Medscape: Nurse Practitioner Groups Unite to Push for Change

Marcia Frellick, December 05, 2012

When the 2 most prominent groups representing nurse practitioners (NPs) merge January 1, they will combine resources, talents, and legislative might just as the future of healthcare is taking shape.

The American Academy of Nurse Practitioners and the American College of Nurse Practitioners announced on November 19 that they will pool their memberships, totaling 41,000 NPs. Having a single group, which will be called the American Association of Nurse Practitioners (AANP), will eliminate confusion for NPs about which organization to join and unify the voice of an increasingly prominent segment of healthcare providers.


Read the rest from Medscape here.

TJC Notice: CAMH Format for Collecting Patient Race and Ethnicity Data

On Monday, December 10, TJC issued an update to CAMH's format for collecting patient race and ethnicity data for hospitals.

For the full update, please visit TJC.

TJC Prepublication Standards - Hospital Deeming Requirements

December 7, 2012

Revisions to elements of performance (EPs) in the hospital manual to maintain alignment with requirements from the Centers for Medicare & Medicaid Services (CMS) following the release of a final rule in May 2012. These revisions include the following:

• Addition of  a note at MS.01.01.01, EP 13 regarding the structure of the medical staff.
• Revision of the timing requirement related to reporting of medication errors, adverse drug events, and medication incompatibilities at MM.07.01.03, EP 6.

Effective Immediately. 

For more information, visit TJC.

AMA Adopts Principles for Physician Employment

Nov. 13, 2012

CHICAGO – The American Medical Association (AMA) adopted new guiding principles for physicians entering into employment and contractual arrangements. The principles address the unique challenges to professionalism and the practice of medicine arising from the physician employment trend and were adopted at the AMA’s semi-annual policy-making meeting.

Read the rest from AMA here.

AOA, ACGME Move Toward Unified Accreditation for Graduate Medical Education Programs

Released Oct. 24, 2012

The AOA [American Osteopathic Association], the Accreditation Council for Graduate Medical Education (ACGME) and the American Association of Colleges of Osteopathic Medicine (AACOM) have entered into an agreement to pursue a single, unified accreditation system for graduate medical education programs in the United States beginning in July 2015. During the coming months, the three organizations will work toward defining a process, format and timetable for ACGME to accredit all osteopathic graduate medical education programs currently accredited by the AOA. The AOA and AACOM would then become organizational members of ACGME.

Read more from the AOC here.

Federation of State Medical Boards Endorses U.S. House Measure to Expand Residency Training

H.R. 6352 would add 15,000 new residency slots over the next five years to address physician shortage

DALLAS – The Federation of State Medical Boards (FSMB) today strongly endorsed "The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act" (H.R. 6352), proposed legislation in the U.S. House of Representatives that would create 15,000 new residency training positions in the United States and add much-needed physicians to the nation’s health care workforce.

Read the rest from FSMB here.

Interested in joining a NAMSS-sponsored online community for Managed Care Credentialing professionals?

The National Association Medical Staff Services (NAMSS) is exploring ways to build a new online community for MCO credentialing professional colleagues. Last year, NAMSS organized focus groups to learn more about the needs of the credentialing professional in a managed care or health plan environment. That research told NAMSS that there are not a lot of resources for individuals working in the MCO environment and often times it’s hard to find trusted colleagues to reach out to for advice and mentoring. NAMSS believes a network could help.

The focus groups also found that differences exist between hospital and the managed care environments that need to be considered, such as, a) Joint Commission, HFAP, or DNV accreditation v. NCQA or URAC; b) Differing terminology among environments; and c) Complexity of hospitals overall, as compared to MCOs. Despite this, NAMSS believes that the similarities are stronger than the differences. NAMSS’ goal is to bring together all Medical Services and Credentialing Professionals and provide resources and networking opportunities that aren’t available elsewhere.

If you’d like to be part of a workgroup to share ideas about the best way to build an online community for managed care credentialing professionals, contact NAMSS by sending an email to tboykin@namss.org. There’s no cost, and we promise not to waste your time! NAMSS wants to hear your ideas on how best they can support you.

Get Ready for National Medical Staff Services Awareness Week

This year, we have something very special to help us kick off NAMSS Awareness Week.  NAMSS has produced a video featuring  NAMSS Treasurer, John Pastrano, to help us get the word out about the important role of the MSP.  This video also aligns with NAMSS' plan to roll out a Technology Strategy in 2013.  We hope you will help us spread the word about MSPs and NAMSS Awareness Week by reposting this video on your Facebook, Twitter, and LinkedIn pages. 

National Medical Staff Services Awareness Week

November 4-10, 2012

In 1992, President George Bush signed Congressional House Joint Resolution #399 proclaiming the first week in November as National Medical Staff Services Awareness Week. Since then, NAMSS has partnered with hospitals, MCOs, doctor’s offices, university health systems, and government agencies to promote awareness of medical services professionals. Join with us as we again celebrate National Medical Staff Services Awareness Week this November 4-10, 2012.

Court: Medical staff bylaws are not contracts between doctors and hospitals

A Minnesota ruling takes away a medical staff’s right to govern itself and make health care decisions that are best for patients, physicians say.

Alicia Gallegos, amednews staff. Oct. 17, 2012.

A judge has ruled in a Minnesota case that medical staff bylaws do not constitute a contract between physicians and hospitals.

The State of Minnesota District Court, 5th Judicial District, County of Lyon, said the creation of bylaws does not include the necessary legal requirements to make the regulations a binding contract. Avera Marshall Regional Medical Center in Marshall, Minn., had the authority to change the hospital’s former medical staff bylaws, and physicians must follow the latest rules, the court said in its Sept. 25 opinion.

Read the rest from amednews.com here.

HealthLeaders Media: Medical Harm Complaint System Could be Quality Data Goldmine

Cheryl Clark, October 18, 2012

 

A first-of-its kind federal pilot project designed to make it easier for patients to directly complain about medical errors, safety issues, and harm may prompt some doctors and hospitals to blanch.

Might it unleash a gripefest about relatively unimportant aspects of care, like the yucky taste of hospital food, the lack of parking, or meandering laments that one got sick in the first place? A rage against the night?

Read more about AHRQ's new database at HealthLeaders Media.

NAHQ Issues a Call to Action: “Safeguarding the Integrity of Healthcare Quality and Safety Systems”

Yesterday, the National Association for Healthcare Quality (NAHQ) announced a Call to Action to leaders of healthcare organizations to implement protective structures to assure accountability for integrity in quality and safety evaluation as well as comprehensive, transparent, accurate data collection, and reporting to internal and external oversight bodies.   

The National Association Medical Staff Services (NAMSS), under the direction of Kate Conklin, Past President of NAMSS, was one of the organizations with whom NAHQ collaborated to develop these guidelines.  Medical services professionals (MSPs) are often on the front line in ensuring that qualified practitioners are caring for patients.  With the adoption of suggested guidelines and techniques, MSPs are further assured protection as they investigate applicants and oversee ongoing medical staff quality initiatives.  

We applaud NAHQ in their efforts to raise the bar in our healthcare system and we encourage each of you to review this document with your administration.  Let’s partner with NAHQ and other national healthcare professional organizations in the noted article to become agents of change to establish a strong safety culture in each of our organizations.     

Q&A with the Joint Commission *Update*

On Tuesday, October 30, at 2:00pm EDT, Mr. John Herringer, Associate Director, Standards Interpretation Group for the Joint Commission (TJC), will share some great news with us about TJC Standards that are published for this year. 

 

The good news is there are no changes in the medical staff standards.  Instead, Mr. Herringer will devote this webinar on TJC Surveys by responding to our burning questions about TJC and or any of their current standards.  We've already received a lot of great questions, but are still accepting more.  Please submit your questions to:  news@namss.org. 

FSMB: Federation Credentials Verification Service Surpasses 150,000th Physician Portfolio Milestone

Service enhances physician mobility between states by providing lifetime portfolio of primary-source verfied credentials

Dallas, Texas – The Federation Credentials Verification Service (FCVS) recently surpassed a major milestone in the organization’s history – the processing of its 150,000th physician portfolio. A service of the Federation of State Medical Boards (FSMB), the FCVS provides physicians and physician assistants with a lifetime portfolio of primary-source verified credentials.

