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Showing posts with label Primary care. Show all posts
Showing posts with label Primary care. Show all posts

Wednesday, August 20, 2014

Questions About Who Should Perform In-Office Surgeries

Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

One of the hopes embedded in the health law was to expand the role of nurse practitioners and physician assistants in addressing the nation’s shortage of primary care providers. But a new study questions whether that’s actually happening in doctors’ offices.
Of the more than 4 million procedures office-based nurse practitioners and physician assistants independently billed more than 5,000 times in a year to Medicare – a list including radiological exams, setting casts and injecting anesthetic agents – more than half were for  dermatological surgeries.

That’s not surprising, according to Ken Miller, president of the American Association of Nurse Practitioners, because when patients are older, skin problems such as “boils, skin tags and warts” are pretty  typical.
“I think that’s where you’re going to see the majority of procedures that are occurring both in primary care and in some of the other specialties like geriatric clinics,” he said.
The Aug. 11 study, published in the JAMA Dermatology analyzing 2012 Medicare claims, is suggesting that nurse practitioners and physician assistants should face higher regulation if performing surgical procedures.
The study’s lead author, Dr. Brett Coldiron, a dermatologist and clinical assistant professor at the University of Cincinnati, said while the “intent for...

Sunday, November 24, 2013

The ePrognosis App: How Calculating Life Expectancy Can Influence Healthcare Decision-Making

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Leslie Kernisan, MD

Last month an intriguing new decision support app launched, created by experts in geriatrics and palliative care. It’s meant to help with an important primary care issue: cancer screening in older adults.
Have you ever asked yourself, when considering cancer screening for an older adult, whether the likely harms outweigh the likely benefits?
Maybe you have, maybe you haven’t. The sentence above, after all, is a bit of wonky formulation for the following underlying questions:
  • How long is this person likely to live, given age and health situation?
  • Given this person’s prognosis, does cancer screening make sense?
The first question seems like one that could easily occur to a person — whether that be a patient, a family member, or a clinician – although I suspect it doesn’t occur to people perhaps as often as it should.
As for the second question, I’m not sure how often it pops up in people’s minds, although it’s certainly very important to consider, given what we now know about the frequent harms of cancer screening in the elderly, and usually less frequent benefits.
Furthermore, there is abundant evidence that “inappropriate” cancer screening remains common. “Inappropriate” meaning the screening of people who are so unwell and/or old that they’re unlikely to live long enough to benefit from screening.
For instance, one astounding study found that 25% of physicians said...
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Tuesday, September 10, 2013

Nurse Practitioners Try New Tack To Expand Foothold In Primary Care

Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org


Nurse practitioners say efforts to expand primary care to millions of Americans under the health law are hampered by insurance industry practices that limit or exclude their participation.

Despite laws in 17 states and the District of Columbia allowing them to practice independently, nurses with advanced degrees say some insurers still don’t accept them into their credentialed networks as primary care providers, while others restrict them mainly to rural areas.

After years of fighting doctors in state legislative battles to expand their authority, nurse practitioners are taking a new tack: asking the Obama administration to require insurers to include them in the plans offered to consumers in new online marketplaces, which open for enrollment Oct. 1.

Millions of newly insured consumers will need access to primary care, but "this will not happen if private insurers continue to exclude or restrict advanced practice registered nurses from their provider networks," said Karen Daley, president of the American Nurses Association (ANA), in a prepared statement.

Nurse advocates want to be able to bill insurers directly for services, which would require them to be credentialed in insurers’ networks. But insurers say a mix of state laws governing nurses’ ability to practice independently complicates such efforts. They say they have taken other steps to expand primary care services, often using nurse practitioners in "medical homes," where doctors, nurses and other...
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