A small but growing number of parents think vaccines against childhood diseases are unsafe and are refusing or delaying shots for their children, despite the discrediting of a medical study linking vaccines and autism that stirred alarm. Ground zero in the debate is the pediatrician's office. Some frustrated pediatricians are drawing a line in the sand by requiring parents in their medical practices to vaccinate their children or seek healthcare elsewhere, a position that rubs some medical professionals the wrong way. Among those taking a stand are the eight pediatricians of Northwestern Children's Practice in Chicago. They no longer see children whose parents refuse to follow the childhood immunization schedule developed by the Centers for Disease Control and Prevention and the American Academy of Pediatrics. A letter and email sent to parents this year announced the policy, which went into effect in June.
Hospital expansion plans in the Metro East have inspired a debate on the best way to serve areas of population growth along the Interstate 64 corridor. Memorial Hospital in Belleville jumped in front of the eastward expansion last week when its plans to build a 94-bed hospital in Shiloh were approved. Memorial Hospital-East, at Frank Scott Parkway and Cross Street, is expected to cost $118 million and open in 2016. A few days before the Illinois Health Facilities and Services Review Board approved Memorial's expansion, Hospital Sisters Health System announced plans to purchase a nearby 105-acre property across I-64 in O'Fallon. Hospital Sisters, which operates St. Elizabeth's Hospital in Belleville, said a full-service hospital was an option for the property.
Even as skin cancer rates in the Sunshine State are on the rise, scheduling an appointment to diagnose and treat the disease may be difficult. An aging population, lots of sun exposure and the rise of cosmetic procedures are cited as reasons for the growing patient volume. That's compounded by a stagnant number of dermatologists graduating from medical school. The result is a backlog of patients who can wait from weeks to months for appointments and have to drive as long as 90 minutes to the doctor's office. Longer wait times can delay identifying pre-cancerous lesions and skin cancer, the most frequently diagnosed cancer in the United States. Florida is second only to California for incidences of melanoma, the deadliest type of skin cancer, according to the most recent data from the Centers for Disease Control and Prevention. "I think there is a shortage," said Douglas Robins, MD, of the Florida Society of Dermatology and Dermatologic Surgery. "I know some places have monthlong backlogs."
Good communication is critical to good medical care. When a physician listens respectfully, asks questions and picks up on clues, patients tend to be more involved in their care, more open about what's wrong, and better informed and more satisfied with their visit. Satisfied patients also have fewer hospitalizations, doctor visits and lab tests. "Inadequate communication," according to a 2010 study published in the Journal of General Internal Medicine, "is associated with worse patient satisfaction, worse trust, more complaints and malpractice claims." Any good physician will be competent and possess the clinical skills in whatever area of medicine she practices — you should expect that, says Diane Pinakiewicz, president of the National Patient Safety Foundation. But there's more to being a good doctor. "A good doctor communicates effectively with the patient and whoever else the patient includes in the process (such as family)," she says.
A group of medical clinics in Illinois is lobbying Congress to adjust the meaningful use program so rural health centers can receive incentive payments for meaningfully using electronic health records, the Springfield State Journal-Register reports. Under the HITECH Act in the 2009 economic stimulus package, healthcare providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments. Hospitals, physicians, dentists and certain other healthcare providers are eligible for the program, but federally qualified health centers and rural health centers are among the healthcare providers that are ineligible. Rich Brennan -- executive director of the Home Care Technology Association of America -- said staffers from the House Energy and Commerce, and Ways and Means committees have met with ineligible healthcare providers and explained that the meaningful use program aims to achieve maximum effect with the amount of funding available, rather than disburse the funding to a greater number of health care providers.
The Centers for Medicare and Medicaid Services said it plans to allow eligible professionals to attest in 2012 that they have used their electronic health records to collect data on clinical quality measures as part of the CMS criteria for "Meaningful Use" of EHRs. The 2010 Meaningful Use regulations required attestation only in 2011; after that, providers were to report the quality data by uploading it from their EHRs to a CMS-designated Web portal. In its new proposed rule on changes in physician reimbursement, CMS explained that it would allow attestation in 2012 because it's not yet ready to accept the data online. At the same time, CMS announced the creation of a new pilot program to pave the way for online submission of quality data from EHRs. Because CMS wants to move toward a system in which physicians can report the same data for meaningful use and for CMS' Physicians Quality Reporting Initiative, the program is called the Physicians Quality Reporting System-Medicare EHR Incentive Pilot.