Read the rest of FSMB's press release here.

amednews.com: ACGME extends accreditation abroad to improve physician training

Officials in Singapore and the Middle East are partnering with the U.S. graduate medical education accrediting body.

Carolyn Krupa, October 1, 2012

For more than three decades, the Accreditation Council for Graduate Medical Education has evaluated and accredited graduate medical education programs in the U.S. Now it is expanding its reach with an international program aimed at raising GME standards in other countries around the world.

ACGME-International recently completed the first phase of a partnership with the Ministry of Health in Singapore to revamp the GME accreditation system in that country. Meanwhile, the ACGME-I has signed contracts in Qatar and Abu Dhabi in the United Arab Emirates and is negotiating with officials in Oman, said John Nylen, ACGME-I executive vice president and chief operating officer.

Read the rest at amednews.com.

Amednews.com: Medical licensure: State lines pose daunting barriers

Several states have expedited licensing to make it easier for physicians to practice in multiple states.  But some doctors say more needs to be done.

Carolyne Krupa, September 17, 2012

Knoxville, Tenn., family physician Chris Sawyer, MD, has traveled the world providing volunteer medical care for patients in countries such as Haiti, Venezuela and Chile. But volunteering to treat needy patients in the United States isn’t as easy.

Dr. Sawyer often finds himself hamstrung by laws that require physicians to be licensed by individual state medical boards.

“America is kind of funny in some ways,” he said. “To be in family practice, I have to take a national board exam every seven years, but I can’t go 50 miles from here to practice in Kentucky. I can travel all over the world, but I can’t go to Kentucky.”

Read more here.

FierceHealthcare: CMS fails to report to anti-fraud database, OIG says

September 14, 2012, Alicia Caramenico

 

The Centers for Medicare & Medicaid Services still isn't living up to healthcare fraud reporting requirements, failing to report all disciplinary actions against providers to the national Healthcare Integrity and Protection Data Bank, the Office of the Inspector General said in a report released Wednesday.

 

Read the rest at FierceHealthcare.

Federation of State Medical Boards Receives Grant to Facilitate Medical Licensure Portability

HRSA grant to support streamlined application processes, reduce barriers to multi-state practice

DALLAS – The Federation of State Medical Boards (FSMB) has been awarded a three-year grant from the U.S. Health Resources and Services Administration (HRSA) to continue initiatives currently underway to streamline the state medical licensure process and reduce statutory and regulatory barriers to telemedicine. The grant is the third the FSMB has received from HRSA since 2006 to facilitate license portability.

Click here to read more.

ABMS News Release: Additional ABMS Member Boards Drop End Dates: Emphasize Continuous Involvement in Maintenance of Certification

August 9, 2012

The American Board of Medical Specialties (ABMS) announced that three additional Member Boards are emphasizing continuous involvement in their respective Maintenance of Certification programs. Ongoing certification with each Member Board is contingent upon meeting the Maintenance of Certification requirements for the specific Member Board, which are part of the ABMS Maintenance of Certification® (ABMS MOC®) program. As a result, each of the three Member Boards listed below have eliminated specific “end dates” for their participating Board Certified physicians. The American Board of Family Medicine (ABFM), American Board of Psychiatry and Neurology (ABPN) and American Board of Radiology (ABR) have joined the American Board of Pediatrics (ABP) in emphasizing the continuous nature of the ABMS MOC program.

Read the rest here.

amednews.com: Setting a global standard for medical education

A 2023 rule that all IMGs graduate from appropriately accredited medical schools to practice in the U.S. is fueling global education requirements.

Carolyne Krupa, Aug. 13, 2012

As an international medical graduate, Dr. Saby Karuppiah, MPH, knows the challenges of becoming certified to practice in the United States. He also knows that all medical schools are different. Views on how to prepare students to practice medicine vary by school and by culture.

“Even though a vast majority of IMG physicians are competent and well-trained like myself, a few undertrained IMGs can give a bad rap to all IMGs in general,” said Dr. Karuppiah, who went to medical school at Sri Ramachandra University in India and completed residency training at the Albert Einstein College of Medicine in New York.

Click here for the full story.

amednews.com: Medical staff has no standing to sue hospital, court rules

The Minnesota Medical Assn. and others say the case’s final ruling could put staff rights at risk.

Alicia Gallegos, Aug. 20, 2012.

A physician medical staff is not an independent, unincorporated body and therefore cannot sue the hospital where it operates, a Minnesota court has ruled. The decision answers one question in a legal dispute between a group of doctors and Avera Marshall Regional Medical Center, but other issues remain.

A judge still must decide if hospital bylaws should be considered a contract between doctors and medical centers, and if hospital administrators can unilaterally repeal those rules.

Read the full article here.

Great News!! E-Synergy is Live!!

You won't have to wait for the mail to be delivered to read Synergy this month, your interactive eSYNERGY with all the latest news for MSPs is now available online! Our vendor issue was a perfect edition to choose for our launch as you will notice when you browse through the vendor pages, hyperlinks to each vendor's website are included in the text. All you need to do is hover over the hyperlink, click, and you will go directly from SYNERGY to the featured vendor's website.

Want to email the author of one of our featured articles? Just hover and click over the email address and your mail messaging system will be activated. Forget your reading glasses again? Just double click on the plus sign to enlarge the text for easy reading. Want to "like" one of our articles on Facebook, Twitter or Pinterest? You can do that directly from SYNERGY. You can also email an article directly to a fellow MSP or other interested party. There are so many features to mention!

All NAMSS members should have received a link to a survey, so they can share their thoughts and comments about this enhanced member benefit. If you don’t have that link, click here OR access eSYNERGY and click the hyperlink to the left of the cover.

These are exciting times for NAMSS as we move to a new level of technology for sharing best practices and information.

Q&A with the Joint Commission

Mr. John Herringer, Associate Director, Standards Interpretation Group for the Joint Commission, has some great news to share with us about the Joint Commission Standards that are about to be published for this year.  The good news is there are no changes in the medical staff standards.  With that in mind, Mr. Herringer will devote his UPCOMING webinar on Joint Commission Surveys by responding to our burning questions about TJC and or any of their current standards.   Please submit your questions via this blog to:  news@namss.org. 

Improve Patient Outcomes by Partnering for Performance

Now more than ever, hospital legal teams regularly depend on physicians and medical services professionals to work efficiently and create a culture of patient safety. Communication and collaboration are keys to achieving success in such an interdependent environment.

Looking for an opportunity to improve how you work with your colleagues to provide safety and optimal care in your facility? Join National Association Medical Staff Services, in partnership with American Health Lawyers Association, American Medical Association -- Organized Medical Staff Section, and American College of Physician Executives for:

Partnering for Performance: Physician Leaders, Medical Staff Professionals and the Legal Team

Wednesday, September 5, 2012

San Francisco, CA

This full-day workshop features a comprehensive agenda tailored to physician leaders and the colleagues they rely on every day. Sample sessions include:

 

• Investigations and Hearings: Controlling the Moving Parts

          Linda Haddad, JD

• Dealing with Disruptive, Impaired Practitioners and Aging Practitioners               

          Michael Callahan, JD

• The National Healthcare Crisis – How to Solve it Through Quality and Medical Staff Leadership

          Brent C. James, MD, MStat

Legal education, medical staff leadership, and credentialing tracks ensure that every attendee will receive information relevant to their field, and CME credits will be available. Download and print the Partnering for Performance brochure for information to share with your colleagues. Then, register online to learn how to better communicate and collaborate across departments and disciplines.

A Preview of Melissa Walters' Synergy Article

Please click here to read NAMSS SYNERGY Editor Melissa Walters' message in the July/August issue.  Keep and eye out for your print copy of the July/August SYNEGRY to learn how E-Synergy can be a great resource for you!

E-Synergy: A Great New Feature

Where Do you Keep your Synergy Magazines?

Many times over the years, I have wanted to reference a past Synergy article and had to refer to my four three-inch binders of magazines on my bookcase to try to find it.  It would take time to look through all of these binders and try to remember when the article was published.

Over a year and a half ago, I took a position at a new hospital.  When I packed up my office, I had two boxes full of the three-inch binders with all my past Synergy magazines.  I thought as I packed them and moved them from my car to my garage to my new office, "Should I keep all of these?"  But quickly I said, "Yes, I might need them someday."

