The number of doctors who each prescribe millions of dollars of medications annually in Medicare's drug program has soared, driven by expensive hepatitis C treatments and rising drug prices overall, federal data obtained by ProPublica show.
The number of providers who topped the $5 million mark for prescriptions increased more than tenfold, from 41 in 2011 to 514 in 2015. The number of prescribers — mostly physicians but also nurse practitioners — exceeding $10 million in drug costs jumped from two to 70 over the same time period, according to the data.
Most of the doctors atop the spending list prescribed Harvoni or Sovaldi, relatively new drugs that cure hepatitis C. Other providers on the list prescribed pricey drugs to treat cancer, multiple sclerosis and rheumatoid arthritis.
More ...
http://www.npr.org/sections/health-shots/2016/11/17/502341021/a-growing-group-of-doctors-are-big-money-prescribers-in-medicare
Saturday, November 19, 2016
Thursday, November 17, 2016
NFL doctors should not report to teams, Harvard study recommends - The Washington Post
A new report from Harvard Law School proposes drastic changes in the way health care is administered in the NFL, urging the nation's most popular sports league to upend its system of medicine and untangle the loyalties of the doctors and trainers charged with treating players.
Asserting that the long-standing current structure has inherent conflicts of interest, the 493-page report outlines a new system in which a team's medical staff is devoted solely to players' interests and no longer reports to team management or coaches.
"The intersection of club doctors' dual obligations creates significant legal and ethical quandaries that can threaten player health," the report states.
The two-year study bills itself as the first of its kind in "examining the complicated and often-paradoxical universe of stakeholders that may influence NFL player health." The NFL strongly took issue with the methodology and conclusions drawn by the Harvard researchers.
On Nov. 1, Jeffrey Miller, the NFL's executive vice president of health and safety, sent the researchers a 33-page response in which he rejected any suggestion that NFL doctors have conflicts of interest and called the proposed change "untenable and impractical." He said researchers have called for "several unrealistic recommendations that would not improve player care."
The report "cites no evidence that a conflict of interest actually exists," Miller wrote. ". . . The Report identified no incident in which team physicians were alleged to have ignored the health status of players, failed to adhere to patient confidentiality consent procedures, or made recommendations to clubs that were contrary to the health of players."
More ...
https://www.washingtonpost.com/sports/redskins/nfl-doctors-should-not-report-to-teams-harvard-study-recommends/2016/11/17/fc3a4e42-ac35-11e6-8b45-f8e493f06fcd_story.html?
Asserting that the long-standing current structure has inherent conflicts of interest, the 493-page report outlines a new system in which a team's medical staff is devoted solely to players' interests and no longer reports to team management or coaches.
"The intersection of club doctors' dual obligations creates significant legal and ethical quandaries that can threaten player health," the report states.
The two-year study bills itself as the first of its kind in "examining the complicated and often-paradoxical universe of stakeholders that may influence NFL player health." The NFL strongly took issue with the methodology and conclusions drawn by the Harvard researchers.
On Nov. 1, Jeffrey Miller, the NFL's executive vice president of health and safety, sent the researchers a 33-page response in which he rejected any suggestion that NFL doctors have conflicts of interest and called the proposed change "untenable and impractical." He said researchers have called for "several unrealistic recommendations that would not improve player care."
The report "cites no evidence that a conflict of interest actually exists," Miller wrote. ". . . The Report identified no incident in which team physicians were alleged to have ignored the health status of players, failed to adhere to patient confidentiality consent procedures, or made recommendations to clubs that were contrary to the health of players."
More ...
https://www.washingtonpost.com/sports/redskins/nfl-doctors-should-not-report-to-teams-harvard-study-recommends/2016/11/17/fc3a4e42-ac35-11e6-8b45-f8e493f06fcd_story.html?
Sunday, November 13, 2016
A Doctor Shortage? Let’s Take a Closer Look - The New York Times
Many people have to wait too long to see a doctor. And it could get worse. If, as many people believe, we have a shortage of doctors in the United States, then it follows that we can fix this only by training and hiring more physicians.
As with almost everything in our health care system, though, it's complicated. Some people think there's no shortage at all — just a poor distribution of the doctors we have.
The main argument for a physician shortage is that we aren't adding enough new doctors to keep up with changing demographics. The Association of American Medical Colleges has projected that by 2025 there will be a shortfall of between 46,100 and 90,400 doctors. In primary care, it projects a shortfall of between 12,500 and 31,100 doctors.
The baby boomers are getting older and sicker, and they have more complex conditions than they did when they were younger, including arthritis, high blood pressure, pulmonary disease, diabetes and cancer. The Affordable Care Act is expected to accelerate the need for additional medical care. Increased insurance coverage increases demand, and Obamacare alone is projected to require about 16,000 to 17,000 more physicians than would have been required without it.
Adding data to this argument, the United States has fewer practicing physicians per 1,000 people than 23 of the 28 countries that reported data in 2013 (among nations in the Organization for Economic Cooperation and Development).
The United States had 2.56 doctors per 1,000 people, which is more than Canada (2.46), Poland (2.24), South Korea and Mexico (both 2.17). But we were way behind countries like Austria (4.99), Norway (4.31), Sweden (4.12), Germany and Switzerland (both 4.04).
Based on these metrics, it would seem that we need more physicians. It would also seem that we're not training them. When it comes to medical graduates, the United States ranks 30th of 35 countries.
But there is strong evidence that we are thinking about this the wrong way. In 2014, the Institute of Medicine released a thorough analysis on graduate medical education that argued there was no doctor shortage, and that we didn't really need to invest more in new physicians.
More ...
http://www.nytimes.com/2016/11/08/upshot/a-doctor-shortage-lets-take-a-closer-look.html?
As with almost everything in our health care system, though, it's complicated. Some people think there's no shortage at all — just a poor distribution of the doctors we have.
The main argument for a physician shortage is that we aren't adding enough new doctors to keep up with changing demographics. The Association of American Medical Colleges has projected that by 2025 there will be a shortfall of between 46,100 and 90,400 doctors. In primary care, it projects a shortfall of between 12,500 and 31,100 doctors.
The baby boomers are getting older and sicker, and they have more complex conditions than they did when they were younger, including arthritis, high blood pressure, pulmonary disease, diabetes and cancer. The Affordable Care Act is expected to accelerate the need for additional medical care. Increased insurance coverage increases demand, and Obamacare alone is projected to require about 16,000 to 17,000 more physicians than would have been required without it.
Adding data to this argument, the United States has fewer practicing physicians per 1,000 people than 23 of the 28 countries that reported data in 2013 (among nations in the Organization for Economic Cooperation and Development).
The United States had 2.56 doctors per 1,000 people, which is more than Canada (2.46), Poland (2.24), South Korea and Mexico (both 2.17). But we were way behind countries like Austria (4.99), Norway (4.31), Sweden (4.12), Germany and Switzerland (both 4.04).
Based on these metrics, it would seem that we need more physicians. It would also seem that we're not training them. When it comes to medical graduates, the United States ranks 30th of 35 countries.
But there is strong evidence that we are thinking about this the wrong way. In 2014, the Institute of Medicine released a thorough analysis on graduate medical education that argued there was no doctor shortage, and that we didn't really need to invest more in new physicians.
More ...
http://www.nytimes.com/2016/11/08/upshot/a-doctor-shortage-lets-take-a-closer-look.html?
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