Jane Anderson

Adverse Event Reports Go Unused

The Food and Drug Administration's Center for Devices and Radiological Health fails to use adverse event reports in a systematic manner to detect and address medical device safety problems, a report from the HHS Office of the Inspector General found. The center has no documentation of following up on deaths, serious injuries, and device malfunctions reported by manufacturers and medical facilities, and most reports are not read in a timely fashion, according to the report. The Inspector General's office found that the FDA center received about 73,000 adverse event reports in 2003, and more than 150,000 in 2007. The Inspector General recommended that the center develop better protocols for reviewing and tracking the reports.

Preventive Services Underused

Only about one in four Americans aged 50-64 years regularly gets recommended preventive services such as screenings and immunizations, according to a report from the Centers for Disease Control and Prevention. The CDC, which compiled the data in collaboration with AARP and the American Medical Association, noted that preventive services often missed by older adults include influenza vaccination, cholesterol screening, breast and cervical cancer screening, and physician screenings for unhealthy behaviors such as binge drinking. The report, which identifies ways to make these services more accessible and convenient, is available at

www.cdc.gov/aging

Electronic Tools Effective: AHRQ

Consumer health informatics—electronic tools designed to provide tailored health advice to patients—could save money by eliminating the need for some health education now provided by clinicians, said a report from the Agency for Healthcare Research and Quality. Health informatics also could improve clinician-patient interactions, the AHRQ said. The agency reviewed more than 100 studies of consumers getting health information via the Web, computer programs, and other electronic avenues such as texting and chat groups. The analysis found that the most effective tools tailor messages using a patients' own health information and provide feedback progress. Feedback provided by a clinician doesn't seem to be any more effective–the key is timeliness, not the human touch, the study concluded.

AMA Weighs In on Chemicals

The American Medical Association has called for more effective government oversight of endocrine-disrupting chemicals. At its midwinter meeting, the organization adopted a resolution, introduced by the Endocrine Society, calling for most regulations on the chemicals to be handled by a single office. The exception: Endocrine disruptors used as pharmaceuticals would continue to be regulated by the FDA. The resolution also calls for policies on the chemicals to be developed jointly by endocrinologists, toxicologists, occupational- and environmental-medicine specialists, epidemiologists, and policy makers. “This new resolution marks an important step in engaging policy makers to enact policies that decrease public exposure to these potentially harmful chemicals,” said Dr. Robert Vigersky, Endocrine Society president.

CDC Eliminates HIV Exclusion

People seeking to immigrate to the United States will no longer be required to undergo HIV testing, under a final rule issued by the CDC. “While HIV infection is a serious health condition, it is not a communicable disease that is a significant public health risk for introduction, transmission, and spread to the U.S. population through casual contact,” CDC officials wrote in the Federal Register. The rule goes into effect on Jan. 4. Until now, CDC policy has been that individuals with HIV who are living outside the United States are not eligible to receive a visa for admission to the country. The CDC received more than 20,000 public comments on the proposed change, of which (about 19,500 supported removing HIV from the list of communicable diseases of public health significance, agency officials said.

New Surgeon General Confirmed

Dr. Regina Benjamin has been unanimously confirmed by the Senate as the U.S. Surgeon General. Dr. Benjamin, a family physician who is founder and CEO of the Bayou La Batre (Ala.) Rural Health Clinic, will start her work by responding to pandemic influenza A(H1N1)i Health and Human Services Secretary Kathleen Sebelius said in a statement. The American Academy of Family Physicians praised the confirmation. “All Americans will benefit from Dr. Benjamin's medical expertise, clinical experience, and advocacy for all patients,” the academy's president, Dr. Lori Heim, said in a statement. “She is committed to ensuring that everyone has access to health care, regardless of economic status.” Dr. Heim also praised Dr. Benjamin's perseverance in providing care to the underserved. Since the late 1990s, her clinic was destroyed by two hurricanes, Georges and Katrina, as well as a fire.

Adverse Event Reports Go Unused

The Food and Drug Administration's Center for Devices and Radiological Health fails to use adverse event reports in a systematic manner to detect and address medical device safety problems, a report from the HHS Office of the Inspector General found. The center has no documentation of following up on deaths, serious injuries, and device malfunctions reported by manufacturers and medical facilities, and most reports are not read in a timely fashion, according to the report. The Inspector General's office found that the FDA center received about 73,000 adverse event reports in 2003, and more than 150,000 in 2007. The Inspector General recommended that the center develop better protocols for reviewing and tracking the reports.

Preventive Services Underused

Only about one in four Americans aged 50-64 years regularly gets recommended preventive services such as screenings and immunizations, according to a report from the Centers for Disease Control and Prevention. The CDC, which compiled the data in collaboration with AARP and the American Medical Association, noted that preventive services often missed by older adults include influenza vaccination, cholesterol screening, breast and cervical cancer screening, and physician screenings for unhealthy behaviors such as binge drinking. The report, which identifies ways to make these services more accessible and convenient, is available at

www.cdc.gov/aging

Electronic Tools Effective: AHRQ

Consumer health informatics—electronic tools designed to provide tailored health advice to patients—could save money by eliminating the need for some health education now provided by clinicians, said a report from the Agency for Healthcare Research and Quality. Health informatics also could improve clinician-patient interactions, the AHRQ said. The agency reviewed more than 100 studies of consumers getting health information via the Web, computer programs, and other electronic avenues such as texting and chat groups. The analysis found that the most effective tools tailor messages using a patients' own health information and provide feedback progress. Feedback provided by a clinician doesn't seem to be any more effective–the key is timeliness, not the human touch, the study concluded.

AMA Weighs In on Chemicals

The American Medical Association has called for more effective government oversight of endocrine-disrupting chemicals. At its midwinter meeting, the organization adopted a resolution, introduced by the Endocrine Society, calling for most regulations on the chemicals to be handled by a single office. The exception: Endocrine disruptors used as pharmaceuticals would continue to be regulated by the FDA. The resolution also calls for policies on the chemicals to be developed jointly by endocrinologists, toxicologists, occupational- and environmental-medicine specialists, epidemiologists, and policy makers. “This new resolution marks an important step in engaging policy makers to enact policies that decrease public exposure to these potentially harmful chemicals,” said Dr. Robert Vigersky, Endocrine Society president.

CDC Eliminates HIV Exclusion

People seeking to immigrate to the United States will no longer be required to undergo HIV testing, under a final rule issued by the CDC. “While HIV infection is a serious health condition, it is not a communicable disease that is a significant public health risk for introduction, transmission, and spread to the U.S. population through casual contact,” CDC officials wrote in the Federal Register. The rule goes into effect on Jan. 4. Until now, CDC policy has been that individuals with HIV who are living outside the United States are not eligible to receive a visa for admission to the country. The CDC received more than 20,000 public comments on the proposed change, of which (about 19,500 supported removing HIV from the list of communicable diseases of public health significance, agency officials said.

New Surgeon General Confirmed

Dr. Regina Benjamin has been unanimously confirmed by the Senate as the U.S. Surgeon General. Dr. Benjamin, a family physician who is founder and CEO of the Bayou La Batre (Ala.) Rural Health Clinic, will start her work by responding to pandemic influenza A(H1N1)i Health and Human Services Secretary Kathleen Sebelius said in a statement. The American Academy of Family Physicians praised the confirmation. “All Americans will benefit from Dr. Benjamin's medical expertise, clinical experience, and advocacy for all patients,” the academy's president, Dr. Lori Heim, said in a statement. “She is committed to ensuring that everyone has access to health care, regardless of economic status.” Dr. Heim also praised Dr. Benjamin's perseverance in providing care to the underserved. Since the late 1990s, her clinic was destroyed by two hurricanes, Georges and Katrina, as well as a fire.

Adverse Event Reports Go Unused

The Food and Drug Administration's Center for Devices and Radiological Health fails to use adverse event reports in a systematic manner to detect and address medical device safety problems, a report from the HHS Office of the Inspector General found. The center has no documentation of following up on deaths, serious injuries, and device malfunctions reported by manufacturers and medical facilities, and most reports are not read in a timely fashion, according to the report. The Inspector General's office found that the FDA center received about 73,000 adverse event reports in 2003, and more than 150,000 in 2007. The Inspector General recommended that the center develop better protocols for reviewing and tracking the reports.

