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Recognizing & Treating Caregiver Burden

Recognizing & Treating Caregiver Burden

Research has shown that unpaid family or informal caregivers provide as much as 90% of the in-home long-term care that is needed by adults. A 2009 study estimated that 65.7 million people in the United States served as unpaid family caregivers to an adult or child, two-thirds of whom provided care for an adult aged 50 or older. “The burden of caring for others is increasing because of our aging population, an increase in the number of people living with chronic disease, and a lack of formal support for caregivers,” says Ronald D. Adelman, MD. In addition to providing assistance with basic and instrumental activities of daily living and medical support, caregivers also provide emotional support and comfort. The economic burden of informal caregiving is substantial, with a recent study estimating that the cost of informal dementia caregiving was $56,290 annually per patient. Furthermore, many caregivers have little choice in taking on a caregiving role, and many report feeling ill prepared to take on these responsibilities. “Many caregivers are unaware of the toll that caregiving takes on them, making them more vulnerable to other serious health problems,” Dr. Adelman says. “In addition, caregivers often receive inadequate support from health professionals and frequently feel abandoned and unrecognized by the healthcare system.” Diagnosis & Assessment of Caregiver Burden In a recent issue of JAMA, Dr. Adelman and colleagues reviewed cohort studies and other analyses to provide strategies to diagnose, assess, and intervene for caregiver burden. Several risk factors for caregiver burden were identified, including female sex, low educational attainment, and residing with care recipients. Depression, social isolation, financial stress, a higher...
Combating Antibiotic Resistance

Combating Antibiotic Resistance

Several factors contri­bute to the urgency of the antibiotic resistance crisis in the United States. “Discovering the next generation of antibiotics is exceedingly challenging,” says Brad Spellberg, MD. Pharmaceutical companies are hesitant to develop antibiotics because they tend to be a poor financial investment. The London School of Economics recently estimated that a new antibiotic would have an average net value of -$50 million at discovery. Further complicating the issue is the overtly hostile regulatory environment, particularly for antibiotics. Fighting Back According to Dr. Spellberg, who co-authored a paper on how to combat antibiotic resistance that was published in Medscape Infectious Diseases, the U.S. needs a national prospective surveillance system to track where antibiotic resistance to specific pathogens is occurring geographically and the frequency of these cases. “The lack of this data is a significant detriment to policy efforts aimed at fighting resistance,” Dr. Spellberg adds. “We also need a publicly available, national data collection system to monitor variation in antibiotic use across healthcare systems and geography.” Antibiotic stewardship has been recommended to combat antibiotic resistance, but Dr. Spellberg says the cornerstone of this strategy lies in stressing the importance to physicians and patients to not overuse these drugs. “Simply telling people to not overuse antibiotics is ineffective,” he says. “We need technologies that support stewardship and economic policies that promote appropriate use of these drugs.” Practical Solutions Rapid diagnostic testing has emerged as a technology to inform providers about what antibiotic to use, if any, for patients. “It’s difficult to determine which patients have bacterial or viral infections,” says Dr. Spellberg. “Rapid diagnostics have the potential to eliminate...
2014 Physician Compensation Report Highlights

2014 Physician Compensation Report Highlights

A newcomer snatched a spot in the top 3 highest earning specialties – check out which one in our summary of Medscape’s 2014 annual compensation report! In this year’s Medscape Physician Compensation Report, a great turnout of over 24,000 physicians across 25 specialties shared their salaries, hours worked, and details of how healthcare reform impacted their healthcare environment. Salary increases were seen in all but six specialties, compared with last year’s 2013 Physician Compensation Report. ♦ The top three earning specialties this year are Orthopedics ($413k), Cardiology ($351k), and both Urology and Gastroenterology at $348k. ♦ The lowest earners remain roughly the same as last year, with Infectious Diseases specialists ($174k), Family Medicine ($176k), and Endocrinologists ($181k).     Source: Medscape. Other highlights from the report include: ♦ Rheumatology hands down had the highest increase at 15% this year. ♦ Nephrology had the lowest increase (8%). ♦ Specialties whose compensation declined this year included Pathology (3%), Radiology (2%), Pulmonary Medicine (2%), and Cardiology (2%). ♦ On average, men made 31% more than women in 2013, down from 39% in 2010. ♦ The highest earners live in the North Central ($257k) and Great Lakes ($258k) regions. ♦ The lowest earners live in the Mid-Atlantic ($240k) and Northeast ($239k) regions. ♦ Almost a quarter of physicians (24%) participated in an Accountable Care Organization, compared with 16% in 2012 and only 3% in 2011. ♦ About 25% of responders said they would drop insurers that pay poorly, while 39% said they would not. Interestingly, in the satisfaction portion of the survey, top earners (plastic surgeons, surgeons, orthopedists, radiologists, and anesthesiologists) were the least likely to...
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