PhyscianSentryPhysicians need to unite more effectively

As physicians, we really need to do more than grumble to ourselves about all of the down sides of our profession.  Reimbursement is down while expectations and our time commitments are up.  Insurances want to “pay for performance” when it comes to patient outcomes, and lawyers want to “make us pay” when patient outcomes are complicated by medication interactions, birth defects, and even well-intentioned prophylactic measures intended to extend life.

Nurse practitioners want to practice independently of physicians on less than a third of the education (at best), yet get 80% of the pay. Administrators at hospitals and other healthcare organizations are calculating how many patients we can see in a time period, and measuring our performance by metrics that have nothing to do with quality of care or patient outcomes.

In short, physicians are catching hell, and all we’ve done is complain amongst ourselves while the art and majesty of medicine is being chipped away by the minute.

PhysicianSentry is here to provide a small yet stable resource we can use to get good information about our profession and not be impacted by political imperatives, insurance profits, lawyer’s parasitic advertisements, and ancillary providers covert agendas.


MACRA – What Is It and What You Can Do Now to Prepare

By Tamiya Williams, CMPE and LaDonna Kessler

Senior Manager’s at Medic Management Group, LLC

On April 16, 2015, the Medicare Access and CHIP Re-Authorization Act (MACRA) of 2015 was signed into law, permanently repealing the Sustainable Growth Rate (SGR) formula and imposing a new payment methodology for Medicare Part B payments starting in 2019 (reflected from performance year 2017). Transitioning from Fee for Service (FFS) to a Quality Payment Program creates two new payment tracks:

The Merit-Based Incentive Payments System (MIPS)

  • Advanced Alternative Payment Models (APMS)
  • Initial Performance Period will be January 2017 – December 2017

On April 2017, 2016, CMS released the proposed rule outlining how it plans to implement the Medicare payment changes stipulated in the law. CMS is soliciting public comment on this proposal until June 27, 2016 and Eligible Clinicians (EC) are encouraged to do so.



Deadly medical errors are less common than headlines suggest

Richard Gunderman, Indiana University

A report published in May from researchers at Johns Hopkins claims that medical errors are the third leading cause of death in the U.S., behind only heart disease and cancer.

According to the researchers, medical errors account for 251,454 U.S. deaths each year – and they regard this figure as an underestimate.

That’s the sort of finding that makes headlines. Indeed, you might have read about this report in the newspaper or even seen it reported on the evening news.

But as we’ll argue, the methods the researchers used to draw this conclusion are flawed, and that means that the conclusion that medical error is the third leading cause of death is highly questionable.

When a report like this gets broad media coverage, it can foster unwarranted mistrust of medicine, which could prevent people from seeking needed care – a concern to everyone who takes care of patients.



Change the ChannelMalpractice commercial? Change the channel.

As a primary care physician, I am particularly sensitive to malpractice commercials.  They seem to come on all the time.  In the evening and on weekends when I have the time to try to ‘get away’ from the demands and stresses of a modern medical practice, I am inundated with commercials asking if an unsuccessful surgery was done, or if you know of a fall at a nursing home, or anyone with muscle aches on a cholesterol-lowering medication.  It is presented as if we physicians, through our gross and blatant negligence, actually meant to cause harm!  In my twenty-five years since graduating from medical school, I never once wanted to cause harm, or risk someone else’s life.  But it is worth saying, I have made mistakes . . . but none requiring me to be punished as if the mistake was malicious.




Hand SanitizerShould we be using alcohol-based hand sanitizers?

Mary-Louise McLaws, UNSW Australia

They’re everywhere in hospitals, travelers’ backpacks and the aisles of pharmacies in winter, but do we really need to use alcohol-based hand sanitizers? And what should we make of the marketing claims they’re needed to kill germs?

Our research found we touch our face up to 23 times each hour and, of these, ten touches are to our eyes, nose or mouth. So while touching your face with contaminated hands you could be contaminating your hands or yourself with many infections, including influenza, the common cold and diarrheal infections. In fact, contaminated hands can spread most infectious diseases.

In developing countries, diarrheal diseases are still the biggest killer of children under five years old. The simplest way to prevent bacteria, viruses and parasites that cause deadly diarrheal disease is handwashing with clean water and soap.



Who asks PHYSICIANS about this? — Maintenance of Certification

NBPASWhose idea was it for us to not only continue “Maintenance of Certification” but to escalate the process to make it more onerous? The reality is MOC is a money making endeavor, nothing more. The ABIM should be completely ashamed of themselves. And we as physicians have only further empowered them. We made board certification what it is. And we can undo it as well. Do your part and remove ABIM certification information from your CV, website, business card, letterhead, and anywhere else it may lay. Pretend it doesn’t exist.  They have betrayed our trust is a HUGE way and do not deserve the attention or distinction they receive. Another board certification resource (The National Board of Physicians & Surgeons) has been established and is run by honorable physicians in a commonsense way. Do your part and join them.  You will not regret it.