The Medical Society of the State of New York has hired extra public relations help, signing a three-month agreement with an outside consultant in addition to its regular staff. At the top of its agenda is a pending bill (S5493/A7889) sponsored by state Sen. Joseph Griffo, R-Utica, and Assemblyman Al Stirpe, D-Syracuse. The bill would make it clear to patients when their health care providers are physicians—not less-trained professionals. Known as the Healthcare Professional Transparency Act, the measure would require workers who come in contact with patients to wear an ID tag that specifies what kind of license he or she has. The bill would also cover medical advertising. “Ambiguous provider nomenclature, related advertisements and marketing and the myriad of individuals one encounters in each point of service exacerbate patient uncertainty,” the bill reads in part. According to MSSNY, an AMA survey found that 54% of patients believe optometrists are medical doctors, 35% believe a nurse with a Ph.D. is a physician, and 44% say they have trouble learning which of their caregivers are M.D.s.
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.”
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.”
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.”
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.”
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.
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.
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 …”
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.”"