Practice Economics

LAS VEGAS – Doctors are dreading what some have started to call EHR "pajama time.”

“That’s the hour or two that physicians are spending – every night after their kids go to bed – finishing up their documentation, clearing out their in-box,” according to Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association.

At a session held in conjunction with the annual meeting of the Healthcare Information and Management Systems Society, Dr. Sinsky spoke about how electronic health records have not lived up to their promise of helping streamline patient care and instead have added hours and headaches to most physicians’ days.

Leah-Anne Thompson/Thinkstock

Data on the impact of EHR systems on physicians’ workflows and satisfaction is beginning to accumulate, she said. University of Wisconsin researchers studying the impact of EHR systems on physicians’ workflow and lives looked at how often and when doctors were accessing their patients’ medical records, she said. What they found was that so many doctors don’t have enough time in their days to finish their documentation, so they spend their evenings and weekends finishing up. Their preliminary findings were presented in 2015 at a primary care research meeting.

Dr. Sinsky said the researchers see “a bump” of time spent on Saturday nights.

“I call that ‘date night’. That Saturday night belongs to Epic, Cerner, or McKesson,” she said sarcastically. “Well, I don’t want my doctor on her electronic health record on a Saturday night. I want my doctor having fun on Saturday night, because I want her to love her job.”

That same study “found that primary care physicians were spending 38 hours a month after hours doing data entry work,” in other words “working a full extra week every month doing documentation after hours, between 7 p.m. and 7 a.m.,” said Dr. Sinky, who is also an internist in Dubuque, Iowa.

Here are 10 ways EHRs contribute to more work, Dr. Sinsky said:

1. Too many clicks. “It takes 33 clicks to order and record a flu shot. And in the emergency room, it takes 4,000 clicks to get through the day for a 10-hour shift,” Dr. Sinsky said. “Studies have shown that physicians are spending 44% of their day doing data entry work, [but] 28% of the day with their patient.”

In her own EHR, she said, “it took 21 clicks, eight scrolls, and five screens just to compose the billing invoice, and within that EHR, the responsibility, which used to be a clerical responsibility, has transferred many things to the physician. All of those clicks, all those screens, and all those minutes add up.”

2. Note bloat. With her current EHR, Dr. Sinksy said, “I have six pages of notes for an upper respiratory infection.” This is not efficient. She offered another example: “I had a patient recently who I sent to a local university,” Dr. Sinsky said. “I got back an enormous note, about 12 pages long. But I still didn’t know, at the end of it. Did she have cancer, or not?”

3. Poor workflow. Today’s EHRs have a workflow that doesn’t match how clinicians work, she said. “Right now, many clinicians are encountering these very rigid workflows that don’t meet the patient’s need and don’t meet the provider’s need.” For example, “in some EHRs, the physician can’t look at any clinical data while dictating the note. This means that the physician has to rely on memory or print lab results, x-ray reports, medication lists, etc., in order to reference these data points in their clinic note.”

4. A lack of focus on the patient. Most EHRs lack a place for a photo of the patient and his or her family, and a place for the patient’s story, a deficiency that detracts from the value of the encounter.

5. No support for team care. Often, both a physician and a nurse or medical assistant need to add documentation to the EHR. Yet many systems are set up such that each party must log in, then log out, before another can contribute. “The nurse has to sign in and sign out; the doctor has to sign in and sign out. That’s about a 2-minute process, so it’s completely unworkable,” Dr. Sinsky said.

6. Distracted hikes to the printer. While most health care settings have installed the computer in the exam rooms, few have also installed a printer. “The doctor types up the exit summary, hits print, runs around the corner, down the hall, around the corner to the one printer, picks up the visit summary, goes back down the corner down the hall. Meanwhile, they’ve broken their bond with the patient and been interrupted several times on that journey.”

7. Single-use workstations. Doctors who can sit side by side with their nurses and talk about the patient as they’re working on the EHR can save 30 minutes per day. But most office practice setups don’t accommodate that interaction.

8. Small monitors. Being able to see a large display of information rather than a tiny swatch can save 20 minutes of physician time a day, Dr. Sinsky said.

9. A long sign-in process. Streamlining the way a doctor signs into a computer, perhaps with the use of technologies like the tap of one’s badge, “can save 14 minutes of physician time a day,” Dr. Sinsky said.

10. Underuse of medical and nursing students. Practices are beginning to hire premed and prenursing students as assistants who shadow the physician with each patient. While the physician is “giving undivided attention to the patient, the practice partner is cuing up the orders, doing the billing invoice ,and recording much of the encounter.” At the University of California, Los Angeles, researchers found that the use of these assistants saves 3 hours of physician time each day (JAMA Intern Med. 2014;174[7]:1190-3).

LAS VEGAS – Doctors are dreading what some have started to call EHR "pajama time.”

“That’s the hour or two that physicians are spending – every night after their kids go to bed – finishing up their documentation, clearing out their in-box,” according to Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association.

At a session held in conjunction with the annual meeting of the Healthcare Information and Management Systems Society, Dr. Sinsky spoke about how electronic health records have not lived up to their promise of helping streamline patient care and instead have added hours and headaches to most physicians’ days.

Leah-Anne Thompson/Thinkstock

Data on the impact of EHR systems on physicians’ workflows and satisfaction is beginning to accumulate, she said. University of Wisconsin researchers studying the impact of EHR systems on physicians’ workflow and lives looked at how often and when doctors were accessing their patients’ medical records, she said. What they found was that so many doctors don’t have enough time in their days to finish their documentation, so they spend their evenings and weekends finishing up. Their preliminary findings were presented in 2015 at a primary care research meeting.

Dr. Sinsky said the researchers see “a bump” of time spent on Saturday nights.

“I call that ‘date night’. That Saturday night belongs to Epic, Cerner, or McKesson,” she said sarcastically. “Well, I don’t want my doctor on her electronic health record on a Saturday night. I want my doctor having fun on Saturday night, because I want her to love her job.”

That same study “found that primary care physicians were spending 38 hours a month after hours doing data entry work,” in other words “working a full extra week every month doing documentation after hours, between 7 p.m. and 7 a.m.,” said Dr. Sinky, who is also an internist in Dubuque, Iowa.

Here are 10 ways EHRs contribute to more work, Dr. Sinsky said:

1. Too many clicks. “It takes 33 clicks to order and record a flu shot. And in the emergency room, it takes 4,000 clicks to get through the day for a 10-hour shift,” Dr. Sinsky said. “Studies have shown that physicians are spending 44% of their day doing data entry work, [but] 28% of the day with their patient.”

In her own EHR, she said, “it took 21 clicks, eight scrolls, and five screens just to compose the billing invoice, and within that EHR, the responsibility, which used to be a clerical responsibility, has transferred many things to the physician. All of those clicks, all those screens, and all those minutes add up.”

