CA Podiatrists and Physicians Pursue Collaborative Education

Podiatrists and physicians are working together in California to even out the educational differences between podiatric and medical schools in the state. The effort is being led by the California Podiatric Medical Association, California Medical Association, and California Orthopaedic Association.

The change would allow California podiatrists to practice as licensed physicians and surgeons with a nationally recognized scope and license.

This collaboration is unique as efforts to align licensure and scope of practice between physicians and other health professionals has been an ongoing debate in many states.

To read the full article, click here:
http://www.ama-assn.org/amednews/2011/06/27/prl20627.htm


Source: amednews.com

Cardiologists Seek Supreme Court Review of Economic Credentialing Case

Three cardiologists have petitioned the US Supreme Court to review an appellate court decision finding that they did not have a claim against a hospital that had allegedly terminated their privileges based on their refusal to refer patients to the hospital's only cardiac surgeon. (Gaalia v. Citizens Medical Center).

The cardiologists claimed that in 2007, they refused to refer patients to Citizens Medical Center's cardiac surgeon because the surgeon's mortality rate exeeded that of other surgeons in the area. They claimed that CMC took action against them, imposing an on-call duty requirement that they were unable to fulfill, essentially leading to the termination of their privileges. They claimed that under the federal Anti-Kickback Act, the hospital wrongfully terminated their privileges under a practice of economic credentialing.

The U.S. Court of Appeals for the Fifth Circuit ruled that CMC had a rational basis for terminating the cardiologists' privileges and that the hospital committed no violation. The cardiologists are seeking review of the decision by the Supreme Court, stating that the healthcare industry needs clarification on when the federal anti-kickback statute applies.


Source: BNA

Oregon Medical Board Investigating Surgeon and Distributorship Relationship

The Oregon Medical Board is investigating neurosurgeon Dr. Vishal James Makker after his privileges were revoked by Providence Portland Medical Center at the end of March.

Medicare claims data showed that Makker was performing spinal surgeries at 10 times the national average rate. In 2006, Makker underwent training for performing unnecessary surgeries and billing for procedures not performed.

The Oregon Medical Board is also investigating Makker's relationship with Omega Solutions, a medical-device manufacturer that engaged in the practice of paying dividends to surgeons who used their products. Omega denies having any relationship with Makker where he was paid. It is also unclear whether or not the revocation of Makker's privileges is related to the investigation.

To read the full story, click here: http://online.wsj.com/article/SB10001424052748704336504576259142044058726.html


Source: The Wall Street Journal

AHA Supports Bill Allowing for General Supervision for Outpatient Services

The following announcement was released by the American Hospital Association (AHA):

The AHA today voiced support for S. 778, legislation that would allow general supervision by a physician or non-physician practitioner for many outpatient therapy services. Introduced last week by Sen. Jerry Moran (R-KS), the bill would require the Centers for Medicare & Medicaid Services to allow a default setting of general supervision, rather than direct supervision, for outpatient therapy services and create an advisory panel to establish an exceptions process for risky and complex outpatient services. The legislation would create a special rule for critical access hospitals that recognizes their unique size and Medicare conditions of participation. The bill also would hold hospitals and CAHs harmless from civil or criminal action for failing to meet CMS' current direct supervision policy for the period 2001 through 2011. "Although CMS claims its policy is a 'restatement and clarification' of existing policy, it is, in fact, a significant change that has left hospitals and CAHs vulnerable," AHA said in a letter of support for the legislation. The AHA also continues to urge the administration to address hospitals' concerns with the requirement.

Source: American Hospital Association

Happy Doctor's Day to Our Medical Staffs!

The first Doctor's Day observance was March 30, 1933 in Winder, Georgia. Eudora Brown Almond, wife of Dr. Charles B. Almond, decided to set aside a day to honor physicians. This first observance included the mailing greeting cards and placing flowers on graves of deceased doctors. The red carnation is commonly used as the symbolic flower for National Doctor's Day.

Doctor's Day marks the date that Crawford W. Long, M.D., of Jefferson, GA, administered the first ether anesthetic for surgery on March 30, 1842. On that day, Dr. Long administered ether anesthesia to a patient and then operated to remove a tumor from the man’s neck. Later, the patient would swear that he felt nothing during the surgery and wasn’t aware the surgery was over until he awoke.

