Fitness Trackers to Save Lives

Technology in patients’ hands can give medical professionals the help they need to ensure patients’ health. Instead of looking up their symptoms on Google, anyone can buy a tracker that can monitor their health. However, since the new technology became available, professionals have worried that patients would be running into ERs thinking they’re having a heart attack, all because their watch sent them a warning. The future, however, is bright for this technology and could be very helpful to medical professionals.

Now, in 2019, there are a handful of wearable trackers like the Fitbit, Apple Watch, or other smart devices. Spotting atrial fibrillation early on is very important and these trackers can help with that. These same trackers could potentially help decrease the 130,000 deaths per year and also help detect heart attacks and strokes earlier. This doesn’t just help the medical professional dealing with the patient, but it also gives the patient a little more grip on their own life.

These devices are not perfect, and hopefully, the user understands that. However, with trackers improving and providing more reliable data, they could be monumental for the medical field. Patients are also smarter than we give them credit for. People also understand that not every time they get a weird feeling do they need to be rushed to the hospital. However, it’s also the patient’s life on the line, and they want to know that they are healthy. So, the smarter our fitness trackers, phones, and watches are, the better off we will be in the future. These advancements could lower death tolls, and additionally help solve health issues that need to be detected early.

Fitness trackers are not just there to tell you you’re unhealthy. They are also put into play to let you know you are doing well. These wellness trackers don’t just check your vitals, they also count steps, measure other movements (like sitting, laying, etc.), can help keep track of calorie intake, monitor sleeping habits and stages of sleep, and also send messages. Not all trackers have these abilities, but most have more than just the one function of checking your heart rate. Trackers help the user understand themselves better. The user can also set a goal for themselves and track those goals easily, and the trackers can also help them train more effectively. Sure the costs for these wrist caretakers vary, but that cost is money spent toward a healthier life.

The Issue of Online Medical (Mis)Information

The internet seems to be a place where people think they can diagnose themselves instead of going to a healthcare professional. The biggest issue here is that if you look up “Why does my head hurt?” on google, you can end up with an answer like, “you may have a brain tumor.” Nothing is going to stop this mass of people who use the internet. So, what should be done? More health care professionals need to establish online presence. Doing so would help create better responses and less havoc for people using the internet for medical knowledge.

The Emerald Coast Medical Association is here for both medical professionals and patients alike to make sure the correct information is available. Another good option would be to create a Q&A service. Dr. Petra Dolman, MD, hosts an hour-long Twitter chat, with guest moderators facilitating conversations ranging from how to negotiate pay, navigating residency interviews, and countering burn out, all searchable under the hashtag #womeninmedicine. Social media will help give those with unheard voices a better opportunity to help those in need.

However, since freedom of speech is a thing, anyone on the internet can get backlash, even if they are correct. For example, Dr. Monique Tello, MD, MPH spoke out in support of vaccinations; she was then targeted by “anti-vaxers” online. Her blog was overthrown with one-star reviews, but those reviews were later removed due to their invalidity. With that being said, this scares medical professionals reaching for the internet because it can be an unforgiving or uncaring place. With the next generation of doctors spending a lot of their time on social media, we can’t deny that the online platforms should be a place with easy to reach medical advice or information. With that information being well known, Universities have begun to take notice and create positions to legitimize social media. The Association for Healthcare Social Media will aim to create the best practices by which all health care professionals can be guided and protected in the emerging field.

By using social media, medical professionals can come off as more human to the public. Just like when a patient is going to see a therapist, they want someone who cares about them and has had good and bad times too. Showing more care for the patient’s emotions and wellbeing can show them that you want to help them. Revealing past experiences, giving your real opinion, voicing the option you’d take, and talking to patients so they can understand better will go a long way. Whether it be in your office or on the web, there will always be a patient looking for a medical professional to help point them in a direction so they can get better.

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The “War on Opioids” Needs to End

“With the first cut of the scalpel, excruciating pain exploded in my foot, and I was shocked speechless. I froze, paralyzed, terrified that any movement would jostle that knife digging into my flesh.” Angelika Byczkowski, a patient suffering from Ehlers-Danlos Syndrome (EDS) has felt multiple surgeries through anesthetics.