I was excited to read Melissa Walter's Synergy Editor article about the new technology for Synergy.  I can now recycle my binders of past magazines and utilize this great new tool.  In minutes, I will be able to find an article simply by typing a few key words.  I can now bookmark articles that I am interested in reading later and I can view them online -- and in large print!!  I won't have to be at my office to look at Synergy; I can pull it up on my IPHONE, IPAD, or laptop.  This is a great change that we definitely will not hate, as Charles Kettering said, it will certainly bring on progress.  Thank you, NAMSS, for this great new tool!

gizmag.com: iRobot introduces telepresence doctor

David Szondy, July 26, 2012

In a medical emergency, seconds count. But if the doctor needed is in another part of the hospital or even another part of town, then those seconds can stretch dangerously. If only the doctor could be in two places at once, then countless lives could be saved. This is one of the most promising applications in the emerging field of telepresence robotics and RP-VITA (Remote Presence Virtual + Independent Telemedicine Assistant) - a joint development by the robotics firm iRobot and telemedicine company InTouch Health - is aiming to bring this closer to reality.

Read the full article here.

Technology and the MSP: Tips on Staying Updated

With all the changes going on in healthcare, it is more important than ever to keep up-to-date on what is going on in our industry. As I mention in my March/April 2012 Synergy article, “Preparing NAMSS for the Next Generation of MSPs Through the Use of Technology,” we are so fortunate to have such wonderful technologies at our fingertips that keep us informed.

For instance, NAMSS offers this blog as one electronic way to stay abreast of news and happenings. Do you ever wonder how I find interesting stories to post on the NAMSS blog? I take advantage of several electronic tools that are readily available online. One of my favorites is "Google Reader," which is an online tool I use to gather, read, and share the blogs and websites that I frequently visit. It saves me time because I don't need to visit each website for the latest news.

Instead, the latest news from each website feeds into my personalized Google Reader. All I do is log into my Reader and view the stories at a glance. You can use Google Reader on any website that has an RSS (Really Simple Syndication) feed feature. RSS feeds are a way for websites to distribute new content as it becomes available. When you subscribe to a feed in Google Reader, the latest posts or stories will appear in your Reader. You can share your Reader or individual stories you find on it with friends or colleagues with a few simple clicks.

As NAMSS continues to roll out its technology initiative, it will introduce more electronic ways to stay current on the latest happenings in healthcare and the medical staff services industry. Watch for more on these great tools coming soon!

amednews.com: Physician quality: What’s age got to do with it?

In the name of patient safety, some hospitals require that senior physicians get a fitness-for-duty evaluation as a condition of medical staff privileges.

Kevin B. O'Reilly, July 30, 2012                                              

Slowly, but surely, Norman Dunitz, MD, discovered the limitations that age placed on his ability to safely practice as an orthopedic surgeon in Tulsa, Okla. As he neared 70, he took fewer cases as a lead surgeon and started assisting on more procedures led by his colleagues.

In his later 70s, Dr. Dunitz gave up surgery entirely due to the physical toll it took.

“My eyesight, my coordination was not as good. I felt pretty good, but I felt the time had come to stop,” he said.

“Surgery was harder in the sense that we’d operate into the late afternoon,” he said. “I’d be more tired in the evening and have muscle cramps after being on my feet all day. I was just obviously not as physically able as I was 10 years before. … It was a warning to me that I was trying to do too much.”

Read the rest here.

NABP: Pharmacist Prescribing: Is Collaborative Practice a Path of the Future?

July 18, 2012

As policymakers and other stakeholders continue debating how to best balance affordable health care and patient access, they are increasingly looking to expand the role pharmacists play in patient care. Numerous factors, including rising health care costs, a longer-living population, and increased reliance on pharmacotherapy, as well as advances in pharmaceutical and biomedical research, increased minimum educational standards for pharmacists entering the workforce, and the shortage of primary care practitioners are encouraging a re-examination of the role pharmacists play in the provision of health care.

Read the rest here.

Pilot Advances ECFMG’s Efforts to Stimulate International Accreditation

July 5, 2012

In September 2010, ECFMG announced that, effective in 2023, physicians applying for ECFMG Certification will be required to graduate from a medical school that has been appropriately accredited. To satisfy this requirement, the physician’s medical school must be accredited through a formal process that uses criteria comparable to those established by the Liaison Committee on Medical Education (LCME) or other globally accepted criteria, such as those put forth by the World Federation for Medical Education (WFME). ECFMG believes that this additional requirement for ECFMG Certification will stimulate the development of a meaningful, universally accepted system of accreditation for undergraduate medical education outside the United States and Canada.

Read the rest here.

BNA: Multiple Medical Groups Back Guidelines From AMA on Doctor Performance Reports

Mindy Yochelson

Dozens of physician groups are behind an American Medical Association effort to standardize performance data reports that doctors receive from health insurers, AMA said July 16.

AMA released a list of more than 60 groups -- mostly specialty organizations and state medical societies -- that support guidelines AMA developed for physician profiling. CIGNA Healthcare, BlueCross BlueShield of Tennessee, DakotaCare, and the Midwest Business Group on Health were among the signatories.

Contact BNA for the full story.

FSMB Celebrating 100 Years

On July 14, 1913, the New York Times reported on the creation of FSMB: "The chief functions of these State Boards are to decide upon the qualifications to be required in aspirants for the right to practice medicine, to see that none do practice it without the fixed minimum of knowledge and experience, and to encourage or suppress medical schools according to whether or not they provide reasonably adequate facilities for their students."

The FSMB is celebrating its Centennial in 2012. For more information about the history of FSMB and medical regulation, please visit its Centennial website.

The Joint Commission's Standards FAQ Details for the Use of Unlicensed Persons Acting as Scribes

Q. What is a scribe and how are they used?

A. A scribe is an unlicensed person hired to enter information into the electronic medical record (EMR) or chart at the direction of a physician or practitioner (Licensed Independent Practitioner, Advanced Practice Registered Nurse or Physician Assistant). It is the Joint Commission’s stand that the scribe does not and may not act independently but can document the previously determined physician’s or practitioner’s dictation and/or activities.

Scribes also assist the practitioners listed above in navigating the EMR and in locating information such as test results and lab results. They can support work flow and documentation for medical record coding.

Scribes are used most frequently, but not exclusively, in emergency departments where they accompany the physician or practitioner and record information into the medical record, with the goal of allowing the physician or practitioner to spend more time with the patient and have accurate documentation. Scribes are sometimes used in other areas of the hospital or ambulatory facility. They can be employed by the healthcare organization, the physician or practitioner or be a contracted service.

Read the rest of the FAQs here.

The Joint Commission's Standards FAQ details for non-licensed, non-employee individuals in health care organizations

The Joint Commission, similar to organization’s themselves, has expectations regarding anyone entering a health care organization.  In order to maintain patient safety, accredited health care organizations need to be aware of who is entering the organization and their purpose at the organization (EC.02.01.01, EP 7).  Accredited health care organization leaders need to also make sure they oversee operations and that responsibilities are assigned for administrative and clinical direction of programs, services, sites, and departments (LD.04.01.05, EPs 1 and 3); this includes processes for knowing who is entering the organization and their purpose.

Read the rest here.

AMA: Don’t make licensure dependent on board certification

Delegates adopt policy urging medical boards to establish flexible medical license requirements that benefit — and don’t harm — physicians.

Carolyne Krupa, amednews. July 2, 2012.

For years, the Federation of State Medical Boards and individual medical boards nationwide have been developing new standards for maintenance of licensure. Many physicians are concerned that those requirements could create undue burdens of time and money on doctors and duplicate what they already do to maintain board certification.

The American Medical Association wants to ensure that those mandates don’t become burdensome and says no doctor should be barred from practice for not keeping up with board-certification requirements, according to policies adopted at the AMA Annual Meeting.

Read more here.

AAMC Publishes Study on Causes of Bad Physician Behavior

Perspective: A Culture of Respect, Part 1: The Nature and Causes of Disrespectful Behavior by Physicians

Lucian L. Leape MD, et al.
July 2012

A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. The authors identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behavior in the health care setting: disruptive behavior; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behavior; passive disrespect; dismissive treatment of patients; and systemic disrespect.

At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognized by health workers as disrespectful.

Click here for the full article.