2. Note bloat. With her current EHR, Dr. Sinksy said, “I have six pages of notes for an upper respiratory infection.” This is not efficient. She offered another example: “I had a patient recently who I sent to a local university,” Dr. Sinsky said. “I got back an enormous note, about 12 pages long. But I still didn’t know, at the end of it. Did she have cancer, or not?”

3. Poor workflow. Today’s EHRs have a workflow that doesn’t match how clinicians work, she said. “Right now, many clinicians are encountering these very rigid workflows that don’t meet the patient’s need and don’t meet the provider’s need.” For example, “in some EHRs, the physician can’t look at any clinical data while dictating the note. This means that the physician has to rely on memory or print lab results, x-ray reports, medication lists, etc., in order to reference these data points in their clinic note.”

4. A lack of focus on the patient. Most EHRs lack a place for a photo of the patient and his or her family, and a place for the patient’s story, a deficiency that detracts from the value of the encounter.

5. No support for team care. Often, both a physician and a nurse or medical assistant need to add documentation to the EHR. Yet many systems are set up such that each party must log in, then log out, before another can contribute. “The nurse has to sign in and sign out; the doctor has to sign in and sign out. That’s about a 2-minute process, so it’s completely unworkable,” Dr. Sinsky said.

6. Distracted hikes to the printer. While most health care settings have installed the computer in the exam rooms, few have also installed a printer. “The doctor types up the exit summary, hits print, runs around the corner, down the hall, around the corner to the one printer, picks up the visit summary, goes back down the corner down the hall. Meanwhile, they’ve broken their bond with the patient and been interrupted several times on that journey.”

7. Single-use workstations. Doctors who can sit side by side with their nurses and talk about the patient as they’re working on the EHR can save 30 minutes per day. But most office practice setups don’t accommodate that interaction.

8. Small monitors. Being able to see a large display of information rather than a tiny swatch can save 20 minutes of physician time a day, Dr. Sinsky said.

9. A long sign-in process. Streamlining the way a doctor signs into a computer, perhaps with the use of technologies like the tap of one’s badge, “can save 14 minutes of physician time a day,” Dr. Sinsky said.

10. Underuse of medical and nursing students. Practices are beginning to hire premed and prenursing students as assistants who shadow the physician with each patient. While the physician is “giving undivided attention to the patient, the practice partner is cuing up the orders, doing the billing invoice ,and recording much of the encounter.” At the University of California, Los Angeles, researchers found that the use of these assistants saves 3 hours of physician time each day (JAMA Intern Med. 2014;174[7]:1190-3).

LAS VEGAS – Doctors are dreading what some have started to call EHR "pajama time.”

“That’s the hour or two that physicians are spending – every night after their kids go to bed – finishing up their documentation, clearing out their in-box,” according to Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association.

At a session held in conjunction with the annual meeting of the Healthcare Information and Management Systems Society, Dr. Sinsky spoke about how electronic health records have not lived up to their promise of helping streamline patient care and instead have added hours and headaches to most physicians’ days.

Leah-Anne Thompson/Thinkstock

Data on the impact of EHR systems on physicians’ workflows and satisfaction is beginning to accumulate, she said. University of Wisconsin researchers studying the impact of EHR systems on physicians’ workflow and lives looked at how often and when doctors were accessing their patients’ medical records, she said. What they found was that so many doctors don’t have enough time in their days to finish their documentation, so they spend their evenings and weekends finishing up. Their preliminary findings were presented in 2015 at a primary care research meeting.

Dr. Sinsky said the researchers see “a bump” of time spent on Saturday nights.

“I call that ‘date night’. That Saturday night belongs to Epic, Cerner, or McKesson,” she said sarcastically. “Well, I don’t want my doctor on her electronic health record on a Saturday night. I want my doctor having fun on Saturday night, because I want her to love her job.”

That same study “found that primary care physicians were spending 38 hours a month after hours doing data entry work,” in other words “working a full extra week every month doing documentation after hours, between 7 p.m. and 7 a.m.,” said Dr. Sinky, who is also an internist in Dubuque, Iowa.

Here are 10 ways EHRs contribute to more work, Dr. Sinsky said:

1. Too many clicks. “It takes 33 clicks to order and record a flu shot. And in the emergency room, it takes 4,000 clicks to get through the day for a 10-hour shift,” Dr. Sinsky said. “Studies have shown that physicians are spending 44% of their day doing data entry work, [but] 28% of the day with their patient.”

In her own EHR, she said, “it took 21 clicks, eight scrolls, and five screens just to compose the billing invoice, and within that EHR, the responsibility, which used to be a clerical responsibility, has transferred many things to the physician. All of those clicks, all those screens, and all those minutes add up.”

2. Note bloat. With her current EHR, Dr. Sinksy said, “I have six pages of notes for an upper respiratory infection.” This is not efficient. She offered another example: “I had a patient recently who I sent to a local university,” Dr. Sinsky said. “I got back an enormous note, about 12 pages long. But I still didn’t know, at the end of it. Did she have cancer, or not?”

3. Poor workflow. Today’s EHRs have a workflow that doesn’t match how clinicians work, she said. “Right now, many clinicians are encountering these very rigid workflows that don’t meet the patient’s need and don’t meet the provider’s need.” For example, “in some EHRs, the physician can’t look at any clinical data while dictating the note. This means that the physician has to rely on memory or print lab results, x-ray reports, medication lists, etc., in order to reference these data points in their clinic note.”

4. A lack of focus on the patient. Most EHRs lack a place for a photo of the patient and his or her family, and a place for the patient’s story, a deficiency that detracts from the value of the encounter.

5. No support for team care. Often, both a physician and a nurse or medical assistant need to add documentation to the EHR. Yet many systems are set up such that each party must log in, then log out, before another can contribute. “The nurse has to sign in and sign out; the doctor has to sign in and sign out. That’s about a 2-minute process, so it’s completely unworkable,” Dr. Sinsky said.

6. Distracted hikes to the printer. While most health care settings have installed the computer in the exam rooms, few have also installed a printer. “The doctor types up the exit summary, hits print, runs around the corner, down the hall, around the corner to the one printer, picks up the visit summary, goes back down the corner down the hall. Meanwhile, they’ve broken their bond with the patient and been interrupted several times on that journey.”

7. Single-use workstations. Doctors who can sit side by side with their nurses and talk about the patient as they’re working on the EHR can save 30 minutes per day. But most office practice setups don’t accommodate that interaction.

8. Small monitors. Being able to see a large display of information rather than a tiny swatch can save 20 minutes of physician time a day, Dr. Sinsky said.

9. A long sign-in process. Streamlining the way a doctor signs into a computer, perhaps with the use of technologies like the tap of one’s badge, “can save 14 minutes of physician time a day,” Dr. Sinsky said.

