Primary care physician practices that offer evening and weekend office hours can help patients avoid trips to the emergency department while cutting overall health system spending, suggests an emerging body of research.

A recent study in The Journal of Pediatrics examining the pediatric population confirms what earlier studies among adult patients have found: When patients with urgent health problems have the option to see their regular physician, they will skip ED visits that can involve long waits, big out-of-pocket costs and unneeded testing.

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Chicago The Council on Ethical and Judicial Affairs is exploring the ethical dimensions related to the American Medical Association’s strategic initiative aimed at improving physicians’ professional satisfaction.

As a first step in that process, the council’s open forum at the AMA Annual Meeting featured three presentations about factors driving the alarming rates of burnout and dissatisfaction among medical students, residents and physicians.

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Chicago The American Medical Association House of Delegates voted to support federal funding of organ transplants for patients on Medicaid.

The move came after a 2010 action in Arizona that cut funding for certain “optional services,” including some organ transplants. The policy affected nearly 100 Arizona patients on the organ wait list and was overturned in 2011 after intense pressure from transplant surgeons and the public.

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Officials at Facebook are exploring how to help patients in need of organ transplants use the social networking service to ask for help.

The functionality, which could go live by the end of 2013, would involve a default format intended to make it easier for patients to raise awareness of their plight while avoiding any hint of coercion or financial exchange.

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Before he even walks into an exam room to greet a patient, Kimberly, Wis., family physician Montgomery “Monk” J. Elmer, MD, already has a good indication of how the patient’s health is holding up. On a rainy day this spring, he had good news for Jim DeBruin, a jovial 79-year-old patient with diabetes visiting for a routine follow-up visit.

“So you’re still passing,” Dr. Elmer said as a smile spread across his face. In his hand, he held a printout of DeBruin’s laboratory test results, showing his glycated hemoglobin reading of 7.6%.

“As long as we’re under eight, you’re OK,” Dr. Elmer added. DeBruin’s blood had been drawn only minutes earlier by a medical assistant at the clinic, which is part of the ThedaCare health system in Appleton, Wis. The sample was analyzed at a lab on site at the clinic.

This just-in-time approach to lab testing and patient care is a principal example of how physician leaders at ThedaCare have earned an outsized reputation within health care for their widespread implementation of the so-called lean-management methods that helped Toyota Motor Corp. become the world’s biggest automaker. Although taking a manufacturing approach to medicine is most commonly associated with hospitals, ThedaCare is implementing the idea aggressively in primary care.

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Chicago Teaching medical students by using virtual electronic health records. Embedding students in clinical care from their first weeks in medical school. Training tomorrow’s physicians to be leaders of interprofessional teams and deliver safer, higher-quality care. Giving students pursuing primary care the opportunity to speed their path to practice and averting dire physician shortages.

These are among the ambitious goals set forth by the 11 medical schools that won approval from the American Medical Association’s expert advisory panel. The $1 million grants awarded to each recipient over five years will give the schools the time and resources to implement changes that the AMA, physicians and educators hope will spark the biggest transformation of U.S. medical education since Abraham Flexner’s 1910 report set the standard for modern physician training.

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Amid growing financial pressure to improve scores on patient satisfaction surveys, some hospitals are looking beyond the potential ding associated with low grades. They are working to redraft their approach to care in an effort to ensure that patients not only have a positive experience but also get the right care at the right time while being spared from harm.

This involves a variety of approaches, from relatively ambitious moves such as creating a senior-level position charged with improving patient experience to something as seemingly simple as asking patients about their biggest hopes, fears or concerns about their care.

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A Web-based mentoring service launched in August 2012 has attracted 400 active users in its effort to help underrepresented minorities pursue careers in medicine.

The project, DiverseMedicine Inc., allows users to request a personal mentor to answer questions through the website’s instant messaging or video chat functions. High school, college and medical students also use discussion forums to cover topics such as admissions testing and residency applications.

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Informed-consent documents that are shorter and use simpler language, bigger type and graphics lead to dramatically improved understanding of risks and benefits, said a study posted online May 13 in JAMA Pediatrics, formerly Archives of Pediatrics & Adolescent Medicine.

Researchers tested various types of forms — some long and complex, some shorter and simpler, some with graphics and some without — among 640 parents of children scheduled for elective surgery. The forms were designed to deliver the traditional elements of an informed consent-document for the clinical trial of a fictional pain-relieving drug called Painaway. The parents were quizzed after going through the informed-consent process to determine whether they understood what was presented about the risks and benefits of trial participation.

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Amid alarming rates of physician burnout, hundreds of clinics nationwide are redesigning their practices with a goal in mind beyond improving the quality of care. They are aiming to make life as a primary care doctor enjoyable once more.

Twenty-three of these clinics are profiled in a report in the May/June Annals of Family Medicine that describes practice innovations that can ease the chaos, administrative overload, miscommunication and computerized busy work that too often characterize primary care. These clinics find that planning visits ahead of time, delegating more tasks to nurses and medical assistants, holding daily meetings and using standing orders for recurring items not only improves patient satisfaction but also creates happier doctors.

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Vermont in May became the first state to enact a law authorizing physician-assisted suicide through the legislative process.

After the bill narrowly passed the state Senate, the House passed the measure 75-65 on May 13, concluding Vermont’s decade-long political tussle over doctor-assisted suicide, which advocates call aid in dying. Democratic Gov. Peter Shumlin signed the bill into law on May 20.

“This historic legislative victory proves that the aid-in-dying issue is no longer the third rail of politics,” said Barbara Coombs Lee, president of Compassion & Choices, a Denver organization that advocates for legal access to doctor-hastened death.

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On the day that Angelina Jolie’s op-ed discussing her hereditary risk for breast cancer and decision to opt for a prophylactic bilateral mastectomy ran in The New York Times, genetic counselor Lisa Madlensky, PhD, checked in with her scheduler to see if the news had prompted patient inquiries.

“She actually didn’t have time to speak to me because she had all these calls backed up on the line,” said Madlensky, director of the Family Cancer Genetics Program at the University of California, San Diego Moores Cancer Center. “Finally, she put someone on hold. She hadn’t seen the news yet and she said, ‘What’s going on?’ ”

In the wake of the actress’s announcement, genetic counselors and breast and cancer centers are reporting similar increases in calls and visits from patients who want to learn more about being tested for the BRCA1 and BRCA2 gene mutations. The Jolie case shows the power that celebrities wield in driving medical care patterns by raising public awareness and tapping into the emotional connection that patients often form with the women and men who grace the covers of supermarket tabloids.

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A new coalition of patient groups, physician organizations, drugmakers, pharmacists and pharmacies is aiming to make headway in battling the persistent problem of medication noncompliance. The coalition, dubbed Prescriptions for a Healthy America and led by the employer- and insurer-backed Council for Affordable Health Coverage, said it hopes to educate lawmakers about the importance of the issue and pursue public-policy solutions to improve drug adherence.

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