Category Archives: Health care

Cancer treatment never better, but oncologist shortage is looming

Cancer treatments are advancing steadily, but the supply of cancer doctors isn’t, USA Today reports.

The United States could face a shortage of as many as 4,080 oncologists by 2020, according to a report from the American Society for Clinical Oncology.

Factors contributing to the impending shortfall include the aging of the U.S. population (cancer is more prevalent among older adults), retiring oncologists, and — shockingly — a growing number of female oncologists. Apparently, studies show female cancer doctors see fewer patients than their male counterparts.

Lifestyle, balance a factor in doctors (not) specializing in primary care medicine

Some of the reasons fewer medical students are choosing to specialize in primary care — a subset of internal medicine — has to do with lifestyle, says a report in the Sept. 10 issue of JAMA, the Journal of the American Medical Association.

They want better hours and recompense for the amount of time and work it requires to treat the large portion of elderly and medically complex patients this specialty sees.

A study to find out students’ impressions and concerns found they were concerned about patient complexity, the practice environment and lifestyle, compared with other specialties, officials said.

“Current students recognize the increasing demands on internists, particularly primary care physicians, to accomplish large numbers of preventive and therapeutic interventions during short visits with chronically ill patients while also managing increasing administrative expectations,” the authors wrote. “Career interest in general (internal medicine) is particularly low, reflecting the challenges in the primary care practice environment…”

Nurses want better working conditions

Turns out, nurses value better working conditions and a greater say in patient care over financial incentives, according to a Washington Post story.

The awe-inspiring bonuses and other impressive incentives from the recruitment craze of recent years, spurred by a national nursing shortage, are starting to settle in favor of the quieter, but more favorable conditions that actually keep nurses happy.

The hard truth:

Five years ago, hospitals waged intense bidding wars to fill nursing vacancies, luring nurses with huge signing bonuses and even sport-utility vehicles and vacations to the Bahamas. Those efforts often only served to exacerbate turnover, spurring nurses to remain in jobs just long enough to claim the prizes before moving to other hospitals with better incentives.

As it turns out, many nurses want better working conditions more than they do extra money. Hospitals now are responding by introducing technology to dramatically reduce paperwork, offering more flexible hours, reducing caseloads, paying for advanced training and giving them more authority.

Quick hits: comparing our hospitals’ death rates by ZIP Code

Medicare’s oft-cited Hospital Compare Web resource now features a new mini-tool that allows you to quickly compare up to three mortality graphs on hospitals within a zip code range.

The results will show you 30-day death (mortality) rates for heart attack, heart failure and pneumonia. Yes, the data is risk-adjusted for balance.

Out of seven hospital choices, I chose to compare Galichia Heart Hospital, Via Christi Regional Medical Center and Wesley Medical Center, three acute-care hospitals/systems in Wichita with emergency departments. I am happy to report that all three hospital systems were very close to the national average and considered, statistically, “no different than the national rate.” However, it’s worth noting that both Galichia and Via Christi rates were consistently a few points better than the national average.

Fewer graduating doctors choosing primary care

This won’t come as a surprise to those who’ve followed my coverage regarding a looming primary care physician shortage, but a new report published this week in the Journal of the American Medical Association says only 2 percent of graduating medical students say they plan to work in primary care internal medicine.

This is a 7 percent decline from 1990, when 9 percent of graduating students said they planned to go into primary care.

Study finds retail health clinics save patients money

Walk-in, retail health clinics are savings consumers a lot of money over doctor’s office visits, a new study found.

The study looked at MinuteClinics — associated with CVS drugstores — vs. family doctors and the emergency department for the treatment of common ailments, such as sore throats and ear infections.

Reports the Pioneer Press on the study published in the latest issue of the journal Health Affairs:

The total cost of a patient treated at a MinuteClinic for one of five basic illnesses was $51 cheaper on average than a patient treated at urgent care and $55 cheaper than a patient treated by a primary-care doctor. Pharmacy costs were also slightly lower for the patients using MinuteClinics.

The study authors note that 10 clinical problems such as sinusitis and immunizations make up more than 90 percent of retail clinic visits. These same 10 clinical problems make up 13 percent of adult primary care visits, 30 percent of pediatric primary care visits, and 12 percent of emergency department visits.

But then the authors talk about the main issue that really concerns the medical establishment:

Whether there will be a future shift of care from emergency departments or primary care doctors to retail clinics is unknown.

Wellness program netted 17 percent ROI for employers

Those wellness programs you’ve been on the fence about? Turns out they just may save you money.

A new study published in the September Journal of Occupational and Environmental Medicine reports that a program to reduce weight and improve health risk factors in obese employees produced a short-term return on investment of $1.17 per dollar spent.

In this case, a group of 890 overweight and obese employees from various companies were studied as they used a program called Healthyroads, which costs an average of $300 a year per employee. The study found for each dollar spent on the obesity management program, costs decreased by $1.17.

