Hospital-based physicians, physician employment, and other physician services, continue to be a source of much discussion in today’s healthcare news. As the debate and experimentation ensues, physician and medical staff rights, responsibilities, and medical necessity require second guessing. This has increasingly become evident with the rise of litigation and defensive medicine. However, there is now a more accelerated development, given the need for hospital and physician integration for the provision of a miriad of physician services.
This article by Amy Lynn Sorrel with Amednews lightly touches upon a few aspects of this new and ongoing discussion.
Hospital TeamCare is proud to launch its newest physician services – Hospital Medicine, and Pediatrics. These newphysician services will be offered throughout all existing US market areas. The physician service-line expansion is a natural progression from the existing hospital-based physician services of emergency medicine and anesthesia currently offered by Hospital TeamCare.
With the demand for hospital physicians rising, Hospital TeamCare strategically developed its service line to fulfill this growing market. Hospital executives understand the positive impact hospital-based physicians have on quality, efficiency, and outcomes. “Given all the change in healthcare delivery, hospitals are turning to those service providers that deliver exceptional patient care, quality oversight, and that are fiscally responsible,” says Dr. James McLean, Vice President of Hospital TeamCare West.
Built upon years of physician experience, leadership, and success, Hospital TeamCare’s Physician Specialty Vice Presidents lead each division. “Our specialty divisions are led by accomplished physician executives who still practice and lead on a daily basis,” says Dr. Paul Pugliese, Vice President of Hospital Medicine.
Their new video spot titled “Our Physicians, Your Success”, couples the announcement of Hospital TeamCare’s service line expansion while underscoring the Company’s purpose. Dr. McLean adds, “We are very proud of our new video production, as it truly defines our purpose, capacity, and commitment to each of our hospital partners.”
Experience the perfect balance of clinical excellence, with a physician staffing, and management company, who understands the business of hospital-based physicians. Our physicians, your success – request Hospital TeamCare today!
About Hospital TeamCare
Hospital TeamCare is a leading provider of quality hospital –based outsourced physician services. We offer physician outsourcing in emergency medicine, anesthesia, hospital medicine, pediatrics, radiology, and urgent care medicine. For more information about Hospital TeamCare, our hospital services, or healthcare solutions, visitTeamCare.com.
As the use of smart phones among physicians increases, so does the concern for medical errors. Although there is sparse evidence to demonstrate clear causation, several are raising the question. Much like any other profession, physicians at times will check text messages, emails, etc., while working – multi-tasking. Unlike other professions, outsourced physician services may frequently use smart phones for drug reference, clinical correlation, differential diagnosis, formula calculation, grading, staging, medical records, or even telemedicine.
In this article by amamednews.com one doctor notes ”Getting distracted is not a feature of technology but a feature of the fact that people don’t multitask particularly well,” said Dr. Feldman, who uses an iPad at bedside to make notes and order medications and tests. “I used to be a primary care doctor, where I had a nurse popping her head into the office every three minutes to tell me something. The constant bombardment of distractions — that’s what being a doctor is. If you can’t safely manage that, then you should do something else with your life.”
Originally cited from the works of Dr. Donald Berwick and the Institute of Medicine, 6 aims for health care improvement remain prudent today. The following are the Institute of Medicine’s six aims for health care improvement for both hospitals and all physician services:
Safe – Operational systems are in place; implement protocols
Effective – Evidence-based protocols are developed collaboratively with physician and nursing input.
Patient-centered – Care is delivered to the needs and values of the patient.
Timely – Protocols eliminate unnecessary waiting.
Efficient – Rapidly identifies AMI/ACS
Equitable – All patients receive the same evidence-based protocol.
The Institute for Healthcare Improvement’s vision for healthcare adapted the IOM’s six improvement aims as follows:
No needless deaths
No needless pain or suffering
No helplessness in those served or serving
No unwanted waiting
No waste
No one left out
Although as administrator for CMS, Dr. Berwick’s statements and position were a subject of controversy, his original works, and those of his previous organization remain relatively undisputed. According to the 2011 edition of the National Scorecard on US Health system Performance, there continues to be substantial erosion in access to care, and rising costs. The US earned an overall score of 64 out of a possible 100 when comparing national averages with best practice performances benchmarks.
It’s clear that for physician services in today’s healthcare, we are still at the breaking point.