Preventive Services Underused

Only about one in four Americans aged 50-64 years regularly gets recommended preventive services such as screenings and immunizations, according to a report from the Centers for Disease Control and Prevention. The CDC, which compiled the data in collaboration with AARP and the American Medical Association, noted that preventive services often missed by older adults include influenza vaccination, cholesterol screening, breast and cervical cancer screening, and physician screenings for unhealthy behaviors such as binge drinking. The report, which identifies ways to make these services more accessible and convenient, is available at

www.cdc.gov/aging

Electronic Tools Effective: AHRQ

Consumer health informatics—electronic tools designed to provide tailored health advice to patients—could save money by eliminating the need for some health education now provided by clinicians, said a report from the Agency for Healthcare Research and Quality. Health informatics also could improve clinician-patient interactions, the AHRQ said. The agency reviewed more than 100 studies of consumers getting health information via the Web, computer programs, and other electronic avenues such as texting and chat groups. The analysis found that the most effective tools tailor messages using a patients' own health information and provide feedback progress. Feedback provided by a clinician doesn't seem to be any more effective–the key is timeliness, not the human touch, the study concluded.

AMA Weighs In on Chemicals

The American Medical Association has called for more effective government oversight of endocrine-disrupting chemicals. At its midwinter meeting, the organization adopted a resolution, introduced by the Endocrine Society, calling for most regulations on the chemicals to be handled by a single office. The exception: Endocrine disruptors used as pharmaceuticals would continue to be regulated by the FDA. The resolution also calls for policies on the chemicals to be developed jointly by endocrinologists, toxicologists, occupational- and environmental-medicine specialists, epidemiologists, and policy makers. “This new resolution marks an important step in engaging policy makers to enact policies that decrease public exposure to these potentially harmful chemicals,” said Dr. Robert Vigersky, Endocrine Society president.

CDC Eliminates HIV Exclusion

People seeking to immigrate to the United States will no longer be required to undergo HIV testing, under a final rule issued by the CDC. “While HIV infection is a serious health condition, it is not a communicable disease that is a significant public health risk for introduction, transmission, and spread to the U.S. population through casual contact,” CDC officials wrote in the Federal Register. The rule goes into effect on Jan. 4. Until now, CDC policy has been that individuals with HIV who are living outside the United States are not eligible to receive a visa for admission to the country. The CDC received more than 20,000 public comments on the proposed change, of which (about 19,500 supported removing HIV from the list of communicable diseases of public health significance, agency officials said.

New Surgeon General Confirmed

Dr. Regina Benjamin has been unanimously confirmed by the Senate as the U.S. Surgeon General. Dr. Benjamin, a family physician who is founder and CEO of the Bayou La Batre (Ala.) Rural Health Clinic, will start her work by responding to pandemic influenza A(H1N1)i Health and Human Services Secretary Kathleen Sebelius said in a statement. The American Academy of Family Physicians praised the confirmation. “All Americans will benefit from Dr. Benjamin's medical expertise, clinical experience, and advocacy for all patients,” the academy's president, Dr. Lori Heim, said in a statement. “She is committed to ensuring that everyone has access to health care, regardless of economic status.” Dr. Heim also praised Dr. Benjamin's perseverance in providing care to the underserved. Since the late 1990s, her clinic was destroyed by two hurricanes, Georges and Katrina, as well as a fire.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

Dr. Regina Benjamin Confirmed

Family physician Dr. Regina Benjamin has been unanimously confirmed by the Senate as the U.S. Surgeon General. Dr. Benjamin, founder and CEO of the Bayou La Batre (Ala.) Rural Health Clinic, will start her work by responding to the A(H1N1) influenza pandemic, said Health and Human Services Secretary Kathleen Sebelius in a statement. The American Academy of Family Physicians praised the confirmation. “All Americans will benefit from Dr. Benjamin's medical expertise, clinical experience, and advocacy for all patients,” said the academy's president, Dr. Lori Heim, in a statement. “She is committed to ensuring that everyone has access to health care, regardless of economic status.” Dr. Heim also praised Dr. Benjamin's perseverance in providing care to the underserved. Since the late 1990s, her clinic was destroyed by two hurricanes, Georges and Katrina, as well as a fire.

Family Docs Get Antiobesity Grant

The MetLife Foundation has awarded the American Academy of Family Physicians and the AAFP Foundation a $150,000 grant to provide family physicians with new ways to promote physical activity, nutrition, and emotional well-being. The antiobesity effort will produce educational materials to encourage children and older patients to talk with their family physicians about fitness and develop plans for the entire family to make and sustain healthy lifestyle choices, AAFP said. The organization will distribute the materials in mid-2010 to approximately 37,000 family physicians and residents. The new grant builds on an initiative launched in 2008 by AAFP and the MetLife Foundation, which to date has produced a DVD and a children's book discussing fitness for the family.

Medicare Premiums Set

Most Medicare beneficiaries will not see a Part B monthly premium increase in 2010, even though costs in the program have risen, the Centers for Medicare and Medicaid Services said. A “hold harmless” provision in Medicare law prevents the CMS from increasing Part B premiums this year because beneficiaries will not get a 2010 cost-of-living increase in their Social Security benefits. The CMS had calculated that Part B premiums will rise to about $110 next year, from $96 in 2009. But under the hold-harmless provision, only 27% of beneficiaries will be charged the increased amount. Most of those are also Medicaid-eligible, which means that the government program will pay their Medicare premiums, including the increase. However, the Obama administration is urging Congress to hold down premiums for all beneficiaries, according to the CMS.

CMS Proposes Medicare Changes

The CMS has proposed stronger standards for Medicare Advantage and Part D drug plans wanting to participate in the Medicare program. The agency said the proposed rule would hike program requirements for the more than 4,000 prescription drug and health plans offered to beneficiaries and would improve protections for the people who enroll in those plans. The rule would ensure “meaningful differences” between drug or health plans offered by the same company in a region, thereby eliminating duplication in offered plans, the CMS said. In addition, the proposal would protect beneficiaries from some costs by clarifying requirements relating to out-of-pocket charges.

New Fraud Prevention Tips

The Department of Health and Human Services and the Department of Justice have released new tips and information to help seniors and Medicare beneficiaries deter, detect, and defend against medical identity theft. The crime occurs when someone steals a patient's personal information and uses it to obtain medical care, to buy drugs and supplies, or to fraudulently bill Medicare. The two departments are warning Medicare beneficiaries to beware of offers of free medical equipment, services, or goods in exchange for their Medicare numbers. The departments also are encouraging patients to review their Medicare statements and medical bills regularly, and to report suspected problems and suspicious charges. Tips and a printable brochure are available at

www.stopmedicarefraud.gov

Med Schools Enroll Most Ever

Enrollment in both new and existing U.S. medical schools continues to expand, according to data released by the Association of American Medical Colleges. First-year enrollment increased by 2% over 2008 to nearly 18,400 students, the AAMC said. Four new U.S. medical schools—Herbert Wertheim College of Medicine in Miami; Commonwealth Medical College in Scranton, Pa.; Paul L. Foster School of Medicine, El Paso, Tex.; and University of Central Florida College of Medicine, Orlando—seated their first classes this year, accounting for half of the 2009 enrollment increase. In addition, 12 existing medical schools expanded their 2009 class sizes by 7% or more. Still, the United States must expand medical school enrollment and residency training slots further to avert an expected shortage of 124,000 to 159,000 physicians by 2025, the AAMC said.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

Dr. Regina Benjamin Confirmed

Family physician Dr. Regina Benjamin has been unanimously confirmed by the Senate as the U.S. Surgeon General. Dr. Benjamin, founder and CEO of the Bayou La Batre (Ala.) Rural Health Clinic, will start her work by responding to the A(H1N1) influenza pandemic, said Health and Human Services Secretary Kathleen Sebelius in a statement. The American Academy of Family Physicians praised the confirmation. “All Americans will benefit from Dr. Benjamin's medical expertise, clinical experience, and advocacy for all patients,” said the academy's president, Dr. Lori Heim, in a statement. “She is committed to ensuring that everyone has access to health care, regardless of economic status.” Dr. Heim also praised Dr. Benjamin's perseverance in providing care to the underserved. Since the late 1990s, her clinic was destroyed by two hurricanes, Georges and Katrina, as well as a fire.

