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A look at issues concerning staffing, safety, and patient care.

The online content of our HealthLeaders Media Daily News & Analysis regularly includes items related to healthcare reform legislation and various regulatory issues. In addition, our online team explores matters of staffing, safety, and patient care. Here are excerpts from stories about physician certification, nurse recognition, and patient handoffs by Cheryl Clark, Sarah Kearns, and Julie McCoy.

Should doctors explain their board certification to patients?
Jack Bruner, MD, former member of the Medical Board of California and a board-certified plastic surgeon in Sacramento, CA, insists doctors should inform their patients whether they are board certified, and by which board, "because there is massive consumer confusion as to the qualifications of practitioners, and patients are being hurt because of it."

Some California lawmakers think he has a point and are considering legislation that would mandate the practice statewide for any physician, osteopath, or podiatrist. If board-certified, they would have to say so. If not, they might have to say that, too.

In Bruner's state, any licensed physician can cut into a patient. And although hospitals usually approve which procedures their staff doctors are allowed to perform, that oversight doesn't happen in a physician's office practice or physician's clinic. And therein lies the problem, Bruner says.

Patients are being injured in droves in his specialty area alone, he says, rattling off a number of examples of recent harm he's seen. Bruner and his colleagues have had to repair the damage non-board-certified doctors did to these patients.

The bill under consideration is backed by the chair of the Assembly Business, Professions, and Economic Development Committee. Committee consultant Joanna Gin says that cosmetic surgery, including liposuction, is an area that has had a lot of recent problems.

In California, she says, "cosmetic surgery can be performed by any licensed physician, from a plastic surgeon to a pediatrician. Patients think, ‘Oh, that individual is qualified. I'll be in good hands.'

"But many physicians may not be specially trained in cosmetic procedures. We want to be sure that if you're performing a complex procedure, you inform consumers about your qualifications, especially with the proliferation of medi-spas," which are hybrids between medical clinics and day spas, Gin says.

The Medical Board of California, the agency that licenses and disciplines doctors, lists each physician's board certification. However, interim executive director Linda Whitney says that the medical board staff doesn't have resources to check what each physician submits to see if it is accurate and current.

The proposed bill would require physicians, podiatrists, and osteopaths "to disclose the name of the certifying board or association either on a name tag in at least 18-point type, in writing given to the patient on the patient's first office visit, or in his or her office."

The idea would be that the patient may start to think twice about whether the doctor had the appropriate qualifications for the procedure under consideration.

Bruner says the requirement may help educate patients who don't know the difference between a physician and other practitioners who have entirely different training.

Reported by Cheryl Clark on April 19.

Hospital management, nurses do not agree on value of recognition
A recent report in the Harvard Business Review contradicts the idea that employees value recognition of their efforts higher than anything else. According to one study, the top motivator of performance is actually progress.

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