The unforgettable recollection above was from a procedure that was done on her foot to remove a plantar wart. She also felt pain when she received stitches, which had anesthetics applied. Her doctor told her it was impossible that she was feeling pain, so she stuck to it and all the while, feeling extreme amounts of pain run through her body, she sat there quietly because she did not want to question authority. She thought she was going crazy. However, once she was 54 years old, she was finally diagnosed with EDS. EDS in many patients has brought them pain even after being numbed through local anesthetics. However, now that the medical world has gotten more advanced, we can help people with EDS with what is called by many a last resort: Opioids.

There is a four-step procedure to be taken before providers prescribe opioids:

Step 1: Initial Assessment

An Evaluation of the patient’s pain, which should include; location of pain, duration of pain, characteristic of pain, what relieves the pain, and what time of day the pain occurs. There should also be a check on how the patient’s past treatments and medication have worked out. A look at the patients personal and family history of alcohol or substance abuse should be taken into precaution.

Step 2: Informed Consent and Treatment Agreement

Before prescribing opioids for the treatment of chronic pain, a practitioner should obtain an informed consent agreement and a treatment agreement.

Step 3: Initiating and Monitoring Treatment

Once the decision has been made to initiate the opioid treatment, it should start as a therapeutic trial for a defined period (not to exceed 30 days). The patient should know that the trail will be carefully monitored to assess the benefits and harm that may occur and to evaluate the level of and change in pain.

Step 4: Red Flags and Aberrant/Diversionary Behavior

There is no exhaustive list of behaviors that might be considered red flags. However, it is a must for practitioners to recognize such behaviors and to document them in the medical record as well as what actions have been taking, including discontinuance of opioid treatment or discharging the patient.

With all of that in mind, opioids are there to help the patient try to function normally in day to day life. It should not be the medical professional’s fault for the patient’s actions. The war on opioids is not helping anyone in this situation because it can cause more problems for the patient by not giving them the drug sooner. Medical professionals are doing everything they can to help their patients; it’s their job, and most often their passion. The war on opioids has been causing more problems than solutions in the medical field and has even led to medical professionals to be questioned.

At Emerald Coast Medical Association, we always have your back. Our Board of Governors routinely take their time to advocate for patients and physicians at the local, state, and federal level. Why wait when you can join today?

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Big Hospitals Sue HHS

Hospitals are beginning to follow in the footsteps of the American Hospital Association and are suing the Trump Administration for its decision to institute site-neutral payments.

The change, which is part of the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule-making for 2019, would lower reimbursements for hospital outpatient department services to match rates set by the physician fee schedule for clinic visits. This would mean lower costs for a patient’s insurance. However, hospitals would lose about $380 million in 2019 alone and possibly up to $760 million in 2020.  The colossal loss of money is causing an uproar with (as of right now) 38 hospitals signing the lawsuit.

This isn’t even helping the patient from what CMS Administrator Seema Verma says, “It doesn’t make sense for taxpayers, and it certainly doesn’t make sense for patients because they end up having to pay more depending on the site of service.”

However, this can be looked at as taking down the money hungry hospitals. University of Michigan health law professor Nicholas Bagley was among the observers who praised the Trump administration for the proposal, saying CMS is “picking a fight with powerful hospitals because it’s the right thing to do.” The site-neutral payments would mean, hospitals would have to offer the same care at lower prices.

The previous system had Medicare paying higher rates for services provided at the hospitals outpatient facilities. The Centers for Medicare & Medicaid Services projects the policy change will save the beneficiaries $150 million in co-payments annually; dropping the average copay from $23 to $9.

“The different payment rates also pushed hospitals to purchase independent practices to increase their reach and take advantage of the higher reimbursement rates,” Verma said. “Neutralizing payments would increase provider competition.” Competition could potentially turn into one hospital bettering the others, just because they have more resources and more funding.

However, Farzad Mostashari, MD, co-founder, and CEO of Aledade, said in a series of tweets that hospitals will fight the OPPS rule “bitterly” but that there could be a long-term benefit for them in it.

“The truth is that this proposal could help hospitals be more competitive in value-based contracts/ alternative payment models, and they should embrace the changes,” Mostashari wrote. “If rural hospitals or AMCs need subsidies, then we should do it directly, not through distorting payment policies.”

Here at Emerald Coast Medical Association, we care about your health too. Since 1981, over 50 local physicians banded together to create a Physician’s Security and Benefit plan.