10. Underuse of medical and nursing students. Practices are beginning to hire premed and prenursing students as assistants who shadow the physician with each patient. While the physician is “giving undivided attention to the patient, the practice partner is cuing up the orders, doing the billing invoice ,and recording much of the encounter.” At the University of California, Los Angeles, researchers found that the use of these assistants saves 3 hours of physician time each day (JAMA Intern Med. 2014;174[7]:1190-3).

AUSTIN, TEX. – Using the federal government’s voluntary self-disclosure protocol to report potential program violations offers advantages and disadvantages.

On one hand, the protocol allows health providers to get in front of possible offenses and retain some control, according to Miami health law attorney Stephen H. Siegel. On the other hand, launching the process could draw increased government scrutiny to a practice.

However, it can pay to be safe, rather than sorry later, Mr. Siegel said at an American Health Lawyers Association meeting.

“You are far better [off] and in a much better position, being proactive than reactive,” Mr. Siegel said in an interview. “Being proactive is an indication that your intention is to do the right thing. Whereas reactive, certainly the government doesn’t view [your intention] that way.”

Several federal agencies offer voluntary disclosure protocols. The HHS Office of Inspector General (OIG) self-disclosure protocol was created in 1998 to enable the self-disclosure of potential health care fraud. The Centers for Medicare & Medicaid Services provides the voluntary self-disclosure protocol, which is limited to potential violations of the physician-self referral statute, also called the Stark Law. Self-disclosures can also be made to the Department of Justice, although the agency has no formal protocol.

Voluntary self-disclosure can limit the possibility of an external investigation and reduce criminal and civil liability, according to Mr. Siegel. In a self-disclosure case, doctors can typically expect to pay back 1.5 times the amount that was improperly paid by the government. Whereas, in a false claims act case, for example, physicians can wind up paying back treble damages, plus a fine of between $5,500 and $11,000. Other advantages to voluntary self-disclosure include an expedited resolution, better control over adverse publicity, and the neutralizing of whistle-blower threats and lawsuits.

Disadvantages include financial loss, potential reputation harm, no immunity from liability or prior commitments by government, and possible penalties for conduct that may have remained undiscovered and thus undisclosed.

“For the most part, doctors are not aware of [voluntary self-disclosure],” Mr. Siegel said in an interview. “They’re not using it. [However], I think voluntary disclosure is going to become more widely used as people realize the ability to control the risk associated with the process.”

A number of issues warrant voluntary self-disclosure in a practice setting: possible government overpayments, potential improper arrangements with service providers, demonstrable patient harm, falsification of medical records, medical directorship issues, inadequate staffing, or the practice of medicine without a license, among others.

Regardless of which agency handles the self-disclosure, the admission will likely make its way to other agencies.

“Be assured that the agencies are going to talk to each other,” Mr. Siegel said. “If you submit it to DOJ [Department of Justice], chances are, it’s going to go to OIG.”

After choosing which agency to direct the self-disclosure, submit a timely, complete, and transparent disclosure, he advised. Each disclosure protocol is specific. For example, the OIG requires the disclosing party to acknowledge that the conduct is a potential violation and explicitly identify the laws that were potentially violated. The disclosing party also must agree ensure that corrective actions are implemented and that potential misconduct has stopped by the time of disclosure or, for improper kickback arrangements, within 90 days of submission.

The process of voluntary self-disclosure can be slow, usually taking more than a year. The OIG and CMS also reserve the right to reject a voluntary disclosure, Mr. Siegel said. If the government has already initiated an investigation for instance, an agency may reject the self-disclosure.

The government considers a host of factors when choosing how to resolve a self-disclosure case including the effectiveness of preexisting compliance programs; the nature of the conduct and its financial impact; the doctor’s ability to repay; whether the discloser is a first‐time offender; whether the incident is isolated; efforts to correct the problem; the period of alleged conduct; how the matter was discovered; and the party’s level of cooperation.

Mr. Siegel stressed there are no guarantees about how a voluntary self-disclosure case may be settled and that the matter will depend on the circumstances.

“There is no one-size-fits-all approach to voluntary self‐disclosure,” he said. “These decisions should be made with the assistance of competent and experienced counsel.”

agallegos@frontlinemedcom.com

On Twitter @legal_med

AUSTIN, TEX. – Using the federal government’s voluntary self-disclosure protocol to report potential program violations offers advantages and disadvantages.

On one hand, the protocol allows health providers to get in front of possible offenses and retain some control, according to Miami health law attorney Stephen H. Siegel. On the other hand, launching the process could draw increased government scrutiny to a practice.

However, it can pay to be safe, rather than sorry later, Mr. Siegel said at an American Health Lawyers Association meeting.

“You are far better [off] and in a much better position, being proactive than reactive,” Mr. Siegel said in an interview. “Being proactive is an indication that your intention is to do the right thing. Whereas reactive, certainly the government doesn’t view [your intention] that way.”

Several federal agencies offer voluntary disclosure protocols. The HHS Office of Inspector General (OIG) self-disclosure protocol was created in 1998 to enable the self-disclosure of potential health care fraud. The Centers for Medicare & Medicaid Services provides the voluntary self-disclosure protocol, which is limited to potential violations of the physician-self referral statute, also called the Stark Law. Self-disclosures can also be made to the Department of Justice, although the agency has no formal protocol.

Voluntary self-disclosure can limit the possibility of an external investigation and reduce criminal and civil liability, according to Mr. Siegel. In a self-disclosure case, doctors can typically expect to pay back 1.5 times the amount that was improperly paid by the government. Whereas, in a false claims act case, for example, physicians can wind up paying back treble damages, plus a fine of between $5,500 and $11,000. Other advantages to voluntary self-disclosure include an expedited resolution, better control over adverse publicity, and the neutralizing of whistle-blower threats and lawsuits.

Disadvantages include financial loss, potential reputation harm, no immunity from liability or prior commitments by government, and possible penalties for conduct that may have remained undiscovered and thus undisclosed.

“For the most part, doctors are not aware of [voluntary self-disclosure],” Mr. Siegel said in an interview. “They’re not using it. [However], I think voluntary disclosure is going to become more widely used as people realize the ability to control the risk associated with the process.”

A number of issues warrant voluntary self-disclosure in a practice setting: possible government overpayments, potential improper arrangements with service providers, demonstrable patient harm, falsification of medical records, medical directorship issues, inadequate staffing, or the practice of medicine without a license, among others.

Regardless of which agency handles the self-disclosure, the admission will likely make its way to other agencies.

“Be assured that the agencies are going to talk to each other,” Mr. Siegel said. “If you submit it to DOJ [Department of Justice], chances are, it’s going to go to OIG.”

After choosing which agency to direct the self-disclosure, submit a timely, complete, and transparent disclosure, he advised. Each disclosure protocol is specific. For example, the OIG requires the disclosing party to acknowledge that the conduct is a potential violation and explicitly identify the laws that were potentially violated. The disclosing party also must agree ensure that corrective actions are implemented and that potential misconduct has stopped by the time of disclosure or, for improper kickback arrangements, within 90 days of submission.

