Mary Ellen Schneider

This November, voters in San Francisco will decide whether to ban circumcision in boys younger than age 18 years, and to make the practice a crime.

Opponents of circumcision gathered more than 7,000 signatures from city residents in order to place the referendum on the Nov. 8 ballot. If approved, circumcision of boys younger than age 18 would be prohibited unless it was medically necessary. The referendum does not allow for exceptions based on religious beliefs. Anyone who violates the policy would face misdemeanor charges, with a possible fine of up to $1,000, up to a year in the county jail, or both.

The effort to pass the referendum is being led by Lloyd Schofield, an activist against circumcision. In the "notice of intent" to circulate the petition, which was filed with the city’s Department of Elections, Mr. Schofield wrote that "genital mutilation constitutes a major health risk, violates human rights, and has lifelong physical and psychological effects." Complications from the procedure can include hemorrhage, infection, nerve damage, sexual dysfunction, and decreased sexual sensitivity, he wrote.

In its official policy on male circumcision, the American Academy of Pediatrics states that existing scientific evidence shows potential medical benefits for newborn male circumcision. But that evidence is not enough to recommend routine neonatal circumcision, according to the AAP’s policy statement, which was published in 1999 and reaffirmed in 2005. The AAP leaves the decision to parents, saying they should determine what is in the "best interest of the child" based on "accurate and unbiased information."

San Francisco’s ballot measure on circumcision is sure to face opposition and possible legal challenges if it is approved. The Anti-Defamation League is heading up a coalition of groups to defeat the proposal, saying it threatens religious freedom, privacy, and parental rights.

This November, voters in San Francisco will decide whether to ban circumcision in boys younger than age 18 years, and to make the practice a crime.

Opponents of circumcision gathered more than 7,000 signatures from city residents in order to place the referendum on the Nov. 8 ballot. If approved, circumcision of boys younger than age 18 would be prohibited unless it was medically necessary. The referendum does not allow for exceptions based on religious beliefs. Anyone who violates the policy would face misdemeanor charges, with a possible fine of up to $1,000, up to a year in the county jail, or both.

The effort to pass the referendum is being led by Lloyd Schofield, an activist against circumcision. In the "notice of intent" to circulate the petition, which was filed with the city’s Department of Elections, Mr. Schofield wrote that "genital mutilation constitutes a major health risk, violates human rights, and has lifelong physical and psychological effects." Complications from the procedure can include hemorrhage, infection, nerve damage, sexual dysfunction, and decreased sexual sensitivity, he wrote.

In its official policy on male circumcision, the American Academy of Pediatrics states that existing scientific evidence shows potential medical benefits for newborn male circumcision. But that evidence is not enough to recommend routine neonatal circumcision, according to the AAP’s policy statement, which was published in 1999 and reaffirmed in 2005. The AAP leaves the decision to parents, saying they should determine what is in the "best interest of the child" based on "accurate and unbiased information."

San Francisco’s ballot measure on circumcision is sure to face opposition and possible legal challenges if it is approved. The Anti-Defamation League is heading up a coalition of groups to defeat the proposal, saying it threatens religious freedom, privacy, and parental rights.

This November, voters in San Francisco will decide whether to ban circumcision in boys younger than age 18 years, and to make the practice a crime.

Opponents of circumcision gathered more than 7,000 signatures from city residents in order to place the referendum on the Nov. 8 ballot. If approved, circumcision of boys younger than age 18 would be prohibited unless it was medically necessary. The referendum does not allow for exceptions based on religious beliefs. Anyone who violates the policy would face misdemeanor charges, with a possible fine of up to $1,000, up to a year in the county jail, or both.

The effort to pass the referendum is being led by Lloyd Schofield, an activist against circumcision. In the "notice of intent" to circulate the petition, which was filed with the city’s Department of Elections, Mr. Schofield wrote that "genital mutilation constitutes a major health risk, violates human rights, and has lifelong physical and psychological effects." Complications from the procedure can include hemorrhage, infection, nerve damage, sexual dysfunction, and decreased sexual sensitivity, he wrote.

In its official policy on male circumcision, the American Academy of Pediatrics states that existing scientific evidence shows potential medical benefits for newborn male circumcision. But that evidence is not enough to recommend routine neonatal circumcision, according to the AAP’s policy statement, which was published in 1999 and reaffirmed in 2005. The AAP leaves the decision to parents, saying they should determine what is in the "best interest of the child" based on "accurate and unbiased information."

San Francisco’s ballot measure on circumcision is sure to face opposition and possible legal challenges if it is approved. The Anti-Defamation League is heading up a coalition of groups to defeat the proposal, saying it threatens religious freedom, privacy, and parental rights.