The primary goals are:

  • Provide affordable health insurance to employees, physicians, and their families
  • Upon the death of a physician, provide insurance for the spouse and children of the physician
  • Use each others’ premium dollars to pay claims for those physicians and their family members who had serious medical conditions
  • To provide a premium-rating schedule that did not discriminate against those physicians and their employees who had incurred large medical claims
  • Avoid implementing “gatekeeper” type “managed care” features
  • Promote access to virtually all providers in and out of the state
  • Establish a stable alternative to those carriers who often abandon the insurance marketplace

You can get all this and more for being an Emerald Coast Medical Association Member.

No reason to wait, sign up today. We want to help you and your practice stay healthy and up to date on relevant information.

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Social Determinants of Health Influence in 2018

Social determinants of health (SDOH) started becoming more mainstream of a concern for the greater healthcare system in 2018. An individual’s socioeconomic status can put their health at risk. Locally, this has become even more apparent since Hurricane Michael hit the panhandle last October. SDOH is defined by the Centers for Disease Control and Prevention as “conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes.” These conditions can determine the health of people.

People have been living in unimaginable conditions since Hurricane Michael hit on October 10th, 2018. We are now in 2019, and many are still unable to live in their homes. Without proper housing and the many hazardous conditions around the panhandle that extend farther than just at home, there has been an increased rate of injury and illness. This hurricane has provided us with a prime example of social determinants impacting health.

The healthcare system has avoided addressing the issue of social determinants for a long time. In 2018, newly launched initiatives, as well as studies showing the need for these initiatives, have caused the healthcare system to take a new look at social determinants and how to address them.

Factors such as housing, transportation, food assistance, and personal finances have been taken into account to begin the process of reassessing healthcare’s take on social determinants. People with limited access to transportation and housing are at a higher risk of injury or illness, especially when they have limited ways to get to a physician. Medicaid plans on helping to offer affordable housing to those who need it. Patients without transportation often forego making an appointment or miss them when they do have them. Uber recently launched a “health dashboard” to provide free rides for those unable to get to a doctor when they need to.

In addition to this, Geisinger Health System started “Fresh Food Farmacy,” which cut costs among diabetic patients from anywhere between $48,000 to $240,000 per member. This caused the risk of serious complications or death for people with diabetes to drop to 40%, a great win for those working with diabetics. Cigna is also planning on offering financial planning services for their group members, as announced in December 2018. Financial stress can take a significant toll on a person’s physical and mental health.

With many physicians claiming social determinants “aren’t their problem,” there is still a long way to go with maintaining equity among Americans. However, now that the panhandle is experiencing even more of these social determinants than usual, we have been provided a new chance to tackle these determinants and make the panhandle a healthier place for everyone. These social determinants will continue to play a significant role in local health for everyone involved with the hurricane, but choosing to see the positive side of this great opportunity is best for our county’s health.

Surprise, Unexpected Medical Bills!

 

The recent legal changes increased national attention to financial difficulties arising from patients receiving surprise, unexpected medical bills has led to a group of insurance, business and consumer groups announcing they have joined forces in an attempt to create solutions to reduce the frequency of this occurrence.

With potential changes including patients being notified when care is considered out-of-network or prior knowledge to charges along with alternative potential medical options and their costs being discussed, this new legislation has the potential to greatly alter the methods and efficiency at which medicine is currently practiced. Other guiding principles in this legislation include a policy to protect patients from increasing premiums as a result of policies enacted to protect them from surprise bills and a federal standard for payments to out-of-network doctors to help protect patients in self-funded health plans. The nine member coalition leading the charge in creating these new regulations consists of the following organizations: America’s Health Insurance Plans, National Business Group on Health and Consumers Union, American Benefits Council, the Blue Cross Blue Shield Association, the ERISA Industry Committee, Families USA, the National Association of Health Underwriters and the National Retail Federation.

There has been much debate on who is truly at fault for these surprise medical bills. A common practice in hospitals called balanced billing has been recently put at received a majority of the blame where patients are financially responsible for the difference between the hospital and insurer perceived cost of care.

Hospital groups stating that this coalition has incorrectly blamed them for these surprise bills have challenged this theory. American Hospital Association CEO Rick Pollack and American Hospitals President and CEO Chip Kahn emphasized in a joint statement a priority of hospitals and health systems is to eliminate surprise bills. The importance of the alliance of consumers, health insurers, employers, and hospitals working together was also brought to the forefront as a solution to prevent these unexpected charges according to these two high ranking officials in the hospital system.

Continuing with the different viewpoints of this problem, a group of physicians earlier this year also formed a multispecialty alliance regarding the problem. The Physicians for Fair Coverage was created and has been pushing for more widespread adoption of legislation. This coalition has been noted to place a majority of the blame on the insurers.

