June 2009
Volume 3, Issue 11
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InforMed Society

Offical E-Newsletter of the Medical Society

Keeping you InforMed about the latest health care news!
Medical bills tied to 60 percent of bankruptcies
Medical bills are involved in more than 60 percent of U.S. personal bankruptcies, an increase of 50 percent in just six years, U.S. researchers reported on Thursday.

More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.

"Using a conservative definition, 62.1 percent of all bankruptcies in 2007 were medical; 92 percent of these medical debtors had medical debts over $5,000, or 10 percent of pretax family income," the researchers wrote.

"Most medical debtors were well-educated, owned homes and had middle-class occupations.  The researchers, whose work was paid for by the Robert Wood Johnson Foundation, said the share of bankruptcies that could be blamed on medical problems rose by 50 percent from 2001 to 2007.

"Unless you're Warren Buffett, your family is just one serious illness away from bankruptcy," Harvard's Dr. David
Himmelstein, an advocate for a single-payer health insurance program for the United States, said in a statement.

Read more...
Obama: Health care a 'ticking time-bomb'

President Barack Obama is urging doctors gathered in Chicago to support wider insurance coverage and targeted federal spending cuts - calling health care "an escalating burden on our families and businesses."Obama spoke at the American Medical Association's annual meeting in his hometown Monday, tellings attendees that a system overhaul cannot wait.

"Today, we are spending over $2 trillion a year on health care - almost 50 percent more per person than the next most costly nation," said the president. "And yet, for all this spending, more of our citizens are uninsured; the quality of our care is often lower; and we aren't any healthier."
He continued, "Make no mistake - the cost of our health care is a threat to our economy ... It is a ticking time-bomb for the federal budget. And it is unsustainable for the United States of America."

Obama added that the high cost of employee health care contributed to the financial woes of General Motors and Chrysler. "If we do not fix our health care system, America may go the way of GM - paying more, getting less, and going broke."

The president told his audience he is open to requiring all Americans to have health insurance. But he emphasized that the plan he envisions would permit continuing help for those who cannot afford it on their own.

Obama said a "health care exchange" would be set up for the uninsured to choose a plan.

Complete article...
In This Issue
Medical bills tied to 60 percent of bankruptcies
Obama: Health care a 'ticking time-bomb'
Practices feel financial pressure as patients ration their own care
WHO Increases Pandemic Alert Level to Phase 6
Medicaid rules linked to more adverse outcomes in mentally ill, increased mental health costs
Medicine decries nurse doctorate exam being touted as equal to physician testing
Vaccine fights Melanoma
Entrepreneur Magazine: MxSecure among 100 "Brilliant Companies"
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Practices feel financial pressure as patients ration their own care
When administrative staff quit the nine-physician practice of Joseph Stubbs, MD, an internist in Albany, Ga., they are not replaced. To generate additional revenue, a room that contained paper charts before the practice switched to electronic medical records has been rented to a vascular surgeon.

The group has had to take these actions because, although sick patients are coming in for care, they are not returning when they are well. They are foregoing check-ups and other preventive services.

"I'm not kicking anybody out of the practice because they cannot pay me, but a lot of people just are not coming in," said Dr. Stubbs, who also is president of the American College of Physicians.

The national unemployment rate hit 9.4% in May, and medical society surveys indicate Dr. Stubbs' experience is not unique. Patients are delaying or skipping all kinds of health care, and as a result physician practices are having to take steps to maintain financial viability.

"Health care in general was protected from major changes in the economy. This [recession] has been a lot slower coming to health care, but ... clearly we are starting to catch up," said Cecil B. Wilson, MD, an internist in Winter Park, Fla., and a member of the American Medical Association's Board of Trustees.

Read more...
WHO Increases Pandemic Alert Level to Phase 6
The World Health Organization (WHO) has increased the pandemic level to phase 6, the final alert phase, indicating that a global pandemic of influenza A (H1N1) is under way.

According to the WHO, pandemic alert level phase 6 is characterized by "community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5." Phase 5 is characterized by human-to-human transmission of the virus into at least 2 countries in 1 WHO region.

After holding an emergency meeting with its influenza experts, the WHO said it has raised the pandemic warning level from phase 5 to 6, according to a statement sent to health officials. WHO Director Dr. Margaret Chan made the announcement during a press conference today.