Family Docs Get Antiobesity Grant

The MetLife Foundation has awarded the American Academy of Family Physicians and the AAFP Foundation a $150,000 grant to provide family physicians with new ways to promote physical activity, nutrition, and emotional well-being. The antiobesity effort will produce educational materials to encourage children and older patients to talk with their family physicians about fitness and develop plans for the entire family to make and sustain healthy lifestyle choices, AAFP said. The organization will distribute the materials in mid-2010 to approximately 37,000 family physicians and residents. The new grant builds on an initiative launched in 2008 by AAFP and the MetLife Foundation, which to date has produced a DVD and a children's book discussing fitness for the family.

Medicare Premiums Set

Most Medicare beneficiaries will not see a Part B monthly premium increase in 2010, even though costs in the program have risen, the Centers for Medicare and Medicaid Services said. A “hold harmless” provision in Medicare law prevents the CMS from increasing Part B premiums this year because beneficiaries will not get a 2010 cost-of-living increase in their Social Security benefits. The CMS had calculated that Part B premiums will rise to about $110 next year, from $96 in 2009. But under the hold-harmless provision, only 27% of beneficiaries will be charged the increased amount. Most of those are also Medicaid-eligible, which means that the government program will pay their Medicare premiums, including the increase. However, the Obama administration is urging Congress to hold down premiums for all beneficiaries, according to the CMS.

CMS Proposes Medicare Changes

The CMS has proposed stronger standards for Medicare Advantage and Part D drug plans wanting to participate in the Medicare program. The agency said the proposed rule would hike program requirements for the more than 4,000 prescription drug and health plans offered to beneficiaries and would improve protections for the people who enroll in those plans. The rule would ensure “meaningful differences” between drug or health plans offered by the same company in a region, thereby eliminating duplication in offered plans, the CMS said. In addition, the proposal would protect beneficiaries from some costs by clarifying requirements relating to out-of-pocket charges.

New Fraud Prevention Tips

The Department of Health and Human Services and the Department of Justice have released new tips and information to help seniors and Medicare beneficiaries deter, detect, and defend against medical identity theft. The crime occurs when someone steals a patient's personal information and uses it to obtain medical care, to buy drugs and supplies, or to fraudulently bill Medicare. The two departments are warning Medicare beneficiaries to beware of offers of free medical equipment, services, or goods in exchange for their Medicare numbers. The departments also are encouraging patients to review their Medicare statements and medical bills regularly, and to report suspected problems and suspicious charges. Tips and a printable brochure are available at

www.stopmedicarefraud.gov

Med Schools Enroll Most Ever

Enrollment in both new and existing U.S. medical schools continues to expand, according to data released by the Association of American Medical Colleges. First-year enrollment increased by 2% over 2008 to nearly 18,400 students, the AAMC said. Four new U.S. medical schools—Herbert Wertheim College of Medicine in Miami; Commonwealth Medical College in Scranton, Pa.; Paul L. Foster School of Medicine, El Paso, Tex.; and University of Central Florida College of Medicine, Orlando—seated their first classes this year, accounting for half of the 2009 enrollment increase. In addition, 12 existing medical schools expanded their 2009 class sizes by 7% or more. Still, the United States must expand medical school enrollment and residency training slots further to avert an expected shortage of 124,000 to 159,000 physicians by 2025, the AAMC said.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

Dr. Regina Benjamin Confirmed

Family physician Dr. Regina Benjamin has been unanimously confirmed by the Senate as the U.S. Surgeon General. Dr. Benjamin, founder and CEO of the Bayou La Batre (Ala.) Rural Health Clinic, will start her work by responding to the A(H1N1) influenza pandemic, said Health and Human Services Secretary Kathleen Sebelius in a statement. The American Academy of Family Physicians praised the confirmation. “All Americans will benefit from Dr. Benjamin's medical expertise, clinical experience, and advocacy for all patients,” said the academy's president, Dr. Lori Heim, in a statement. “She is committed to ensuring that everyone has access to health care, regardless of economic status.” Dr. Heim also praised Dr. Benjamin's perseverance in providing care to the underserved. Since the late 1990s, her clinic was destroyed by two hurricanes, Georges and Katrina, as well as a fire.

Family Docs Get Antiobesity Grant

The MetLife Foundation has awarded the American Academy of Family Physicians and the AAFP Foundation a $150,000 grant to provide family physicians with new ways to promote physical activity, nutrition, and emotional well-being. The antiobesity effort will produce educational materials to encourage children and older patients to talk with their family physicians about fitness and develop plans for the entire family to make and sustain healthy lifestyle choices, AAFP said. The organization will distribute the materials in mid-2010 to approximately 37,000 family physicians and residents. The new grant builds on an initiative launched in 2008 by AAFP and the MetLife Foundation, which to date has produced a DVD and a children's book discussing fitness for the family.

Medicare Premiums Set

Most Medicare beneficiaries will not see a Part B monthly premium increase in 2010, even though costs in the program have risen, the Centers for Medicare and Medicaid Services said. A “hold harmless” provision in Medicare law prevents the CMS from increasing Part B premiums this year because beneficiaries will not get a 2010 cost-of-living increase in their Social Security benefits. The CMS had calculated that Part B premiums will rise to about $110 next year, from $96 in 2009. But under the hold-harmless provision, only 27% of beneficiaries will be charged the increased amount. Most of those are also Medicaid-eligible, which means that the government program will pay their Medicare premiums, including the increase. However, the Obama administration is urging Congress to hold down premiums for all beneficiaries, according to the CMS.

CMS Proposes Medicare Changes

The CMS has proposed stronger standards for Medicare Advantage and Part D drug plans wanting to participate in the Medicare program. The agency said the proposed rule would hike program requirements for the more than 4,000 prescription drug and health plans offered to beneficiaries and would improve protections for the people who enroll in those plans. The rule would ensure “meaningful differences” between drug or health plans offered by the same company in a region, thereby eliminating duplication in offered plans, the CMS said. In addition, the proposal would protect beneficiaries from some costs by clarifying requirements relating to out-of-pocket charges.

New Fraud Prevention Tips

The Department of Health and Human Services and the Department of Justice have released new tips and information to help seniors and Medicare beneficiaries deter, detect, and defend against medical identity theft. The crime occurs when someone steals a patient's personal information and uses it to obtain medical care, to buy drugs and supplies, or to fraudulently bill Medicare. The two departments are warning Medicare beneficiaries to beware of offers of free medical equipment, services, or goods in exchange for their Medicare numbers. The departments also are encouraging patients to review their Medicare statements and medical bills regularly, and to report suspected problems and suspicious charges. Tips and a printable brochure are available at

www.stopmedicarefraud.gov

Med Schools Enroll Most Ever

Enrollment in both new and existing U.S. medical schools continues to expand, according to data released by the Association of American Medical Colleges. First-year enrollment increased by 2% over 2008 to nearly 18,400 students, the AAMC said. Four new U.S. medical schools—Herbert Wertheim College of Medicine in Miami; Commonwealth Medical College in Scranton, Pa.; Paul L. Foster School of Medicine, El Paso, Tex.; and University of Central Florida College of Medicine, Orlando—seated their first classes this year, accounting for half of the 2009 enrollment increase. In addition, 12 existing medical schools expanded their 2009 class sizes by 7% or more. Still, the United States must expand medical school enrollment and residency training slots further to avert an expected shortage of 124,000 to 159,000 physicians by 2025, the AAMC said.

