#PNN In Other News

Here are some other local, state or national stories we are reading that may impact you, your practice or your patients.

In Rural Areas, California’s Physician Shortage Getting Worse | In a northern California valley stretching under miles of bright blue sky between two snowy volcanic peaks, Mt. Lassen and Mt. Shasta, Daniel Dahle is known as a godsend, a friend, a lifesaver, a companion until the end. For more than three decades, “Doc” Dahle has been the physician in Bieber, serving a region about the size of five smaller U.S. states. When he started, he was one of five doctors in the region.  Today he is joined by only one other full-time physician. At 71, Dahle has delayed retirement for years — waiting for someone to take his place. “I was going to retire November 8th of last year; it was going to be a third of a century,” he said. “It’s tough to recruit young new vibrant family practitioners or internists or pediatricians to come up here.”

Trump Administration Hits Brakes On Law To Curb Unneeded Medicare CT Scans, MRIs | Five years after Congress passed a law to reduce unnecessary MRIs, CT scans and other expensive diagnostic imaging tests that could harm patients and waste money, federal officials have yet to implement it. The law requires that doctors consult clinical guidelines set by the medical industry before Medicare will pay for many common exams for enrollees. Health care providers who go way beyond clinical guidelines in ordering these scans (the 5% who order the most tests that are inappropriate) will, under the law, be required after that to get prior approval from Medicare for their diagnostic imaging. But after physicians argued the provision would interfere with their practices, the Trump administration delayed putting the 2014 law in place until January 2020, two years later than originally planned.

Telemedicine could keep older patients out of the hospital. So why hasn’t it taken off? | It's easy enough for a doctor on an app to prescribe a birth control pill or an antibiotic. But try getting one to virtually examine your sick mom in a nursing home. Chances are, she'll end up instead being sent to the hospital, where bad problems often get worse. For years, experts have touted the use of telemedicine as a way to let elder care organizations tap the expertise of geriatricians or other doctors to treat their residents for problems that don't appear to rise to the level of an emergency. Virtual care seems ideal for treating frail elderly people, for whom a hospital visit can be the start of a decline in health. They get disoriented in emergency rooms, where drug lists and care instructions get lost, beeping monitors and intrusive nurses make it hard to sleep and there's always a risk of acquiring a serious infection.

EHRs fuel burnout but don't blame it all on them, study says | When electronic health record systems began gaining traction in the late 1990s, they were touted as a way to boost the efficiency of medical practices. But those practicing medicine have often begged to differ. Data from the study in JAMA Open, authored by physicians and researchers from institutions of higher learning such as Stanford and the University of Mexico and hospitals and healthcare systems in California, Colorado and Minnesota, reinforced the uneasy relationship clinicians have with EHRs. Nearly 75% of surveyed clinicians said they felt under time pressure to perform appropriate documentation, more than 60% said they spent moderately high or even excessive time on EHR-related work at home and 45% described symptoms of burnout.

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