The process of voluntary self-disclosure can be slow, usually taking more than a year. The OIG and CMS also reserve the right to reject a voluntary disclosure, Mr. Siegel said. If the government has already initiated an investigation for instance, an agency may reject the self-disclosure.

The government considers a host of factors when choosing how to resolve a self-disclosure case including the effectiveness of preexisting compliance programs; the nature of the conduct and its financial impact; the doctor’s ability to repay; whether the discloser is a first‐time offender; whether the incident is isolated; efforts to correct the problem; the period of alleged conduct; how the matter was discovered; and the party’s level of cooperation.

Mr. Siegel stressed there are no guarantees about how a voluntary self-disclosure case may be settled and that the matter will depend on the circumstances.

“There is no one-size-fits-all approach to voluntary self‐disclosure,” he said. “These decisions should be made with the assistance of competent and experienced counsel.”

agallegos@frontlinemedcom.com

On Twitter @legal_med

AUSTIN, TEX. – Using the federal government’s voluntary self-disclosure protocol to report potential program violations offers advantages and disadvantages.

On one hand, the protocol allows health providers to get in front of possible offenses and retain some control, according to Miami health law attorney Stephen H. Siegel. On the other hand, launching the process could draw increased government scrutiny to a practice.

However, it can pay to be safe, rather than sorry later, Mr. Siegel said at an American Health Lawyers Association meeting.

“You are far better [off] and in a much better position, being proactive than reactive,” Mr. Siegel said in an interview. “Being proactive is an indication that your intention is to do the right thing. Whereas reactive, certainly the government doesn’t view [your intention] that way.”

Several federal agencies offer voluntary disclosure protocols. The HHS Office of Inspector General (OIG) self-disclosure protocol was created in 1998 to enable the self-disclosure of potential health care fraud. The Centers for Medicare & Medicaid Services provides the voluntary self-disclosure protocol, which is limited to potential violations of the physician-self referral statute, also called the Stark Law. Self-disclosures can also be made to the Department of Justice, although the agency has no formal protocol.

Voluntary self-disclosure can limit the possibility of an external investigation and reduce criminal and civil liability, according to Mr. Siegel. In a self-disclosure case, doctors can typically expect to pay back 1.5 times the amount that was improperly paid by the government. Whereas, in a false claims act case, for example, physicians can wind up paying back treble damages, plus a fine of between $5,500 and $11,000. Other advantages to voluntary self-disclosure include an expedited resolution, better control over adverse publicity, and the neutralizing of whistle-blower threats and lawsuits.

Disadvantages include financial loss, potential reputation harm, no immunity from liability or prior commitments by government, and possible penalties for conduct that may have remained undiscovered and thus undisclosed.

“For the most part, doctors are not aware of [voluntary self-disclosure],” Mr. Siegel said in an interview. “They’re not using it. [However], I think voluntary disclosure is going to become more widely used as people realize the ability to control the risk associated with the process.”

A number of issues warrant voluntary self-disclosure in a practice setting: possible government overpayments, potential improper arrangements with service providers, demonstrable patient harm, falsification of medical records, medical directorship issues, inadequate staffing, or the practice of medicine without a license, among others.

Regardless of which agency handles the self-disclosure, the admission will likely make its way to other agencies.

“Be assured that the agencies are going to talk to each other,” Mr. Siegel said. “If you submit it to DOJ [Department of Justice], chances are, it’s going to go to OIG.”

After choosing which agency to direct the self-disclosure, submit a timely, complete, and transparent disclosure, he advised. Each disclosure protocol is specific. For example, the OIG requires the disclosing party to acknowledge that the conduct is a potential violation and explicitly identify the laws that were potentially violated. The disclosing party also must agree ensure that corrective actions are implemented and that potential misconduct has stopped by the time of disclosure or, for improper kickback arrangements, within 90 days of submission.

The process of voluntary self-disclosure can be slow, usually taking more than a year. The OIG and CMS also reserve the right to reject a voluntary disclosure, Mr. Siegel said. If the government has already initiated an investigation for instance, an agency may reject the self-disclosure.

The government considers a host of factors when choosing how to resolve a self-disclosure case including the effectiveness of preexisting compliance programs; the nature of the conduct and its financial impact; the doctor’s ability to repay; whether the discloser is a first‐time offender; whether the incident is isolated; efforts to correct the problem; the period of alleged conduct; how the matter was discovered; and the party’s level of cooperation.

Mr. Siegel stressed there are no guarantees about how a voluntary self-disclosure case may be settled and that the matter will depend on the circumstances.

“There is no one-size-fits-all approach to voluntary self‐disclosure,” he said. “These decisions should be made with the assistance of competent and experienced counsel.”

agallegos@frontlinemedcom.com

On Twitter @legal_med

The Food and Drug Administration has proposed a ban on most powdered gloves used during surgery and for patient examination, and on absorbable powder used for lubricating surgeons’ gloves.

Aerosolized glove powder on natural rubber latex gloves can cause respiratory allergic reactions, and while powdered synthetic gloves don’t present the risk of allergic reactions, all powdered gloves have been associated with numerous potentially serious adverse events, including severe airway inflammation, wound inflammation, and postsurgical adhesions, according to an FDA statement.

The proposed ban would not apply to powdered radiographic protection gloves; the agency is not aware of any such gloves that are currently on the market. The ban also would not affect non-powdered gloves.

The decision to move forward with the proposed ban was based on a determination that the affected products “are dangerous and present an unreasonable and substantial risk,” according to the statement.

In making this determination, the FDA considered the available evidence, including a literature review and the 285 comments received on a February 2011 Federal Register Notice.

That notice announced the establishment of a public docket to receive comments related to powdered gloves and followed the FDA’s receipt of two citizen petitions requesting a ban on such gloves because of the adverse health effects associated with use of the gloves. The comments overwhelmingly supported a warning or ban.

The FDA determined that the risks associated with powdered gloves cannot be corrected through new or updated labeling, and thus moved forward with the proposed ban.

“This ban is about protecting patients and health care professionals from a danger they might not even be aware of,” Dr. Jeffrey Shuren, director of the FDA Center for Devices and Radiological Health said in the statement. “We take bans very seriously and only take this action when we feel it’s necessary to protect the public health.”

In fact, should this ban be put into place, it would be only the second such ban; the first was the 1983 ban of prosthetic hair fibers, which were found to provide no public health benefit. The benefits cited for powdered gloves were almost entirely related to greater ease of putting the gloves on and taking them off, Eric Pahon of the FDA said in an interview.

A ban on the gloves was not proposed sooner in part because when concerns were first raised about the risks associated with powdered gloves, a ban would have created a shortage, and the risks of a glove shortage outweighed the benefits of banning the gloves, Mr. Pahon said.