EE Times: Tablets to drive telemedicine market growth to more than 300% by 2018

Jean-Pierre Joosting -- June 10, 2012

Telemedicine systems provide a way to improve clinical care delivery to patients with chronic disease, decreasing hospitalizations and visits to the emergency room. The ability to accurately access patient condition via a combination of advanced testing and telemonitoring creates the opportunity to intervene when what is called for clinically can make a difference.

A telemedicine market research report from Wintergreen Research explores how telemedicine device and software companies will capitalize on the revenue streams that will come from services delivery. Just as cell phones are paid for in conjunction with the services contracts, so also the telemedicine applications will be paid by insurance. In some cases the insurance companies recognize that their long term costs are lower by delivering clinical intervention to try to impact lifestyle for patients with chronic disease conditions.

Read the rest here.

Supreme Court upholds health-care law, individual mandate

Robert Barnes and N.C. Aizenman, Thursday, June 28, 10:30 AM
The Washington Post

The Supreme Court on Thursday upheld the individual health-insurance mandate that is at the heart of President Obama’s landmark health-care law, saying the mandate is permissible under Congress’s taxing authority.

The potentially game-changing, election-year decision -- a major victory for the White House less than five months before the November elections -- will help redefine the power of the national government and affect the health-care choices of millions of Americans.

Read the rest of the article here.

Read the full opinion here. 

Annals of Internal Medicine: Maintenance of Licensure: Supporting a Physician's Commitment to Lifelong Learning

The new issue of Annals of Internal Medicine includes an update on the FSMB's MOL initiative, "Maintenance of Licensure: Supporting a Physician's Commitment to Lifelong Learning".

Check it out here.

amednews.com: Med schools start picturing their place in a medical home world

 Medical schools and residency programs seek to teach teamwork, quality imrovement and community-based care to prepare students for practicing in a patient-centered medical home.

Carolyne Krupa, June 25, 2012.

As the health care system shifts toward a more patient-centered and outcomes-based approach, more medical schools and residency programs are exploring how to train the next generation of physicians to practice in the medical home model.

For many programs, the shift is causing them to rethink traditional medical education, including decisions about how, where and with whom they train students. Several schools either are testing new instructional models or are revamping their curricula to educate trainees on the medical home concept.

Read more here.

HealthLeaders Media: Hospitalists ID Unprofessional Physician Behaviors

John Commins, June 15, 2012

Ridiculing coworkers, clumsy and callous patient transfers, texting during meetings, and leaving work early were among a handful of rare, but unprofessional behaviors attributed by some hospitalists to themselves and more so to their peers, a survey published in the in the Journal of Hospital Medicine shows. 

The survey and study asked 77 Illinois hospitalists to identify what they considered unprofessional behavior in themselves and their colleagues. 

Click here to see the survey results.

KevinMD.com: The frustrating gap of physician leadership skills

By Dike Drummon, MD

One of the big practice challenges most physicians face is a frustrating gap in our leadership skills. We step out of residency and are instantly installed as the leader of a multidisciplinary team charged with delivering the highest quality care to our patients.

This new leadership role can be daunting. We are prepared to diagnose and treat, but what about all the other questions that come our way?  At times It can feel like you don’t “have what it takes” when, in fact, this leadership vacuum is a natural consequence of our medical training and medicine’s unique business model.


Here are three leadership challenges specific to physicians – with suggestions on how to bypass them for a better day at the office for you, your staff and your patients.

Read more here.

ABMS Member Boards Set Time Limits for Board Certification to Define When Physicians are "Board Eligible"

CHICAGO - June 5, 2012 - The American Board of Medical Specialties (ABMS) and its Member Boards have established limits to the number of years that can elapse between a physician's completion of residency training and achievement of Board Certification. Each  Member Board's time limits and transition dates can be viewed here.

Iowa Board of Medicine: Board adopts 4 pilot projects to prepare for system to ensure physician competency

June 11, 2012

DES MOINES, IA – The Iowa Board of Medicine will begin preliminary work in July on a national initiative aimed at strengthening patient care by requiring licensed physicians to participate in programs that enable them to maintain or improve their competence in the scope of their daily medical practice.

The Board on Friday (June 8, 2012) authorized staff to pursue four pilot projects in cooperation with the Federation of State Medical Boards (FSMB) as a prelude to determining what may be required of physicians to demonstrate professional competence when seeking licensure renewal.

Read more here.

Cleveland Jewish News: Doctors returning to practice face challenges

Michael C. Butz

In 1991, after six years of practicing family medicine in St. Paul, Minnesota, Dr. Bob Elson hung up his stethoscope to pursue a career in medical informatics.

For the next 18 years, Elson successfully navigated that growing field – which works to improve doctors’ practices by integrating new technology, like electronic medical records – while occasionally seeing patients as a part-time hospital doctor.


Click here for the rest of the story.

HRSA: On the Horizon: July Compliance Web Posting

The Data Bank will add the status of Behavioral Health professions to the Reporting Compliance Status Reporting Compliance Status page on July 1. The July posting also will update the compliance status of previously audited professions. On the website, you can view the current results for the Adverse Licensure Action Comparison Project and Never Reported Professions Compliance Effort.

amednews.com: Medical Boards Get More Tools To Investigate Physicians

New laws and efforts to end over-prescribing play roles in greater activity by boards.

Carolyne Krupa, June 4, 2012.

Political pressure and more attention to the growing problem of prescription drug abuse have contributed to increased scrutiny of medical boards in recent years. That has led some states to pass legislation or make policy changes to bolster how the boards regulate and discipline physicians. States such as Delaware, Florida and Texas have enacted laws to prevent the operation of so-called pill mills by targeting physicians who abuse their prescribing rights, said Lisa Robin, chief advocacy officer at the Federation of State Medical Boards. Other states have increased their medical board staffs or expanded their boards’ abilities to investigate and discipline doctors.

Read the entire article in American Medical News.

amednews.com: Challenges to peer review confidentiality rising

Physician organizations say court rulings that release files could deter doctor participation in the process.

Alicia Gallegos, May 28, 2012

Physicians historically have enjoyed state protections when discussing a colleague’s behavior or analyzing an adverse event in peer review committees. At least 45 states prevent disclosure of what is said during such meetings to facilitate open communication and foster better health care.

But a recent rise in legal challenges against peer review protections is putting doctors’ confidentiality — and the process itself — at risk, legal experts and physicians say.

Click here for the rest of the story.

HealthLeaders Media: Medical Boards Step Up Disciplinary Actions

Cheryl Clark, May 18, 2012

The number of bad doctors who were punished by their state medical boards increased 6.8% between 2010 and 2011, with significant increases in high population states such as Florida, California, Ohio and Texas, according to the latest annual summary from the Federation of State Medical Boards.

The number of disciplinary actions of all types rose from 5,652 to 6,025. These actions include the most severe penalties, in which a physician loses the license to practice or loses certain privileges, to less severe or "non-prejudicial" actions or public reprimands.

Read the rest here.

FierceHealthcare: Joplin hospitals share lessons on disaster planning

Karen M. Cheung, May 16, 2012

Hospitals in Missouri coped well with natural disasters last year after a blizzard and floods in January 2011, but they were not as prepared for the overwhelming patient surge from the EF-5 tornado that wiped out Joplin in May, according to a Missouri Hospital Association report.

As one of the deadliest tornados in American history, the tornado caused 161 fatalities and approximately 1,371 injuries.

Read more here.

HealthTech: Need a Doctor? Just Text or Call and a Prescription Is On The Way, with Telemedicine

Generation Y may feel it’s a real pain to visit the doctor in person, preferring instead to look things up on their smartphones or just skip medical care doctor altogether. But when you’re really sick, only a doctor will do.

But you still may not have to go in person. Enter telemedicine. Youths are using their mobile devices to be “examined” – or at least explain what’s troubling them medically to get prescriptions and care instructions – right over the phone.

Read the rest here.

amednews.com: Physician interest in online CME is strong

A survey looking at physicians’ technology use finds that the majority prefer online learning that can be accessed anywhere, anytime.

Pamela Lewis Dolan, May 14, 2012


There is a demand among physicians for continuing medical education training that can be accessed on the go.

A survey by ON24 and MedData Group found that 84% of physicians would prefer attending CME events online. Among the benefits physicians expect from Web-based CME is the ability to view the content “on demand” while avoiding the hassles and costs of traveling.

