“Many People Will Not Be Able to See the Physicians Who Have Treated Them for Years, Use Facilities Providing the Most Appropriate Treatment, or Access Care within a Reasonable Time and Distance from Their Homes.”

Don’t assume that you can continue to see your doctor…

A City Journal article noted that “… having health insurance is not the same thing as getting good health care, or any health care. In fact, it doesn’t matter how many Americans obtain insurance under the ACA. Most will have difficulty finding a physician.”

“Those who do get coverage through the exchanges and pay their premiums will also struggle to get medical care. The ACA requires insurers to accept every patient regardless of risk, provide expansive benefits packages, and eliminate caps on lifetime benefits. Looking to control costs, most insurers are offering exchange plans that severely limit the number of doctors and hospitals patients can visit. Some state exchanges—including New York’s—don’t offer a single plan that covers visits to out-of-network doctors or hospitals.”

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“Nurse Practitioners Are Worthy Professionals … but They Are Not Doctors.”

The New York Times op-ed noted “EARLIER this month, the New York State Legislature passed a bill granting nurse practitioners the right to provide primary care without physician oversight. New York joins 16 other states and the District of Columbia in awarding such autonomy. (Most states still require nurse practitioners to work with physicians under a written practice agreement.) The bill’s authors contend that mandatory collaboration with a physician “no longer serves a clinical purpose” and reduces much-needed access to primary care.”

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Nurse Practitioners in NY Will No Longer Need to Be Formally Tethered to a Physician

An article in Modern Healthcare explained the change.

“The Nurse Practitioners Modernization Act was introduced last year and was included in the state budget … The law will allow NPs with more than 3,600 hours of experience to practice without a written practice agreement with a supervising physician. It does not expand NPs’ scope of practice or allow them to provide additional services, according to the 3,500-member Nurse Practitioner Association New York State.”

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Beware of Shifting Options within Medicare Plans

The New York Times reported: “The Medicare open enrollment season, which runs from Oct. 15 through Dec. 7, gives individuals a chance to rethink it all and reassess whether their plan still fits their needs.”

“Elizabeth Cooper, a 68-year-old former elementary schoolteacher, weighs her options each year. She has already tried a couple of plans, including one through Medicare Advantage, which lured her in because it had no monthly premium. But the plan required her to shoulder a significant share of her medical costs.”

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How Hospitals Should Prepare For A Potential Ebola Patient

The Huffington Post reported “Back in August, it only took Mount Sinai Hospital workers in New York seven minutes to isolate and start treating a man who they suspected of having Ebola. Other U.S. hospitals have also speedily screened and tested suspected Ebola patients, all without incident.

The contrast between those other hospitals’ responses and the actions of workers at Texas Health Presbyterian Hospital Dallas, who recently mistook a Liberian man’s symptoms for a common illness and didn’t properly communicate his travel history to other colleagues, can be explained with training and drills, explained Dr. Brian Koll, the executive director of infection prevention for Mount Sinai Health System.

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“I’m Here, Doc, to Make Sure I Don’t Have Anything Serious. I’m Not Sure My Regular Doctor Was Listening to Everything I Was Trying to Tell Him.”

The New York Times article included the following vignette:

“According to the nurse’s note, the patient had received a clean bill of health from his regular doctor only a few days before, so I was surprised to see his request for a second opinion. He stared intently at my name badge as I walked into the room, then nodded his head at each syllable of my name as I introduced myself.

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“…Many Decisions about Discussing Errors with Patients … Involve Situations in Which Other Clinicians Were Primarily Responsible for the Error.”

Have you ever wondered what your physician should say to you if a medical error by another physician is identified?

A New England Journal of Medicine article focused on this question.

“Although a consensus has been reached regarding the ethical duty to communicate openly with patients who have been harmed by medical errors physicians struggle to fulfill this responsibility …”

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“…Variation … is What Plagues Healthcare”

An article in Beckers Hospital Review focused on clinical care variation -

“Back when he was a resident, (he) saw two physicians perform separate colonoscopies, in which they discovered polyps in their respective patients. Each, however, went about removing the polyp in a different way — one via endoscopic surgery, another through open surgery. Despite having the resources and expertise to perform the procedure endoscopically, the physician who decided on surgery said his reason was a simple one: “That’s how I like to do it.”"

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“The Sudden Termination of a Close Doctor-Patient Relationship Is a Wrenching Scenario …”

A major source of emotional and spiritual suffering among patients who are nearing the end of life is the abandonment they feel when they stop being cared for by a physician to whom they have become attached.

The New York Times article noted “’I can tell you, it happens all the time and it breaks the heart of patients and families and oncologists,’ said Dr. Diane Meier, director of the Center to Advance Palliative Care at Mount Sinai’s Icahn School of Medicine in New York City.”

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