Here's an interesting statistic from the American Academy of Family Physicians: In areas where there are few physicians, there are still usually more doctors than nurse practitioners.
I was sent that stat and more after writing a blog post responding to the AAFP's and the American Medical Association's (PDF) insistence that in the drive toward team-based healthcare, physician leadership is an absolute requirement for any healthcare team.
While physicians have presented a unified front, they stand in isolation.
Nurse practitioners criticized the AAFP and called it "misdirected and out of step” on the issue. With a nod to the idea that the care-coordination-focused medical-home practice model is the new foundation of team-based care in the U.S., the NPs noted that none of the organizations that recognize practices as medical homes requires practices to be physician-led to earn the organization's seal of approval. (I had trouble believing that last part, so I called the National Committee for Quality Assurance, the Joint Commission and the Accreditation Association for Ambulatory Health Care, and they all confirmed it was true.)
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To defend against malpractice suits, one speaker at the recent MGMA-ACMPE annual conference in San Antonio recommended, practices must maintain constant vigilance of their health information technology systems. Another speaker said lawsuits can be avoided by showing patients courtesy and respect.
They are probably both right, though the second speaker's message was more inspiring.
Ronald Sterling, an electronic health-record consultant based in Silver Spring, Md., gave a presentation titled "Malpractice Discovery in the Age of EHR" and warned his audience that he was about to address a "depressing" subject.
Sterling said the good news was that mitigation efforts in the area of malpractice discovery could best be described as "good housekeeping," and he warned against "ceding clinical control to the techno geeks."
Sterling sprinkled his talk with horror stories such as the pediatric practice whose patient immunization records were not transferred into the EHR, and his main message seemed to be: Test systems; verify data; train staff; and document what you did.
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When pay raises are small, some can take solace if their compensation rose above the rate of inflation, but that rate—as measured by the consumer price index—is a moving target, so using it as a historical measure may be of limited value. But that won't stop me from trying to do so.
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