Hospital TeamCare, a leading provider of quality hospital-based outsourced physician services, introduces new video. The 60 second video captures the essence of physician services offered.
Experience the perfect balance of clinical excellence, with a physician staffing, and management company, who understands the business of hospital-based medicine. Our physicians, your success! Request Hospital TeamCare today! (800) 616-8236 www.TeamCare.com
Khat held by Vendor in Yemen: image via Wiki Commons
Chewing herbal amphetamine (khat) increases risk of death and stroke in patients with heart disease, so says researchers in a recent study published in Circulation: Journal of the American Heart Association. Researchers find that there are worse in-hospital outcomes among acute coronary syndrome patients who chew khat. In particular, khat chewers were more likely to present with ST-segment–elevation myocardial infarction.
Khat leaves (from the Catha edulis plant) have been chewed since ancient times by people in the Arabian Peninsula and East Africa. The use of khat has spread throughout Western Europe and into the United States. Hospital physicians must be particularly observant for this as an exacerbating factor for Acute Corornary Syndromes. Furthermore, all physician services should be cognizant of this herbal amphetamine.
“Global awareness of the negative impact of khat chewing on health and social life is warranted before it becomes endemic,” said Jassim Al Suwaidi, M.B., Ch.B., study co-author and Consultant Cardiologist and Director of Cardiovascular Research in the Department of Cardiology and Cardiovascular Surgery at Hamad General Hospital in Doha, Qatar. “This report underscores the importance of improving education about the cardiovascular risks of khat chewing as well as the need for further studies in the field.”
These physician researchers found the worse in-hospital outcomes were associated with patients with delays in seeking care after the onset of symptoms, and failing to receive thrombolytics or beta blockers. These core measures require strict adherence by hospital physicians. Additionally, it is clear that past medical history, travel, and social histories should be carefully explored in the clinical presentation of ACS.
It seems technology is advancing the lives of hospital physicians, allowing them to approach patient care more effectively and efficiently, while maximizing the capabilities of nurses.
“A Florida hospital has developed a system for wireless real-time monitoring and reprogramming of cardiac devices, including pacemakers and defibrillators, using an iPad. A doctor can suggest changes to a cardiac device’s settings, then relay the information for a nurse in the hospital to execute using a touch screen laptop,” as reported in “MobiHealthNews,” a publication that chronicles mobile technology trends within the healthcare sector.
The system, developed by E. Martin Kloosterman, MD, Director of the Electrophysiology Laboratory and Chief of the Cardiology Department at Boca Raton Regional Hospital, enables hospital physicians to lay out instructions for nurses to follow, allowing them to adjust their patients’ cardiac device’s settings. This saves the physician time, and ultimately, the hospital money.
“The project came to mind several years ago,” said Dr. Kloosterman, in a press release. “First, the evolution of the electronic medical records disseminated computer terminals with internet connections in the medical work space allowing clinicians ready access to patient information.
“Then recently, the iPad emerged providing the ability to be online in seconds anytime, anywhere, allowing remote access to computer information. The combination of these two new innovations led me to the creation of the new technology: the remote-K-viewer. I designed and constructed a dedicated cart that hosts the programmer connected to a touch screen laptop with a wireless internet connection and a printer. The remote-K-viewer cart is mobile and designed to be used by nurses or non-specialized physicians with minimal training.”
‘Data already has been successfully reviewed internationally as well as during airplane flights,” according to “MobiHealthNews.”
This system will undoubtedly enhance the lives of hospital physicians as well as outsourced physicians who are placed in various hospitals; it will encourage medical staff to work together and create more of a team-orientated environment.
“We are excited [about] the possibilities that this application has to offer in regards to the development of a new generation of programmers and service models in the near future,” as stated by Dr. Kloosterman (in a press release).
With the New Year quickly approaching hospital physicians, as well as most folks working on the patient care side of the healthcare industry, are preparing for some significant changes.
“Physician News Digest” recently highlighted some areas in which change can be anticipated:
1. The ever-changing nature of medical practices will continue. “Many physicians are choosing hospital and group settings versus private practice due to the perceived security employed settings offer. Only one quarter of physicians surveyed said they plan to continue practicing as they are; half said they would adopt a style of practice different from the traditional full-time independent private practice model,” as reported in “Physician News Digest.”