So where was the money saved? Mostly reduced health care spending, but also better productivity:

To assess the financial impact of the program, the researchers used a recently developed ROI model, which estimated the changes in medical costs and worker productivity resulting from reductions in health risks. The results suggested a total projected savings of nearly $312,000. About 60 percent of the savings resulted from reduced health care spending; the remaining 40 percent resulted from improvements in productivity.

If that’s not an argument for the effectiveness of workplace wellness programs, I don’t know what is.

Providers tackle hospital-acquired infections Medicare will no longer tolerate

More than 400 health care industry leaders are meeting in Washington today to figure out how they can put a stop to the hospital-acquired infections that impact about 2 million patients annually, kill as many as 100,000 patients and add as much as $20 billion in additional costs to the health care industry, organizers report.

In an informal poll of Chasing Zero Summit attendees, respondents said that of the 11 preventable conditions that will receive lower or no Medicare reimbursements, the top three most difficult conditions to address are HAIs (hospital acquired infections). In addition, 80 percent of poll respondents indicated that increasing hospital staff awareness, education and training related to infection prevention would have the most significant impact on providers’ abilities to reduce HAIs.

The first ever summit on hospital-acquired infections features a number of prominent speakers, including Alan Greenspan, chairman of the Federal Reserve System from 1987 to 2006; Thomas Valuck, Center for Medicare Management medical officer and senior advisor; Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution and Uwe Reinhardt, James Madison Professor of Political Economics at Princeton University.

Too bad it took Medicare’s plan to lower or deny claims for certain preventable conditions beginning next month to get these folks to the table, but I’m glad they’re there.

Trend: Large companies are auditing their covered employees

Forbes magazine in its Sept. 15 issue describes an interesting new trend among large employers: auditing employees and their dependents who are enjoying health benefits through the company.

Employers are looking for people who are claiming benefits to which they may not be entitled. General Motors said by the end of the year, some 12,000 people could be dropped from its health plan, saving the company around $100 million a year. Forbes writes:

It’s hardball time. Checking health plan eligibility is a good way to pinch pennies, since the stakes are large. Often employers find themselves footing health care costs for employees’ ex-spouses and adult children who aren’t in school.

The story notes AT&T also will save $40 million this year by dropping 10,000 people who don’t qualify for the coverage they’ve been receiving. Chrysler saved an estimated $50 million in paid benefits from employees who defrauded its health care plan in recent years. And America Airlines finished an audit in 2006 that resulted in almost 10,000 ineligible people losing their coverage.

A sound business move or does this prying do more damage than it’s worth? A tough one: Millions in savings vs. disgruntled employees.

Hey, mister, what’s your problem with Wichita?

Seems Jeff Burkel, chief operating officer for MicroMass Communications, a health care advertising firm, has an image problem with Wichita.

Medical Marketing & Media, a health care marketing business publication, recently published a story on its Career & Salary Survey 2008, in which it is discovered that salaries across the health care marketing industry (read: pharmaceutical reps) have decreased by 3.7 percent — from $133,700 in 2007 to $128,800 this year — causing a shift in hiring and recruitment strategies.

In that story, Burkel is commenting that location can play a key factor in the hiring process for some candidates. Then he’s quoted:

“With our Raleigh location, we get [applicants] that are done with the Northeast scene, and are looking to escape,” he says. That isn’t always the case, however. Some locations are less appealing than others. “If you want to move people to Wichita, KS, forget about it,” says Burkel.

Has Burkel even been to Wichita and seen its unique, extremely prolific and robust health care sector?

His company’s headquarters are in Cary, N.C., and the firm has an office in Morristown, N.J.

Ahem.

I’ll stick with Wichita.

Higher health premiums = more cost-shifting to employees

New data from Mercer shows that employers say they will be forced yet again to offset their rising premiums on the wallets of their employees:

Well over half (59 percent) of employers taking action to reduce their 2009 cost increase will raise deductibles, copayments, coinsurance or employee out-of-pocket spending limits. Employee cost-sharing has risen sharply over the past five years:  Between 2003 and 2007, the median family deductible for in-network services in a PPO (the type of plan offered by the most employers) rose from $1,000 to $1,500.

How much more can employers take or employees endure?

How to take a nap at work, from your pals at Harvard

Harvard Men’s Health Watch says a quickie power nap in the afternoon at work is very good for alertness, performance and mood.

Those wiley researchers don’t recommend a two-hour nap, of course. A simple 20 to 40 minute nap sometime between noon and 4 p.m. should suffice. And make sure to give yourself 10 to 15 minutes to wake up fully before you resume a demanding task, Harvard pros say.

And just to shore up your argument when your boss asks where the heck you are, Harvard says this:

Voluntary napping … is not a sign of sleep deprivation, illness, or aging. In fact, a “power nap” can be helpful as well as enjoyable. Many studies of shift workers and other volunteers have reported that a nap as brief as 20 minutes can improve alertness, psychomotor performance, and mood.

Now get up and go nap! Harvard said so!