Even though more than half of all students attending U.S. medical schools are female, the neurosurgery field is having difficulty attracting and retaining women to the profession, according to a new report. The lack of women specialists in surgery of the brain and nervous system highlights a potential problem that could lead to a shortage of neurosurgeons as a whole given the increasing role of women in medicine, say the study's authors. Female board-certified neurosurgeons currently account for less than 6% of a neurosurgical work force that numbers more than 3,000.
Monroeville, PA-based medical supply company Intermedics-McCullough has filed suit against six medical device companies, alleging they made kickback payments to several Pittsburgh-area doctors to gain a competitive edge. In the suit, the owners of Intermedics-McCullough say the companies blocked them out of the market with inferior and more costly products by offering kickbacks "for the purpose of gaining exclusive access to the lucrative replacement hip, knee and joint industry and to the orthopedic industry in general." In addition to the six companies, more than two dozen physicians also are mentioned in the suit, with a listing of payments allegedly made to them by the defendants. The payments ranged from less than $100 to more than $8 million.
ProHealth Care and Children's Hospital of Wisconsin are in discussions with Waukesha Memorial Hospital's to have Waukesha's neonatal intensive care unit and its inpatient pediatric unit become part of Children's Hospital. Children's Hospital has similar arrangements with Kenosha Medical Center and Theda Clark Medical Center in Neenah. The agreement would enable Children's Hospital to provide care closer to home for children in the Waukesha County area. It also would enable Waukesha Memorial to affiliate with one of the largest children's hospitals in the country.
The University of Kansas Hospital has implemented a mandatory training program—the first of its kind in the nation—to train staff on how to handle delivery emergencies. The exercises are designed to save newborns and their mothers during potentially catastrophic emergencies. About 100 members of the hospital's staff have been going through two days of classroom and hands-on training. They have been learning how to deal as a team with a variety of obstetrical emergencies that are each relatively rare, but account for many of the deaths and serious injuries of childbirth.
Over the next few years, the world is likely to see a lot more investment, medical staff, and patients crossing borders into other countries. The surge in global medical tourism could prove a powerful catalyst for government bureaucracies and sclerotic American health-maintenance organizations to think afresh about what they do, according to this article in The Economist. It may even introduce competition to private healthcare in America and elsewhere, say the authors.
Is there a point where CMS' demands will become more important to hospitals than providing actual patient care? I suspect that most CEOs would immediately answer "No!" But as CMS reporting requirements continue to increase, there may come a time when healthcare organizations are forced to choose between collecting data and providing patient care.
The 13 new reporting requirements added by CMS late last month probably won't add too much of an additional reporting burden on most hospitals. Most of the 13 added indicators are already calculated from Medicare billing information. But by adding these 13 requirements, CMS is sending a clear message to hospitals that data reporting is the way of the future, and many in the industry believe these new mandates are the tip of the iceberg. There may come a day when a hospital will have to choose between hiring an additional nurse for the intensive care unit, or an additional staffer to collect and report data.
Which will you choose?
Answering that question will no doubt be difficult. Hospital executives know how important reimbursement from CMS is to the financial health of a hospital, and they must do everything they can to position their organization to receive the appropriate amount. But on the other hand, making someone a data collector rather than a caregiver seems to go against the mission of any hospital. And as patients get more demanding, the care you offer them can also have a financial impact on your organization.
Studies have shown that patients remain unconcerned with data when it comes to healthcare, and they are even less interested when the data is something that they don't understand. Most patients, for example, don't know why the time between when a patient comes out of surgery and when he or she receives a beta blocker is important. What does matters most to patients is that they have a nurse who responds quickly when they hit the call button, gives them medication on schedule, and helps them out of bed to use the restroom. For patients, quality is receiving the care they need when they need it. And if they don't receive the care they want, they're likely to take their business elsewhere, and that of friends and family who hear about their poor hospital experience.
Thankfully, the 13 additional reporting indicators that CMS will require in this year's rule won't be significantly taxing to a hospital's resources. The new requirements are significantly less than the 43 the agency proposed earlier this year. However, I'm not convinced that the 30 requirements that didn't make this year's cut are gone forever. Down the road, CMS will place further reporting mandates on America's hospitals, and at some point, executives might have tough choices between patient care and the organization's financial wellbeing.
Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.
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