Office Health
The latest news about health in the office workplace
Below is a collection of the latest news about Office Health. Please excuse us if some of the content isn't quite pertinant, we're still working on improving our sources.
Still Pending: Medicare Pay Cuts to Doctors
The House of Representatives kept busy this weekend, narrowly passing the big health-care bill late Saturday. You probably know that already; if you need to catch up on your reading, here’s a primer on what the bill would do, and here’s the bill itself.
Now it’s back to the Senate, where the big news this week is likely to be the CBO’s estimates of the bill that Dem leader Harry Reid has been putting together. Those estimates are expected in the next few days.
Still unresolved: The 21% cut to the rate Medicare pays doctors, scheduled to take effect next year. House Dems shifted their plan to permanently block those cuts into a separate bill. But that bill didn’t come up for a final vote this weekend; that vote could come in a week or so, after Congress gets back from its Veterans Day recess, according to The Hill.
Of course, a permanent fix already failed in the Senate, because they couldn’t figure out how to pay for it. (Blocking the cuts would cost more than $200 billion over 10 years.) Reid said the Senate is likely to go back to the pattern Congress has been following in recent years — putting in place a temporary, one-year fix to block the cuts, without permanently repealing the underlying payment formula.
Unhappy Docs Push AMA to Drop Support for House Health Bill
A battle is brewing in Houston today as the American Medical Association considers whether to rescind the support it gave last week to the health-overhaul bill that passed the House on Saturday night.
Some physicians are fuming that the AMA backed the House bill despite the fact that the proposed legislation lacks elements like medical malpractice reform and a solution to deep Medicare cuts to physician reimbursements expected next year. In addition, many doctors oppose the House measures option for a government-sponsored health insurance plan.
The AMAs support of that bill should be removed and AMA should give a list of specific AMA policies they would support in a bill, said Donald J. Palmisano, a former AMA president. Dont give a blanket endorsement to a specific bill that contains provisions that violate AMA policy and interfere with the patient physician relationship.
Democrats considered it a coup when the AMA said on Thursday that the group was supporting the House billwhich two days later was passed by the full House. The AMAs statement of endorsement, however, had been lukewarm, saying the measure is not the perfect bill.
Despite the tepid endorsement, 10 of the 180 medical societies in the AMA House of Delegatesthe voting body of the AMAsubmitted a resolution on Friday to rescind the AMAs support of the bill. The resolution came just in time for the AMAs interim policy-making meeting that started over the weekend in Houston and ends Tuesday. The resolution to rescind, among others dealing with the health overhaul, was the subject of spirited debate on Sunday in Houston, and the organizations 544 delegates are expected to vote on it today or Tuesday.
In my opinion I would vote to rescind the AMA position, said Joseph Reichman, president of the Medical Society of New Jersey and a delegate. But while physicians like Palmisano and Reichman have been vocal at the Houston meeting against the AMAs endorsement, its impossible to know how a vote will go.
Many physician organizations have formally supported the House bills; others have different opinions, said J. James Rohack, the president of the AMA, in a statement. This shows us that physicians are engaged and passionate about health reform, and that’s a good thing The AMA will stay engaged to improve the final bill and achieve a better health-care system for patients and physicians.
Image: Associated Press
What Double-Decker Buses Taught Us About Heart Attacks
In the middle of the 20th century, the number of people dying of heart attacks was rising sharply in the developed world, but nobody knew why. Jeremy Morris, a doctor who died the week before last, figured it out.
Morris thought there might be some link between occupation and heart-attack risk. And when he looked at the men who worked on London’s double-decker buses, he found a striking result: The conductors — who went up and down the stairs on the bus all day long — were half as likely to die of heart attacks as the drivers, who sat at the wheel all day.
He was admirably cautious about interpreting the results, trying to poke holes in his hypothesis that exercise lowered heart-attack risk. “We set about destroying this observation,” he told the FT, which ran a profile of Morris earlier this year.
But the data held up; among postal workers, Morris found, those who delivered mail by bike or on foot were far less likely to die of heart attacks than those who sat behind the counter at the post office. He published his findings in the Lancet in 1953, under the title “Coronary Heart-Disease and Physical Activity of Work.”
