More than half of New Jersey residents believe there are "major problems" with the state's healthcare system, with one in five describing a "state of crisis," according to a recently released poll. Some of that stems from concern over medical errors, with almost of a third of those responding to the AARP New Jersey survey reporting that they or a family member had been the victim of a preventable medical error.
There is a possibility that unsafe procedures at the Endoscopy Center of Southern Nevada--procedures that have placed 40,000 people at risk for three potentially fatal blood diseases--could have been discovered during scheduled state inspections. The Nevada agency in charge of inspecting medical facilities--the Nevada State Health Division's Licensure and Certification Bureau--issued a memo in 2001 promising complete inspections every three years. But the agency did not follow its own schedule.
Nurses are on the front lines of a battle Connecticut hospitals are waging against multiple drug-resistant organisms. In February, the Connecticut Hospital Association held a symposium on MDROs, kicking off a collaborative effort that is bound to change the lives of nurses and patients in the state's hospitals, hopefully for the better. Some 30 of the state's acute-care and long-term care hospitals are participating and have agreed to share best practices for preventing MDROs through a password-protected website, a dedicated listserv, and frequent conference calls to monitor progress.
Maryland hospital safety experts are looking at a new standard for many preventive infections and mishaps that can harm the most vulnerable patients: zero. The Maryland Health Care Commission is putting a framework in place for the public to see specific infection and other mishap rates by hospital and should begin reporting MRSA infections by the end of this year.
A British hospital is banning neck ties and encouraging its employees to leave the long sleeve shirts at home in an effort to curb MRSA. Doctors seem to be taking the new rules well. One doctor was quoted as saying, "If you look at the state of many doctors' ties, they probably need a wash, so it should reduce infections."
The National Patient Safety Foundation has proposed a Universal Patient Compact to establish a mutual covenant between healthcare providers and their patients. The compact will describe the agreed upon commitments that both patients and physicians must make to make sure a patient has a quality healthcare experience.
A study published in the February 25 edition of the Archives of Internal Medicine says that mandatory reporting of hospital quality measures has led to a high rate of misdiagnosis among pneumonia patients.
After spending a few days at the AMGA annual conference talking to physicians and group practice executives, I can't escape the notion that, if the U.S. healthcare system is headed for major change, it won't happen without physicians leading the way.
AMGA selected industry outsiders as its keynote speakers--Former Speaker of the House Newt Gingrich, Former Senator Bill Bradley, and economist Michael Porter--and though they differed on their approaches to reform, their common message was this: The healthcare system can only change from within.
That seemed to resonate with attendees, many of whom are already making innovative changes to improve care--and their bottom line--while they wait for the federal government to get its act together. Richard L. Reece, MD, thinks we're seeing the beginnings of a physician empowerment movement. Fed up with battling reimbursement cuts and waiting for a top-down solution to the broken healthcare system, physicians are mobilizing, innovating, and finally finding their collective voice, he says.
He cites involvement in online communities and increased political involvement as examples of physician empowerment, as well as physician-led practice innovations. Today's physician leaders want to focus on patient care, but to do so they are becoming more business savvy and taking an interest in the legal and political aspects of healthcare.
Take Barry L. Gross, MD, executive vice president and chief medical officer of Riverside Health System; when his organization faced some of the systemic problems that many practices encounter--physician shortages, crumbling reimbursement, Stark constraints--it used joint ventures and physician employment to transform into what he calls a "physician-centric health system."
The culmination of changes improved morale, retention, and grew the bottom line, and there are countless other physician innovators with similar stories about finding unique solutions to common problems across the country. (Note: If your medical group fits this category, you have two weeks left to submit an entry to our Top Leadership Teams contest.)
But some are also finding empowerment in shunning the system. A recent MGMA survey reveals that nearly 24% of physicians have already begun limiting or not accepting new Medicare patients, and nearly half may take similar steps if the 10.6% Medicare cut goes into effect in July. Other physicians are adopting concierge or cash-only practices to avoid the hassles of third-party involvement.
Whether physicians are able to collectively offer solutions to the systemic problems plaguing U.S. healthcare or are forced to work around them is not entirely in their control. But one thing is clear, Reece says: "There's a sense that the buck stops here and we've got to take a stand."
If you missed our coverage of the AMGA annual conference, here are some reports we filed from Orlando:
Doc the Vote. Former Speaker of the House Newt Gingrich and former Senator Bill Bradley kicked off the AMGA annual conference in Orlando with 30,000-foot discussion of the healthcare system.
Newt Speaks. I caught up with Gingrich after the session to follow up on some of his comments about insurance mandates and Republicans' plans for healthcare.
Orchestrating Change. Carl Heltne, MD, president of Duluth Clinic and executive vice president of SMDC Health System discussed physician leadership development and how he turned around an organization characterized by low physician engagement and high turnover in leadership positions.
Part-Time Problems. Cejka Search and AMGA unveiled the results of their 2007 Physician Retention Survey at the conference. The big news: The number of physicians practicing part-time is on the rise.
Trends in Physician Retention. Senior Online Editor Rick Johnson sat down with Carol Westfall, president of Cejka Search, to talk about the growing number of part-time physicians and other results from the retention survey.
Tracking Disparities. I spoke with Beth Averbeck, MD, associate medical director for care improvement with HealthPartners Medical Group, about her organization's approach to tracking and addressing racial and ethnic health disparities.
Due to Lousiana's construction budget being overloaded, New Orleans lawmakers and Louisiana State University System officials say they are worried about the prospects for a teaching medical center proposed to replace Charity Hospital in the city. Several state officials say the project is not in immediate peril, but the hospital still must eventually compete for financing with a backlog of projects.
Despite pleading guilty to lying about his credentials as a heart surgeon, admitting to suffering memory problems and possible strokes, and being kicked off the staff of one hospital for being linked to numerous patient deaths, Alex Zakharia continues to have a "clear/active" Florida medical license. Critics say Zakharia's case is the latest example of a system that does little to discipline problem practitioners and does a lot to hide their problems.