ON24, a virtual communication technology vendor with headquarters in San Francisco, and MedData Group, an interactive content and database marketing services company based in Topsfield, MA., surveyed 971 physicians across a variety of specialties about their digital behaviors. The survey found that physicians are “more mobile than ever before,” and that is impacting the way they want to access educational materials.

Click here for the rest of the story.

FSMB: Washington Board of Osteopathic Medicine and Surgery adopts Uniform Application

The Washington Board of Osteopathic Medicine and Surgery is the most recent state board to adopt the FSMB's Uniform Application for Physician State Licensure (UA). The board is the 17th FSMB member board to use this tool, which was designed to enhance license portability. Through the UA, member boards utilize common application elements while capturing unique state requirements in an addendum customized to meet a state's specific needs.

Click here for more information.

HHS Finalizes New Rules To Cut Regulations For Hospitals and Health Care Providers

Health and Human Services (HHS) Secretary Kathleen Sebelius announced significant steps to reduce unnecessary, obsolete, or burdensome regulations on American hospitals and health care providers. These steps will help achieve the key goal of President Obama’s regulatory reform initiative to reduce unnecessary burdens on business and save nearly $1.1 billion across the health care system in the first year and more than $5 billion over five years.


Read the rest here.

FierceHealthIT: State med boards group issues social media rules for docs

Dan Bowman, May 8, 2012

Healthcare providers with an interest in using social media must be cognizant of patient privacy and personal boundaries, according to new guidelines from the Federation of State Medical Boards. The guidelines, developed by the FSMB's Special Committee on Ethics and Professionalism, point out that despite the potential of social media for patient care, that potential must be reached within the "proper framework of professional ethics."


Read the rest here.

Medscape: Can a Hospital Say, "Only Thin Doctors Can Work Here"?

Arthur L. Caplan, PhD

To put it bluntly, should hospitals hire employees who are overweight?

A hospital in Texas, Citizens Medical Center, has said that it is not going to hire anybody -- doctors, health staff, nurses -- who is overweight. For them, that means a body mass index of over 35 kg/m2; or in other words, for a 5'10" man, if you weigh more than about 250 lb, you wouldn't get hired at this particular Texas facility.

Click here for the rest of the story.

BNA: Hospitals, Doctors Agree With CMS Decision Not to Change Major EMTALA Requirements

Nathaniel Weixel

Stakeholder groups support the Centers for Medicare & Medicaid Services' decision not to change current requirements for hospitals under the Emergency Medical Treatment and Labor Act.

EMTALA, also known as the patient anti-dumping statute, was passed in 1986. It is meant to ensure that an individual with an emergency medical condition is not denied essential lifesaving services, regardless of the individual's insurance coverage status.

A hospital failing to fulfill its EMTALA obligations may be subject to termination of its Medicare provider agreement, which would result in the loss of Medicare and Medicaid payments, according to CMS.

Click here for the rest of the story.

HHS: Data Bank Updates Research Data and Resources

The Data Bank expanded its research offerings on April 30, 2012 to include additional data analysis and output capabilities. Our intent is to build upon the recent map-based reporting tool currently on our website by offering a data analysis tool that facilitates independent analysis of the more than 800,000 reports contained in the National Practitioner Data Bank (NPDB).

Located on the Data Bank’s website, the new statistical application permits users to perform specific data analyses and create their own customized data tables.

Read more here.

HHS: Data Bank Updates Research Data and Resources

The Data Bank expanded its research offerings on April 30, 2012 to include additional data analysis and output capabilities. Our intent is to build upon the recent map-based reporting tool currently on our website by offering a data analysis tool that facilitates independent analysis of the more than 800,000 reports contained in the National Practitioner Data Bank (NPDB).

Located on the Data Bank’s website, the new statistical application permits users to perform specific data analyses and create their own customized data tables.

Read more here.

WSJ Health Blog: Aviation Is an Inspiration for Improving Patient Safety

Laura Landro

Searching for ways to reduce medical errors and keep patients safe?

Look up.

That’s the idea of some patient-safety experts, who today will discuss the formation of an independent patient-safety agency modeled on the National Transportation Safety Board, and other strategies to reduce errors at a summit in Washington.

Many of the safety and error-prevention strategies used in aviation are applicable to health care, such as investigating the root causes of accidents and developing programs to reduce fatalities, experts say. One pilot who will share lessons from aviation’s best practices at the summit: retired US Airways pilot Chesley “Sully” Sullenberger, who coolly brought down stricken Flight 1549 into the Hudson River with no loss of life.

Read more here.

FSMB Centennial Moment

From FSMB:

First published in 1956 and now updated every three years, the FSMB policy, Essentials of a Modern Medical and Osteopathic Medical Practice Act, is intended to (1) serve as a guide to those states that may adopt new medical practice acts or amend existing laws; and to (2) encourage the development and use of consistent standards, language, definitions and tools by boards responsible for physician regulation.

FSMB CELEBRATES 100 YEARS

More than 700 members of state and territoral medical boards, physicians, physician assistants, medical students, medical school deans, board attorneys and investigators, and FSMB leaders and staff were on hand yesterday for the Opening Ceremony of our Annual Meeting. Regina Benjamin, MD, MBA, Surgeon General of the United States and former Chair of the FSMB, and former Chief Technology Officer Aneesh Chopra, MPP, were among the featured speakers.

The morning's presentations were webcasted worldwide and are now available on FSMB's website.

The Advisory Board Company: The ICD-10 delay clarified: What it means for you

Josh Gray, April 9, 2012

CMS on Monday released a proposed rule that would delay the ICD-10 compliance date by one year, until October 1, 2014. The agency considers a one-year delay a “reasonable compromise” between the incremental costs that a delay imposes on hospitals already on track for compliance in 2013 and the additional time that many small hospitals and provider groups need to become compliant.

Learn more about the ICD-10 delay from The Advisory Board Company.

CAQH: One Million Healthcare Providers Now Use the CAQH Universal Provider Datasource

Trusted Healthcare Industry Resrouce Improves Efficiency and Reduces Costs Associated with Provider Data Administration

April 18, 2012

CAQH® announced today that one million healthcare providers are now using the Universal Provider Datasource® (UPD®), demonstrating that the service is the trusted healthcare industry standard for self-reported provider data used to streamline critical processes including credentialing, member services, network directories, referrals and claims administration.

Read the full press release here.

The Sydney Morning Herald: Meet the new flying doctors

Simon Webster, April 23, 2012

Advertisement Neurologist Professor Geoffrey Boyce has just seen a patient with severe Parkinson's disease and explained that their disease is also causing dementia.

The consultation was like many others Professor Boyce conducts at his practice in Lismore, northern New South Wales, but with one big difference: the patient was almost 2000 kilometres away in Cairns.


Click here for the rest of the story.

The Joint Commission's Standards FAQ Details

April 25, 2012

Human Resources (CAMH / Hospitals): Non-licensed, Non-employee Individuals

What are The Joint Commission’s expectations regarding non-licensed, non-employee individuals in health care organizations, including health care industry representatives (HCIRs)?

The Joint Commission, similar to organization’s themselves, has expectations regarding anyone entering a health care organization. In order to maintain patient safety, accredited health care organizations need to be aware of who is entering the organization and their purpose at the organization (EC.02.01.01, EP 7). Accredited health care organization leaders need to also make sure they oversee operations and that responsibilities are assigned for administrative and clinical direction of programs, services, sites, and departments (LD.04.01.05, EPs 1 and 3); this includes processes for knowing who is entering the organization and their purpose.

Click here for TJC's full response.

Congratulations, Top 100 Hospitals!!

Thomson Reuters Names Top 100 Hospitals for 2012

Cheryl Clark
HealthLeaders Media
April 17, 2012

If all Medicare patients received care equal to that provided by hospitals that made Thomson Reuters' new top 100 list for 2012, 186,000 people who died would be alive, more than $4.3 billion would be saved, and about 56,000 patients would have avoided complications from hospital procedures they otherwise endured.

Thomson Reuters made that assessment after evaluating 2,886 short-term acute-care, non federal hospitals for quality characteristics that included Medicare cost reports, Medicare Provider Analysis and Review (MedPAR) data, as well as core measures and patient experience scores tallied by the Centers for Medicare & Medicaid Services to come up with this year's list.

Read the full story here.

amednews.com: Health system changes inspire more med students to pursue dual degrees

Medical schools see growth in enrollment in extra degree programs as students seek an edge in what they believe will be a changing job environment.

