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Key Tip to Avoid Embezzlement; Experiments Gone Wrong; Physician Bullies


Noteworthy items from Physicians Practice.


10 The percentage of incorrect payments for claims physicians submit to insurers.

Source: AMA 2012 National Health Insurer Report Card



"Wholesale substitution of nonphysician healthcare providers for physicians is not the solution, especially at a time when primary-care practices are being called upon to take on more complex care ... Creating a system in which some patients have access to only a nurse practitioner is endorsing two-tiered care. That doesn't happen in the physician-led Patient-Centered Medical Home, and we believe all Americans should have access to this quality of care."

Roland Goertz, MD, chair of the American Academy of Family Physicians Board of Directors

"The American Academy of Nurse Practitioners strongly supports patient-centered and team-based care models. However, AANP believes that AAFP's efforts to link these evolving models of care with the licensure of nurse practitioner practice are misdirected and out of step with today's environment ... In fact, the requirement for physician-leadership of a healthcare home, as proposed by the AAFP, is inconsistent with the requirements set by the National Committee for Quality Assurance, URAC, and The Joint Commission, each a well-known and respected organization currently accrediting patient-centered healthcare homes led by NPs."

Angela Golden, president, AANP

Key Tip to Avoid Embezzlement

Want to prevent employee embezzlement at your practice and quickly detect it if it does happen? One of the best ways to do both is by closely monitoring and managing your financial accounts, consultant Carol Stryker recently wrote in Practice Notes, Physicians Practice's blog. If you only have time to monitor one of your accounts, focus on the operating account, she wrote, noting that in general, all receipts are deposited into it, all operating expenses are paid from it, and all transfers are made from it into other accounts of the practice. "In no case should anyone other than an owner be allowed to both prepare and sign a check or authorize a transfer from this account," she wrote. "Daily monitoring of the operating account is important because commercial accounts have only 24 hours to notify the bank of an unauthorized Automated Clearing House (ACH) transaction and reject it."

For more of Stryker's tips, visit http://bit.ly/avoid-embezzlement.

Experiments Gone Wrong

Two University of California, Davis, neurosurgeons are accused of experimenting on brain cancer patients without university permission. One of the surgeons has "temporarily relinquished" his position as chairman of the department of neurological surgery, according to The Sacramento Bee. The surgeons obtained permission from three terminally ill patients with brain tumors to open their skulls and introduce bacteria, in the hope that the procedure would prolong their lives. University documents show that the bacteria were restricted to use on rats, according to The Bee. Two of the patients developed sepsis and died. The third died more recently.

Formula Ban

All 49 maternity hospitals in Massachusetts will no longer give free infant formula gift bags to new mothers, according to Boston.com. The move is praised by breast-feeding advocates, who fear the free formula sways some mothers to stop nursing. Massachusetts is the second state to ban free formula bags; Rhode Island banned them last November. In September 2012, New York City launched a voluntary program, Latch On NYC, for local hospitals. Nurses in participating hospitals (27 of 40 have agreed to participate) will only provide formula if it is medically necessary or if a mother requests it, according to Time. So does limiting formula actually increase breast-feeding rates? NYU Langone Medical Center has seen its rates increase from 39 percent to 68 percent, according to the New York Post.

Longer CPR

A new study suggests that many doctors may give up too soon when conducting CPR on patients. The study, funded by the American Hospital Association, the Robert Wood Johnson Foundation, and the National Institutes of Health, found that patients were more likely to survive in hospitals that conducted CPR nine minutes longer, on average, than in other hospitals, according to The New York Times. The study, which was published in the The Lancet, also found that patients who survived prolonged CPR were just as healthy as patients who were quickly resuscitated.

Age Gaps

As more physicians put off retirement for financial reasons, it raises concerns about how this wave of elderly doctors might influence patient care. While many doctors remain sharp as they age, others may fail to recognize when a cognitive decline is impairing their abilities. To combat such issues, elderly physicians should visit a personal physician annually, and ask colleagues to inform them if they observe any troubling signs, physicians and experts told American Medical News.

Physician Bullies

Turns out bullying persists way beyond elementary and high school. Nearly half of medical students participating in a survey of more than 12,000 students at 126 U.S. medical schools reported experiencing mistreatment, according to an Association of American Medical Colleges questionnaire. Public humiliation and sexist remarks were some of the most common complaints from students.

Specialists Preferred

Primary-care physicians are missing out on patients, according to a research letter published in the Archives of Internal Medicine based on a review of National Ambulatory Medical Care Survey records. The review found that 41 percent of patient visits for primary-care services in 2007 occurred at a specialist's office. Why? Patients might believe specialists provide better care for specific conditions, which could lead them to prefer specialists for general services, the researchers said. They also noted that the primary-care physician shortage could be playing a role, according to Modern Healthcare.

Scare Tactics

A California doctor has been charged with murder for prescribing medication to three patients who fatally overdosed on their medications. The news is fueling the debate about whether such crackdowns on doctors create a "chilling effect" that prevents them from prescribing pain medication to patients who actually need it, according to the Los Angeles Times.

Global Aid

The Peace Corps is partnering with the Global Health Service Corps, a nonprofit organization led by internist Vanessa Kerry, daughter of Sen. John Kerry, to send doctors and nurses to developing countries to provide medical education and medical care. Participants in the program, dubbed the Global Health Service Partnership, will receive about $30,000 for each year of service to pay off school loans. The organization plans to have 36 health workers in Tanzania, Malawi, and Uganda by July 2013, according to NPR.

ACA Uninformed

A recent survey of 843 medical students in Minnesota sheds light on just how unenlightened many medical students are about the 2010 healthcare law. Here are some of the key findings, as noted in Reuters:

• Fewer than half of respondents said they understood the law's basic components

• More than 40 percent of respondents said they had no opinion of the law

• Though many of the respondents said they did not understand the law, 69 percent agreed that physicians are professionally obligated to play a role in its implementation

The study was published in the Archives of Internal Medicine

This article originally appeared in the January 2013 issue of Physicians Practice.

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