On March 30, 1958, a Resolution commemorating Doctor's Day was adopted by the United States House of Representatives. In 1990, legislation was introduced in the House and Senate to establish a national Doctors Day. Following overwhelming approval by the United States Senate and the House of Representatives, on October 30, 1990, President George Bush signed S.J. RES. #366 (which became Public Law 101-473) designating March 30 as "National Doctor's Day."

Are you and your medical staff doing anything to celebrate Doctor's Day today? Share your stories in the comment area below this post on the NAMSS Blog.

Celebrate Doctor's Day on March 30

Chevalier Jackson, MD a laryngologist, pediatrician, inventor and designer saved thousands of children in the late 1800 and early 1900’s by removing objects that they had swallowed from their esophagi, traheae and lungs. Some 2,000 of the items he retrieved and catalogued are on display at Philadelphia's Mütter Museum.

As we approach Doctor’s Day, this is a timely article to share. As MSPs, each day we are truly honored to work with the most intelligent and respected men and women in our nation, who like Dr. Jackson, make significant contributions to the advance of medicine.

Join me in showing your appreciation for our medical staffs this week as we celebrate Doctor’s Day on Wednesday, March 30, 2011.

Read more about Dr. Chevalier Jackson here:
http://www.ama-assn.org/amednews/2011/03/21/prsa0321.htm


Source: amednews.com

CMS to Withdraw Physician Signature Rule

The American Association of Bioanalysts has announced that the Centers for Medicaid & Medicare Services intends to withdraw the current physician signature rule regarding diagnostic laboratory tests. The rule, which was supposed to be in effect starting January 1, 2011, but was delayed, required physicians or qualified nonphysician practitioners to sign requisitions and paperwork for clinical lab tests in order to have the test paid for under Medicare Part B.

Opponents of the rule stated that it was disruptive and complicated matters since many physicians relied on nonphysician staff to process laboratory test paperwork. CMS stated that they will re-evaluate the policy.

To see the American Association of Bioanalysts' announcement, click here:
http://www.aab.org/aab/NewsBot.asp?MODE=VIEW&ID=86&SnID=1949563646


Sources: BNA, American Association of Bioanalysts

Medical Staff Elects Nurse Practitioner as President

The title "director of emergency medicine and president of the medical staff" usually evokes the image of a physician. However, in Ellenville Regional Hospital in New York, it is a nurse practitioner who holds that title.

Bob Donaldson is a nurse practitioner who has attending status in Ellenville Regional's emergency room. He is part of an innovative structure that replaced all ER doctors with nurse practitioners and physician assistants -- and has increased admissions since making the change.

When the hospital had difficulty attracting volunteers to run for the medical staff leadership position, Donaldson volunteered and was elected president.

As the number of nurse practitioners and physicians assistants in the hospital setting continues to rise, it will be interesting to see if more and more non-physicians begin to assume medical staff leadership roles.

To read the full article, click here:
http://www.healthleadersmedia.com/page-3/NRS-262335/Nurse-Practitioner-Elected-Medical-Staff-President


Source: HealthLeaders Media

Proposed Legislation Would Require Transparent Disclosure of Credentials

Rep. John Sullivan (R-OK) and Rep. David Scott (D-GA) have re-introduced a bill which would require healthcare professionals who advertise services to state that they possess the license that authorizes them to perform the services listed. The bill, which is titled the Healthcare Truth and Transparency Act, is supported by groups such as the American Medical Association and American Osteopathic Association.

Introduction of the bill follows a trend among states that have passed legislation to ensure that patients are more aware of the credentials held by health professionals.

To read more, click here:
http://www.ama-assn.org/amednews/2011/02/07/prl20207.htm


Source: amednews.com

Challenge to Nurse Anesthetists' Scope of Practice Continues in California

California physicians are appealing the latest court decision that upheld the right for nurse anesthetists to administer anesthesia without physician supervision, an issue that has pitted nurses and doctors against each other in a nationwide turf battle.

Medicare allows state governors to opt out of a federal policy that requires physician supervision of nurse anesthetists when delivering anesthesia to Medicare patients. This provision is intended to address staffing shortages where anesthesiologists may not be readily available. California and 16 other states currently operate under the opt-out provision.

Opponents of the provision claim that the state's current scope of practice for nurse anesthetists does not allow for unsupervised practice.

