February 21st, 2011 by RyanDuBosar in Better Health Network, Research
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The use of temporary physicians is rising, filling in until permanent physicians can be hired amid the ongoing shortage of doctors nationwide, a locum tenens firm has found. The company estimates between 30,000 and 40,000 physicians worked on a locum tenens basis in 2010.
The survey, by Staff Care, polled hospital and medical group managers about their use of locum tenens. Eighty-five percent said their facilities had used temporary physicians sometime in 2010, up from 72 percent in 2009.
Psychiatrists and other behavioral health specialists were the most sought-after specialty (22 percent of all requests), followed by primary care physicians, defined as family physicians, general internists and pediatricians (20 percent) and internal medicine subspecialists (12 percent). Hospitalists were 9 percent.
According to the survey, the primary reason cited by 63 percent of healthcare facilities was to fill a position until a permanent physician could be found. Forty-six percent of healthcare facilities now use locum tenens physicians to fill in for physicians who have left the area, compared to 22 percent in 2009. Fourteen percent use locum tenens doctors to either help meet rising patient demand for medical services or to fill in during peak times, such as flu season. Fifty-three percent use locum tenens physicians to fill in for physicians who are on vacation, ill or for other absences.
Most locum tenens physicians plan to stick with temporary practice in the short-term, the company noted. Sixty percent said they plan to practice on a locum tenens basis for more than three years, 28 percent for one to three years and 12 percent for less than a year.
Freedom trumps pay, the company noted, as 82 percent cited flexibility as a benefit, compared to 16 percent who identified pay as a benefit. Other reasons cited for working as a locum tenens include absence of medical politics (48 percent), travel (44 percent), professional development (21 percent) and searching for permanent practice (20 percent).
The locum tenens option is important to maintaining physician supply, the company concluded, because during a time of physician shortages it allows doctors who might be considering full retirement to remain active in medicine.
*This blog post was originally published at ACP Internist*
February 17th, 2011 by RyanDuBosar in Health Policy, Research
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Less than one in three primary care practices offer all 10 recommended adult vaccines, citing a variety of financial and logistical reasons.
Researchers sponsored by the Centers for Disease Control and Prevention sampled 993 family physicians and 997 general internists. Of the respondents, 27 percent (31 percent of family practitioners and 20 percent of internists) stocked all 10. Results appear in the Feb. 17 issue of the journal Vaccine.
The 10 vaccines were hepatitis A; hepatitis B; human papillomavirus vaccine (HPV); combined measles, mumps, and rubella (MMR); meningococcal conjugate vaccine (MCV4); pneumococcal polysaccharide (PPSV23); tetanus diphtheria (Td); combined tetanus, diphtheria, and pertussis (Tdap); varicella; and zoster.
Of the responding practices, two percent plan to stop vaccine purchases, 12 percent plan to increase them and the rest had no plans to change their vaccination stocking habits. But physicians who identified themselves as their respective practices’ decision makers for stocking vaccines were more likely to decrease the number of different vaccines stocked for adults (11 percent vs. three percent; P=.0001).
The National Vaccine Advisory Committee, a group that advises the various federal agencies involved in vaccines and immunizations, arrived at even bleaker figures in 2009, reported the April 2009 issue of ACP Internist. For example, 62 percent of decision makers in practices said they had delayed purchase of a vaccine at some time in the prior three years due to financial concerns. And in the prior year, 16 percent of practice decision makers had seriously considered stopping vaccinations for privately-insured patients due to the cost and reimbursement issues. Read more »
*This blog post was originally published at ACP Internist*
February 15th, 2011 by RyanDuBosar in Better Health Network, Research
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Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits.
On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent.
Similar amounts were spent on prescription medicines ($1.4 billion) and emergency room visits ($1.5 billion). Hospital stays amounted to $9.1 billion. Medicare paid 40 percent of the total expenditures to treat kidney disease.
*This blog post was originally published at ACP Internist*
February 12th, 2011 by RyanDuBosar in News, Research
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Enriched chicken feed may have resulted in eggs having less cholesterol and more Vitamin D than previously measured, reports the U.S. Department of Agriculture (USDA).
A large egg today has about 185 milligrams of cholesterol, down 14 percent from 215 milligrams in 2002, according to new research from the USDA’s Agricultural Research Service, reports USA Today. Also, an egg today has 41 international units (IUs) of Vitamin D, up 64 percent from 25 IUs measured in 2002. (That’s still only about 7 percent of the 600 IUs recommended per day.)
The agency regularly does nutrient checks on popular foods, this time analyzing eggs taken from store shelves in 12 locations around the country. The American Egg Board said in a press release that hen feed is made up mostly of corn, soybean meal, vitamins and minerals. Nutrition researchers at Iowa State University are also looking into reasons why cholesterol in eggs is decreasing.
The government’s “Dietary Guidelines for Americans” recommend that most people eat less than 300 milligrams of total dietary cholesterol a day, and people at a high risk of cardiovascular disease should eat less than 200 milligrams a day. The average American man consumes about 337 milligrams of cholesterol a day and the average woman consumes 217 milligrams, reports the Los Angeles Times.
One egg a day fits within the average, healthy American’s diet, reports WebMD, citing research funded by the Centers for Disease Control and Prevention and by the American Egg Board — owners of the slogan “the incredible, edible egg.”
*This blog post was originally published at ACP Internist*
February 10th, 2011 by RyanDuBosar in Health Tips, Research
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Physicians said in a survey that noncompliance with advice or treatment recommendations was their foremost complaint about their patients. Most said it affected their ability to provide optimal care and more 37 percent said it did so “a lot.”
Three-quarters of patients said they were highly satisfied with their doctors. But they still had complaints ranging from long wait times to ineffective treatments.
Those are just some of the findings from two surveys, the first a poll of 660 primary care physicians conducted by the Consumer Reports National Research Center in September 2010 and the second a poll of 49,000 Consumer Reports subscribers in 2009. The magazine reported its results online.
In the doctors’ poll, physicians named these top challenges:
— 76 percent of doctors said when it came to getting better medical care, forming a long-term relationship with a primary care physician would help “very much.”
— 61 percent said being respectful and courteous toward doctors would help “very much,” while 70 percent said respect and appreciation from patients had gotten “a little” or “much” worse since they had started practicing medicine. This was a two-way street, since patients reported the same feelings.
— 42 percent physicians said health plan rules and regulations interfered “a lot” with the care they provided.
Also noted in the poll, 37 percent of physicians thought they were “very” effective when it comes to minimizing pain and discomfort for their patients, though 97 percent thought they were “somewhat” effective. But, 79 percent of patients said their doctor helped to minimize their pain or discomfort, according to the Consumer Reports blog. The gap might be explained by doctors thinking of their overall effectiveness with all of their patients, including those with chronic pain conditions that are difficult to diagnose and treat, and who are as a group less satisfied with their physicians. Read more »
*This blog post was originally published at ACP Internist*