2010 Medicare Premiums Set

Most Medicare beneficiaries will not see a Part B monthly premium increase in 2010, even though costs in the program have risen, the Centers for Medicare and Medicaid Services said. A “hold harmless” provision in Medicare law prevents the CMS from increasing Part B premiums this year because beneficiaries will not get a 2010 cost-of-living increase in their Social Security benefits. The CMS had calculated that Part B premiums will rise to about $110 next year, from $96 in 2009. But under the hold-harmless provision, only 27% of beneficiaries will be charged the increased amount. Most of those are also Medicaid-eligible, which means that the government program will pay their Medicare premiums, including the increase.

CMS Proposes Medicare Changes

The CMS has proposed stronger standards for Medicare Advantage and Part D drug plans wanting to participate in Medicare. The agency said the proposed rule would hike program requirements for the more than 4,000 prescription drug and health plans offered to beneficiaries and would improve protections for the people who enroll in those plans. The rule would ensure “meaningful differences” between drug or health plans offered by the same company in a region, thereby eliminating duplication in offered plans, the CMS said. The proposal also would protect beneficiaries from some costs by clarifying requirements relating to out-of-pocket charges.

Dr. Tooker Stepping Down at ACP

Dr. John Tooker is stepping down as executive vice president and chief executive officer of the American College of Physicians, the college has announced. Dr. Tooker will remain in his position until a search committee selects his replacement, a process the ACP said should take 6-12 months. “It has been and remains a privilege to serve as ACP's executive vice president and CEO,” Dr. Tooker said in a statement. “My decision was influenced by a family member's health, and my desire to spend more time with my family.” Dr. Tooker served as the college's deputy executive vice president and chief operating officer from 1995 until 2002, when he assumed his current title. He also chairs the boards of the National Committee for Quality Assurance and the National eHealth Collaborative, and serves on the boards of the National Quality Forum, Certification Commission for Health Information Technology, and Electronic Health Record Patient Safety Advisory.

Med Schools Enroll Most Ever

Enrollment in both new and existing U.S. medical schools continues to expand, according to data released by the Association of American Medical Colleges. First-year enrollment increased by 2% over 2008 to nearly 18,400 students, the AAMC said. Four new U.S. medical schools—Herbert Wertheim College of Medicine, Miami; Commonwealth Medical College, Scranton, Pa.; Paul L. Foster School of Medicine, El Paso, Tex.; and University of Central Florida College of Medicine, Orlando—seated their first classes this year, accounting for half of the 2009 enrollment increase. In addition, 12 existing medical schools expanded their 2009 class sizes by 7% or more. Still, medical school enrollment must be expanded further to avert an expected shortage of 124,000 to 159,000 physicians by 2025, the AAMC said.

Boomer Health Spending Rises

Total health care expenses for Americans aged 45-64 doubled between 1996 and 2006, from an inflation-adjusted $187 billion to $370 billion, according to the Agency for Healthcare Research and Quality. The AHRQ found that while the proportion of middle-aged people who incurred medical expenses remained constant at 89%, average health care expenses increased from an inflation-adjusted $3,849 to $5,455. Prescriptions constituted a much higher portion of total expenses in 2006 than in 1996, the federal agency said, while the share spent for hospital inpatient care decreased. The average expense per service rendered also increased significantly. For example, the average physician office visit jumped to $207 from an inflation-adjusted $128, prescription medicines nearly doubled from $103 to $199, and an emergency department visit rose from $563 to $947, the AHRQ found.

Docs Like State's Health Reforms

A large majority of practicing physicians in Massachusetts support that state's 2006 health reform law, a study in the New England Journal of Medicine indicated. Three-quarters of physicians essentially said they want to continue the law's policies, although 46% would make some changes—especially to cover more of the uninsured and to better control costs. Only 13% of physicians in the state opposed the health reforms created through the legislation, and just 7% said they believe the policies should be repealed, according to the study, conducted by Harvard researchers. “The findings suggest that it is possible to provide near-universal coverage of the population and have a resulting system that most physicians believe improves care for the uninsured without undermining their ability to provide care to their patients,” study coauthor Robert Blendon, Sc.D., said in a statement.

2010 Medicare Premiums Set

Most Medicare beneficiaries will not see a Part B monthly premium increase in 2010, even though costs in the program have risen, the Centers for Medicare and Medicaid Services said. A “hold harmless” provision in Medicare law prevents the CMS from increasing Part B premiums this year because beneficiaries will not get a 2010 cost-of-living increase in their Social Security benefits. The CMS had calculated that Part B premiums will rise to about $110 next year, from $96 in 2009. But under the hold-harmless provision, only 27% of beneficiaries will be charged the increased amount. Most of those are also Medicaid-eligible, which means that the government program will pay their Medicare premiums, including the increase.

CMS Proposes Medicare Changes

The CMS has proposed stronger standards for Medicare Advantage and Part D drug plans wanting to participate in Medicare. The agency said the proposed rule would hike program requirements for the more than 4,000 prescription drug and health plans offered to beneficiaries and would improve protections for the people who enroll in those plans. The rule would ensure “meaningful differences” between drug or health plans offered by the same company in a region, thereby eliminating duplication in offered plans, the CMS said. The proposal also would protect beneficiaries from some costs by clarifying requirements relating to out-of-pocket charges.

Dr. Tooker Stepping Down at ACP

Dr. John Tooker is stepping down as executive vice president and chief executive officer of the American College of Physicians, the college has announced. Dr. Tooker will remain in his position until a search committee selects his replacement, a process the ACP said should take 6-12 months. “It has been and remains a privilege to serve as ACP's executive vice president and CEO,” Dr. Tooker said in a statement. “My decision was influenced by a family member's health, and my desire to spend more time with my family.” Dr. Tooker served as the college's deputy executive vice president and chief operating officer from 1995 until 2002, when he assumed his current title. He also chairs the boards of the National Committee for Quality Assurance and the National eHealth Collaborative, and serves on the boards of the National Quality Forum, Certification Commission for Health Information Technology, and Electronic Health Record Patient Safety Advisory.

Med Schools Enroll Most Ever

Enrollment in both new and existing U.S. medical schools continues to expand, according to data released by the Association of American Medical Colleges. First-year enrollment increased by 2% over 2008 to nearly 18,400 students, the AAMC said. Four new U.S. medical schools—Herbert Wertheim College of Medicine, Miami; Commonwealth Medical College, Scranton, Pa.; Paul L. Foster School of Medicine, El Paso, Tex.; and University of Central Florida College of Medicine, Orlando—seated their first classes this year, accounting for half of the 2009 enrollment increase. In addition, 12 existing medical schools expanded their 2009 class sizes by 7% or more. Still, medical school enrollment must be expanded further to avert an expected shortage of 124,000 to 159,000 physicians by 2025, the AAMC said.

Boomer Health Spending Rises

Total health care expenses for Americans aged 45-64 doubled between 1996 and 2006, from an inflation-adjusted $187 billion to $370 billion, according to the Agency for Healthcare Research and Quality. The AHRQ found that while the proportion of middle-aged people who incurred medical expenses remained constant at 89%, average health care expenses increased from an inflation-adjusted $3,849 to $5,455. Prescriptions constituted a much higher portion of total expenses in 2006 than in 1996, the federal agency said, while the share spent for hospital inpatient care decreased. The average expense per service rendered also increased significantly. For example, the average physician office visit jumped to $207 from an inflation-adjusted $128, prescription medicines nearly doubled from $103 to $199, and an emergency department visit rose from $563 to $947, the AHRQ found.

Docs Like State's Health Reforms

A large majority of practicing physicians in Massachusetts support that state's 2006 health reform law, a study in the New England Journal of Medicine indicated. Three-quarters of physicians essentially said they want to continue the law's policies, although 46% would make some changes—especially to cover more of the uninsured and to better control costs. Only 13% of physicians in the state opposed the health reforms created through the legislation, and just 7% said they believe the policies should be repealed, according to the study, conducted by Harvard researchers. “The findings suggest that it is possible to provide near-universal coverage of the population and have a resulting system that most physicians believe improves care for the uninsured without undermining their ability to provide care to their patients,” study coauthor Robert Blendon, Sc.D., said in a statement.