The creation of these various coalitions will hopefully continue to lead to discussions regarding surprise medical bills and will ultimately end in a solution that will benefit all parties involved.

Original Article – https://www.fiercehealthcare.com/hospitals-health-systems/coalition-forms-to-back-efforts-to-stem-problem-surprise-bills

Should Doctors “Stay in Their Lane..”?

 

A recent uproar in the media was the National Rifle Association telling doctors in a tweet to “stay in their lane” when addressing the issue of gun violence. As you know, doctors see the aftermath of gun violence; you have to tell the family whether their loved one is alive or dead from this senseless act of violence. An immediate tweet back to the NRA from the Annals of Internal Medicine simply said: “Doctors are in our lane.” In addition to this, the AIM also decided to collaborate with the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM) to fund new research supporting new practice recommendations.

These two tweets have sparked an uprise of tweets from doctors and nurses. These tweets show pictures from the ER where patients with gunshot wounds have come in. Most of these pictures have considerable amounts of blood and are something the general population is not used to seeing. Accompanying these tweets are hashtags like “#Thisismylane” or “#Stayinyourlane.” Amid all of this, providers and affiliate organizations have begun to present a broader definition of their lane and how gun violence fits within it.

The medical community has been known to be reluctant when sharing its opinions on gun rights. Due to the rise of high-profile mass shootings, the medical community has been changing its perspective and redefining its role in advocating for policies related to public health. Many have said doctors do have the right to advocate for stricter gun policies since they see the immediate aftermath of gun violence.

Daniel T. Wu, M.D., associate professor of emergency medicine at Emory University and chief medical information officer for Grady Health System, studies violence of all kinds as a public health issue. His studies place gun violence along a broader continuum of all types of abuse. Most of these acts of violence occur invisibly to most of society, besides high-profile incidents involving firearms. Considering that doctors and nurses act as the only point of contact between many victims and any type of social support, you have a unique perspective on the breadth of the problem. The imperative to help can force doctors and nurses out of roles that were much more narrowly defined. Dr. Wu surveyed his team and found that over 90% saw the extra work of treating the patient in more than just a physical way as a core part of their job as making sure the patient is safe for the long run. New research into various areas of interface between gun violence and public health can be the next step into engaging action.

We at Emerald Coast Medical Association want to know what our members think about all of this. Do you think doctors should “stay in their lane,” or do you think that as physicians you have a right to have an input on these acts of gun violence.

Feel free to contribute to this discussion in the comments section of this blog; we appreciate every comment from our members.

Reasons for Patients Ignoring Physician Advice

 

It is a known fact among all of our members that patients often do not do what their physician advises them to after seeing them. As frustrating as it can be, it is important to us at Emerald Coast Medical Association to make our members know that this is not a failure on your part, as you can only do so much. Our meetings are open for our members to discuss these frustrations without judgment, and allow them to discuss among each other how to better address these types of situations.

Many patients disregard a physician’s advice because they have read an article on Facebook or Google that states the opposite of what the physician has advised. Many of these articles are from an inexperienced person who believes that they can give professional advice in the medical field. Many other patients listen to their friend’s claims, figuring that they should listen to those close to them rather than a random doctor. Although this can be infuriating to everyone in the medical field, it is more common than we all wish to think.

According to the National Academy of Medicine, many people have issues with “health literacy,” which means the ability to obtain, process, and understand basic health information and the services needed to make the appropriate health decisions and follow treatment instructions. Most doctors are aware that health literacy is significantly under-recognized, but it is a major issue that affects the care of patients. It is estimated that around 90 million adults struggle to understand what the doctor is explaining to them about their sickness, and how to take the proper steps to treat it. Anywhere between 20%-30% of prescriptions are never filled, resulting in more illnesses, hospitalizations, and in some cases, death. Existing data supports that although physicians believe they are accurately communicating advice to their patients, it can often be misinterpreted by the patient, which is a huge part of the problem.

An aspect to consider is moving away from the mindset of “telling” the patients what to do, but rather act as more of a partner and advocate for their health. Translating terms from the medical terminology you were taught all through medical school into easier and more common words can aid in how the patient will interpret it all. Having an understanding of the difficulties this patient may be having with their illness and factors aside from that, is a great first step towards gaining patient trust. Empowering and engaging a patient can lead to them being more likely to follow your advice as a physician.

Effective physician-patient communication increases the chances that the patient leaves your office and readily takes your professional advice. We encourage our members to consider all of this when treating your patients, as it can mean a better outcome for you and your patient.

