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1% of Physicians Account for 32% of Paid Malpractice Claims

Image from StockMonkeys.comIt turns out that some doctors are more prone to malpractice claims than others. Unsurprising as this may seem, the imbalance of malpractice claim distribution among physicians is very telling.
The New England Journal of Medicine published an article this January which outlines the distribution of malpractice claims among physicians. The article, by David Studdert, et al, concludes that 1% of physicians accounted for 32% of all paid malpractice claims over the ten year period studied.

The authors used data from the National Practitioner Data Bank to analyze over 65,000 malpractice claims which were paid out against 54,000 practitioners between 2005 and 2014. 16% of all physicians had more than one paid malpractice claim which accounted for 32% of all claims in the study. Additionally, 4% of physicians had paid three or more claims, which accounts for 12% of the total number.

Another finding of this study would indicate that those practitioners who have paid out two or more claims have a very high likelihood of facing additional suits in the following two years. 2,160 physicians who paid three claims had a 24% chance of paying another malpractice claim within that two year period. This downward spiral accounts for a majority of total claims paid out.

Physicians face malpractice suits for many reasons, and we shouldn’t make too many assumptions about those individuals who have lost claims. The study would certainly indicate that some practitioners are particularly prone to malpractice claims. This serves to underscore the importance of avoiding your first malpractice suit, and if a physician has paid one claim they may really want to learn how to avoid a second.


David M. Studdert, L.L.B., Sc.D., Marie M. Bismark, M.B., Ch.B., L.L.B., Michelle M. Mello, J.D., Ph.D., Harnam Singh, Ph.D., and Matthew J. Spittal, Ph.D. “Prevalence and Characteristics of Physicians Prone to Malpractice Claims” N Engl J Med 2016; 374:354-362January 28, 2016DOI: 10.1056/NEJMsa1506137

Making the Move to Registered Nurse

The following post comes to us from Carrington College. Carrington’s medical, dental, administrative, and veterinary programs are offered at 21 locations in Arizona, California, Idaho, New Mexico, Nevada, Oregon, Texas and Washington states. Learn more at http://carrington.edu/.

Registered Nursing

 

Registered Nursing: The Right Choice for You?

Licensed practical nurses, vocational nurses and even high school graduates who are interested in nursing should consider becoming registered nurses (RNs). As Carrington College’s guide to Registered Nursing explains, RNs hold more jobs than any other profession in the healthcare industry while the number of practicing RNs is set to reach up to nearly 3.2 million by the year 2024. Yet, experts are predicting a shortfall of up to 1.2 million registered nurses by the year 2022.

If you want to save lives and improve healthcare for hundreds or even thousands of people, you would be hard-pressed to choose a better profession.

What Specializations are in Highest Demand?

Aspiring registered nurses will find that there are a number of specializations to pick from with additional certifications, including midwifery, critical care, emergency care, neonatal care, pain management and gerontology. Alternatively, a registered nurse may opt to choose a career in management or post-secondary education.

Even so, some specializations are in higher demand than others. Nursing specializations that are estimated to be in highest demand include emergency care, critical care, and perioperative nursing. Nurses with computer skills are also in short supply, as hospitals need RNs who can not just use but even develop and improve electronic medical record systems.

What is Right for You?

Choose a nursing specialization based on your skills, talents and aspirations. While nursing is a highly demanding job, it can be a fulfilling one if you work in a field that is important to you personally. Consider the level of education and training needed for any given specialization. Realistically assessing your schedule and finances can help you determine which type of training works for you.

Registered nurses play an integral role in the healthcare industry. If you think that this profession is right for you, consider various specialization options, choose the one or ones that you feel are best suited for you and then throw your heart into the right registered nursing training program.

Study Suggests that Healthcare Price Transparency Tools Don’t Work

An article published last Tuesday (May 3rd, 2016) seems to indicate that healthcare price transparency tools do not have the intended impact on outpatient spending. The study, conducted by Sunita Desai, et al, followed implementation of a price comparison tool across two major employers across the United States. The resource, called the Truven Health Analytics Treatment Cost Calculator, allowed insured employees to compare prices at different clinics and providers for the same treatments. A control group of employees who did not have access to the comparison tool was included in the study.

 
While the study only surveyed two employers, the number of employees offered access to the cost calculator was about 150,000. The control group included approximately 300,000 employees.

 
The results may not be what you would expect. Only 10% of the employees who were offered the tool actually accessed it. 90% of employees studied did not open this health care cost comparison resource. Additionally, health care spending among employees actually increased from an average $507 annually to $550 for the year. Average out-of-pocket spending among the control group increased from $490 to $520, which means those employees offered this resource actually increased spending $18 more than their peers.

 
It is difficult to isolate variables which caused employees to be disinterested in the cost calculator, and we can’t be sure why costs didn’t decrease among those who did open the resource. A study author notes that more than 50% of searches were for medical expenses of more than $1,000. This could be an important factor since many employees would be paying the same deductible rate regardless of their chosen health care provider in this instance. The motivation to choose less expensive services isn’t as strong when an insurance provider is the primary beneficiary of savings, not the patient.

