperson.
Although Irene has been downgraded from a hurricane to a tropical storm, the woes it left behind are enormous. An estimated 4.2 million homes and businesses along the Eastern seaboard lacked power as of Sunday night. Meanwhile, storm-swollen rivers continue to flood inland cities and threaten to contaminate drinking water.
Irene has been a troublemaker with a wide reach. A healthcare research company called Stratasan estimated through computer mapping technology that more than 60 million people, 135,000 physicians, and 459 hospitals lay within the storm's path.
Well Prepared
Irene did not wreak the havoc that Hurricane Katrina did in 2005, but nevertheless it caused the deaths of at least 16 individuals in 6 states, according to news accounts.
At the same time, storm-battered hospitals continued to usher in new lives. Seventeen babies were born during the weekend at New Hanover Regional Medical Center in Wilmington, North Carolina, said Stephanie Strickland, a spokesperson for the North Carolina Hospital Association.
Similar to other facilities up and down the seaboard that suffered power outages, New Hanover Regional kept its monitors and lights on thanks to an emergency generator.
Good preparation translated into good patient care during the weekend, said Donna Leusner, a spokesperson for the New Jersey Department of Health and Senior Services.
"Two weeks before the storm, coastal hospitals, the Department of Health and Senior Services, and county Offices of Emergency Management completed a hurricane exercise that really ensured that the state's plans were up to date and [that] the issues that we found in training were addressed appropriately," Ms. Leusner told Medscape Medical News.
Coping with the storm also required the best of Hippocratic spirits. Some physicians and nurses spent the weekend at East Coast hospitals, not knowing when they might be relieved.
"Many slept in rooms where their patients were housed," said Ms. Leusner.
'Priceless' Experience
At Kings County Hospital Center in Brooklyn, New York, psychiatric resident Kendra Campell, MD, curled up on a bed in a resident on-call room Saturday night.
"I got 4 or 5 hours of sleep," said Dr. Campbell. "It wasn't bad."
Dr. Campbell worked during the weekend in the psychiatric emergency department, where stressed-out patients came for shelter, medications, and a listening ear. Clinicians kept them occupied with games and art exercises. One of the attending physicians strummed an acoustic guitar to brighten the mood.
"I felt an overwhelming sense of teamwork," said Dr. Campbell.
Dr. Campbell was able to go off-duty at 5 pm on Sunday. She Tweeted her sense of relief: "Hours worked at the hospital: 33. Meals eaten out of paper bags: 3. Showers taken: 1. Walking home post-call and post-hurricane: Priceless."
Robert Lowes
East Coast hospitals that had evacuated their patients before Hurricane Irene struck during the weekend have begun to admit them again as diminished winds continue to blow northward in the form of Tropical Storm Irene.
In New York City, for example, Staten Island University Hospital reopened its doors last night, as did Palisades Medical Center in North Bergen, New Jersey. However, nobody has given the all-clear sign just yet. St. Clare's Hospital in Sussex, New Jersey, is discharging or transferring 14 patients today because of a malfunctioning emergency generator, said a hospital spokesperson.
Although Irene has been downgraded from a hurricane to a tropical storm, the woes it left behind are enormous. An estimated 4.2 million homes and businesses along the Eastern seaboard lacked power as of Sunday night. Meanwhile, storm-swollen rivers continue to flood inland cities and threaten to contaminate drinking water.
Irene has been a troublemaker with a wide reach. A healthcare research company called Stratasan estimated through computer mapping technology that more than 60 million people, 135,000 physicians, and 459 hospitals lay within the storm's path.
Well Prepared
Irene did not wreak the havoc that Hurricane Katrina did in 2005, but nevertheless it caused the deaths of at least 16 individuals in 6 states, according to news accounts.
At the same time, storm-battered hospitals continued to usher in new lives. Seventeen babies were born during the weekend at New Hanover Regional Medical Center in Wilmington, North Carolina, said Stephanie Strickland, a spokesperson for the North Carolina Hospital Association.
Similar to other facilities up and down the seaboard that suffered power outages, New Hanover Regional kept its monitors and lights on thanks to an emergency generator.
Good preparation translated into good patient care during the weekend, said Donna Leusner, a spokesperson for the New Jersey Department of Health and Senior Services.
"Two weeks before the storm, coastal hospitals, the Department of Health and Senior Services, and county Offices of Emergency Management completed a hurricane exercise that really ensured that the state's plans were up to date and [that] the issues that we found in training were addressed appropriately," Ms. Leusner told Medscape Medical News.
Coping with the storm also required the best of Hippocratic spirits. Some physicians and nurses spent the weekend at East Coast hospitals, not knowing when they might be relieved.
"Many slept in rooms where their patients were housed," said Ms. Leusner.
'Priceless' Experience
At Kings County Hospital Center in Brooklyn, New York, psychiatric resident Kendra Campell, MD, curled up on a bed in a resident on-call room Saturday night.
"I got 4 or 5 hours of sleep," said Dr. Campbell. "It wasn't bad."
Dr. Campbell worked during the weekend in the psychiatric emergency department, where stressed-out patients came for shelter, medications, and a listening ear. Clinicians kept them occupied with games and art exercises. One of the attending physicians strummed an acoustic guitar to brighten the mood.