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Arming Ourselves Against Physician Burnout

Physicians, nurses, and healthcare professionals everywhere are experiencing burnout due to stress related factors. The suicide rate among physicians is more than double that of the general population. Burnout and depression can lead to medical error, something no patient wants to experience.

Studies have shown that it is important for medical professionals to surround themselves with people who can understand them and help them to reflect on their true purpose for picking this field. Emerald Coast Medical Association is the perfect place to do this as it is made up of healthcare professionals who support each other and interact with each other. It is of the utmost importance for us to help to support physicians and other healthcare workers while allowing them to grow as individuals and a group. We have found that our members are not only better personally, but also when interacting with their patients.

Emerald Coast Medical Association is working to fight back against burnout and depression. Here at Emerald Coast Medical Association, we value our medical professionals and do everything we can to combat burnout. Our members participate in retreats and workshops that allow them to relieve their stress from the job and interact with others who understand the feelings they have on a day-to-day basis.

There are many more benefits to becoming a member of Emerald Coast Medical Association. There are meetings every month, where members are recognized for the hard work they have put in. Member meetings also spotlight current trends in medicine so that members are always informed of the newest hot topics.

Many of these meetings aim to encourage growth from members. Members have various opportunities to speak with other physicians and expand their network among each other. Our network of physicians is ever-expanding so there is always someone new to have the opportunity to speak with at our meetings. In addition, we encourage our members to grow by holding scientific sessions every spring where anyone looking to expand their knowledge is invited to come. Members also have access to cutting edge Continuing Medical Education, allowing them to excel at their trade.

Members should take full advantage of all these opportunities as it is proven to only help them better themselves as physicians. We are aware of the hardships that physicians and other healthcare professionals face, and we hope to make the public more aware through our association.

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CMS Proposal Aims to Improve Doctor-Patient Relationships

In May, Health and Human Services Secretary Alex Azar told us that he planned to use his pen to make significant and hopefully positive changes to the healthcare industry in the United States. Staying true to his word, the HHS Centers for Medicare & Medicaid Services (CMS) has issued a proposal that could have a drastic, positive impact on doctor-patient relationships in the U.S.

The proposed rule would update the Medicare fee schedule for physicians and routines sweeping changes for the third year of the payment program implemented by MACRA. CMS higher-ups say they have been attentive to physicians and responded with these rules in order to allow practitioners more time with their patients.

The proposal was announced on July 12th. CMS Administrator Seema Verma stated in a press call, “Today’s proposals deliver on the pledge to put patients over paperwork by enabling doctors to spend more time with their patients. Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care.”

These proposals, which are part of the Physician Fee Schedule and Quality Payment Program, also serve to update Medicare to allow payments for virtual care, which would save money for beneficiaries while allowing them better access to quality treatment regardless of their location. Patients could connect with their care providers remotely, and the practitioners would have the opportunity to determine if the patient needs to come to the office or not. The clinician can be paid under this new proposal for both these “virtual visits” and for time spent evaluating photos or videos sent in electronically by the patient. Medicare coverage of “telehealth” benefits would also be expanded to include preventative services over the long-term.

Additionally, the reform would make broad changes to the reporting requirements in order to effectively put the focus on the most important measures, the ones that have the most impact on health outcomes. The shift in reporting would also encourage electronic information sharing between providers, so patients can be more effectively “followed” through the system by their entire care record.

If the new proposals are adopted and finalized, clinicians should see a boost in their productivity levels, which in turn is likely to lead to a better quality of care for their patients. CMS estimates that upwards of 50 work hours per year would be saved by the paperwork this proposal would eliminate from the workload of a doctor with 40% of their patients covered by Medicare.

This proposal also aims to advance President Trump’s efforts to lower prescription drug costs, by suggesting a change in the payment amounts for new drugs under Part B, so the payment amount is commensurate with the actual drug cost. This could significantly reduce the amount that seniors are asked to pay out of pocket, especially when it comes to newer drugs with high launch prices.

The proposal can be viewed at this link: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14985.pdf  and HHS is asking for public comments and input to be submitted by September 10th 2018.

Emerald Coast Medical Association works to keep our members informed about changes that impact us as medical practitioners, at the federal as well as the state level. These changes, if they go into effect, will be significant to all of us, and we pledge to help our members understand and implement them. Together, we are stronger, and our shared knowledge improves the lives of all of us as well as our patients.

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