2010 Medicare Premiums Set

Most Medicare beneficiaries will not see a Part B monthly premium increase in 2010, even though costs in the program have risen, the Centers for Medicare and Medicaid Services said. A “hold harmless” provision in Medicare law prevents the CMS from increasing Part B premiums this year because beneficiaries will not get a 2010 cost-of-living increase in their Social Security benefits. The CMS had calculated that Part B premiums will rise to about $110 next year, from $96 in 2009. But under the hold-harmless provision, only 27% of beneficiaries will be charged the increased amount. Most of those are also Medicaid-eligible, which means that the government program will pay their Medicare premiums, including the increase.

CMS Proposes Medicare Changes

The CMS has proposed stronger standards for Medicare Advantage and Part D drug plans wanting to participate in Medicare. The agency said the proposed rule would hike program requirements for the more than 4,000 prescription drug and health plans offered to beneficiaries and would improve protections for the people who enroll in those plans. The rule would ensure “meaningful differences” between drug or health plans offered by the same company in a region, thereby eliminating duplication in offered plans, the CMS said. The proposal also would protect beneficiaries from some costs by clarifying requirements relating to out-of-pocket charges.

Dr. Tooker Stepping Down at ACP

Dr. John Tooker is stepping down as executive vice president and chief executive officer of the American College of Physicians, the college has announced. Dr. Tooker will remain in his position until a search committee selects his replacement, a process the ACP said should take 6-12 months. “It has been and remains a privilege to serve as ACP's executive vice president and CEO,” Dr. Tooker said in a statement. “My decision was influenced by a family member's health, and my desire to spend more time with my family.” Dr. Tooker served as the college's deputy executive vice president and chief operating officer from 1995 until 2002, when he assumed his current title. He also chairs the boards of the National Committee for Quality Assurance and the National eHealth Collaborative, and serves on the boards of the National Quality Forum, Certification Commission for Health Information Technology, and Electronic Health Record Patient Safety Advisory.

Med Schools Enroll Most Ever

Enrollment in both new and existing U.S. medical schools continues to expand, according to data released by the Association of American Medical Colleges. First-year enrollment increased by 2% over 2008 to nearly 18,400 students, the AAMC said. Four new U.S. medical schools—Herbert Wertheim College of Medicine, Miami; Commonwealth Medical College, Scranton, Pa.; Paul L. Foster School of Medicine, El Paso, Tex.; and University of Central Florida College of Medicine, Orlando—seated their first classes this year, accounting for half of the 2009 enrollment increase. In addition, 12 existing medical schools expanded their 2009 class sizes by 7% or more. Still, medical school enrollment must be expanded further to avert an expected shortage of 124,000 to 159,000 physicians by 2025, the AAMC said.

Boomer Health Spending Rises

Total health care expenses for Americans aged 45-64 doubled between 1996 and 2006, from an inflation-adjusted $187 billion to $370 billion, according to the Agency for Healthcare Research and Quality. The AHRQ found that while the proportion of middle-aged people who incurred medical expenses remained constant at 89%, average health care expenses increased from an inflation-adjusted $3,849 to $5,455. Prescriptions constituted a much higher portion of total expenses in 2006 than in 1996, the federal agency said, while the share spent for hospital inpatient care decreased. The average expense per service rendered also increased significantly. For example, the average physician office visit jumped to $207 from an inflation-adjusted $128, prescription medicines nearly doubled from $103 to $199, and an emergency department visit rose from $563 to $947, the AHRQ found.

Docs Like State's Health Reforms

A large majority of practicing physicians in Massachusetts support that state's 2006 health reform law, a study in the New England Journal of Medicine indicated. Three-quarters of physicians essentially said they want to continue the law's policies, although 46% would make some changes—especially to cover more of the uninsured and to better control costs. Only 13% of physicians in the state opposed the health reforms created through the legislation, and just 7% said they believe the policies should be repealed, according to the study, conducted by Harvard researchers. “The findings suggest that it is possible to provide near-universal coverage of the population and have a resulting system that most physicians believe improves care for the uninsured without undermining their ability to provide care to their patients,” study coauthor Robert Blendon, Sc.D., said in a statement.

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, which was performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (those aged 25–34 years) than did the Masterfile (JAMA 2009;302:1674–80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger.

He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data. These adjustments could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D., a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues.

“Establishing the right number of physicians is difficult if they cannot be accurately counted,” Dr. Ricketts wrote. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform” (JAMA 2009;302:1701–2).

'Establishing the right number of physicians is difficult if they cannot be accurately counted.'

Source Dr. ricketts

U.S. census data showed that the AMA Masterfile underestimated the physician workforce aged 25–34 years.

Source ©andresinfinite/Fotolia.com

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, which was performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (those aged 25–34 years) than did the Masterfile (JAMA 2009;302:1674–80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger.

He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data. These adjustments could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D., a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues.

“Establishing the right number of physicians is difficult if they cannot be accurately counted,” Dr. Ricketts wrote. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform” (JAMA 2009;302:1701–2).

'Establishing the right number of physicians is difficult if they cannot be accurately counted.'

Source Dr. ricketts

U.S. census data showed that the AMA Masterfile underestimated the physician workforce aged 25–34 years.

Source ©andresinfinite/Fotolia.com

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, which was performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (those aged 25–34 years) than did the Masterfile (JAMA 2009;302:1674–80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger.

He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data. These adjustments could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D., a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues.

“Establishing the right number of physicians is difficult if they cannot be accurately counted,” Dr. Ricketts wrote. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform” (JAMA 2009;302:1701–2).

'Establishing the right number of physicians is difficult if they cannot be accurately counted.'

Source Dr. ricketts

U.S. census data showed that the AMA Masterfile underestimated the physician workforce aged 25–34 years.

Source ©andresinfinite/Fotolia.com

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, which was performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (those aged 25-34 years) than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data. These adjustments could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues (JAMA 2009;302:1701-2).

“Establishing the right number of physicians is difficult if they cannot be accurately counted,” he wrote. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform.”

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, which was performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (those aged 25-34 years) than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data. These adjustments could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues (JAMA 2009;302:1701-2).

“Establishing the right number of physicians is difficult if they cannot be accurately counted,” he wrote. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform.”

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, which was performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (those aged 25-34 years) than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data. These adjustments could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues (JAMA 2009;302:1701-2).

“Establishing the right number of physicians is difficult if they cannot be accurately counted,” he wrote. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform.”

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (aged 25–34 years) than did the Masterfile (JAMA 2009;302:1674–80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D., noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues. “Establishing the right number of physicians is difficult if they cannot be accurately counted,” wrote Dr. Ricketts, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform”(JAMA 2009;302:1701–2).

'Establishing the right number of physicians is difficult if they cannot be accurately counted.'

Source DR. RICKETTS

U.S. census data showed that the AMA Masterfile underestimated the physician workforce aged 25–34 years.

Source ©andresinfinite/Fotolia.com

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (aged 25–34 years) than did the Masterfile (JAMA 2009;302:1674–80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D., noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues. “Establishing the right number of physicians is difficult if they cannot be accurately counted,” wrote Dr. Ricketts, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform”(JAMA 2009;302:1701–2).

'Establishing the right number of physicians is difficult if they cannot be accurately counted.'

Source DR. RICKETTS

U.S. census data showed that the AMA Masterfile underestimated the physician workforce aged 25–34 years.

Source ©andresinfinite/Fotolia.com

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, performed by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The researchers sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (aged 25–34 years) than did the Masterfile (JAMA 2009;302:1674–80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. He added that surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an accompanying editorial, Thomas C. Ricketts, Ph.D., noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues. “Establishing the right number of physicians is difficult if they cannot be accurately counted,” wrote Dr. Ricketts, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform”(JAMA 2009;302:1701–2).

'Establishing the right number of physicians is difficult if they cannot be accurately counted.'

Source DR. RICKETTS

U.S. census data showed that the AMA Masterfile underestimated the physician workforce aged 25–34 years.