However, a recent economic analysis conducted by the FDA because of the critical role medical gloves play in protecting patients and health care providers showed that a powdered glove ban would not cause a glove shortage or have a significant economic impact, and that a ban would not be likely to affect medical practice since numerous non-powdered gloves options are now available, the agency noted.

The proposed rule will be available online March 22 at the Federal Register, and is open for public comment for 90 days.

If finalized, the powdered gloves and absorbable powder used for lubricating surgeons’ gloves would be removed from the marketplace.

sworcester@frontlinemedcom.com

The Food and Drug Administration has proposed a ban on most powdered gloves used during surgery and for patient examination, and on absorbable powder used for lubricating surgeons’ gloves.

Aerosolized glove powder on natural rubber latex gloves can cause respiratory allergic reactions, and while powdered synthetic gloves don’t present the risk of allergic reactions, all powdered gloves have been associated with numerous potentially serious adverse events, including severe airway inflammation, wound inflammation, and postsurgical adhesions, according to an FDA statement.

The proposed ban would not apply to powdered radiographic protection gloves; the agency is not aware of any such gloves that are currently on the market. The ban also would not affect non-powdered gloves.

The decision to move forward with the proposed ban was based on a determination that the affected products “are dangerous and present an unreasonable and substantial risk,” according to the statement.

In making this determination, the FDA considered the available evidence, including a literature review and the 285 comments received on a February 2011 Federal Register Notice.

That notice announced the establishment of a public docket to receive comments related to powdered gloves and followed the FDA’s receipt of two citizen petitions requesting a ban on such gloves because of the adverse health effects associated with use of the gloves. The comments overwhelmingly supported a warning or ban.

The FDA determined that the risks associated with powdered gloves cannot be corrected through new or updated labeling, and thus moved forward with the proposed ban.

“This ban is about protecting patients and health care professionals from a danger they might not even be aware of,” Dr. Jeffrey Shuren, director of the FDA Center for Devices and Radiological Health said in the statement. “We take bans very seriously and only take this action when we feel it’s necessary to protect the public health.”

In fact, should this ban be put into place, it would be only the second such ban; the first was the 1983 ban of prosthetic hair fibers, which were found to provide no public health benefit. The benefits cited for powdered gloves were almost entirely related to greater ease of putting the gloves on and taking them off, Eric Pahon of the FDA said in an interview.

A ban on the gloves was not proposed sooner in part because when concerns were first raised about the risks associated with powdered gloves, a ban would have created a shortage, and the risks of a glove shortage outweighed the benefits of banning the gloves, Mr. Pahon said.

However, a recent economic analysis conducted by the FDA because of the critical role medical gloves play in protecting patients and health care providers showed that a powdered glove ban would not cause a glove shortage or have a significant economic impact, and that a ban would not be likely to affect medical practice since numerous non-powdered gloves options are now available, the agency noted.

The proposed rule will be available online March 22 at the Federal Register, and is open for public comment for 90 days.

If finalized, the powdered gloves and absorbable powder used for lubricating surgeons’ gloves would be removed from the marketplace.

sworcester@frontlinemedcom.com

The Food and Drug Administration has proposed a ban on most powdered gloves used during surgery and for patient examination, and on absorbable powder used for lubricating surgeons’ gloves.

Aerosolized glove powder on natural rubber latex gloves can cause respiratory allergic reactions, and while powdered synthetic gloves don’t present the risk of allergic reactions, all powdered gloves have been associated with numerous potentially serious adverse events, including severe airway inflammation, wound inflammation, and postsurgical adhesions, according to an FDA statement.

The proposed ban would not apply to powdered radiographic protection gloves; the agency is not aware of any such gloves that are currently on the market. The ban also would not affect non-powdered gloves.

The decision to move forward with the proposed ban was based on a determination that the affected products “are dangerous and present an unreasonable and substantial risk,” according to the statement.

In making this determination, the FDA considered the available evidence, including a literature review and the 285 comments received on a February 2011 Federal Register Notice.

That notice announced the establishment of a public docket to receive comments related to powdered gloves and followed the FDA’s receipt of two citizen petitions requesting a ban on such gloves because of the adverse health effects associated with use of the gloves. The comments overwhelmingly supported a warning or ban.

The FDA determined that the risks associated with powdered gloves cannot be corrected through new or updated labeling, and thus moved forward with the proposed ban.

“This ban is about protecting patients and health care professionals from a danger they might not even be aware of,” Dr. Jeffrey Shuren, director of the FDA Center for Devices and Radiological Health said in the statement. “We take bans very seriously and only take this action when we feel it’s necessary to protect the public health.”

In fact, should this ban be put into place, it would be only the second such ban; the first was the 1983 ban of prosthetic hair fibers, which were found to provide no public health benefit. The benefits cited for powdered gloves were almost entirely related to greater ease of putting the gloves on and taking them off, Eric Pahon of the FDA said in an interview.

A ban on the gloves was not proposed sooner in part because when concerns were first raised about the risks associated with powdered gloves, a ban would have created a shortage, and the risks of a glove shortage outweighed the benefits of banning the gloves, Mr. Pahon said.

However, a recent economic analysis conducted by the FDA because of the critical role medical gloves play in protecting patients and health care providers showed that a powdered glove ban would not cause a glove shortage or have a significant economic impact, and that a ban would not be likely to affect medical practice since numerous non-powdered gloves options are now available, the agency noted.

The proposed rule will be available online March 22 at the Federal Register, and is open for public comment for 90 days.

If finalized, the powdered gloves and absorbable powder used for lubricating surgeons’ gloves would be removed from the marketplace.

sworcester@frontlinemedcom.com

The federal government has launched the second phase of its HIPAA Audit Program and will soon be identifying health providers it plans to target.

For the 2016 Phase 2 HIPAA Audit Program, auditors will review policies and procedures enacted by covered entities and their business associates to meet selected standards of the Privacy, Security, and Breach Notification Rules, according to a March 21 announcement by the Department of Health & Human Services Office for Civil Rights (OCR).

©zimmytws/Thinkstock.com

Physicians and other covered entities can expect an email at some point this year requesting that updated contact information be provided to the OCR. The office will then send health providers a pre-audit questionnaire to gather data about the practice’s size, type, and operations, according to the announcement. The government will use the data as well as other information to create audit subject pools. If an entity does not respond to the OCR’s contact request or the pre-audit questionnaire, the agency will use publicly available information about the practice.

Every covered entity and business associate is eligible for an audit, the OCR noted. For Phase 2, the government plans to identify health providers and business associates that represent a wide range of health care providers, health plans, health care clearinghouses and business associates to access HIPAA compliance across the industry. Sampling criteria for auditee selection will include size of the entity, affiliation with other health care organizations, whether an organization is public or private, geographic factors, and present enforcement activity with OCR. Entities with open complaints or that are currently undergoing investigations will not be chosen.

