AMA pledges millions to jump-start innovation in medical education

The American Medical Association will award $10 million in grants over five years to a group of medical schools to engage in a broad range of teaching innovations.

They would include new ways of teaching and assessing core competencies, individualized learning plans, and a greater focus on patient safety, quality improvement and health care financing.

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Disparities in care for blacks linked to segregation, unconscious bias

Two studies published in January highlight the challenges blacks face in accessing equitable, quality health care.

In one study, primary care physicians found to have unconscious bias against blacks received lower marks from their African-American patients on measures of trust and communication skills. Another study found that racial segregation exacerbates disparities in lung cancer mortality.

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Keys to drug compliance may be trust and pill shape

Patients who give their physicians low grades are likelier to have lapses in drug adherence, said a study of nearly 10,000 Northern California patients with diabetes.

Thirty-nine percent of patients who said they never or only sometimes have confidence in their primary care physicians skipped their cardiometabolic medicines at least 20% of the time, the study said. That is a nonadherence rate 11 percentage points higher than for patients who said they usually or always trust their doctors.

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Surgical errors: In ORs, “never events” occur 80 times a week

About 80 times each week, U.S. patients undergoing surgery experience mistakes that safety advocates say never should happen.

The types of errors being made: Surgical instruments such as sponges are unintentionally left behind in the patient; a wrong procedure is performed; a wrong surgical site is operated upon; and surgery is done on the wrong patient altogether.

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Using mindfulness to soothe physician stress

At a Rush University Medical Center continuing education course in Chicago last fall, a room of more than 80 physicians and other health professionals did something they rarely do during days packed with rushed patient encounters and consultations with colleagues — they sat together in silence for a solid 35 minutes.

In neat rows of chairs, the doctors, nurses, social workers, psychologists and other health professionals sat straight-backed with their hands on their knees and their eyes open, gazing into the middle distance. Throats were cleared, coughs pierced the stillness, and an elevated train rumbled just outside the conference room’s picture windows.

“The effort in this practice is remembering to come back — back to your posture, back to your breathing, over and over again,” said Mitchell M. Levy, MD. He led the exercise, known as mindfulness meditation, with a quiet yet commanding tone of voice.

“Whatever thought or feeling arises, just bring it here,” he said. “Let it be here in this space.”

This sort of meditative exercise is only one element of what Dr. Levy and the course participants covered during two days in October 2012, and the well-attended course is just one sign of the rising interest among physicians, medical schools and hospitals in using mindfulness practices to help alleviate doctors’ stress and reconnect them with their patients and their calling in medicine.

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Despite warning, some hospitals get harsh patient safety grade

When the employer-backed Leapfrog Group handed out grades of A, B or C on patient safety to individual hospitals in June, 5% of hospitals scored low enough to receive D’s or F’s but were marked as “grade pending.” The hospitals had better shape up by the end of the year, Leapfrog said, or they will get a D or F.

Now the group has kept its promise, handing out the low marks to 146 U.S. hospitals, including highly regarded facilities such as Cleveland Clinic and the Ronald Reagan UCLA Medical Center in Los Angeles.

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