Doctors and lawyers; PAs to read mammograms? medical errors; healthcare and the election
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"If your child expressed an interest in becoming a lawyer, would you recommend it?" Over half of those in a recent Medical Economics poll (54 percent) said Yes. Almost 37 percent of all respondents allowed that law was a respected profession, and 6 percent would recommend it because lawyers "make lots more money than doctors."
Although a sizeable percentage of physicians (46 percent) wouldn't recommend law to their children, most of those say it's because "the field is overcrowded now." That's not to say that there's no antipathy toward lawyers, however: 17 percent said flat out that lawyers "aren't to be trusted," and 12 percent of physicians who'd endorse a legal career said they'd do so only if the child "didn't do malpractice work."
The US healthcare system can't keep up with the demand for breast screening services, according to a new report. Why? One key reason is that fewer radiologists are going into breast imaging. The report recommends that mammography facilities enlist specially trained physician assistants to alleviate shortages and reduce the workload of radiologists who interpret mammograms. However, breast imaging specialists would still view every mammogram, while physician extenders could be used to prescreen and double-read mammograms.
The FBI has launched a national investigation into a scheme by some doctors and ambulatory surgery centers in California to defraud health insurers. "Scam recruiters" target healthy immigrants who have generous medical insurance benefits and convince them to travel to California for unnecessary procedures, including colonoscopy, adult circumcision, and sweat gland removal. The clinics then bill health insurers up to 10 times the normal cost of these procedures and split the booty with the doctors and recruiters. For their effort, the rent-a-patients get airfare, hotel expenses, a cut of the scam profits, and sometimes a little cosmetic surgery thrown in as a bonus, the FBI says. Insurance companies estimate that they've been hit with over $500 million in claims.
Where the presidential and congressional candidates stand on health reform will be "very important" to voters this year, say nearly three out of five adults polled for The Commonwealth Fund, a private foundation that supports independent research on health and social issues. What's more, vast majorities across the political spectrum rank the issue as at least "somewhat important."
Physicians' and other providers' understanding of patient safety is often colored by preconceived notions of professional roles and of what constitutes an error. For example, adverse events that fell within the realm of nursing practice were likely to be reported as "errors;" when they were associated with physicians, they were apt to be viewed as a difference in "clinical judgment" or a "variation in practice." Moreover, 90 percent of physicians, administrators, and pharmacists who participated in the study placed primary responsibility for patient safety on nurses, as did 96 percent of the RNs. Yet only 8 percent of doctors considered nurses to be part of the decision-making team.
The study, conducted over three years in 29 small rural hospitals in nine Western states, was published in the June issue of the American Journal of Nursing.
Joan Rose. UPDATE: Focus on Practice. Medical Economics Aug. 6, 2004;81:9.