The first set of audits will be desk audits of covered entities followed by a second round of desk audits of business associates, OCR stated. OCR plans to complete all desk audits by December 2016. A third set of audits will be on site and will examine a broader scope of requirements under the HIPAA rules. Some desk auditees may be subject to a subsequent on-site audit, the government noted.

A list of frequently asked questions about the 2016 Phase 2 HIPAA Audit Program can be found on the OCR’s website.

Round 2 of the HIPAA audits follows a pilot program launched in 2011 and 2012 by OCR that assessed HIPAA controls and processes implemented by 115 covered entities. The second phase will draw on the results and experiences learned from the pilot program, according to OCR.

agallegos@frontlinemedcom.com

On Twitter @legal_med

The federal government has launched the second phase of its HIPAA Audit Program and will soon be identifying health providers it plans to target.

For the 2016 Phase 2 HIPAA Audit Program, auditors will review policies and procedures enacted by covered entities and their business associates to meet selected standards of the Privacy, Security, and Breach Notification Rules, according to a March 21 announcement by the Department of Health & Human Services Office for Civil Rights (OCR).

©zimmytws/Thinkstock.com

Physicians and other covered entities can expect an email at some point this year requesting that updated contact information be provided to the OCR. The office will then send health providers a pre-audit questionnaire to gather data about the practice’s size, type, and operations, according to the announcement. The government will use the data as well as other information to create audit subject pools. If an entity does not respond to the OCR’s contact request or the pre-audit questionnaire, the agency will use publicly available information about the practice.

Every covered entity and business associate is eligible for an audit, the OCR noted. For Phase 2, the government plans to identify health providers and business associates that represent a wide range of health care providers, health plans, health care clearinghouses and business associates to access HIPAA compliance across the industry. Sampling criteria for auditee selection will include size of the entity, affiliation with other health care organizations, whether an organization is public or private, geographic factors, and present enforcement activity with OCR. Entities with open complaints or that are currently undergoing investigations will not be chosen.

The first set of audits will be desk audits of covered entities followed by a second round of desk audits of business associates, OCR stated. OCR plans to complete all desk audits by December 2016. A third set of audits will be on site and will examine a broader scope of requirements under the HIPAA rules. Some desk auditees may be subject to a subsequent on-site audit, the government noted.

A list of frequently asked questions about the 2016 Phase 2 HIPAA Audit Program can be found on the OCR’s website.

Round 2 of the HIPAA audits follows a pilot program launched in 2011 and 2012 by OCR that assessed HIPAA controls and processes implemented by 115 covered entities. The second phase will draw on the results and experiences learned from the pilot program, according to OCR.

agallegos@frontlinemedcom.com

On Twitter @legal_med

The federal government has launched the second phase of its HIPAA Audit Program and will soon be identifying health providers it plans to target.

For the 2016 Phase 2 HIPAA Audit Program, auditors will review policies and procedures enacted by covered entities and their business associates to meet selected standards of the Privacy, Security, and Breach Notification Rules, according to a March 21 announcement by the Department of Health & Human Services Office for Civil Rights (OCR).

©zimmytws/Thinkstock.com

Physicians and other covered entities can expect an email at some point this year requesting that updated contact information be provided to the OCR. The office will then send health providers a pre-audit questionnaire to gather data about the practice’s size, type, and operations, according to the announcement. The government will use the data as well as other information to create audit subject pools. If an entity does not respond to the OCR’s contact request or the pre-audit questionnaire, the agency will use publicly available information about the practice.

Every covered entity and business associate is eligible for an audit, the OCR noted. For Phase 2, the government plans to identify health providers and business associates that represent a wide range of health care providers, health plans, health care clearinghouses and business associates to access HIPAA compliance across the industry. Sampling criteria for auditee selection will include size of the entity, affiliation with other health care organizations, whether an organization is public or private, geographic factors, and present enforcement activity with OCR. Entities with open complaints or that are currently undergoing investigations will not be chosen.

The first set of audits will be desk audits of covered entities followed by a second round of desk audits of business associates, OCR stated. OCR plans to complete all desk audits by December 2016. A third set of audits will be on site and will examine a broader scope of requirements under the HIPAA rules. Some desk auditees may be subject to a subsequent on-site audit, the government noted.

A list of frequently asked questions about the 2016 Phase 2 HIPAA Audit Program can be found on the OCR’s website.

Round 2 of the HIPAA audits follows a pilot program launched in 2011 and 2012 by OCR that assessed HIPAA controls and processes implemented by 115 covered entities. The second phase will draw on the results and experiences learned from the pilot program, according to OCR.

agallegos@frontlinemedcom.com

On Twitter @legal_med

Organizations looking to become a next generation accountable care organization (ACO) must have their letter of intent to apply submitted to the Centers for Medicare & Medicaid Services by May 2.

This deadline represents the second and final round of applications the agency is accepting to become next generation ACOs. New ACOs under this model will begin in the second year of the next generation program in January 2017, joining 21 other organizations already designated as next generation ACOs.

©roobcio/Thinkstock

CMS is hosting a number of open door forums to provide guidance to applicants:

• March 22: Letter of intent overview

• March 29: Application overview

• April 5: Financial methodology

• April 12: Participating provider list

• April 19: Benefit enhancements

Additional information on the next generation ACO model, along with application instructions, can be found here.

gtwachtman@frontlinemedcom.com

Organizations looking to become a next generation accountable care organization (ACO) must have their letter of intent to apply submitted to the Centers for Medicare & Medicaid Services by May 2.

This deadline represents the second and final round of applications the agency is accepting to become next generation ACOs. New ACOs under this model will begin in the second year of the next generation program in January 2017, joining 21 other organizations already designated as next generation ACOs.

©roobcio/Thinkstock

CMS is hosting a number of open door forums to provide guidance to applicants:

• March 22: Letter of intent overview

• March 29: Application overview

• April 5: Financial methodology

• April 12: Participating provider list

• April 19: Benefit enhancements

Additional information on the next generation ACO model, along with application instructions, can be found here.

gtwachtman@frontlinemedcom.com

Organizations looking to become a next generation accountable care organization (ACO) must have their letter of intent to apply submitted to the Centers for Medicare & Medicaid Services by May 2.

This deadline represents the second and final round of applications the agency is accepting to become next generation ACOs. New ACOs under this model will begin in the second year of the next generation program in January 2017, joining 21 other organizations already designated as next generation ACOs.

©roobcio/Thinkstock

CMS is hosting a number of open door forums to provide guidance to applicants:

• March 22: Letter of intent overview

• March 29: Application overview

• April 5: Financial methodology

• April 12: Participating provider list

• April 19: Benefit enhancements

Additional information on the next generation ACO model, along with application instructions, can be found here.

gtwachtman@frontlinemedcom.com

Medical school seniors scored a record number of available first-year slots in this year’s Main Residency Match, with both internal medicine and family medicine programs offering more spots to residents in 2016.