Source ©andresinfinite/Fotolia.com

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

HHS Awards $40M to States

The Department of Health and Human Services has awarded $40 million in grants to help states find and enroll children who are uninsured but eligible for either Medicaid or the Children's Health Insurance Program (CHIP). The grants were paid to 69 applicants in 41 states and the District of Columbia whose outreach, enrollment, and retention efforts will target areas where many such children are believed to live, particularly in underserved populations. For example, HHS said, one-fifth of the projects will target Hispanic children, with an emphasis on teenagers, and more than 10% of the projects will focus on homeless children. Most grantees work through community groups, HHS said. For instance, church volunteers in Missouri will go door to door to locate potentially eligible children and then help their families apply for the health coverage.

CMS Clarifies CHIP Dental Coverage

States may provide dental services for children covered by CHIP either by creating their own benefits package or by selecting one of three standard coverage plans, the Centers for Medicare and Medicaid Services said in a memo. The document was intended to guide states implementing the new requirement to provide dental coverage to all CHIP-enrolled children, which was included in the CHIP reauthorization approved by Congress and signed by the president earlier this year. CMS told the states that they must cover medically necessary orthodontia services and that they may provide supplemental dental-only coverage to low-income children who have private health insurance but inadequate or no dental coverage.

NIH Awards $65M in Autism Grants

The National Institutes of Health has chosen 50 autism research projects to share $65 million in grants from the stimulus act passed last spring. The grants are part of the largest funding opportunity for research on autism spectrum disorders ever, according to NIH, and will address short-term research objectives detailed in the Interagency Autism Coordinating Committee's strategic plan for such research. “These studies currently hold the best promise of revealing what causes autism, how it might be prevented, what treatments are effective, and how service needs change across the lifespan—questions noted in the IACC strategic plan as critically important to improving the lives of people with [autism spectrum disorder] and their families,” Dr. Thomas Insel, director of the National Institute of Mental Health and IACC chair, said in a statement.

IOM Pushes School Lunch Changes

School lunches and breakfasts need a nutritional makeover to increase fruits and vegetables, set caloric levels, and reduce saturated fat and salt, according to the Institute of Medicine. The IOM made the recommendations in a new report for the Department of Agriculture. That agency is expected to use the findings to write new regulations on school meals. Specifically, the IOM said, school meals should include two servings per day of fruits and vegetables, with a wide variety provided each week. Half of all grains and breads should be “whole grain rich,” the report said, and all milk should be fat free or low fat. In fact, students should be required to choose a fruit at breakfast and either a fruit or a vegetable at lunch if their meals are to be paid for by the program, the IOM said. However, the nutrition-advocacy group Center for Science in the Public Interest said that the IOM did not go far enough. It also should have recommended limits on sugars in school meals, the group said.

Site Details Newborn Screening

The National Library of Medicine has launched a Web site intended to promote standards in electronically recording and transmitting the results of newborn screening tests. The objectives, said the NLM, are to speed the delivery of newborn screening reports, improve care for infants with positive test results, enable the use and comparison of data from different laboratories, and support the development of strategies for improving the newborn screening process. The Web site includes standardized codes and terminology for newborn tests and the conditions they target. These include all the core and secondary conditions that the Advisory Committee on Heritable Disorders in Newborns and Children recommends for screening plus other conditions and markers that one or more states recommend. The Web site is

http://newbornscreeningcodes.nlm.nih.gov

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its 2009 practice cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue last year from 2008, with substantial drops in both the number of procedures and the number of patients.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

HHS Awards $40M to States

The Department of Health and Human Services has awarded $40 million in grants to help states find and enroll children who are uninsured but eligible for either Medicaid or the Children's Health Insurance Program (CHIP). The grants were paid to 69 applicants in 41 states and the District of Columbia whose outreach, enrollment, and retention efforts will target areas where many such children are believed to live, particularly in underserved populations. For example, HHS said, one-fifth of the projects will target Hispanic children, with an emphasis on teenagers, and more than 10% of the projects will focus on homeless children. Most grantees work through community groups, HHS said. For instance, church volunteers in Missouri will go door to door to locate potentially eligible children and then help their families apply for the health coverage.

CMS Clarifies CHIP Dental Coverage

States may provide dental services for children covered by CHIP either by creating their own benefits package or by selecting one of three standard coverage plans, the Centers for Medicare and Medicaid Services said in a memo. The document was intended to guide states implementing the new requirement to provide dental coverage to all CHIP-enrolled children, which was included in the CHIP reauthorization approved by Congress and signed by the president earlier this year. CMS told the states that they must cover medically necessary orthodontia services and that they may provide supplemental dental-only coverage to low-income children who have private health insurance but inadequate or no dental coverage.

NIH Awards $65M in Autism Grants

The National Institutes of Health has chosen 50 autism research projects to share $65 million in grants from the stimulus act passed last spring. The grants are part of the largest funding opportunity for research on autism spectrum disorders ever, according to NIH, and will address short-term research objectives detailed in the Interagency Autism Coordinating Committee's strategic plan for such research. “These studies currently hold the best promise of revealing what causes autism, how it might be prevented, what treatments are effective, and how service needs change across the lifespan—questions noted in the IACC strategic plan as critically important to improving the lives of people with [autism spectrum disorder] and their families,” Dr. Thomas Insel, director of the National Institute of Mental Health and IACC chair, said in a statement.

IOM Pushes School Lunch Changes

School lunches and breakfasts need a nutritional makeover to increase fruits and vegetables, set caloric levels, and reduce saturated fat and salt, according to the Institute of Medicine. The IOM made the recommendations in a new report for the Department of Agriculture. That agency is expected to use the findings to write new regulations on school meals. Specifically, the IOM said, school meals should include two servings per day of fruits and vegetables, with a wide variety provided each week. Half of all grains and breads should be “whole grain rich,” the report said, and all milk should be fat free or low fat. In fact, students should be required to choose a fruit at breakfast and either a fruit or a vegetable at lunch if their meals are to be paid for by the program, the IOM said. However, the nutrition-advocacy group Center for Science in the Public Interest said that the IOM did not go far enough. It also should have recommended limits on sugars in school meals, the group said.

Site Details Newborn Screening

The National Library of Medicine has launched a Web site intended to promote standards in electronically recording and transmitting the results of newborn screening tests. The objectives, said the NLM, are to speed the delivery of newborn screening reports, improve care for infants with positive test results, enable the use and comparison of data from different laboratories, and support the development of strategies for improving the newborn screening process. The Web site includes standardized codes and terminology for newborn tests and the conditions they target. These include all the core and secondary conditions that the Advisory Committee on Heritable Disorders in Newborns and Children recommends for screening plus other conditions and markers that one or more states recommend. The Web site is

http://newbornscreeningcodes.nlm.nih.gov

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its 2009 practice cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue last year from 2008, with substantial drops in both the number of procedures and the number of patients.

Can't get enough Policy & Practice? Check out our new podcast each Monday. egmnblog.wordpress.com

HHS Awards $40M to States

The Department of Health and Human Services has awarded $40 million in grants to help states find and enroll children who are uninsured but eligible for either Medicaid or the Children's Health Insurance Program (CHIP). The grants were paid to 69 applicants in 41 states and the District of Columbia whose outreach, enrollment, and retention efforts will target areas where many such children are believed to live, particularly in underserved populations. For example, HHS said, one-fifth of the projects will target Hispanic children, with an emphasis on teenagers, and more than 10% of the projects will focus on homeless children. Most grantees work through community groups, HHS said. For instance, church volunteers in Missouri will go door to door to locate potentially eligible children and then help their families apply for the health coverage.

CMS Clarifies CHIP Dental Coverage

States may provide dental services for children covered by CHIP either by creating their own benefits package or by selecting one of three standard coverage plans, the Centers for Medicare and Medicaid Services said in a memo. The document was intended to guide states implementing the new requirement to provide dental coverage to all CHIP-enrolled children, which was included in the CHIP reauthorization approved by Congress and signed by the president earlier this year. CMS told the states that they must cover medically necessary orthodontia services and that they may provide supplemental dental-only coverage to low-income children who have private health insurance but inadequate or no dental coverage.

