Physicians have duty to monitor their own competence

Physicians’ ethical responsibility to provide competent care is fluid and context-dependent at different phases of their careers, according to an AMA Council on Ethical and Judicial Affairs report adopted at the 2019 AMA Interim Meeting.

“The ethical responsibility of competence requires that physicians at all stages of their professional lives be able to recognize when they are and when they are not able to provide appropriate care for the patient in front of them or the patients in their practice as a whole,” says the report.

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How border conditions threaten our nation’s decency, health

AMA President Patrice A. Harris, MD, MA, has issued a clarion call to the country to avoid turning a blind eye to the inhumane conditions among people claiming asylum at the U.S.-Mexico border who are being held in detention: open toilets, around-the-clock lighting, not enough food and water, extreme temperatures, severe overcrowding and no access to basic hygiene.

“Our nation cannot turn our backs on the thousands of children and families whose lives have been torn apart by our government’s draconian approach to immigration; this will have negative physical and mental health impacts for generations to come. To ignore this crisis is to lose sight of the humanitarian values and decency that comprise the core of the American experience,” Dr. Harris wrote in an op-ed published today on the Healthline website as the AMA House of Delegates gathers at the 2019 AMA Interim Meeting held in that border city.

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Google-Ascension deal comes as concerns rise on use of health data

Google and the 2,600-hospital Ascension health system are collaborating on an effort—dubbed Project Nightingale—that puts identifiable patient data in the hands of the tech giant’s engineers for use in projects on machine learning (ML) and augmented intelligence (AI), often called artificial intelligence.

Google and Ascension say the activities, first reported by Rob Copeland of The Wall Street Journal, are covered by a business associate agreement, which is a long-standing, and legal, way for health care providers to share identifiable data with third parties under the Health Insurance Portability and Accountability Act (HIPAA).

The third parties may only use the data for certain purposes and must protect it as HIPAA requires. Failure to do so can result in direct liability for the business associate. The Department of Health and Human Services’ Office of Civil Rights has announced that it will seek to learn more to ensure that HIPAA protections were fully implemented.

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New research links hard-to-use EHRs and physician burnout

The electronic health record (EHR) systems now used in the vast majority of U.S. hospitals and physician offices get an average grade of “F” on the usability scale in the results of a newly published survey of nearly 900 doctors. Given that EHR work gobbles up as much as two hours of physicians’ time for every one hour they spend delivering patient care, that result is grimly unsurprising.

After researchers adjusted for physician respondents’ age, gender, medical specialty, practice setting, and hours worked, they found that how well doctors rated their EHRs’ usability was “independently associated with the odds of burnout,” according to a study published today in Mayo Clinic Proceedings.

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8 prior authorization terms that drive every doctor crazy

Physicians know all too well about the headaches and heartaches associated with prior authorization (PA) in medicine today. Here’s a handy glossary—or perhaps a devil’s dictionary—to help guide you through the madness, with pointers to how the AMA is fighting to make a big dent into this time-gobbling payer practice that delays your patients’ access to care.

Prior authorization is a health plan cost-control process that restricts patient access to treatments, drugs and services. This process requires physicians to obtain health plan approval before delivery of the prescribed treatment, test or medical service in order to qualify for payment.

According to an  AMA survey of 1,000 practicing physicians, more than nine in 10 respondents said PA had a significant or somewhat negative clinical impact, with 28% reporting that PA had led to a serious adverse event such as a death, hospitalization, disability or permanent bodily damage, or other life-threatening event for a patient in their care.

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How a presidential order threatens the physician-led care team

Physicians are raising concerns about a portion of a recent presidential executive order that pertains to the scope of practice in medicine and could undermine well-established Medicare supervision requirements for nonphysician professionals.

Such requirements are “a critical safeguard to ensure the health and safety of Medicare patients and the cornerstone of the widely adopted team-based approach to health care,” says an Oct. 29 letter to Health and Human Services Secretary Alex Azar from the AMA and more than 100 other organizations, together representing hundreds of thousands of physicians.

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4 disability insurance details physicians often overlook

Compared with other professionals, physicians generally have a strong understanding of the critical importance that disability insurance plays in their overall plans for financial well-being and security.

But research from AMA Insurance Agency finds there are some disability insurance details—ones that can make a big impact on covering your bottom line should the need arise—that lots of doctors may overlook. Mike Hegwood is director of brokerage marketing at AMA Insurance Agency Inc., which is licensed as an insurance producer in all 50 states. He took time to review with this writer four of those fine points, and why they matter.

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90% who need substance-use disorder treatment don’t get it

The AMA, the American Society of Addiction Medicine and others are taking part in National Addiction Treatment Week to promote the reality that substance-use disorder is a chronic medical disease for which there are evidence-based treatments to support recovery.

The AMA has detailed the road ahead in “Confronting the Opioids Epidemic in Our Communities,” an advertisement that is being published in news outlets across the country.

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Born yesterday

My dad was born yesterday, 70 years ago. A lifelong die-hard Cubs fan who reared me to be the same, he taught me to keep score and to watch out for the hit and run.

When the Cubs went up 3-1 against the Marlins back in ’03, he shelled out for Champagne. Game six came the day after he turned 54.

Finally — after the College of Coaches, Brock-for-Broglio, 1969, 1984, letting Maddux get away — the National League pennant was close at hand. Then we endured those soul-crushers together and kept the bubbly corked.

I waited a couple of years before drinking the Champagne to celebrate with my then-wife Karen the first pennant win for her hometown Houston Astros. Pa was not happy about that one.

“Dad,” I said, trying to explain, “we can’t wait around for the Cubs. Even Champagne goes bad eventually.”

So how could I ever forget where Pa was on that overdue November night when Anthony Rizzo squeezed Kris Bryant’s toss for the final out?

Well, he sat alone in his bedroom, tucked neatly inside of a plastic bag, nestled in an urn with a lovely Oriental pattern that his wife had picked out. In another room, she watched a soap opera on TV.

Die-hard Cubs fan, indeed, for more than 24,000 days. He died, hard — small cell carcinoma of the prostate — 190 days short of tasting the ultimate victory and embracing his only child.

Why the AMA’s standing up for LGBTQ rights in the Supreme Court

Oral arguments were held today in the U.S. Supreme Court in the case of R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission. The case involves a funeral-home director who was fired after informing the owner that they planned to begin a gender transition. The legal question at issue is whether the 1964 Civil Rights Act’s Title VII protections apply to sexual orientation and gender identity.

Earlier this year, the AMA filed an amicus brief in the case arguing that they do and should, and AMA President Patrice A. Harris, MD, MA, today published an op-ed in The Advocate urging the Supreme Court justices to “do the right thing” in the case.

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How to improve screening for social determinants of health

A recently published survey finds that about one in four hospitals and one in six physician practices screen their patients for social conditions that affect health, such as food access, housing stability, utility and transportation needs, and interpersonal violence.

Results of the cross-sectional survey of 2,300-plus physician practices and nearly 800 hospitals were published in JAMA Network Open, and they highlight barriers to discovering the factors outside the exam room or hospital wall that can affect health or interfere with patients’ engagement in their clinical care.

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