Continuing a 4-year growth trend, the number of available post-graduate year 1 (PGY-1) positions rose to 27,860 in 2016, 567 more spots than in 2015, and a record 18,668 U.S. allopathic medical school seniors registered for the match, 221 more than in 2015, according to data from the National Resident Matching Program (NRMP).

Family medicine residency programs offered 3,238 positions in 2016, up from 3,195 in the 2015 match. This year, greater than 95% of those positions were filled; 45% were filled by U.S. medical school graduates, the NRMP announced March 18.

Internal medicine experienced similar increases, with residency programs offering 7,024 positions this year, up from 6,770 positions in 2015. Just less than 99% of the positions were filled, with 47% filled by U.S. medical school graduates in this year’s Match.

“We’re very pleased with the way the numbers turned out,” said Dr. Philip A. Masters, clinical content development director for the American College of Physicians (ACP). “About 45% of new slots in this year’s Match were in internal medicine. So that coupled with a very high fill rate really suggests a continuing and an increased interest in the field.”

Dr. Wanda Filer, president of the American Academy of Family Physicians, said she was glad to see an increased number of medical school graduates matching to family medicine, but she stressed that the numbers are not enough.

“This nation needs far more family medicine physicians than the current numbers are achieving,” she said in an interview. “The growth in family medicine residency slots is not fast enough and our antiquated graduate medical education payment is misaligned with U.S. workforce needs. Additionally, poor accountability for federal dollars by some U.S. medical schools to deliver that workforce should be rapidly addressed.”

While ACP officials were satisfied with the overall internal medicine numbers, Dr. Masters said that the lack of medical students entering general internal medicine and primary care careers is concerning.

“The number of people in the regular categorical [internal medicine] training programs is a lot lower than it used to be,” Dr. Masters said in a interview. “A long time ago, upwards of half of people who went in categorical training pursued a career in general internal medicine. [Now], the overall trend tends to be away from primary care/general internal medicine. That is concerning because that’s what society really needs right now.”

Pediatric positions, meanwhile, rose slightly in 2016, growing to 2,689, with 21 more slots than last year. Just more than 99% were filled, and 68% were filled by U.S. seniors.

The NRMP data shows that of 18,668 U.S. allopathic seniors who registered for the Match this year, 18,187 submitted program choices and 17,057 matched to first-year positions. This is up from the 18,025 U.S. allopathic medical school seniors who submitted program preferences for the 2015 Match, of which 16,932 matched to first-year positions.

The larger scope of this year’s Match is likely attributed to growing enrollment among medical colleges, said NRMP President and CEO Mona Signer.

“Every year seems to be larger than the year before, at least, certainly recently,” Ms. Signer said in an interview. “It isn’t just a little bit larger. It’s a lot larger. Medical schools have been increasing enrollment and new medical schools have been [opened]. We certainly expect to see that trickle into the Match as those new schools begin to graduate their first classes and as those existing schools begin to graduate larger classes.”

But Ms. Signer agrees with others that larger Match numbers will not necessarily curb future physician shortages.

“The increasing enrollment in medical schools can’t help but at least address the physician-to-population ratio,” she said. “The issue is, are those new physicians gong to be in the specialties that we need? Obviously, we need more primary care physicians. It remains to be seen whether larger class sizes are going to result in a better physician-to-population ratio in primary care.”

agallegos@frontlinemedcom.com

On Twitter @legal_med

Medical school seniors scored a record number of available first-year slots in this year’s Main Residency Match, with both internal medicine and family medicine programs offering more spots to residents in 2016.

Continuing a 4-year growth trend, the number of available post-graduate year 1 (PGY-1) positions rose to 27,860 in 2016, 567 more spots than in 2015, and a record 18,668 U.S. allopathic medical school seniors registered for the match, 221 more than in 2015, according to data from the National Resident Matching Program (NRMP).

Family medicine residency programs offered 3,238 positions in 2016, up from 3,195 in the 2015 match. This year, greater than 95% of those positions were filled; 45% were filled by U.S. medical school graduates, the NRMP announced March 18.

Internal medicine experienced similar increases, with residency programs offering 7,024 positions this year, up from 6,770 positions in 2015. Just less than 99% of the positions were filled, with 47% filled by U.S. medical school graduates in this year’s Match.

“We’re very pleased with the way the numbers turned out,” said Dr. Philip A. Masters, clinical content development director for the American College of Physicians (ACP). “About 45% of new slots in this year’s Match were in internal medicine. So that coupled with a very high fill rate really suggests a continuing and an increased interest in the field.”

Dr. Wanda Filer, president of the American Academy of Family Physicians, said she was glad to see an increased number of medical school graduates matching to family medicine, but she stressed that the numbers are not enough.

“This nation needs far more family medicine physicians than the current numbers are achieving,” she said in an interview. “The growth in family medicine residency slots is not fast enough and our antiquated graduate medical education payment is misaligned with U.S. workforce needs. Additionally, poor accountability for federal dollars by some U.S. medical schools to deliver that workforce should be rapidly addressed.”

While ACP officials were satisfied with the overall internal medicine numbers, Dr. Masters said that the lack of medical students entering general internal medicine and primary care careers is concerning.

“The number of people in the regular categorical [internal medicine] training programs is a lot lower than it used to be,” Dr. Masters said in a interview. “A long time ago, upwards of half of people who went in categorical training pursued a career in general internal medicine. [Now], the overall trend tends to be away from primary care/general internal medicine. That is concerning because that’s what society really needs right now.”

Pediatric positions, meanwhile, rose slightly in 2016, growing to 2,689, with 21 more slots than last year. Just more than 99% were filled, and 68% were filled by U.S. seniors.

The NRMP data shows that of 18,668 U.S. allopathic seniors who registered for the Match this year, 18,187 submitted program choices and 17,057 matched to first-year positions. This is up from the 18,025 U.S. allopathic medical school seniors who submitted program preferences for the 2015 Match, of which 16,932 matched to first-year positions.

The larger scope of this year’s Match is likely attributed to growing enrollment among medical colleges, said NRMP President and CEO Mona Signer.

“Every year seems to be larger than the year before, at least, certainly recently,” Ms. Signer said in an interview. “It isn’t just a little bit larger. It’s a lot larger. Medical schools have been increasing enrollment and new medical schools have been [opened]. We certainly expect to see that trickle into the Match as those new schools begin to graduate their first classes and as those existing schools begin to graduate larger classes.”

But Ms. Signer agrees with others that larger Match numbers will not necessarily curb future physician shortages.

“The increasing enrollment in medical schools can’t help but at least address the physician-to-population ratio,” she said. “The issue is, are those new physicians gong to be in the specialties that we need? Obviously, we need more primary care physicians. It remains to be seen whether larger class sizes are going to result in a better physician-to-population ratio in primary care.”

agallegos@frontlinemedcom.com

On Twitter @legal_med

Medical school seniors scored a record number of available first-year slots in this year’s Main Residency Match, with both internal medicine and family medicine programs offering more spots to residents in 2016.