This November, voters in San Francisco will decide whether to ban circumcision in boys younger than age 18 years, and to make the practice a crime.

Opponents of circumcision gathered more than 7,000 signatures from city residents in order to place the referendum on the Nov. 8 ballot. If approved, circumcision of boys younger than age 18 would be prohibited unless it was medically necessary. The referendum does not allow for exceptions based on religious beliefs. Anyone who violates the policy would face misdemeanor charges, with a possible fine of up to $1,000, up to a year in the county jail, or both.

The effort to pass the referendum is being led by Lloyd Schofield, an activist against circumcision. In the "notice of intent" to circulate the petition, which was filed with the city’s Department of Elections, Mr. Schofield wrote that "genital mutilation constitutes a major health risk, violates human rights, and has lifelong physical and psychological effects." Complications from the procedure can include hemorrhage, infection, nerve damage, sexual dysfunction, and decreased sexual sensitivity, he wrote.

In its official policy on male circumcision, the American Academy of Pediatrics states that existing scientific evidence shows potential medical benefits for newborn male circumcision. But that evidence is not enough to recommend routine neonatal circumcision, according to the AAP’s policy statement, which was published in 1999 and reaffirmed in 2005. The AAP leaves the decision to parents, saying they should determine what is in the "best interest of the child" based on "accurate and unbiased information."

San Francisco’s ballot measure on circumcision is sure to face opposition and possible legal challenges if it is approved. The Anti-Defamation League is heading up a coalition of groups to defeat the proposal, saying it threatens religious freedom, privacy, and parental rights.

This November, voters in San Francisco will decide whether to ban circumcision in boys younger than age 18 years, and to make the practice a crime.

Opponents of circumcision gathered more than 7,000 signatures from city residents in order to place the referendum on the Nov. 8 ballot. If approved, circumcision of boys younger than age 18 would be prohibited unless it was medically necessary. The referendum does not allow for exceptions based on religious beliefs. Anyone who violates the policy would face misdemeanor charges, with a possible fine of up to $1,000, up to a year in the county jail, or both.

The effort to pass the referendum is being led by Lloyd Schofield, an activist against circumcision. In the "notice of intent" to circulate the petition, which was filed with the city’s Department of Elections, Mr. Schofield wrote that "genital mutilation constitutes a major health risk, violates human rights, and has lifelong physical and psychological effects." Complications from the procedure can include hemorrhage, infection, nerve damage, sexual dysfunction, and decreased sexual sensitivity, he wrote.

In its official policy on male circumcision, the American Academy of Pediatrics states that existing scientific evidence shows potential medical benefits for newborn male circumcision. But that evidence is not enough to recommend routine neonatal circumcision, according to the AAP’s policy statement, which was published in 1999 and reaffirmed in 2005. The AAP leaves the decision to parents, saying they should determine what is in the "best interest of the child" based on "accurate and unbiased information."

San Francisco’s ballot measure on circumcision is sure to face opposition and possible legal challenges if it is approved. The Anti-Defamation League is heading up a coalition of groups to defeat the proposal, saying it threatens religious freedom, privacy, and parental rights.

This November, voters in San Francisco will decide whether to ban circumcision in boys younger than age 18 years, and to make the practice a crime.

Opponents of circumcision gathered more than 7,000 signatures from city residents in order to place the referendum on the Nov. 8 ballot. If approved, circumcision of boys younger than age 18 would be prohibited unless it was medically necessary. The referendum does not allow for exceptions based on religious beliefs. Anyone who violates the policy would face misdemeanor charges, with a possible fine of up to $1,000, up to a year in the county jail, or both.

The effort to pass the referendum is being led by Lloyd Schofield, an activist against circumcision. In the "notice of intent" to circulate the petition, which was filed with the city’s Department of Elections, Mr. Schofield wrote that "genital mutilation constitutes a major health risk, violates human rights, and has lifelong physical and psychological effects." Complications from the procedure can include hemorrhage, infection, nerve damage, sexual dysfunction, and decreased sexual sensitivity, he wrote.

In its official policy on male circumcision, the American Academy of Pediatrics states that existing scientific evidence shows potential medical benefits for newborn male circumcision. But that evidence is not enough to recommend routine neonatal circumcision, according to the AAP’s policy statement, which was published in 1999 and reaffirmed in 2005. The AAP leaves the decision to parents, saying they should determine what is in the "best interest of the child" based on "accurate and unbiased information."

