For years, nurses have been subordinate to doctors — both in the exam room and the political arena. But aided by new allies ranging from the AARP to social workers and health-policy experts, nursing groups are pressing ahead in a controversial bid to persuade state lawmakers to shift the balance of power. In 11 states, they are pushing legislation that would permit nurses with a master's degree or higher to order and interpret diagnostic tests, prescribe medications and administer treatments without physician oversight. Similar legislation is likely to be introduced soon in three other states.
Private physician practices increasingly are being integrated into large hospital systems in Kentucky. But that integration is coming with a cost of $100,000 or more per physician each year for many hospital systems, according to a new report from Lexington-based accounting and consulting firm Dean Dorton Allen Ford. Those losses are occurring across hospital systems of varying sizes, the report said. There can be local and regional market share advantages to having employed physicians, the report said. "However, if hospitals are to continue with this strategy, they must rapidly improve physician operations and narrow the immense losses physician groups are now incurring," the report said.
ANNAPOLIS, Md. — A measure to further implement federal health care reform in Maryland passed the House of Delegates on a 93-43 vote Monday with little debate. The measure creates a dedicated funding stream for the Maryland Health Benefit Exchange, which is a new insurance market that will offer residents a choice of private health plans. While the exchange is on track to be up and running by Jan. 1 with federal help in the first year, the state will begin paying roughly $24 million in fiscal year 2015. The money will come from an existing 2 percent tax on insurance plans that are state-regulated.
In Colorado, where more people die from gunshots than car crashes, the victims have a profound effect on the physicians who treat them. For some of the doctors on the front lines, the experiences lead to a strong opposition to guns, questions about gun laws and even activism. Dr. Chris Colwell, an emergency department physician in Denver, says he sees gun-violence victims on a weekly basis. And when those cases are fatal, they are hard to forget. "These are the injuries that the [patients] will come in, and they'll look at me, and they'll talk to me, and then they'll die," says Colwell, who's been at Denver Health, the city's biggest public hospital, for 20 years.
A study that suggests more hospitals will be eyeing primary care practices this year is in line with some hospital administrators' strategies in Maryland. About half of the hospitals surveyed by Jackson Healthcare, a health care staffing company that researches industry trends, said they planned to acquire private physician practices and primary care specialties. Maryland hospitals are among those that have their sights set on primary care practices. Hospital administrators here say building a network of primary care providers is a priority and that they will be targeting local private practices.
BOSTON (AP) — House Democratic Leader Nancy Pelosi is faulting the U.S. Senate for voting to strip away a portion of President Obama's landmark health care law. Last week the Senate voted 79-20 to repeal a 2.3 percent sales tax on medical devices such as catheters, pacemakers and MRI machines. The tax was intended to help to finance coverage for the uninsured that starts next year. Among those voting to eliminate the tax were Massachusetts Sens. Elizabeth Warren and William ''Mo'' Cowan, both Democrats.