Continuing a 4-year growth trend, the number of available post-graduate year 1 (PGY-1) positions rose to 27,860 in 2016, 567 more spots than in 2015, and a record 18,668 U.S. allopathic medical school seniors registered for the match, 221 more than in 2015, according to data from the National Resident Matching Program (NRMP).

Family medicine residency programs offered 3,238 positions in 2016, up from 3,195 in the 2015 match. This year, greater than 95% of those positions were filled; 45% were filled by U.S. medical school graduates, the NRMP announced March 18.

Internal medicine experienced similar increases, with residency programs offering 7,024 positions this year, up from 6,770 positions in 2015. Just less than 99% of the positions were filled, with 47% filled by U.S. medical school graduates in this year’s Match.

“We’re very pleased with the way the numbers turned out,” said Dr. Philip A. Masters, clinical content development director for the American College of Physicians (ACP). “About 45% of new slots in this year’s Match were in internal medicine. So that coupled with a very high fill rate really suggests a continuing and an increased interest in the field.”

Dr. Wanda Filer, president of the American Academy of Family Physicians, said she was glad to see an increased number of medical school graduates matching to family medicine, but she stressed that the numbers are not enough.

“This nation needs far more family medicine physicians than the current numbers are achieving,” she said in an interview. “The growth in family medicine residency slots is not fast enough and our antiquated graduate medical education payment is misaligned with U.S. workforce needs. Additionally, poor accountability for federal dollars by some U.S. medical schools to deliver that workforce should be rapidly addressed.”

While ACP officials were satisfied with the overall internal medicine numbers, Dr. Masters said that the lack of medical students entering general internal medicine and primary care careers is concerning.

“The number of people in the regular categorical [internal medicine] training programs is a lot lower than it used to be,” Dr. Masters said in a interview. “A long time ago, upwards of half of people who went in categorical training pursued a career in general internal medicine. [Now], the overall trend tends to be away from primary care/general internal medicine. That is concerning because that’s what society really needs right now.”

Pediatric positions, meanwhile, rose slightly in 2016, growing to 2,689, with 21 more slots than last year. Just more than 99% were filled, and 68% were filled by U.S. seniors.

The NRMP data shows that of 18,668 U.S. allopathic seniors who registered for the Match this year, 18,187 submitted program choices and 17,057 matched to first-year positions. This is up from the 18,025 U.S. allopathic medical school seniors who submitted program preferences for the 2015 Match, of which 16,932 matched to first-year positions.

The larger scope of this year’s Match is likely attributed to growing enrollment among medical colleges, said NRMP President and CEO Mona Signer.

“Every year seems to be larger than the year before, at least, certainly recently,” Ms. Signer said in an interview. “It isn’t just a little bit larger. It’s a lot larger. Medical schools have been increasing enrollment and new medical schools have been [opened]. We certainly expect to see that trickle into the Match as those new schools begin to graduate their first classes and as those existing schools begin to graduate larger classes.”

But Ms. Signer agrees with others that larger Match numbers will not necessarily curb future physician shortages.

“The increasing enrollment in medical schools can’t help but at least address the physician-to-population ratio,” she said. “The issue is, are those new physicians gong to be in the specialties that we need? Obviously, we need more primary care physicians. It remains to be seen whether larger class sizes are going to result in a better physician-to-population ratio in primary care.”

agallegos@frontlinemedcom.com

On Twitter @legal_med

Spending on physicians rose by 2.4% per year from 2003 to 2013 – the largest increase among the major components of national health expenditures, according to the Agency for Healthcare Research and Quality (AHRQ).

Per capita spending for the physician and clinical sector went from $1,432 in 2003 to $1,775 in 2013 when adjusted to 2009 dollars, for a total increase of almost 24%. Total per capita health expenditures were $7,284 in 2003 and $8,555 in 2013, which represents an annual increase of 1.75%, the AHRQ reported.

The largest portion of national health expenditures, hospital spending, increased from $2,264 (in 2009 dollars) per capita in 2003 to $2,700 in 2013 – just under 2% per year. Physician and clinical costs were the second-largest component of health expenditures, followed by prescription drugs, health insurance administration and profit, and nursing care facilities in 2013, the AHRQ noted.

Overall per capita spending on prescription drugs was up just 0.5% from 2003 to 2013, giving it the smallest increase among the five sectors. Spending on nursing home facilities rose slightly more, 0.7% a year, while the cost of insurance company administration and profit increased by 1.4% a year over that time, according to data from the Centers for Medicare & Medicaid Services.

rfranki@frontlinemedcom.com

Spending on physicians rose by 2.4% per year from 2003 to 2013 – the largest increase among the major components of national health expenditures, according to the Agency for Healthcare Research and Quality (AHRQ).

Per capita spending for the physician and clinical sector went from $1,432 in 2003 to $1,775 in 2013 when adjusted to 2009 dollars, for a total increase of almost 24%. Total per capita health expenditures were $7,284 in 2003 and $8,555 in 2013, which represents an annual increase of 1.75%, the AHRQ reported.

The largest portion of national health expenditures, hospital spending, increased from $2,264 (in 2009 dollars) per capita in 2003 to $2,700 in 2013 – just under 2% per year. Physician and clinical costs were the second-largest component of health expenditures, followed by prescription drugs, health insurance administration and profit, and nursing care facilities in 2013, the AHRQ noted.

Overall per capita spending on prescription drugs was up just 0.5% from 2003 to 2013, giving it the smallest increase among the five sectors. Spending on nursing home facilities rose slightly more, 0.7% a year, while the cost of insurance company administration and profit increased by 1.4% a year over that time, according to data from the Centers for Medicare & Medicaid Services.

rfranki@frontlinemedcom.com

Spending on physicians rose by 2.4% per year from 2003 to 2013 – the largest increase among the major components of national health expenditures, according to the Agency for Healthcare Research and Quality (AHRQ).

Per capita spending for the physician and clinical sector went from $1,432 in 2003 to $1,775 in 2013 when adjusted to 2009 dollars, for a total increase of almost 24%. Total per capita health expenditures were $7,284 in 2003 and $8,555 in 2013, which represents an annual increase of 1.75%, the AHRQ reported.

The largest portion of national health expenditures, hospital spending, increased from $2,264 (in 2009 dollars) per capita in 2003 to $2,700 in 2013 – just under 2% per year. Physician and clinical costs were the second-largest component of health expenditures, followed by prescription drugs, health insurance administration and profit, and nursing care facilities in 2013, the AHRQ noted.

Overall per capita spending on prescription drugs was up just 0.5% from 2003 to 2013, giving it the smallest increase among the five sectors. Spending on nursing home facilities rose slightly more, 0.7% a year, while the cost of insurance company administration and profit increased by 1.4% a year over that time, according to data from the Centers for Medicare & Medicaid Services.

rfranki@frontlinemedcom.com