2. The shortage of primary care physicians will continue. It is not breaking news that there is a serious shortage of primary care physicians in the United States. “Physicians News Digest” reported that “the majority of physicians (60 percent) said health reform will compel them to close or significantly limit their practices to certain categories of patients. Of these, 93 percent said they will close or significantly limit their practices to Medicaid patients and 87 percent said they would close or significantly restrict their practices to Medicare patients. In 2012, physicians will need to evaluate how they can optimize their time to accommodate the current and future needs of their patients.”
3. The physician’s impact on patients will continue. Many hospitals are looking at options, in terms of hiring physicians who are able to juggle medical services as well as administrative tasks. Many healthcare facilities are finding it in their best interest to partner with companies that specialize in outsourced physician services, as “increased reporting, problematic reimbursement and high potential liability, will place extraordinary stress on physicians,” as reported in “Physician News Digest.”
“Proposed changes to our healthcare system have already significantly impacted physicians and patients,” said Lou Goodman, President of The Physicians Foundation. “We hope the physician watch list helps to address the core issues under the new legislation and offers doctors and the healthcare community guidance on how to deliver the best care possible to patients in 2012.”
For decades, hospital physicians, outsourced physicians, and family physicians have advised patients that in order to lose weight, two key components must be addressed and managed; the age-old myth was that diet and exercise are essential for achieving weight loss.
However, new research in “The New England Journal of Medicine” has found that weight loss might not be as simple as that; it seems that hormones factor in to the equation more than those practicing physician services could have known.
“WebMD” recently reported that in a new study, “50 overweight or obese people went on a low-calorie diet for 10 weeks. Researchers measured levels of several key hormones involved in appetite control before they started the diet, after they completed the diet, and then again 62 weeks later. They found that changes in the hormonal mix tip the scale toward hunger and weight regain. Up to a year after weight loss, there are increases in the “hunger hormone” ghrelin and reductions in other hormones such as leptin that could promote weight gain.”
“The findings explain why most people find it difficult to maintain weight loss long-term,” said Joseph Proietto, a researcher who contributed to the study. “It may also explain why public health measures adopted so far have generally failed to reduce obesity prevalence.”
“WebMD” added that “several medications are being studied that may help combat some of these hormonal changes.”
But results from this study should not sway people from eating healthy and exercising, as those two components remain key in promoting a healthy lifestyle.
“Until we have appetite suppressants that are safe to use long-term, studies show that the following behaviors are associated with better weight loss maintenance: weigh yourself regularly; eat breakfast; exercise at least one hour per day; and eat a low-fat diet,” said Proietto.
My maternal grandmother had diabetes for a significant number of years, during the latter part of her life. Had I not witnessed my mother give her daily insulin injections, I wouldn’t have known the extent of discomfort that she experienced regularly. As sick as she was, she rarely complained; as a matter of fact, looking back, all I can remember her saying now and again was, “My eyes are bothering me.”
I thought of my grandmother as I was reading a story printed in “Florida Health Care News” that detailed the correlation between type 2 diabetes and vision loss. My grandmother’s vision became significantly impaired several years prior to her death in September 2001.
Learning about diabetic retinopathy, made me wonder if her case could have turned out differently, had she been properly diagnosed. It also reaffirmed the milestones made in patient care since her death, in terms of scientific and technological advances in medicine.
“There is a common misconception that equates a legally blind diagnosis with total blindness, but this is not the case,” said Dr. Soloman Melgen. “When a patient is diagnosed as legally blind, it means they have a ‘blind spot’ that is blocking their central vision in both eyes. Unfortunately, there is no objective method of measuring the various degrees of legal blindness, and oftentimes these patients are left helpless.”
According to the American Diabetes Association, “the number of Americans with diabetes is about 25 million; of that 25 million, 18 million have been diagnosed, while seven million remain undiagnosed. With all diabetes cases, about 90 percent of patients, between the ages of 20-74, develop diabetic retinopathy, which leads to new cases of blindness.”
With more medical information becoming available to emergency physicians, hospital physicians, and outsourced physicians, diabetes patients suffering from diabetic retinopathy will have better chances of seeing things more clearly.
“Fortunately there are things that can be done,” said Dr. Melgen. “We can make a patient’s blind spot smaller and lighter, thereby improving their peripheral vision.”
January 28, 2012
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