Nurses Most Ethical Profession, Americans Say

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.

In Nurses We Trust

Gallup polled 1,028 Americans aged 18 and older on what professions they find most and least ethical. Healthcare providers in general ranked fairly high, but nurses took the top spot. Eighty-four percent of Americans rated nurses' ethical standards as "high" or "very high." After that, pharmacists ranked second (67 percent) and medical doctors ranked third (65 percent). Coming in last place was members of Congress. Only 8 percent of people polled by Gallup said Congress' ethical standards were "high" or "very high." HMO managers had the lowest ranking of any healthcare professional at 12 percent. For full results of the survey, click here.

Repealing Obamacare a Challenge for GOP

With President-elect Donald Trump set to take office in two weeks, Republican members of Congress began laying out a plan to repeal the Affordable Care Act. While they agree that the health law needs to go, Kaiser Health News reports that they have yet to come to a consensus on how to do that. Repealing the law outright could cause 20 million Americans to lose coverage and lead to heavy backlash from the public, so Kaiser Health News says Republicans are looking at various ways to disassemble it carefully. "It's not that Republicans don’t have replacement bills. They have a couple dozen. The problem is they don’t have consensus," Douglas Badger, who oversaw health policy for President George W. Bush, said at a recent policy forum, according to Kaiser Health News.

Is There a Malpractice Crisis?

Many top Republicans see a major issue in healthcare: a wave of frivolous malpractice lawsuits that threaten the U.S. health system, reports California Healthline. For this reason, top Republicans, House Speaker Paul Ryan and Rep. Tom Price, who is slated to be the Secretary of Health and Human Services, have vowed to make tort reform a part of their package replacing the ACA. However, California Healthline talked with malpractice experts who dispute this claim. "It's a time of relative calm and this hasn't been a front burner issue or crisis," Nicholas Pace, a researcher who studies the civil justice system at the Rand Corp., a nonprofit think tank, told the publication.

Value-Based Care is Going Nowhere

While Trump's rise to power alongside a Republican-led Congress will undoubtedly have a major impact on the ACA and other aspects of the health industry, Joe Guerriero, senior vice president of MDGuidelines, writes in Managed Health Executive that value-based care won't be part of that change. Guerriero says that if the ACA is not fully repealed, many of the parts surrounding value-based care will be kept. He also points to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which was a bipartisan law and expected to unfold as planned. The enactment of this law will "considerably raise the stakes for value-based care," he writes.

Quote of the Week:

Finding Empathy for Patients on a Difficult Day

"We are all recipients of patient ‘dumps’ (which is a really unfortunate way to describe the care of a fellow human being). Our colleagues disappoint us. Our staff disappoints us. We disappoint ourselves. Medicine is hard work and each patient encounter requires your full attention, compassion, intellect, and skill."

Jennifer Frank, family physician in northeastern Wisconsin