Morris, who would have turned 100 next year, died of pneumonia and kidney failure, the New York Times said in its obit. He swam, rode an exercise bike or walked for at least half an hour on most days until he was well into his 90s. And in recent years, he often walked up and down the stairs of the London School of the London School of Hygiene and Tropical Health, where he was an emeritus professor.
“I’m constantly being asked: Your long life, what would you advise? and so forth,” Morris told the FT. “To start telling other people what to do Im very reluctant. Except on exercise, where to a large extent I feel its what Ive done myself thats contributed to longevity.”
Photo: iStockphoto
Which R&D Sites Is Pfizer Closing?
More news today on the cutbacks at Pfizer following the merger with Wyeth. Pfizer just sent out the list of research sites it’ll be shrinking and, in some cases, closing. Here’s the key paragraph:
The company will move a number of functions from Collegeville, Pa.; Pearl River, N.Y.; and St. Louis to other locations and will discontinue R&D operations in Princeton, N.J.; Chazy, Rouses Point and Plattsburgh, N.Y.; Sanford and Research Triangle Park, N.C.; and Gosport, Slough/Taplow, U.K. In addition, Pfizer will consolidate R&D functions from its New London, Conn., site to its nearby research facility in Groton, Conn.
The company says its research efforts will be spread at more than a dozen sites around the world, with a particular focus on five centers: Cambridge, Mass.; Groton; Pearl River; La Jolla, Calif.; and Sandwich in the U.K.
The company has previously said it plans to cut 15% of the combined Pfizer-Wyeth work force, but didn’t release specific figures on how many R&D jobs are being cut as part of this consolidation. Job cuts are rolling through the industry these days; for more, read our recent posts on cuts at Pfizer, as well as recently announced cuts at Merck, J&J and Eli Lilly.
Photo: Associated Press
Only 1% of Hospitals Are Below Average*
*In the opinion of the people who chair hospital boards.
Ninety-nine percent of hospital board chairmen think their hospital fares at least as well as a typical hospital on standard quality measures. Among the chairmen of hospitals that perform worst, 100% say their hospital performs at least as well as a typical hospital.
The figures are from a survey published in the journal Health Affairs, based on responses from 722 people who chair the boards of nonprofit hospitals.
Yes, measuring quality can be a tricky thing. Yes, some hospitals treat sicker patients, on average, than others. Still, the quality data the authors used are drawn from those reported on the feds’ Hospital Compare Web site, which uses quality measures that are pretty widely accepted, and which adjusts to account for differences in the mix of patients seen by different hospitals.
The authors, who are affiliated with the Harvard School of Public Health, say that getting hospital boards to pay more attention to quality of care may be tough, given boards’ focus on hospital balance sheets. “With hospitals’ financial margins at 23 percent nationally and likely even lower in the recent economic downturn, the focus on financial issues may reflect the reality of assuring financial viability for many hospitals,” they write.
Photo: iStockphoto
Shocker: Doctor Visits Are Getting Longer
The standard narrative of contemporary medicine tells us that doctor visits with patients are getting shorter and shorter, as docs struggle with rising overhead and pressure to be more efficient.
But as it turns out, the amount of time primary-care docs spend with each patient actually increased a little bit between 1997 and 2005, according to an analysis published today in the Archives of Internal Medicine.
This may have been driven in part by the aging population, because older people tend to be sicker and require more complex treatment. But even within each age group, the average time docs spent with patients increased, the authors said.
Another possible driver, they suggest, is an increased focus on having patients participate in making decisions about their care — it takes a longer to explain things to patients and seek their input than simply to tell them what to do.
Overall, the average length of time the patient spent with the doctor rose from 18 minutes to 21 minutes.
The findings were based on data from a detailed survey of office-based primary-care docs that’s funded by the federal government and conducted at regular intervals.
Bonus Time: A separate study, also published today in the Archives of Internal Medicine, found that the percentage of emergency-room patients seen by a doctor within the recommended triage time declined between 1997 and 2006.
Photo: iStockphoto