To read more, click on the following link:
http://www.healthleadersmedia.com/page-1/TEC-262136/Nurse-Anesthetists-Scope-of-Practice-Challenged-Again-in-CA


Source: HealthLeaders Media

Useful Articles from the AMA

Below are two useful articles from the American Medical Association (AMA):

• Credentialing files maintained by hospitals should be protected against disclosure even if subpoenaed, according to a recent ruling by the state of Michigan Court of Appeals. http://www.ama-assn.org/amednews/2011/01/24/prsc0125.htm
  
  
• CME courses starting to focus on disciplined doctors and how they can prevent future mistakes. http://www.ama-assn.org/amednews/2011/01/24/prsa0124.htm

Source: amednews.com

As the Physician Population Ages, Concerns about Comptency Increase

Many aging doctors face financial pressures that make them reluctant to retire. Sometimes, their peers may notice changes in their ability to practice, but are hesitant to confront or report their colleagues if they suspect age to be the issue.

Be sure your Physician Health Policy is up to date with safeguards in place to protect patients, assist your aging medical staff and guide medical staff leaders through these tough decisions.

A recent article in The New York Times discusses the issue of aging physicians. To read the article, click here:
http://www.nytimes.com/2011/01/25/health/25doctors.html?_r=2&partner=rss&emc=rss


Source: The New York Times

Hospital Researcher Found to Have Neither a Medical Degree Nor a PhD

A recent story in The Detroit News discusses the case of William Hamman, a researcher at Western Michigan University who claimed that he had a medical degree as well as a PhD. Hamman had allegedly been working on journal articles on patient safety and care before his credentials were found to be false.

Hamman had impressive credentials in the aviation industry and had worked with WMU on a project to study how aviation industry standards could be applied to improve safety in healthcare. In 2009, Hamman joined William Beaumont Hospital to help train the members of the medical staff on communication and teamwork skills. Hamman was never a member of the medical staff, nor did he provide patient care.

To read the full story, click here:
http://www.detnews.com/article/20101215/METRO02/12150355/1409/WMU--hospital-researcher-lied-for-years-about-Ph.D


Source: detnews.com

House Passes Physician Pay Cut Delay

Today, the House passed H.R. 4994, a bill that delays a scheduled 25% Medicare physician pay cut for another year. President Obama is expected to sign the bill. The cut would have been effective January 1, 2011. The bill keeps reimbursement rates for 2011 at the 2010 levels.

The Senate passed the bill on December 8.


Source: BNA

CMS Final Rule Cuts Physician Payments 24.9% in 2011

The Centers for Medicare and Medicaid Services (CMS) has released a final rule that will cut Medicare payments to physicians by 24.9 percent in 2011. CMS states that the reason for the cut is to provide a permanent fix for the sustainable growth rate and Medicare payment formula.

The rule also attempts to curb physician self-referral for services that may be obtained elsewhere in the area and implements rules on the expansion of preventative services, which went into effect as part of the Affordable Care Act.

The physician pay cut is effective January 1, 2011.


Source: Healthcare Finance News
http://www.healthcarefinancenews.com/news/cms-final-rule-cut-2011-medicare-pay-physicians

Patient Deaths at CA Facility Allegedly a Result of Substandard Care

A discrimination lawsuit filed by a medical assistant and two cardiologists attributes a 2009 patient death to substandard care. Furthermore, the suit alleges that the level of substandard care was permitted to continue because they were "ignored, embarrassed, or terminated" for reporting problem.

The suit, filed against Santa Clara Valley Medical Center in California, alleges that after Dr. Geeta Singh suggested that a patient undergo a cardiac catherization rather than a stress test due to his history of heart attack. The patient was given a stress test and later died. After Singh and administrative assistant Theresa Walker submitted a report of substandard care to TJC, they claim that they were ignored by other members of the staff and abused through e-mail.

Dr. Kai Ihnken is also a plaintiff in the suit, alleging that administrators denied him the ability to perform cardiac surgery, leading to the patient's death. After reporting the incident, he claims that he was slandered and his contract was not renewed.

The Santa Clara County Executive stated that examiners have found no direct link indicating that negligence caused the patients' deaths; however, he did acknowledge that the hospital's cardiac department was prone to conflict and arguments.