San Francisco’s ballot measure on circumcision is sure to face opposition and possible legal challenges if it is approved. The Anti-Defamation League is heading up a coalition of groups to defeat the proposal, saying it threatens religious freedom, privacy, and parental rights.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

GRAPEVINE, TEX. – Officials at the Society of Hospital Medicine are organizing a meeting with physicians from several specialties, as well as hospital executives and others, to discuss what it will mean when more subspecialists move into the hospital medicine fold.

The Nov. 4 meeting in Las Vegas is still in the planning stages, said Dr. John R. Nelson, an SHM founder and a hospitalist in Bellevue, Wash. The society expects the meeting will be attended by hospitalists in internal medicine, pediatrics, and family medicine, but also by those in neurology, ob.gyn., gastroenterology, general surgery, and psychiatry.

Nearly 90% of hospitalists specialize in general internal medicine, according to 2010 figures from SHM, with many of the remaining hospitalists trained in pediatrics and family medicine. But Dr. Nelson said the hospital medicine model is beginning to emerge across specialties, with ob.gyn. and neurology leading the way.

The upcoming meeting won’t be a clinical conference or a meeting to discuss payments to physicians, Dr. Nelson said. Instead, it will focus on likely implications of expanding the hospital medicine model. Dr. Nelson, who is helping to organize the meeting, said that organizers plan to tackle such questions as the potential impact on hospital credentialing, compensation, and the pace of changes including bundled payments.

Creating a cadre of subspecialty hospitalists is also likely to affect malpractice, Dr. Nelson said, though it’s unclear how. On the one hand, patients would have ready access to physicians at all times in the hospital, potentially lowering the malpractice risk. However, patients would also be seeing physicians who they didn’t know, potentially raising legal risks, he said. And there’s the question of how this could affect patient handoffs and other quality issues around the hospital. "We ought to start thinking about these things," Dr. Nelson said.

The Las Vegas meeting will include several formal presentations on lessons learned from the medicine and pediatric hospitalist movement, and a look at the current quality data, Dr. Nelson said. It will also be a chance for physicians from across specialties to get in a room together and share their experiences, he said.

Dr. Nelson was among a small group of hospitalists from various specialties who got together in San Francisco a few months ago to discuss these issues. He said the physicians had lots of questions for each other about how they handled follow-up, patient reactions, and interactions with community physicians. "We could have talked forever," he said.

The potential audience for the upcoming meeting will also include hospital executives, physician recruiters, and others in health care who have a stake in how hospital medicine evolves.

The Food and Drug Administration on May 6 expanded the indication for the RX Acculink carotid stent, allowing it to be marketed for use in patients with carotid artery disease who do not face an increased risk of complications from surgery.

The RX Acculink stent, which is marketed by Abbott Vascular, a subsidiary of Abbott Laboratories, was originally approved by the FDA in 2004. At that time, the stent was approved for patients at high risk of complications from carotid endarterectomy.

The company sought an expanded approval based on the results of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST), a randomized, multicenter, noninferiority study sponsored by the National Institutes of Health and funded in part by the manufacturer. The study of more than 2,500 patients in the United States and Canada showed that at 1 year, patients who were treated with RX Acculink had a combined 30-day rate of death, stroke, and myocardial infarction, and a 31-365–day rate of ipsilateral stroke, of 7.1%, compared with 6.6% among those who underwent endarterectomy, a difference that met the prespecified criteria for noninferiority.

As a condition of the expanded approval, the FDA is requiring Abbott Vascular to conduct a postapproval study. The study would follow new patients treated with RX Acculink for at least 3 years to confirm the results from the CREST study. The FDA has also asked the manufacturer to look at how patients aged 80 years and older respond to treatment and whether patients who show symptoms prior to treatment experience different outcomes than those who don’t exhibit symptoms.

The FDA’s action follows a recommendation from the Circulatory System Devices Panel, which voted in January that the benefits of using the RX Acculink stent outweighed the risks when used by patients at standard risk for surgery.

The Food and Drug Administration on May 6 expanded the indication for the RX Acculink carotid stent, allowing it to be marketed for use in patients with carotid artery disease who do not face an increased risk of complications from surgery.

The RX Acculink stent, which is marketed by Abbott Vascular, a subsidiary of Abbott Laboratories, was originally approved by the FDA in 2004. At that time, the stent was approved for patients at high risk of complications from carotid endarterectomy.

The company sought an expanded approval based on the results of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST), a randomized, multicenter, noninferiority study sponsored by the National Institutes of Health and funded in part by the manufacturer. The study of more than 2,500 patients in the United States and Canada showed that at 1 year, patients who were treated with RX Acculink had a combined 30-day rate of death, stroke, and myocardial infarction, and a 31-365–day rate of ipsilateral stroke, of 7.1%, compared with 6.6% among those who underwent endarterectomy, a difference that met the prespecified criteria for noninferiority.

