Starting with this report, I'll be featuring stories from Modern Healthcare, a great source of news that digs much deeper into the real and more complicated problems of health care than the simple repeal ObamaCare or not distraction. This a subscription service, so some of the links will be inaccessible.
Republicans Oppose Saving Money on Medicare:
Multiplesources confirmed that Republicans upset with what they say is overreach by the Center for Medicare and Medicaid Innovation, also known as CMMI … (and) could lead to (Republican) legislation intended to hinder the agency and slow its attempts to further the goal of paying providers for value rather than volume.
More than 170 House Republicans sent a letter to Adminstrator Andy Slavitt in September asking that the CMMI stop requiring mandatory participation in any payment models; “Medicare providers and their patients are blindly being forced into high-risk government-dictated reforms with unknown impacts. Any true medical experiment requires patients' consent. However, patients residing in an affected geographical area will have no choice about their participation.”
The Food and Drug Administration is considering dramatic changes to its drug marketing rules that threaten to make the problem of already out-of-control drug spending even worse … responding to the drug industry's demands for greater freedom to “promote” the off-label use of prescription drugs and to the courts' drift toward giving corporations unlimited freedom-of-speech rights.
“Off-label” refers to uses that have never received approval or scrutiny from the FDA's regulatory scientists (Doctors are allowed to prescribe off-label). The FDA is undertaking its “comprehensive review” now because of a string of recent court decisions saying the First Amendment gives industry sales representatives free rein to promote unproven uses to physicians. The agency may be betting that by weakening its current rules, it will forestall review by a U.S. Supreme Court that is moving rapidly to giving corporations the rights of individuals. But that's the wrong calculus for an agency that's supposed to ensure every drug is safe and efficacious.
Burnout, defined as physical and emotional exhaustion as a result of prolonged stress, has become shockingly prevalent among U.S. physicians. Doctors experiencing professional burnout not only put their own well-being at risk, but also that of their patients … studies have found that distressed healthcare providers make more mistakes on the job. Surgeons who feel burned out have a higher likelihood of reporting major medical errors, which are estimated to be the third-leading cause of death in the U.S. ahead of stroke and diabetes. Half of surveyed physicians believe that overwork, stress and fatigue among health professionals significantly contribute to medical errors.
In recent years, changes have caused the problem of burnout to worsen. Demographers project the Medicare-eligible population will more than double by 2060. Older people require more care.
A study published in July by the Mayo Clinic Proceedings explored the relationship between clerical tasks, the electronic practice environment and burnout. Doctors who used Electronic Health Records and computerized physician order entry (CPOE) had lower levels of satisfaction because of the amount of time spent on clerical tasks and reported higher rates of burnout. “There are several broad categories of contributors to physician burnout, including greater work hours and effort, poor work efficiency and support, and loss of meaning in work,” said Dr. Colin P. West at the Mayo Clinic, who co-authored the study. “Although the promise of the electronic medical record has been to allow more efficient, higher-quality care, often clerical tasks and electronic medical records negatively affect all of these contributors … leaving less opportunity to interact with patients. In short, we need the technology to support its users rather than the current norm of the users serving the technology.” The extra time required for these routine tasks often crosses the borders of the office into the physician's home, disrupting work-life balance and personal relationships.
A former liberal radio talk host who likes to ask the “follow-up question” at Democurmudgeon.blogspot.com