Read more...
Medicaid rules linked to more adverse outcomes in mentally ill, increased mental health costs

Some state Medicaid requirements meant to save money are associated with more adverse outcomes among mentally ill patients and might actually be increasing mental-health costs, new research suggests.

Practices such as requiring a switch to generics, placing limits on the number or dosing of medication, requiring prior authorization, and requiring use of step therapy or fail-first protocols were associated with a greater number of adverse events in patients, the study authors, led by Joyce C. West, PhD, from the American Psychiatric Institute for Research and Education, in Arlington, Virginia, conclude.

The investigators also conclude that states with more prescription-drug-management practices in place had significantly higher medication-access problems. After adjusting for patient case mix, the researchers found that patients with medication-access problems had a 3.6 times greater likelihood of experiencing a significant adverse event. 

More information...
Medicine decries nurse doctorate exam being touted as equal to physician testing

Physician leaders say a new doctor of nursing practice certification exam is being wrongly compared with testing that physicians take. And they fear that patients may be misled into believing nurses who pass the exam share the same qualifications as physicians.

Last fall, the National Board of Medical Examiners began offering the voluntary DNP test, based in part on Step 3 of the U.S. Medical Licensing Examination. Step 3 is the final stage in the physician testing series. In January, the Council for the Advancement of Comprehensive Care -- a nonprofit nursing group that contracted with the NBME to develop the exam -- announced the results of the first DNP certification test, with 50% of candidates receiving passing scores.

In its announcement, the CACC said the exam "was comparable in content, similar in format and measured the same set of competencies and applied similar performance standards as Step 3 of the USMLE, which is administered to physicians as one component of qualifying for licensure." In past statements, the NBME stated that the scope of the DNP exam was "materially different" from physician testing, in addition to differences in underlying training.

More information...

Vaccine fights Melanoma

For the first time, a vaccine that trains the immune system to seek out and attack cancer cells has been shown to shrink tumors in people with melanoma.

In a study of 185 melanoma patients, the experimental vaccine also extended the time that people remained free of cancer.

There are even indications that people given the vaccine live longer, but patients need to be followed longer before researchers can be sure, says Patrick Hwu, MD, head of melanoma medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston.

Hwu presented the results at the annual meeting of the American Society of Clinical Oncology.

More information...
Entrepreneur Magazine: MxSecure among 100 "Brilliant Companies"

In Entrepreneur Magazine's annual "Hot 100" issue, Editor-in-Chief Amy C. Cosper says they first identified 10 hot market segments, "sectors that are defining and juicing the new economy...," then they "sniffed out 10 innovative companies within those industries that are reaping the fruits of their brilliance."

In their assessment of the $2.4 trillion healthcare sector, the magazine told their monthly audience of 3 million why MxSecure is one of 10 healthcare companies to watch: "With a presidential mandate calling for electronic medical records, MxSecure, which transcribes records using a 24-hour Internet-based system, is poised for growth."

MxSecure's President and CEO Colin Christie was thrilled with the magazine's assessment: "It's gratifying when someone outside the company recognizes not only what we've accomplished, but also our great potential for future growth. I'm pleased for our MxSecure team, and also thankful for our many clients."

Entrepreneur echoed Christie's sentiment, characterizing the healthcare companies they recognized as: "10 companies that know the best medicine for a bad recession is a stellar business model."

About MxSecure, Inc.
MxSecure, Inc. - the fastest growing provider of medical transcription services to medical practices as recognized by Inc. 5000 - serves thousands of health care providers in over 600 medical facilities nationwide. MxSecure clients include physician and group practices, community health centers and multi-state, multi-specialty clinics. The company's digital medical transcription and electronic document management system - MxTranscribe EHR™ - includes Internet-based access to files 24/7; online review and editing; single and dual electronic signature; key word search capabilities; distribution options for routing to network printers, faxing and secure e-mail; and detailed management reporting tools. MxTranscribe EHR™ is fully scalable to multiple clinic locations with no capital outlay required. MxSecure also offers MxNotes™, a user-friendly, internet-based transcription service designed exclusively for medical practices with fewer than three physicians. With MxNotes™ physicians can dictate, review and edit electronic transcriptions within 24 hours of signing up. For more information see www.MxSecure.com

 
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