Carolyne Krupa, April 23, 2012

As they contemplate careers in a rapidly changing health care landscape, a growing number of medical students are deciding that a medical degree is not enough.

Most U.S. medical schools offer students the chance simultaneously to get advanced degrees in a variety of other areas, such as public health, law, business administration, mass communications and the sciences. Some schools have offered the programs for more than two decades. However, more recently, dual degrees are growing in popularity as prospective physicians feel they must develop expertise beyond medicine to compete in a dynamic health care market.

For the full story:
http://www.ama-assn.org/amednews/2012/04/23/prl20423.htm

BNA: House Judiciary Committee Considers Bill to Cap Medical Malpractice Awards

The House Judiciary Committee April 17 began considering legislation (H.R. 5) that would cap medical malpractice awards, as part of its plan to find savings under the budget proposal the House passed in March.

The Help Efficient, Accessible, Low-cost, Timely Healthcare Act of 2012 would create federal rules for medical malpractice cases, including a $250,000 cap on noneconomic damages. The markup is expected to conclude April 18.

For the full article:
http://healthlawrc.bna.com/hlrc/4225/split_display.adp?fedfid=25843469&vname=hcenotallissues&jd=a0d1n3w6k5&split=0

missourian.com: Mercy Opens New Hospital in Joplin

April 11, 2012

The startling thing in first seeing the new Mercy Hospital Joplin — the factory built, trucked-in replacement for the building destroyed by last May’s tornado — is how attractive and permanent it looks. Joplin has a new hospital as of mid-April, and this one isn’t tents or trailers.

For the full article:
http://www.emissourian.com/more_news/business_news/article_7b0b2117-ca4d-5e26-8daf-7f2d0b922772.html

H&HN Daily: Combating Physician Stress

Physician burnout is on the rise. Help your medical staff cope by providing stress relievers such as job flexibility, ancillary services and time to exercise.

Mitchell Best and Alan Rosenstein, M.D., April 12, 2012


Almost 87 percent of physicians report they feel moderately to severely stressed and burned out on an average day, and almost 63 percent of them are feeling more stressed and burned out than they did three years ago, according to a recent survey.

For the full story:
http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=1560003741

amednews.com: Criminal background checks provide patchwork protection against rogue doctors

About two-thirds of medical boards have the authority to investigate whether a physician has a criminal history, but rules vary by state.

Carolyne Krupa, April 2, 2012

Driving under the influence, tax evasion, fraud, battery and sexual assault.

These are some of the charges that have been revealed in criminal background checks of physicians by medical boards around the country. Often the doctors in question try to hide their criminal past, but that has become increasingly difficult.

During the last 15 years, concerns over public safety have led to many state medical boards being given authority to investigate as a condition of licensure whether doctors have a criminal history. But how that authority is used varies from state to state.

For the full story:
http://www.ama-assn.org/amednews/2012/04/02/prsa0402.htm

A NAMSS' Government Relations Update

NAMSS’ President, Connie Riedel; Industry & Government Relations Chair, Nancy Lian; and the Government Relations team are keeping busy this year with various meetings and discussions with industry and government leaders to advance NAMSS’ strategic plan. We’d like to take a moment to tell you about some of our latest initiatives.

Capitol Hill
As you may know, Senator Tom Udall plans to introduce a bill, “Increasing Telehealth and Access to Care through Streamlining Licensing and Credentialing Portability Act.” This legislation tackles both licensing and credentialing inefficiencies by establishing a national licensing body and a credentialing data-exchange system for primary source-verified data.

The bill makes great strides simply by recognizing the current inefficiencies within the licensing and credentialing processes, but taking on both issues in one bill is difficult.

Creating a federal license could, in theory, increase efficiencies for telehealth providers, but the draft bill goes beyond these providers and offers the licensure for all practitioners. There are many complex issues, such as creating a national scope of practice, which would be extremely difficult to establish a consensus among all stakeholders.

We are also concerned with the bill's ambiguity regarding critical issues such as jurisdiction and the ability to sanction providers. While we appreciate that this is not the intent, NAMSS is concerned that these issues could undermine patient safety.

Credentialing, as you know, goes much further than licensure and could benefit from the government evaluating the current process. Assessing the significant resources that the current process requires could help MSPs better focus on ensuring that medical staffs are qualified to provide high quality services. The data-exchange idea contained in the Senator’s draft bill is a good start.

We have discussed this with Senator Udall’s staff over the past several months and will continue to work with his office on these efforts.


HHS’ Office of the National Coordinator
We also recently met with Jodi Daniel, Director of Policy and Planning, as well as other members of the Office of the National Coordinator (ONC), to discuss our mutual goal to update and modernize the healthcare system. We shared our vision for improving the credentialing process and provided insight into the system’s current inefficiencies. We certainly put credentialing on ONC’s radar and we look forward to continuing to make strides in improving the system.

amednews.com: Data bank information needs careful interpretation

April 9, 2012.

How transparent should the National Practitioner Data Bank be?

Scenario: How transparent should the National Practitioner Data Bank be?
The National Practitioner Data Bank recently has been through a shutdown and restart. Some of the physician data can lead to mistaken conclusions. Some physicians worry about government reach into their practice matters and the media’s instinct to use any available data for a physician “gotcha” story.

In September 2011, the Dept. of Health and Human Services blocked access to the public use data file of the National Practitioner Data Bank, which contains information on malpractice payments and disciplinary actions of health care professionals. HHS’ action raised debate about whether such information should be kept from the public. Some medical organizations, including the American Medical Association, argue against release of data bank information on grounds of known inaccuracies and likely misinterpretation by the public. Patient advocacy groups, among others, stress that NPDB transparency is essential for advancing safety and quality.


For the rest of the story:
http://www.ama-assn.org/amednews/2012/04/09/prca0409.htm

ABMS Establishes Time Limits for Achieving Board Certification A new policy defines a limited period for "Board Eligibility"

February 2012 - For the first time, a new policy of the American Board of Medical Specialties (ABMS), effective on January 1, 2012, establishes limits to the time that can elapse between a physician's completion of residency training and achievement of Board Certification.

The policy establishes a window of no fewer than three years and no more than seven years between training and certification. Within that timeframe, the maximum time allowed will depend on the specialty.


Click here for the full press release:
http://www.abms.org/News_and_Events/Media_Newsroom/Releases/release_BoardEligibility_02072012.aspx

Happy Doctor's Day!

Please join us in wishing our medical staffs a Happy Doctor’s Day.

The Origin of Doctors’ Day

Eudora Brown Almond was reared in the small Georgia village of Fort Lamar, and from early childhood was greatly impressed with the selfless devotion of the medical profession’s humanitarian service to mankind. She always carried in her heart fond memories of the gentle kindness of her family physician whose skill and understanding endeared him to his patients as both a beloved doctor and a revered friend.

Because of her affinity for the medical profession, Eudora Brown was destined to become a doctor’s wife. In 1920, she married Dr. Charles B. Almond and moved to Winder, Ga., where they made their home. Their happy and busy life together, serving their fellow men, was the guiding spirit that influenced her idea for a doctors’ day.

As she walked through the years beside her husband, sharing the dedication of his life to the practice of medicine, the charity and courage, and love and sacrifices in his daily ministry of healing humanity’s ills, Mrs. Almond became convinced that medicine is the greatest profession on earth, and doctors, the greatest heroes. This respect and appreciation of the noble achievements of the profession inspired her to present to her local Auxiliary the idea of having a day on which to honor the practitioners of the Medical Arts. The suggestion met with immediate approval and the Auxiliary adopted the following resolution in 1933:

"Whereas, the Auxiliary to the Barrow County Medical Society wishes to pay lasting tribute to her Doctors, therefore, be it,

"Resolved by the Auxiliary to the Barrow County Medical Society, that March 30, the day that famous Georgian, Dr. Crawford W. Long, first used ether anesthesia in surgery, be adopted as ‘Doctors’ Day,’ the object to be the well-being and honor of the profession, its observance demanding some act of kindness, gift or tribute in remembrance of the Doctors."