As a condition of the expanded approval, the FDA is requiring Abbott Vascular to conduct a postapproval study. The study would follow new patients treated with RX Acculink for at least 3 years to confirm the results from the CREST study. The FDA has also asked the manufacturer to look at how patients aged 80 years and older respond to treatment and whether patients who show symptoms prior to treatment experience different outcomes than those who don’t exhibit symptoms.

The FDA’s action follows a recommendation from the Circulatory System Devices Panel, which voted in January that the benefits of using the RX Acculink stent outweighed the risks when used by patients at standard risk for surgery.

The Food and Drug Administration on May 6 expanded the indication for the RX Acculink carotid stent, allowing it to be marketed for use in patients with carotid artery disease who do not face an increased risk of complications from surgery.

The RX Acculink stent, which is marketed by Abbott Vascular, a subsidiary of Abbott Laboratories, was originally approved by the FDA in 2004. At that time, the stent was approved for patients at high risk of complications from carotid endarterectomy.

The company sought an expanded approval based on the results of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST), a randomized, multicenter, noninferiority study sponsored by the National Institutes of Health and funded in part by the manufacturer. The study of more than 2,500 patients in the United States and Canada showed that at 1 year, patients who were treated with RX Acculink had a combined 30-day rate of death, stroke, and myocardial infarction, and a 31-365–day rate of ipsilateral stroke, of 7.1%, compared with 6.6% among those who underwent endarterectomy, a difference that met the prespecified criteria for noninferiority.

As a condition of the expanded approval, the FDA is requiring Abbott Vascular to conduct a postapproval study. The study would follow new patients treated with RX Acculink for at least 3 years to confirm the results from the CREST study. The FDA has also asked the manufacturer to look at how patients aged 80 years and older respond to treatment and whether patients who show symptoms prior to treatment experience different outcomes than those who don’t exhibit symptoms.

The FDA’s action follows a recommendation from the Circulatory System Devices Panel, which voted in January that the benefits of using the RX Acculink stent outweighed the risks when used by patients at standard risk for surgery.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.

Starting in July, hospitals, nursing homes, office-based surgical practices and other health care organizations accredited by the Joint Commission will need to comply with new requirements for medication reconciliation.

Officials at the Joint Commission have approved a revised national patient safety goal on medication reconciliation that requires providers at accredited organizations to find out what medications patients are taking when they are admitted to the hospital or arrive at the facility, and compare that information with any new medications ordered. Providers must also give the patient or family a list of the medications that should be taken once they leave the facility.

The Joint Commission is also asking providers to do something new: Educate patients and their families about the importance of maintaining a list of current medications. For example, hospital staff could fulfill this goal by advising patients to give the reconciliated medication lists to their primary care physicians.

The Joint Commission’s requirements differ somewhat depending on the setting of care. For example, in settings where medications are not prescribed, providers will not be required to compare old and new medications, or to give patients written information on the medications they should be taking. They will also not be required to provide education on medication management.

These new requirements replace a national patient safety goal on medication reconciliation from 2009, which was placed on hold due to concerns from physicians and hospitals that it was too prescriptive. Since then, officials at the Joint Commission have been talking to physicians and other providers about their concerns, and working to revise the requirements.

"We really tried to work with the field to find out what the goal should be all about," Maureen Carr, project director for the division of health care quality evaluation at the Joint Commission, said in an interview.

Ms. Carr said the previous medication reconciliation goal was much more prescriptive and included requirements related to several elements of the care process that were already addressed in other Joint Commission goals. This time around, officials tried to simplify the requirements by focusing on "risk points" associated with medication reconciliation. They also tried to minimize the documentation requirements.

And they backed away from some of the more prescriptive elements, Ms. Carr said. For example, the goal used to require that providers give the reconciled medication list to the next provider of care. But that was problematic because in some situations there wasn’t a next provider of care, she said. Now the requirement is to give the list to the patient or family. "We’re trying to take away some of the things that were unnecessarily prescriptive," she said.

The revised goal also spells out that making a "good faith effort" to get an accurate medication list would meet the intent of the standard. Officials at the Joint Commission understand that it’s difficult to get a correct medication list from patients for a number of reasons, ranging from patients who withhold information to those that simply forget, Ms. Carr said. It has been the position of the Joint Commission that a good faith effort is enough, but they decided to make that explicit in the policy, she said.

While the burden on providers should be lessened under the revised goal, Ms. Carr said it still addresses patient safety by targeting the most critical areas. For example, the new requirements focus on getting information from the patients when they come in, comparing current medications with new ones, and ensuring that patients understand their medications when the episode of care is over.