Tuesday, October 11, 2011

A Much Needed Update

1. As of this coming January, the federal SGR (sustained growth rate) for Medicare payments will go into effect. This means an almost 30% cut to Medicare reimbursements, a freeze in payments for 10 years (aka reimbursement will be static), and other changes that will create access issues for Medicare beneficiaries, as well as hurt physicians. The AMA has created radio and TV spots to encourage constituents to call their representatives on behalf of SGR repeal. Contact your elected officials through the AMA Grassroots Network.

2. Last month, Sens. Nelson (D-FL), Schumer (D-NY), and Reid (D-NV) introduced a bill to increase the number of CMS-funded residency spots by 15,000 over five years. If passed, this would be the first expansion of residency positions since a cap was established in 1997. This is especially important as the number of students applying for residency (MD, DO, and international grads) exceed the number of residency slots. A recent NEJM article estimates that the number of domestic applicants will exceed the number of residency slots by 2015.

3. The AMA has organized a series of three webinars regarding physician and medical student suicide awareness and prevention. We’ve missed the first two (they’re archived here), but the final lecture is Wed. Nov. 16 at 1 pm. Studies show that physicians are more likely than the general public to commit suicide, and they are less likely to seek treatment for depression and suicidal thoughts than non-physicians. This is excellent information to use in future practice, to recognize warning signs in friends and colleagues, and to empower you to get help if you experience depression or thoughts of self-harm.

4. The official word from the USPSTF this week is that the prostate specific antigen (PSA) test “does not save lives, but results in needless medical procedures that have left tens of thousands of men impotent, incontinent or both.” This is the result of a panel that convened to determine whether PSA testing saves enough lives to justify the tests adverse outcomes, not to determine whether the test works. Nevertheless, the recommendation has unsurprisingly caused heated debate within the medical community. For example, the American Urological Association believes that the USPSTF recommendations will do more harm than good. Additionally, this has posed a problem for insurers and whether they will continue to pay for the test at all.

5. For those of you looking for a good study snack, a recent study published in the American Journal of Cardiology observed that women who ate more darkchocolate were less likely to have strokes. Granted, it was an observational study – no causal relationship here – but that doesn’t stop speculation. This is one of several studies that point to benefits of chocolate consumption, perhaps because of flavonoids that can decrease blood pressure and improve other blood factors linked to heart health.

In other junk food related news, the Interagency Work Group (comprised of the FTC, FDA, USDA, and CDC) is working on new guidelines to limit the advertising of unhealthful foods tochildren. One big change is broadening the definition of this market from 2-11 years old to 2-17 years old. The guidelines also expand the scope of advertising to include Internet pop-up ads, online sweepstakes, advertising through cellphones, celebrity endorsements, and in-school marketing. In astatement before the House Energy and Commerce Committee to be deliveredtomorrow, the FTC writes, “Children’s health is the ultimate goal, and marketing of more nutritious foods is one effective tool to help achieve that goal.”

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