NIH Awards $65M in Autism Grants

The National Institutes of Health has chosen 50 autism research projects to share $65 million in grants from the stimulus act passed last spring. The grants are part of the largest funding opportunity for research on autism spectrum disorders ever, according to NIH, and will address short-term research objectives detailed in the Interagency Autism Coordinating Committee's strategic plan for such research. “These studies currently hold the best promise of revealing what causes autism, how it might be prevented, what treatments are effective, and how service needs change across the lifespan—questions noted in the IACC strategic plan as critically important to improving the lives of people with [autism spectrum disorder] and their families,” Dr. Thomas Insel, director of the National Institute of Mental Health and IACC chair, said in a statement.

IOM Pushes School Lunch Changes

School lunches and breakfasts need a nutritional makeover to increase fruits and vegetables, set caloric levels, and reduce saturated fat and salt, according to the Institute of Medicine. The IOM made the recommendations in a new report for the Department of Agriculture. That agency is expected to use the findings to write new regulations on school meals. Specifically, the IOM said, school meals should include two servings per day of fruits and vegetables, with a wide variety provided each week. Half of all grains and breads should be “whole grain rich,” the report said, and all milk should be fat free or low fat. In fact, students should be required to choose a fruit at breakfast and either a fruit or a vegetable at lunch if their meals are to be paid for by the program, the IOM said. However, the nutrition-advocacy group Center for Science in the Public Interest said that the IOM did not go far enough. It also should have recommended limits on sugars in school meals, the group said.

Site Details Newborn Screening

The National Library of Medicine has launched a Web site intended to promote standards in electronically recording and transmitting the results of newborn screening tests. The objectives, said the NLM, are to speed the delivery of newborn screening reports, improve care for infants with positive test results, enable the use and comparison of data from different laboratories, and support the development of strategies for improving the newborn screening process. The Web site includes standardized codes and terminology for newborn tests and the conditions they target. These include all the core and secondary conditions that the Advisory Committee on Heritable Disorders in Newborns and Children recommends for screening plus other conditions and markers that one or more states recommend. The Web site is

http://newbornscreeningcodes.nlm.nih.gov

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its 2009 practice cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue last year from 2008, with substantial drops in both the number of procedures and the number of patients.

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population,” Dr. Staiger said in an interview.

The study compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. The census data estimated up to 17,000 more physicians aged 25-34 years than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population,” Dr. Staiger said in an interview.

The study compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. The census data estimated up to 17,000 more physicians aged 25-34 years than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population,” Dr. Staiger said in an interview.

The study compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS).

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. The census data estimated up to 17,000 more physicians aged 25-34 years than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its 2009 practice cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue last year from 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008.

Student Posts Are Unprofessional

A majority of medical schools say they have experienced incidents of students posting unprofessional content online, researchers reported in the Journal of the American Medical Association. However, only 28 of the 78 schools surveyed said they had policies to address such postings, which typically occur on social networking sites, media-sharing sites, blogs, wikis, and podcasts, the authors said. Only six schools said they had encountered patient confidentiality violations, such as online descriptions of identifiable patients, and issues of conflict of interest were rare. But posts using profanity, discriminatory language, depictions of intoxication, and sexually suggestive material were common. Two-thirds of the schools gave students informal warnings, while three schools said they dismissed the students involved.

EHRs Improve Care Quality

Routine use of electronic health records may improve the quality of care provided in community-based primary care practices more than other common strategies do, according to a new study from RAND Corp. Researchers looking at 305 groups of physicians in Massachusetts found that EHR-equipped practices were more likely to deliver better care for diabetes and to provide some health screenings, as long as the EHR systems were used routinely and included advanced functions such as reminders to physicians. The quality differences were small, but the authors said they were surprised at how few strategies to improve quality actually were linked to better performance. The study was published in the Annals of Internal Medicine.

NIH Grants Total $5 Billion

The National Institutes of Health has awarded more than 12,000 grants for $5 billion in stimulus package funds toward research in HIV, cancer, heart disease, and autism. Announced at a press conference by President Obama, the grants come from the American Recovery and Reinvestment Act passed and signed last spring. “This represents the single largest boost to biomedical research in history,” the president said. Some of the funds will be used to apply findings from the Human Genome Project to treatment and prevention of the target diseases. Other stimulus package funding was designated by the Department of Health and Human Services for chronic disease prevention and wellness programs as well as for information technology at large federally funded health centers. The Centers for Disease Control and Prevention will administer $373 million for the chronic disease programs and community-based approaches that increase physical activity, improve nutrition, and decrease obesity. Eighteen grants totaling more than $22 million will fund information technology in medicine, the department said.

Medicaid Funds More Home Care

Annual Medicaid spending for assisted living and community-based services ballooned by more than 80% in the past 7 years as states sought alternatives to costly nursing home care, a report from the National Center for Assisted Living found. Over the same period, Medicaid's nursing home spending grew only about 10%, and the number of nursing home beds dropped nearly 1.6%, the report said. The program's bills for nursing home care, at $47 billion in 2007, were still far higher than the nearly $17 billion states spent on alternative services such as home care and assisted living. But “consumer preferences for options to institutional care and the states' interest in reducing Medicaid-expenditure growth rates have created a shift in the supply and utilization of nursing homes over the past several years,” the assisted living group concluded in its report.

Resistance Cuts Antibiotic Sales

Antibacterial drugs will soon see a slump in sales, partly because of declining effectiveness and partly because of generic competition, according to the market research company Kalorama Information. The segment had sales growth of just over 3% in 2008 and 2009, but sales will rise only 1.1% in 2010 and will decline by 0.6% in 2011, Kalorama estimated in its report “Worldwide Market for Anti-Infectives (Antifungals, Antibacterials and Antivirals).” The company pegged the 2009 world market for antibacterial drugs at $24.5 billion. It forecast global sales of all classes of anti-infectives to hit $53.3 billion, up from $45.3 billion in 2006.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its 2009 practice cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue last year from 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008.

Student Posts Are Unprofessional

A majority of medical schools say they have experienced incidents of students posting unprofessional content online, researchers reported in the Journal of the American Medical Association. However, only 28 of the 78 schools surveyed said they had policies to address such postings, which typically occur on social networking sites, media-sharing sites, blogs, wikis, and podcasts, the authors said. Only six schools said they had encountered patient confidentiality violations, such as online descriptions of identifiable patients, and issues of conflict of interest were rare. But posts using profanity, discriminatory language, depictions of intoxication, and sexually suggestive material were common. Two-thirds of the schools gave students informal warnings, while three schools said they dismissed the students involved.

EHRs Improve Care Quality

Routine use of electronic health records may improve the quality of care provided in community-based primary care practices more than other common strategies do, according to a new study from RAND Corp. Researchers looking at 305 groups of physicians in Massachusetts found that EHR-equipped practices were more likely to deliver better care for diabetes and to provide some health screenings, as long as the EHR systems were used routinely and included advanced functions such as reminders to physicians. The quality differences were small, but the authors said they were surprised at how few strategies to improve quality actually were linked to better performance. The study was published in the Annals of Internal Medicine.

NIH Grants Total $5 Billion

The National Institutes of Health has awarded more than 12,000 grants for $5 billion in stimulus package funds toward research in HIV, cancer, heart disease, and autism. Announced at a press conference by President Obama, the grants come from the American Recovery and Reinvestment Act passed and signed last spring. “This represents the single largest boost to biomedical research in history,” the president said. Some of the funds will be used to apply findings from the Human Genome Project to treatment and prevention of the target diseases. Other stimulus package funding was designated by the Department of Health and Human Services for chronic disease prevention and wellness programs as well as for information technology at large federally funded health centers. The Centers for Disease Control and Prevention will administer $373 million for the chronic disease programs and community-based approaches that increase physical activity, improve nutrition, and decrease obesity. Eighteen grants totaling more than $22 million will fund information technology in medicine, the department said.