The first Doctors’ Day observance ever held was by the Barrow County Auxiliary on March 30, 1933. The Auxiliary mailed cards to the doctors and their wives. Flowers were placed on graves of the deceased doctors including that of Dr. Crawford W. Long. The ceremonies concluded with an elegant four-course dinner at the spacious home of Dr. and Mrs. William Randolph with appropriate toasts, tributes and responses, and the hope that hereafter, Doctors’ Day would continue to be observed on March 30 of each year.

When suggesting that physicians be honored, Mrs. Almond originally had in mind only the Winder and Barrow Country doctors. Little did she realize, when at last the cherished dream she carried within her heart for so many years became a reality, that it would include doctors in all parts of this country and across the seas as well. Our neighbors to the south of us in Cuba also celebrate a day in honor of the men and women fashioned after our Day of Commemoration.

And so, out of the gratitude of a little girl for her kindly family physician, and from the loving heart of a doctor’s wife, so justly proud of her husband whose work was his glory, emerged a most beautiful tribute to the medical profession—Doctors’ Day!


The Red Carnation is the Symbol of Doctors' Day

Red denotes:
Love -- Charity -- Sacrifice -- Bravery -- Courage

The analogy of the carnation is closely woven in medical science, so it is only fitting that this flower, so tailored by nature with its spicy scent, was
chosen as the symbol of Doctors’ Day.

FSMB celebrates 100 years!

The Federation of State Medical Boards (FSMB) is a national non-profit organization representing the 70 medical and osteopathic boards of the United States and its territories. FSMB leads by promoting excellence in medical practice, licensure, and regulation as the national resource and voice on behalf of state medical and osteopathic boards in their protection of the public.

http://www.fsmb.org/pdf/nr-100yr-plan.pdf

Hugh Greeley Featured in Synergy

Learn about medical staff communication tools by taking a look into the future through the eyes of visionary, Hugh Greeley. Don’t miss Greeley’s article titled “Become Your Medical Staff’s Content Expert” in the March/April Issue of Synergy.

amednews.com: New accreditation system will shift focus of resident training

ACGME says it is moving from a blueprint that stifles originality to one that allows more flexibility in graduate medical education.

Carolyne Krupa, March 12, 2012

The Accreditation Council for Graduate Medical Education is revamping how it accredits graduate medical education programs in an effort to foster innovation and alleviate administrative burdens.

Starting in 2013, the Next Accreditation System will begin to shift away from a system described by many as too prescriptive and inflexible, said ACGME CEO Thomas Nasca, MD. The new system is designed to allow GME programs to better train physicians to meet the needs of today's changing health care system.

"If there is a criticism of our GME system, it is that it is slow to adapt to new needs," Dr. Nasca said. "We believe this new model is much better than our existing model in providing the impetus for the innovation to help [programs] improve and grow."

Details of the system have yet to be finalized, but it will include waivers from certain ACGME rules for high-performing programs. The system, announced online Feb. 22 in The New England Journal of Medicine, will be piloted in seven specialties starting in July 2013 and expand to the remaining 19 core specialties in 2014.

The current system has been in place since the ACGME was founded in 1981. At that time, there were disparate training programs for 28 specialties and subspecialties, and the ACGME's goal was to standardize the way all programs were evaluated. Uniform standards have since been established, but the system is criticized as being too rigid for today's more than 130 specialties and subspecialties, Dr. Nasca said.

"The price of those prescriptive standards has been to stifle innovation," he said.

Providing flexibility
Under the new system, programs with strong accreditation performance will be allowed to have a waiver from some of the ACGME standards that govern how residents are trained. For example, all programs are required to have residents go on teaching rounds, where they are introduced to patients and discuss their cases in groups with a faculty member at the bedside. In the new system, well-performing programs still would be required to do teaching rounds but could determine for themselves how those rounds are run.

"If I have a program that has excellent survey results, and if board scores continue to be excellent, why do I care how they do their teaching rounds?" Dr. Nasca asked.

More than 80% of ACGME-accredited programs are high performing and will be allowed some flexibility for innovation, he said.

The system will emphasize the six core competencies that the ACGME announced in 1999: patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice. Program directors will be required to submit data to the ACGME from resident evaluations on those competencies that they already do every six months.

Committees for each specialty will review data annually to evaluate trends in key performance measurements. ACGME representatives will visit sponsoring GME programs every 18 months. But longer, more detailed accreditation visits will be done every 10years, as opposed to every four to five years, Dr. Nasca said.

Waiting for specifics
The Alliance for Academic Internal Medicine is optimistic about the changes, said AAIM President D. Craig Brater, MD, the Dean & Walter J. Daly Professor at Indiana University School of Medicine in Indianapolis. AAIM is a consortium of specialty organizations representing internal medicine departments at medical schools and teaching hospitals in the U.S. and Canada.

"The notion is now the time should be spent in having those kind of broader discussions looking at how individuals are really doing, rather than checking boxes about prescriptive stuff -- which is great," Dr. Brater said. "No one knows the residents better than the program leadership. They spend countless hours with these residents."

The new ACGME accreditation program keeps the same 6 core elements it has had since 1999. But change always comes with some difficulties. Dr. Brater said he anticipates some "bumps in the road," but AAIM is developing tools and guidance for program directors to help make the transition as smooth as possible.

Mark Friedell, MD, president of the Assn. of Program Directors in Surgery, said many program directors are unclear about how the new system will work and are awaiting more specifics.

"My biggest concern would be that this not cause more work for us to do, and hopefully make it easier to manage accreditation," said Dr. Friedell, chair of the University of Missouri-Kansas City Dept. of Surgery. "I have more questions now than I did before. I'm just waiting for all of the details to come out."

BNA: New Social Media Pose Legal Risks For Health Care Providers, Attorneys Say

Ralph Lindeman, March 9

The explosive growth of blogs, Twitter, Facebook, and other social media creates new legal risks for health care professionals in areas ranging from privacy to employment, legal experts warned at a panel discussion March 8.

“The biggest problem” in health care caused by social media communication “is a lack of control over patient confidentiality,” said Jennifer R. Breuer, a partner and vice chair of the health care practice group at Drinker Biddle & Reath in Chicago, which sponsored a webinar titled “The Rise of Social Media in Health Care.”

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits health care providers from using or disclosing individually identifiable health information, she noted, adding, “Yet it's very easy to inadvertently disclose patient health information through social media.”

Citing one recent example, Breuer told of a pediatric nurse who posted on her Facebook page a photo of a child in a hospital bed, along with a request for prayers before the child was to undergo brain surgery. The nurse said she did so at the request of the child's parents.

“Even so, the nurse should have obtained a HIPAA-compliant, signed authorization from the parents,” Breuer said. “Without authorization, the nurse was bound by HIPAA to safeguard the child's personal health information.”

Live Tweets of Coronary Bypass
Social media also expose hospitals and other health care providers to risks beyond privacy concerns, Breuer said. In late February surgeons at Memorial Hermann Hospital in Houston “live-tweeted” a double coronary artery bypass, with one surgeon tweeting, posting photos to the hospital's Facebook page, and responding to questions while another surgeon performed the operation.

“Whether there was a privacy violation is unclear,” Breuer said, because the operation did not show readily identifiable images of the patient. “But what about malpractice risk if something went wrong?” she asked. The surgery was sent to more than 4,000 Twitter followers in real time with photos and videos, she said.

Blogs sponsored by hospitals and other providers may also pose legal risks through such features as “Frequently Asked Questions,” or “Ask the Professional,” Breuer noted. “You need to consider whether you are creating a physician-patient relationship,” she advised.

Moreover, when the “patient” and medical blog are in different states, there may be problems with practicing medicine without a license, she noted, because the controlling law is where the “patient” is, not the physician. To reduce risks, providers should avoid diagnosing specific medical problems or providing specific medical advice, Breuer said.

Labor Law Issues Arise
Like other businesses, hospitals and other health care providers need to be aware of how social media affect employment relationships, said Stephanie Dodge Gournis, a partner with Drinker Biddle & Reath's labor and employment practice.

In the area of labor law, employers need to be careful about interfering with social media communications between employees, Gournis said. For example, the National Labor Relations Board has said employees are free to engage in communications with other employees that their employer may consider “rude, discourteous or disloyal,” she noted. The NLRB considers such communications to be protected as “concerted activity” under the National Labor Relations Act.

The NLRB will consider unlawful “any social media policy that employees could reasonably interpret to prohibit protected activity,” Gournis said.

“Most of the health care provider policies that I'm seeing today are not going to meet the NLRB standards,” Gournis said.

