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Myths in Diabetes Care: A Clinician’s Perspective

Myths in diabetes are common among patients suffering from the disease, but myths can also affect the clinicians managing these individuals. Understanding myths and misconceptions about the care of patients with diabetes is important in optimizing outcomes. Here are some common myths held by clinicians and some potential solutions to overcome potential barriers: Myth: “My patients aren’t interested in or concerned about making the changes they need to make in order to control their diabetes.” Solution: In general, people are not opposed to change but resent when others try to change them. While it can be discouraging when patients don’t take advantage of sound advice, it’s critical that physicians make every effort to understand diabetes from their patient’s perspectives. Most people want to live long, healthy lives, and every person has the ability to make changes. Management of patients with diabetes is not one-size-fits-all.  Asking patients what is hardest or most concerning will help you understand what is motivating for them. It’s a good way to engage them in their care. Myth: “I don’t have the time to get everything addressed in one office visit.” Solution: Time constraints can have a significant impact on physicians, and no one expects that you can do it all. There are other options to help your patients. The use of a multidisciplinary team improves outcomes. Office staff can handle some of the simpler issues for patients, such as linking them to trusted diabetes information on the internet or connecting them with diabetes self-management educators. They can search community diabetes support groups and create simple handouts to guide patients to these groups. Taking a...
We’re Giving Away iPads!

We’re Giving Away iPads!

Physician’s Weekly is giving away two iPads to qualified Medical Professionals. You could be a lucky winner! Click on the image at right to enter.  The giveaway runs through March 7, 2011; one entry per person. Click here for complete rules &...

New Surveys Classify Pharma Access to Physicians

A new survey of physician access preferences found that nearly half of physicians require or prefer appointments by pharmaceutical sales reps to be scheduled. This percentage appears to significantly increase when practices are owned by hospitals or health systems. Further data showed that about 23% of doctors refuse sales calls entirely. This week, SK&A, a Cegedim Company which provides healthcare information solutions and research, announced these results from their extensive ongoing survey based on 237,000 telephone interviews with medical sites—representing 680,000 physicians.  The Physician Access survey helps depict the willingness of doctors to interact with sales representatives. Which Physicians Give Pharma Greatest Access? Juggling sales-rep calls among their patient appointments consumes a significant portion of the physician workweek.  Ninety-eight percent of doctors report being visited by 20 industry reps per week.  Other trends established by the Physician Access survey include: The most accessible physicians are allergists/immunologists, orthopedic specialists, and diabetes specialists. The least accessible physicians are diagnostic radiologists, pathologists, and neuroradiologists. Sites with low patient volume are less likely to see sales reps. The greater the office size (number of doctors) the less likely sales reps will be seen. Health system- and hospital-owned offices are less likely to grant sales rep access. Western regions of the United States had the highest no-access rate, compared to southern regions, which had the lowest no-access rate. Despite the willingness of doctors to interact with sales representatives, a recent survey by Pri-Med found that clinicians with low rates of physician access still value the information industry provides—and this information still plays a significant role in patient care, even among low- or no-access physicians....

Transcatheter Cardiovascular Therapeutics Annual Scientific Symposium

The 22nd Transcatheter Cardiovascular Therapeutics, or TCT, Annual Scientific Symposium was held from September 21 to 25 in Washington, DC, showcasing the latest advances in current therapies and clinical research in interventional cardiovascular medicine. The features below highlight just some of the studies that emerged from the symposium. Transcatheter Valves for Aortic Stenosis The Particulars: Patients with severe aortic stenosis and coexisting conditions are not candidates for surgical replacement of the aortic valve. The Placement of AoRTic TraNscathetER Valve Trial (PARTNER) was a randomized controlled trial that compared transcatheter aortic-valve implantation (TAVI) with standard therapy in people with severe aortic disease who were unable to undergo surgery. Data Breakdown: At 1 year in the PARTNER study, the rate of death from any cause was significantly lower with TAVI when compared with standard therapy (30.7% vs 50.7%, respectively). The rate of the composite endpoint of death from any cause or repeat hospitalization was also significantly lower with TAVI when compared with standard therapy (42.5% vs 71.6%, comparatively). Among survivors at 1 year, the rate of cardiac symptoms was lower among patients who had undergone TAVI than among those who had received standard therapy. Take Home Pearls: Patients with severe aortic stenosis who are not suitable candidates for surgery appear to benefit significantly from TAVI. The procedure reduces the rates of death from any cause, death from any cause or repeat hospitalization, and cardiac symptoms. Robotically-Assisted PCI Safe & Feasible The Particulars: Concerns of interventional cardiology include occupational injuries for clinicians, including sore backs, shoulders, hips and knees, as well as cumulative risks of long-term radiation exposure. A robotically-assisted PCI (CorPath...