"I felt an overwhelming sense of teamwork," said Dr. Campbell.
Dr. Campbell was able to go off-duty at 5 pm on Sunday. She Tweeted her sense of relief: "Hours worked at the hospital: 33. Meals eaten out of paper bags: 3. Showers taken: 1. Walking home post-call and post-hurricane: Priceless."
Robert Lowes
American Medical News: Criminal convictions and discipline of Illinois doctors returning online
Profiles were posted on a website for a few years, but a court required the state to remove the information.
Illinois has rejoined the nation's other 49 states in making physician profiles available to the public in some form.
Disciplinary actions, criminal convictions, medical liability payments going back five years and other information on the state's physicians will be provided online by the Illinois Dept. of Financial and Professional Regulation.
A "key to good health is a great doctor, which is why we are ensuring that all of the important information needed to select a physician is online and available 24 hours a day," Illinois Gov. Pat Quinn said after signing the legislation Aug. 9.
Physician profiles went online as part of the state's 2005 comprehensive medical liability reform. But they were removed from the public eye when the Illinois Supreme Court struck down the liability reform in February 2010 because legislation included caps on noneconomic damages.
Under the new law, physicians will have the right to review the information posted about them and will be able to have inaccurate information corrected. Having the opportunity to review and correct information is a positive thing, said Illinois State Medical Society President Wayne V. Polek, MD, an anesthesiologist.
More than 30 states require background checks at licensure for health professionals. "And we encourage patients to confirm information with a physician," he said.
Dr. Polek said physicians are more comfortable with physician profiles than they were five or 10 years ago. But he said one sticking point is putting medical liability claims in the profiles.
"People are sued for a variety of reasons, and they settle for a variety of reasons. For example, an insurance company or employer says you have to [settle]. That information is not necessarily helpful to patients," Dr. Polek said.
ISMS was neutral on the Patient Right to Know Act because it was a stand-alone measure and not part of more comprehensive legislation to extend the state's Medical Practice Act, Dr. Polek said. The act, which governs the practice of medicine in Illinois, is scheduled for sunset repeal on Nov. 30.
The medical society has supported online physician profiles, including those that were part of the 2005 medical liability reform.
With the new Illinois law, all states now make some type of physician profile information available to the public in some form, said the Federation of State Medical Boards.
"We have come a long way," said FSMB President and CEO Humayun J. Chaudhry, DO. "Back in 1996, no boards had physician profiles. State boards recognize the value of physician profiles. We see Illinois as an example of this continuing trend."
How physician profiles are made public varies among states, Dr. Chaudhry said. But the trend is moving toward states making more information publicly available, he said.
Meanwhile, physicians applying for a new medical license in Indiana must pay for and complete a national criminal background check. Under a law that took effect July 1, doctors also must provide fingerprints. More than 30 states require background checks at licensure for health professionals.
Tanya Albert Henry, Posted Aug. 29, 2011.
Illinois has rejoined the nation's other 49 states in making physician profiles available to the public in some form.
Disciplinary actions, criminal convictions, medical liability payments going back five years and other information on the state's physicians will be provided online by the Illinois Dept. of Financial and Professional Regulation.
A "key to good health is a great doctor, which is why we are ensuring that all of the important information needed to select a physician is online and available 24 hours a day," Illinois Gov. Pat Quinn said after signing the legislation Aug. 9.
Physician profiles went online as part of the state's 2005 comprehensive medical liability reform. But they were removed from the public eye when the Illinois Supreme Court struck down the liability reform in February 2010 because legislation included caps on noneconomic damages.
Under the new law, physicians will have the right to review the information posted about them and will be able to have inaccurate information corrected. Having the opportunity to review and correct information is a positive thing, said Illinois State Medical Society President Wayne V. Polek, MD, an anesthesiologist.
More than 30 states require background checks at licensure for health professionals. "And we encourage patients to confirm information with a physician," he said.
Dr. Polek said physicians are more comfortable with physician profiles than they were five or 10 years ago. But he said one sticking point is putting medical liability claims in the profiles.
"People are sued for a variety of reasons, and they settle for a variety of reasons. For example, an insurance company or employer says you have to [settle]. That information is not necessarily helpful to patients," Dr. Polek said.
ISMS was neutral on the Patient Right to Know Act because it was a stand-alone measure and not part of more comprehensive legislation to extend the state's Medical Practice Act, Dr. Polek said. The act, which governs the practice of medicine in Illinois, is scheduled for sunset repeal on Nov. 30.
The medical society has supported online physician profiles, including those that were part of the 2005 medical liability reform.
With the new Illinois law, all states now make some type of physician profile information available to the public in some form, said the Federation of State Medical Boards.
"We have come a long way," said FSMB President and CEO Humayun J. Chaudhry, DO. "Back in 1996, no boards had physician profiles. State boards recognize the value of physician profiles. We see Illinois as an example of this continuing trend."
How physician profiles are made public varies among states, Dr. Chaudhry said. But the trend is moving toward states making more information publicly available, he said.
Meanwhile, physicians applying for a new medical license in Indiana must pay for and complete a national criminal background check. Under a law that took effect July 1, doctors also must provide fingerprints. More than 30 states require background checks at licensure for health professionals.
Tanya Albert Henry, Posted Aug. 29, 2011.
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