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Physicians Don’t Profit From Tests And Prescriptions

Physicians don’t make money from the tests, prescriptions, procedures and admissions they order, according to a new survey by the staffing and technology company Jackson Healthcare. At most, 6.2% of physicians’ total compensation comes from the doctor’s orders, the survey reported.

Direct income from medical orders comprised:
–0.5% from charges from prescriptions,
–1.0% from charges from lab tests,
–1.1% from charges associated with hospital admission,
–1.3% from charges associated with facility fees for surgeries, and
–2.3% from charges from diagnostic imaging.

The survey of 1,512 physicians challenged claims that physicians won’t stop practicing defensive medicine because they profit from their medical orders, the company stated in a press release.

“Many outside the industry believe that physicians make a lot of money on the tests, prescriptions, procedures and admissions they order,” said Richard Jackson, chairman and CEO of Jackson Healthcare. “The reality is that most (82%) do not make any money from their orders. For the remaining that do, it constitutes a fraction of their total compensation.” Read more »

*This blog post was originally published at ACP Internist*

Scary Images On Cigarette Packages Do Make People Think About Quitting

The World Health Organization (WHO) says graphic health warnings on tobacco packages are a powerful “best buy” in decreasing tobacco use and its many health consequences.

Photo by Bill Branson, National Cancer InstituteThe Centers for Disease Control and Prevention outlined the research in the MMWR.

The World Health Organization (WHO) created a treaty for tobacco product labels that many countries have ratified. Among other requirements, these warnings are expected to appear on at least 30%, and ideally 50% or more, of the package’s principal display areas, and preferably use pictures.

To assess how cigarette package labels impact quitting smoking, researchers used data from the Global Adult Tobacco Survey (GATS) in 14 countries from 2008 to 2010 that had ratified WHO’s tobacco control treaty. Current smokers of manufactured cigarettes were asked whether they had noticed health warnings on a cigarette package in the previous 30 days, and whether the label led them to think about quitting smoking.

Among men in 12 of the countries and women in seven countries, more than 90% of smokers reported noticing a package warning in the previous 30 days. Read more »

*This blog post was originally published at ACP Internist*

Internists Not Using Simple Test (Ankle-Brachial Index) For Peripheral Artery Disease

Despite poor awareness and a lack of training on handling peripheral artery disease, internists can and should be able to recognize the symptoms and manage 95% of such cases. Experts advise using the ankle-brachial index as a quick and effective diagnostic method.

Rebecca J. Beyth, ACP Member, demonstrates the ease and quickness of the ankle-brachial index in diagnosing peripheral artery disease. Photo by Eric Zamora/UF News BureauBut internists often don’t. As was reported in ACP Internist‘s previous cover story on the subject, the ankle-brachial index can be a major part of preventing peripheral artery disease, itself a major predictor of strokes and heart attacks, over and above the Framingham risk score.

The ankle-brachial index is the ratio of the ankle to the arm systolic pressure. A ratio of 0.90 or less indicates peripheral artery disease. Its sensitivity is 79% to 95%, and its specificity is 95% to 100%. It takes less than five minutes to perform in the office.

Yet, among the 85 respondents, 36 (42.35%) said “It’s a quick and easy test.” Another 27 (31.76%) thought, “It’s difficult to fit into the standard visit.” The final 22 (25.88%) said, “I don’t use the ABI to screen patients for PAD.” Read more »

*This blog post was originally published at ACP Internist*

Brain Imaging Shows Overlap Between Emotional Pain And Physical Pain

Heart-ache can be a literal thing, as well as a metaphor for all those weepy, jilted-lover torch songs.

Consensus thinking in the peer-review literature is that the parts of one’s brain responsible for physical pain, the dorsal anterior cingulate and anterior insula, also underlie emotional pain.

Researchers at Columbia University in New York recruited 40 people who’d recently ended a romantic relationship, put them in a functional magnetic resonance imaging machine, and recorded their reactions to physical and then emotional pain.

Physical pain was created by heating the person’s left forearm, compared to having the arm merely warmed. Emotional pain was created by looking at pictures of the former partner and remembering the breakup, compared to when looking at a photo of a friend.

The fMRI scans showed physical and emotional pain overlapped in the dorsal anterior cingulate and anterior insula, with overlapping increases in thalamus and right parietal opercular/insular cortex in the right side of the brain (opposite to the left arm).

The theory is that Read more »

*This blog post was originally published at ACP Internist*

Press Release Contains Ridiculous Health Claim Of The Week

Every once in a while, a press release comes along that’s worth mocking publically. Here’s one of them.

In honor of National Mental Health Month, one PR flack pitched Philip Stein watches. In the flack’s words: “The highlighted element of the watch is the brand’s exclusive wellness technology that helps wearers improve sleep and reduce stress. The watch is embedded with a metal disk that emits natural frequencies into the body wearer and in turn, affects the wearer’s energy field. It’s called ‘Natural Frequency Technology’ and is a new patented technology studies suggest help to improve sleep quality and reduces stress.”

Really. That’s what the flack said. Right off the bat, he’s gone from mental health issues to sleepless nights from stress. Not content with confounding the two issues, he continues: “Dr. Jeff Gardere, America’s well-known psychologist, is Chief Medical Executive for Philip Stein Watches and had been running a practice for over 20 years. He recognized during that time that there was a huge need to educate the public on the possible severities of stress and everyday lifestyle changes that everyday people can make without a prescription. Dr. Gardere found a natural way to reduce stress and prescribed his patients with a high-end accessory Philip Stein Watch.”

The psychologist “prescribed” a watch. I wonder if my insurance company would pay for that scrip? Read more »

*This blog post was originally published at ACP Internist*

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