Conference Highlights: ICAAC Annual Meeting

The 50th Interscience Conference on Antimicrobial Agents and Chemotherapy, or ICAAC, held its 2010 annual meeting from September 12 to 15 in Boston. Among the news emerging from the meeting was the risk of invasive aspergillosis in non-traditional patients, the continuing danger of sharps injuries, and a new potential treatment for recurrent CDI. Soap & Water Wipes Reduce Wrestlers’ Skin Infections A Potential New Treatment for Recurrent CDI Looking at the Effect of Public Data on Performance Patients Shed H1N1 Virus Longer Risk of Invasive Aspergillosis in Non-Traditional Patients Sharps Injuries Still a Danger Water Wipes Reduce Wrestlers’ Skin Infections The Particulars: Skin infections are common among high school wrestlers. The vast majority arise within 1 week following exposure, including tinea corporus, folliculitis/impetigo, and herpetic infections. Weekend tournaments that extend over a 10- to 12-hour period allow for long periods of potential exposure to pathogens that may cause these infections to propagate. Data Breakdown: A study of 151 high school wrestlers found that those who used soap and water wipes following a match reduced their risk of skin infection by 97% when compared with athletes who used a 75% alcohol wipe or no wipe at all. Those who used soap and water wipes had only one instance of bacterial infection, with an odds ratio (OR) of 0.089. Those in the alcohol wipe group had three bacterial infections and one herpes infection (OR, 0.44). Wrestlers who did not wipe off after a match had four instances of tinea corporis, two bacterial infections, and two outbreaks of herpes. Take Home Pearl: High school wrestlers may be able to significantly reduce their...

Hospitals Attract Doctors From Private Practice

A recent report by the American Medical Association on data from 2009 found that 1 in 6 doctors works for a hospital—and the number is rapidly increasing. According to the Medical Group Management Association (MGMA), hospital-owned practices were the most successful in attracting physicians in 2009. More than half (65%) of established physicians were placed in hospital-owned practices, and almost half (49%) of physicians hired out of residency or fellowship were placed within hospital-owned practices. Hospitals are even more motivated to recruit doctors because the new health overhaul law rewards creation of more efficient, integrated models of care. Having more doctors also guarantees a steady stream of patient referrals. There are a number of reasons why physicians are being drawn to hospital-owned practices. Currently, there is considerable uncertainty of reimbursement for the future. And those with large Medicare populations are more likely to want to move to hospital-employed positions. Many hospital systems can offer physicians a competitive salary as well as the ability to handle all of their administrative services for the practice, including billing, claims processing, negotiating payments from insurers, retirement benefits, and new EHR systems. Administrative work comprises a large chunk of the day in the private practice world, consuming valuable time that can be dedicated to patients. Additionally, higher starting compensation may be one of the reasons behind this trend. According to the MGMA report, primary care and specialty care physicians in hospital-owned practices were offered more in first-year guaranteed compensation than in not hospital-owned practices.  Hospitals that employ doctors generally have more influence when negotiating with insurers than doctors working in private practice. The price difference can be significant,...

Raising Awareness on Breakthrough Cancer Pain

Pain is one of the most common but misunderstood and feared symptoms of cancer. According to published data, as many as two-thirds of people with cancer-related pain also experience episodes of breakthrough cancer pain (BCP). BCP is varied; the most common type is a flare of the background pain, which may occur without warning and typically has a fast onset with a duration of less than 30 minutes. BCP is often triggered by a specific activity or movement. It may result from walking, dressing, changing positions, or even simpler events, such as coughing or sneezing. Most patients with BCP have several episodes each day. Compared with patients who do not have BCP, those that do have more severe pain overall, more pain-related distress, and poorer functioning. “BCP leaves many cancer patients fearful of the next episode,” says Russell K. Portenoy, MD. “It unduly burdens patients and their families.” New Survey Data A recent survey commissioned by the American Pain Foundation (APF) and conducted online by Harris Interactive explored the impact BCP has on patient quality of life, medical treatment, and finances among adults diagnosed with cancer, living with cancer-related pain, taking medication to manage their pain, and experiencing sudden, temporary pain flares (Table 1). “Although the APF survey was internet-based and not epidemiological, it serves a good purpose in that it provides a snapshot of the problem in an affected subgroup,” explains Dr. Portenoy. “A key finding was that BCP can be highly significant and is associated with many adverse effects on quality of life. As cancer is becoming more treatable, clinicians must recognize the importance of improving quality...

Success in Recruiting Pediatric Specialists

Hospitals and healthcare systems have continued to struggle with recruiting and retaining top pediatric medical talent. Effective recruiting and retention have long bedeviled professional institutions and organizations of all stripes. Now, the prospect of an acute shortage of primary, specialized, and critical care medical professionals for children in the United States is upon us. “Many hospitals and healthcare systems fail to factor in the importance of the family/life balance of their recruits when designing benefits and compensation packages for their pediatric specialist recruits.”   Recognizing the need to address this urgent problem, the Association of Administrators in Academic Pediatrics (AAAP) partnered with MillicanSolutions to determine the key drivers in the successful recruitment and retention of pediatric medical specialists. A survey of dozens of pediatric physicians from various specialties was conducted. The primary goals were to benchmark key similarities and differences in their processes and identify any positive or negative impact these processes have had on physician recruitment and retention efforts. The survey was conducted in conjunction with the AAAP and serves as a complimentary tool to the AAAP Annual Compensation Survey. Survey Findings Filled With Surprises One of the most surprising findings among those surveyed is that quality of life, along with familial and spousal considerations, are as important or, in some cases, more important than compensation or upward career mobility opportunities. It should be noted that many hospitals and healthcare systems fail to factor in the importance of the family/life balance of their recruits when designing benefits and compensation packages for their pediatric specialist recruits. A large percentage of those surveyed accepted offers where the holistic...
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