This pending case sheds light on the importance of maintaining professional working relationships among members. It also calls on hospitals to look at their staff culture and to see if employees and members of the medical staff are provided with a comfortable environment that allows them to speak up if they witness an adverse event.


Source: MercuryNews.com
http://www.mercurynews.com/crime-courts/ci_16438955?source=email&nclick_check=1

Arkansas Court Strikes Down Economic Credentialing

The Arkansas Supreme Court upheld a 2009 decision stating that a hospital could not deny staff privileges to physicians with an ownership stake in competing hospital based on financial concerns because this policy violates state laws.

Baptist Health in Little Rock, Arkansas denied staff privileges to 12 physicians stating that its conflict of interest policy permitted the hospital to do so because of the economic interests of the facility.

Organizations such as the American Medical Association joined the physicians as plaintiffs, stating that restricting physician practice through economic credentialing restricts patient choice and that physicians should be evaluated on performance, not financial factors.

This is the highest court decision issued on the subject of economic credentialing. The AMA states that it is an issue that if challenged again, will be determined on a state-by-state basis.


Source: amednews.com
http://www.ama-assn.org/amednews/2010/10/18/prsc1018.htm

Whistleblower Physician Awarded $1 in Damages after Hospital Took Retaliatory Action

The US District Court for the District of Maine awarded Dr. Kristine Thayer $1 in damages, plus recovery of attorney's fees and court costs after a jury found that Eastern Maine Medical Center (EMMC) took retaliatory action against her in violation of Maine's Whistleblower Protection Act (Thayer v. Eastern Maine Medical Center).

Thayer, a pediatric surgeon, told her supervisor that pediatric gastroenterologist Dr. Mohammed Tabbah was providing substandard patient care. Following the report, the hospital began an investigation of Dr. Thayer as a disruptive physician and the medical staff executive committee recommended that she attend anger management counseling, with the threat of disciplinary action for further disruptive behavior. Thayer voluntarily chose to leave EMMC.

At trial, the jury found that the supervisor's initiation of peer review was retaliation for Dr. Thayer's actions and a violation of the Whistleblower Protection Act; however, they believe that that she suffered no injury that would entitle her to damages. Thayer filed an amended complaint for damages as well as the cost of court and attorneys' fees.

The district court ruled that Thayer was entitled to court and attorneys' fees. However, they limited her damages to $1, stating that the reinstatement of her professional reputation and the negative reputation cast on EMMC was an appropriate remedy that did not need to be supplemented by a further award of monetary damages.


Source: BNA

Study Shows Patients Are Provided with Insufficient Quality Physician Quality Data

Patients are encouraged to select physicians based on certain quality characteristics; however, a recent study reveals that patients don't have access to the information that should be used in order to make decisions on healthcare providers. This finding can be found in the September 13, 2010 issue of the American Medical Association's Archives of Internal Medicine.

The report states that the profile information given to the public to assist with the selection of a doctor does not strongly correlate with a doctor's ability to provide quality clinical care. For example, malpractice claims were found to be a weak indicator of performance. The study noted that there are three characteristics that are associated with higher performance --"female sex, board certification, and graduation from a domestic medical school;" however, even this data only indicated marginal differences in quality.

The report also notes the need for greater public access to physician quality data, so patients can make well-informed choices regarding their care. As MSPs know, one must search beyond the basic information on a physician's training to reveal the true level of quality that the physician can provide.

To view the report's abstract, click here (payment required for access to the full article): http://archinte.ama-assn.org/cgi/content/abstract/170/16/1442?view=short&fp=1442&vol=170&lookupType=volpage


Source: Archives of Internal Medicine

Resident Suspected of Altering Performance Records

Dr. Eric George Batterson of the University of Michigan Health System is accused of accessing computers without authorization to alter his performance records.

Batterson allegedly used a program that tracks the typing of a computer's user. He used this information to obtain passwords for computers and e-mail accounts so he could alter his performance records and lower the performance records of his colleagues. Batterson's activities were discovered when employees realized that their computers and e-mails had been accessed without their permission.

A preliminary court hearing is scheduled for Sept. 29. Batterson is charged with "nine counts each of unauthorized access of computers and using computers to commit a crime, as well as one count of possessing a Taser."


Source: annarbor.com
http://www.annarbor.com/news/man-accused-of-illegally-accessing-records-at-u-of-m-hospital/