 

 

 


Desai S, Hatfield LA, Hicks AL, Chernew ME, Mehrotra A. Association Between Availability of a Price Transparency Tool and Outpatient Spending. JAMA. 2016;315(17):1874-1881. doi:10.1001/jama.2016.4288.

Medical errors revealed to be the third leading cause of death in America

An article published in The BMJ Journal by Martin Makary and Michael Daniel on May 3rd, 2016 identified that medical errors are the third most common killer in the United States. The Centers for Disease Control and Prevention do not report medical error on death certificates, resulting in public ignorance as to the scale of fatal mistakes during patient care. Death certificates rely on the International Classification of Diseases coding system, which does not include a classification for “medical error”.

According to the researchers, medical error was the cause of death in 251,000 cases in 2013, beating lung disease, suicide and motor vehicle deaths combined. The two leading causes of death in 2013 were heart disease (661,000) and cancer (585,000). Examples of such errors include patients being handed the incorrect medication, infections from improperly sterilized equipment, accidental cuts on the operating table, and many more.

“Although we cannot eliminate human error, we can better measure the problem to design safer systems mitigating its frequency, visibility, and consequences” say the authors. “Strategies to reduce death from medical care should include three steps: making errors more visible when they occur so their effects can be intercepted; having remedies at hand to rescue patients; and making errors less frequent by following principles that take human limitations into account”. Of course another major strategy should be educating practitioners on best practices for those procedures which most commonly result in accidental deaths.

Clearly this study has implications for healthcare recruiters and human resources managers as well. When hiring for open positions it is crucial that an employer has the opportunity to interview the most highly qualified candidate. That isn’t possible if only one or two applicants express interest and show up for a job interview. Strong recruiting platforms are necessary to empower employers to survey a range of would-be employees, and that’s where the quantity of applicants breeds quality in eventual employee performance.

Patients should also be empowered to make intelligent decisions about their care. By publishing more data about medical errors, and utilizing resources like Hospital Safety Score, patients can choose the medical teams which are more likely to provide incident-free care.

 

Martin A Makary, Michael Daniel. “Medical error—the third leading cause of death in the US”. BMJ 2016;353:i2139

New Report Predicts a National Physician Shortage

On April 5th 2016, IHS Inc. released a 2016 update to their report on behalf of the Association of American Medical Colleges about the projected supply and demand for physicians in American from 2014 – 2015.1

 

The updated report comes in at around 40 pages, and contains projections for many different scenarios that have an effect on demand for physicians services such as demographic changes like the aging of the baby boomer generation, or the ability of non-physician healthcare providers like ARNPs to provide services presently offered by physicians. The report also discusses the supply of physician services, which is impacted by the number of physicians retiring in the next decade and the number of physicians graduating from medical school who are expected to enter the workforce. The report is very detailed, and it is worth a read to anyone who faces the difficult task of recruiting physicians over the coming decades.

Empty Waiting Room

The key findings of the report are:

 

1. Even under the “brightest” of assumptions, there will be a physician shortfall in 2025, it’s just a matter of how large that shortfall is. The report projects there will be between 61K-94K fewer physicians than needed by 2025. For comparison, the US had about 1 million physicians in 2012.2

 

2. There will be a shortfall in both primary care physicians and non-primary care physicians by 2025.

 

3. The largest impact on supply will be the retirement of currently practicing physicians. Just as the aging of the baby boomers will have a drastic effect of the age diagram of the American population over the coming decade, many physicians are members of the baby boom generation, so we will see a similar demographic trends. Today 11% of the physician workforce is age 65-75. That fraction will increase to one-third by 2025. The exact percentage that will retire as they age is unknown, but the aggregate effect will push down the total supply of physicians.

 

4. The aging of the American population will be the primary cause of increased demand for physician services. The population under 18 is expected to grow by 5% and the population over 65 will grow by 41% – a factor of 8X.

 

5. The expansion of coverage under the Affordable Care Act (ACA) will push up demand for physicians. Depending on how many states expand medicaid, the ACA could contribute to the shortfall by 10,000 to 17,000 physicians.

What does this all mean for physician jobs around the country?

 

It’s good news for physicians. The shortfall should push up wages for physicians as employers compete to hire the best talent. This is also good news for non-physician providers who may be able to perform services once restricted to physicians as states change their regulations in order to help address this shortfall. Medical schools are also likely to see an increase in enrollment, so new programs around the country are essential. New MD and DO programs like the CUNY Medical School in New York and the University of Nevada’s Las Vegas School of Medicine are popping up all around the country. One thing this report makes clear is that churning out qualified practitioners should be a major priority for the healthcare industry.

 

All signs indicate that physician recruiters will have an increasingly challenging task ahead in the coming decade. While the exact magnitude of the shortfall is unknown, its impending presence is rather certain according to this report. Employers will need to continue to innovate and improve their recruiting practices to stay competitive with the hospital down the road. Tools like FindHealthcareCareers.com can be a big asset for recruiters within this competitive demographic.