Medicaid Funds More Home Care

Annual Medicaid spending for assisted living and community-based services ballooned by more than 80% in the past 7 years as states sought alternatives to costly nursing home care, a report from the National Center for Assisted Living found. Over the same period, Medicaid's nursing home spending grew only about 10%, and the number of nursing home beds dropped nearly 1.6%, the report said. The program's bills for nursing home care, at $47 billion in 2007, were still far higher than the nearly $17 billion states spent on alternative services such as home care and assisted living. But “consumer preferences for options to institutional care and the states' interest in reducing Medicaid-expenditure growth rates have created a shift in the supply and utilization of nursing homes over the past several years,” the assisted living group concluded in its report.

Resistance Cuts Antibiotic Sales

Antibacterial drugs will soon see a slump in sales, partly because of declining effectiveness and partly because of generic competition, according to the market research company Kalorama Information. The segment had sales growth of just over 3% in 2008 and 2009, but sales will rise only 1.1% in 2010 and will decline by 0.6% in 2011, Kalorama estimated in its report “Worldwide Market for Anti-Infectives (Antifungals, Antibacterials and Antivirals).” The company pegged the 2009 world market for antibacterial drugs at $24.5 billion. It forecast global sales of all classes of anti-infectives to hit $53.3 billion, up from $45.3 billion in 2006.

Practice Revenues Decline

Medical practice revenues fell in 2008, possibly because of declining patient volumes and payments from people in financial hardship, according to the Medical Group Management Association. Medical practices responded by trimming overhead costs more than 1%, but that wasn't enough to offset shrinking revenues, the MGMA found in its 2009 practice cost survey. Multispecialty group practices saw a 1.9% decline in total medical revenue last year from 2008, with substantial drops in both the number of procedures and the number of patients. Bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008.

Student Posts Are Unprofessional

A majority of medical schools say they have experienced incidents of students posting unprofessional content online, researchers reported in the Journal of the American Medical Association. However, only 28 of the 78 schools surveyed said they had policies to address such postings, which typically occur on social networking sites, media-sharing sites, blogs, wikis, and podcasts, the authors said. Only six schools said they had encountered patient confidentiality violations, such as online descriptions of identifiable patients, and issues of conflict of interest were rare. But posts using profanity, discriminatory language, depictions of intoxication, and sexually suggestive material were common. Two-thirds of the schools gave students informal warnings, while three schools said they dismissed the students involved.

EHRs Improve Care Quality

Routine use of electronic health records may improve the quality of care provided in community-based primary care practices more than other common strategies do, according to a new study from RAND Corp. Researchers looking at 305 groups of physicians in Massachusetts found that EHR-equipped practices were more likely to deliver better care for diabetes and to provide some health screenings, as long as the EHR systems were used routinely and included advanced functions such as reminders to physicians. The quality differences were small, but the authors said they were surprised at how few strategies to improve quality actually were linked to better performance. The study was published in the Annals of Internal Medicine.

NIH Grants Total $5 Billion

The National Institutes of Health has awarded more than 12,000 grants for $5 billion in stimulus package funds toward research in HIV, cancer, heart disease, and autism. Announced at a press conference by President Obama, the grants come from the American Recovery and Reinvestment Act passed and signed last spring. “This represents the single largest boost to biomedical research in history,” the president said. Some of the funds will be used to apply findings from the Human Genome Project to treatment and prevention of the target diseases. Other stimulus package funding was designated by the Department of Health and Human Services for chronic disease prevention and wellness programs as well as for information technology at large federally funded health centers. The Centers for Disease Control and Prevention will administer $373 million for the chronic disease programs and community-based approaches that increase physical activity, improve nutrition, and decrease obesity. Eighteen grants totaling more than $22 million will fund information technology in medicine, the department said.

Medicaid Funds More Home Care

Annual Medicaid spending for assisted living and community-based services ballooned by more than 80% in the past 7 years as states sought alternatives to costly nursing home care, a report from the National Center for Assisted Living found. Over the same period, Medicaid's nursing home spending grew only about 10%, and the number of nursing home beds dropped nearly 1.6%, the report said. The program's bills for nursing home care, at $47 billion in 2007, were still far higher than the nearly $17 billion states spent on alternative services such as home care and assisted living. But “consumer preferences for options to institutional care and the states' interest in reducing Medicaid-expenditure growth rates have created a shift in the supply and utilization of nursing homes over the past several years,” the assisted living group concluded in its report.

Resistance Cuts Antibiotic Sales

Antibacterial drugs will soon see a slump in sales, partly because of declining effectiveness and partly because of generic competition, according to the market research company Kalorama Information. The segment had sales growth of just over 3% in 2008 and 2009, but sales will rise only 1.1% in 2010 and will decline by 0.6% in 2011, Kalorama estimated in its report “Worldwide Market for Anti-Infectives (Antifungals, Antibacterials and Antivirals).” The company pegged the 2009 world market for antibacterial drugs at $24.5 billion. It forecast global sales of all classes of anti-infectives to hit $53.3 billion, up from $45.3 billion in 2006.

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS). They sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (aged 25-34 years) than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. Surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data and that could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an editorial, Thomas C. Ricketts, Ph.D, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform,” he wrote (JAMA 2009;302:1701-2).

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS). They sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (aged 25-34 years) than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. Surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data and that could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an editorial, Thomas C. Ricketts, Ph.D, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform,” he wrote (JAMA 2009;302:1701-2).

More young physicians are entering the workforce than previously thought while fewer older physicians are remaining active, making the physician workforce younger on average, both now and in the future, a recent study of census data showed.

The workforce analysis, which challenges conclusions drawn from the American Medical Association (AMA) Physician Masterfile dataset that is commonly used to calculate physician workforce numbers, ultimately could indicate ways to make the Masterfile data more accurate, according to the study's lead author, Douglas O. Staiger, Ph.D., the John French Professor of Economics at Dartmouth College in Hanover, N.H.

“Workforce projections rely on accurate estimates of the current number of physicians as a starting point,” Dr. Staiger said in an interview. “Without more accurate estimates of the size and age distribution of the current workforce, projections of physician supply, requirements, and potential shortages may mislead policy makers as they try to anticipate and prepare for the health care needs of the population.”

The study, by researchers at Dartmouth College, the U.S. Congressional Budget Office, and the center for interdisciplinary health workforce studies at Vanderbilt University Medical Center in Nashville, Tenn., compared physician workforce estimates and supply projections using AMA Masterfile data with estimates and projections from the U.S. Census Bureau Current Population Survey (CPS). They sought to determine the annual number of physicians working at least 20 hours per week in 10-year age categories. Recent workforce trends were used to project future physician supply by age, the authors said.

The analysis showed that in an average year, the census data estimated 67,000 (or 10%) fewer active physicians than did the AMA's Masterfile, almost entirely because the census data found fewer active physicians aged 55 years and older. In addition, the census data estimated up to 17,000 more young physicians (aged 25-34 years) than did the Masterfile (JAMA 2009;302:1674-80).

Projections using the AMA's Masterfile indicate that there will be about 1,050,000 physicians in practice in 2020, whereas census data estimates indicate that there will be only 957,000 physicians in practice then, with a smaller percentage older than age 65.

“Delays in reporting when physicians enter and exit the workforce appear to lead to an underestimate of younger physicians and an overestimate of older physicians in the Masterfile,” said Dr. Staiger. Surveys such as the CPS cannot replace the Masterfile because they lack geographic and specialty detail, but they provide benchmark data that could be used to adjust estimates based on Masterfile data and that could be important as policy makers struggle to deal with workforce issues, he said.

The study was funded by a grant from the National Institute on Aging. No financial disclosures for any of the authors were reported.

In an editorial, Thomas C. Ricketts, Ph.D, a researcher at the North Carolina Rural Health Research and Policy Analysis Center in Chapel Hill, noted that the health care reform debate highlights how physician supply is linked to universal access and cost issues. “Having accurate estimates for determining not only the number of physicians, but also current and future physician workforce requirements and capabilities for delivering primary and specialty care, will be essential for achieving and sustaining effective health care reform,” he wrote (JAMA 2009;302:1701-2).