Allowable Topics in Policies
Specific topics that can be addressed in employer social media policies, Gournis said, include:

• prohibitions against employee release of personal health information;
• prohibitions against release of confidential business information and trade secrets;
• requirements that employees include disclaimers when discussing provided services; and
• prohibitions on employee violations of law, including discrimination, harassment, and
defamation.

Beyond company social media policies that affect employees, Gournis said, “Social media has become the smoking gun in all sorts of discrimination and harassment claims, wrongful termination and defamation claims, and negligent referral claims.”

She added: “Now we have the paper trail or comment trail that shows either communications by managers directed toward employees or co-workers toward one another. All these types of issues create additional challenges and legal risks that [a company's human resources department] is going to have to answer.”

Employees' Heavy Use Poses Challenges
In addition, “There is a tension,” said Gournis, between how employees perceive their right to use social media at work and how employers view their right to monitor social media use.

A workplace survey conducted by Deloitte in 2009 revealed that 22 percent of the employees surveyed said they visited social networking sites five or more times per week, Gournis noted. Seventy-four percent of the employees surveyed said it was “easy” to damage an employer's reputation on social media.

In the case of disgruntled employees, she said, “They know how much damage they can do to an employer by using social media as a megaphone.”

Synergy to Feature a Joint Commission Surveyor's Perspective

Dr. Larry Kachik, Joint Commission Surveyor, attended the National Credentialing Forum in February. He shares his takeaways from this informative gathering of industry leaders in his upcoming Synergy article.

His article reviews the characteristics of organizations with high-functioning OPPE and FPPE processes. How does yours measure up? Don’t miss this informative article in the March/April issue of Synergy.

ECFMG Launches Electronic Verification of Medical Credentials

February 28, 2012

The Educational Commission for Foreign Medical Graduates (ECFMG), a world expert on international medical schools and the credentials they issue, is pleased to announce the launch of an electronic process for verifying the medical education credentials of international physicians who seek entry into the U.S. health care system.

In January 2012, after more than a year of intensive development, a pilot of ECFMG’s electronic Credentials Verification program was launched with participation from approximately 20 international medical schools. Participating institutions use Credentials Verification to electronically receive and verify the medical education credentials of their students and graduates who apply to ECFMG.

For more than 50 years, through its certification program, ECFMG has assessed whether international medical graduates are ready to enter U.S. graduate medical education programs. As part of this certification program, ECFMG requires international physicians to provide copies of their medical education credentials, specifically medical diplomas and transcripts. Since 1986, ECFMG has verified applicant credentials by mailing copies directly to the issuing institutions. The electronic Credentials Verification program represents a significant advance over the paper primary-source verification process, benefiting medical schools and their students/graduates while maintaining ECFMG’s rigorous standards for primary-source verification.

ECFMG’s President and Chief Executive Officer, Emmanuel G. Cassimatis, M.D., comments, “ECFMG’s role in verifying the medical education credentials of international physicians is critical to protecting the public. Electronic Credentials Verification revolutionizes the way we perform this vital function.”

To read the press release:
http://www.ecfmg.org/annc/ECFMG-release-Feb-28-2012.pdf

ECFMG's Certification Program:
http://www.ecfmg.org/certification/index.html

amednews: Arkansas court rejects expert witness provision in medical liability cases

The 2003 rule required experts to practice in the same specialty as defendant physicians.

Alicia Gallegos, Feb. 6, 2012.

The Supreme Court of Arkansas has struck down a key provision of the state's tort reform law, ruling that expert witnesses in medical liability lawsuits no longer must practice in the same specialty as defendant doctors.

The decision is another setback for physicians who have seen most reform measures overturned by the courts since the law's 2003 enactment.

"We're extremely disappointed that the state Supreme Court has decided to circumvent the will of the Legislature, which is obviously charged with representing the people of the state," said David Wroten, executive vice president of the Arkansas Medical Society. "Each provision of the tort reform was enacted for a specific purpose."

The ruling stems from a lawsuit filed by Teresa Broussard, who in 2006 underwent a parathyroidectomy performed by general surgeon Stephen Seffense, MD. After the surgery, Broussard said she noticed a burn near the incision.

She was prescribed steroids and pain medication, said Gerry Schulze, Broussard's attorney. She was released from the hospital but returned to the emergency department a few days later complaining of pain from the burn.

State courts have issued mixed rulings on tort reform provisions. During her hospitalization, nephrologist Michael Coleman Jr., MD, treated Broussard for an unrelated condition and consulted with a dermatologist about the burn, records show. Doctors told Broussard she had a second-degree chemical burn but that it should improve within two weeks, Schulze said.

Broussard sued Dr. Coleman and Dr. Seffense in 2007, accusing them of improperly addressing and treating the burn. She said their delay led to skin grafts and other painful procedures at a local burn center. The doctors denied any wrongdoing.

During discovery, a specialist in forensic medicine testified as an expert witness for Broussard. Attorneys for the doctors requested the case be thrown out because the expert witness was not in the same specialty as the physicians sued, as required by state law.

A lower court ruled for the doctors. Broussard appealed.

The Supreme Court on Jan. 19 reversed and remanded the case to the lower court. The same-specialty rule is unconstitutional because it violates the separation-of-powers doctrine, the high court said.

"The authority to decide who may testify and under what conditions is a procedural matter solely within the province of the courts ... and pursuant to the inherent authority of common-law courts," the court said in its opinion. "The trial court controls the admissibility of evidence and the determination of applicable law and always has the inherent authority to secure the fair trial rights of litigants before it."

Tort reform law weakening
The provision mandating that expert witnesses practice in the same specialty as defendants was unnecessary, Schulze said.

"A lot of times, the nature of the negligence doesn't have anything to do with the specialty," he said. The requirement led to hiring multiple expert witnesses, he added.

Schulze said the high court has procedural standards in place to ensure that expert witnesses for both sides are qualified to testify. Procedural court rules provide judges with the discretion to decide whether a witness has enough knowledge to act as an expert.

The ruling will make it more difficult for lawsuits to be dismissed early, said Vicki Bronson, an attorney for the doctors. She believes the lower court will again throw out the Broussard case.

The plaintiff's expert witness is unqualified to testify, regardless of the same-specialty rule being overturned, she said. The defense plans to prove the witness does not meet procedural court criteria for qualified experts.

The court's decision means expert witnesses have the potential to hold physicians to a different standard of care than their specialty is otherwise required to provide, Wroten said. Although the ruling doesn't stop a judge from excluding witnesses, it sends the message that tort reforms enacted by the state will not stand.

When the state's reform package was approved, the provisions said that a liability suit could not proceed without an affidavit of merit, that cases be filed in the same county where the alleged negligence occurred and that plaintiffs could sue only for medical costs owed as opposed to billed charges. The reforms addressed joint and several liability and incorporated the expert witness rule. Courts in the state have thrown out all but the venue and joint and several liability provisions.

It's too early to tell how the Broussard case will impact the medical liability market, Wroten said. But doctors expect the court rulings against reform provisions probably will erode the reform law's success. Improvements due to the law included more medical liability insurance carriers coming to the marketplace and a slowed growth rate of insurance premiums for doctors, Wroten said.

In recent years, state courts have issued mixed rulings on tort reform provisions. The 5th District Court of Appeals in Texas in September 2011 upheld the state's certificate-of-merit requirement for medical liability cases. The Maryland Court of Appeals in 2009 validated a measure requiring certain qualifications for expert witnesses in medical liability cases, including that the witness must be involved in active participation in the medical profession and contribute in some form to its advancement.

However, the Washington Supreme Court in 2009 ruled unconstitutional a state law requiring plaintiffs, as the start of a lawsuit, to submit a statement from a medical expert certifying there is a reasonable basis for a suit's allegations.


ADDITIONAL INFORMATION:
Case at a glance
Is an Arkansas requirement that expert witnesses be the same specialty as defendant doctors constitutional?

The Supreme Court of Arkansas said no. The court overturned the requirement, ruling that the provision violated the separation of powers doctrine.

Impact: Expert witnesses in medical liability cases can practice in specialties other than that of the physician sued.

Teresa Broussard v. St. Edward Mercy Health System Inc., Supreme Court of Arkansas, Jan. 19
opinions.aoc.arkansas.gov/WebLink8/ElectronicFile.aspx?docid=253517