IOM - Connected coverage — selected articles on trends, challenges and controversies in the changing world of medicine.

OPINION

IOM’s landmark reports over the years

Connected coverage — selected articles on trends, challenges and controversies in the changing world of medicine.

Connected Coverage. Posted Oct. 8, 2012.

 

When the Institute of Medicine says something, people throughout the health system listen. The IOM, founded in 1970 as the health care arm of the National Academy of Sciences, functions to provide nonpartisan, practical reform advice to policymakers. The institute’s reports often are described as groundbreaking, seminal events in the world of health policy.

American Medical News regularly follows the work of the IOM and the specific impact the institute has on debates about physician issues. Some of the systemic problems the IOM has identified over the years include a prevalence of medical errors that cost patient lives, delivery system shortcomings that interfere with quality improvement, and wasteful utilization of health system resources that rob from patient care. The good news in these reports, however, is that the IOM thinks there are plenty of things that doctors and others can do about it.

IOM: Physicians play key role in stopping health system waste

http://www.ama-assn.org/amednews/2012/10/08/edsa1008.htm

Will a “silent exodus” from medicine worsen doctor shortage?

Many physicians, nervous about the impact of health system reform and dispirited by trends in medicine, are exploring career options that involve treating fewer patients.

By Kevin B. O'Reilly, amednews staff. Posted Oct. 8, 2012.

Frustrated by mounting regulation, declining pay, loss of autonomy and uncertainty about the effect of health system reform, doctors are cutting back the number of hours they work and how many patients they see.

Between 2008 and 2012, the average number of hours physicians worked fell by 5.9%, from 57 hours a week to 53, and doctors saw 16.6% fewer patients, according to a survey of nearly 14,000 doctors released in September. If the trend continues through 2016, it would equate to the loss of 44,250 full-time physicians, said the report, conducted by the doctor-recruiting firm Merritt Hawkins & Associates for the Physicians Foundation. The foundation was started in 2003 with more than $30 million from class-action settlements that 22 state and county medical societies made with health plans.

“This is a silent exodus,” said Mark Smith, president of Merritt Hawkins. “Physicians are feeling extremely overtaxed, overrun and overburdened.”

for complete AMA article:
http://www.ama-assn.org/amednews/2012/10/08/prl11008.htm

NIH’s 1,000 Genomes Project gains wider access, from amednews.com

Researchers and physicians now will have access to the largest-known database of genetic variations thanks to a partnership announced in March between Amazon Web Services and the National Institutes of Health.

Through the partnership, the 200-terabyte 1000 Genomes Project database, equivalent to more than 30,000 standard DVDs, will be stored on Amazon’s cloud and accessible to anyone with an Internet connection and a computer capable of processing that amount of data. Tools to process the data also are available on Amazon for a fee that varies according to the data access and analyses needed. Amazon created a website explaining the computing requirements or tools that can be used to access the database (aws.amazon.com/1000genomes/).
The 1,000 Genomes Project was launched in 2008 to create the most comprehensive map of human genetic variation available anywhere in the world. The goal is to collect data from the genomes of more than 2,600 people from 26 populations around the world and find the majority of all genome variations in existence. The database now has the genome sequencing of 1,700 people.
Whole genome sequencing allows researchers to identify genetic variations that increase a person’s risk of developing any one of a variety of conditions or diseases.
“The explosion of biomedical data has already significantly advanced our understanding of health and disease. Now we want to find new and better ways to make the most of these data to speed discovery, innovation and improvements in the nation’s health and economy,” said Francis S. Collins, MD, PhD, NIH director.
Lisa Brooks, PhD, program director of the Genetics Variation Program at the NIH, said most research labs do not have access to such a large data set or the computing power to work with one. The NIH is investing this money to advance disease study that otherwise would be difficult to carry out, she said.
The 1,000 Genomes Project database is geared toward researchers as opposed to the practicing physician. But if a physician already deals with genetic testing, he or she could use the database to determine whether a patient’s genetic variation may have led to them developing a particular disease or condition, Brooks said. A physician’s office computer would not likely be able to process the data, but a doctor could get access through a teaching hospital that does research.

more... http://www.ama-assn.org/amednews/2012/04/16/bise0418.htm

Limit certain patents, not patient care, from American Medical News

The AMA and other medical organizations have taken a strong stand on how wrongly permitted patents stand in the way of good health care.

Editorial. Posted April 16, 2012.

A recent opinion of the U.S. Supreme Court starts out citing an earlier judicial example tying together Albert Einstein, Sir Isaac Newton and the essence of what’s off-limits to be patented. Einstein could not have patented E=mc2, nor could Newton have patented the law of gravity, noted the court, because those discoveries were manifestations of nature upon which no one could make an exclusive claim.

Smaller in scale, but no less a manifestation of nature, are workings and responses of the human body. In a unanimous decision, the justices rightly applied the example from that earlier ruling to a patent case that represented a major threat to patient care.

more... http://www.ama-assn.org/amednews/2012/04/16/edsa0416.htm

The Supreme Court’s other business

The intense attention paid to the U.S. Supreme Court’s March 26-28 consideration of the health system reform law overshadowed several other health care cases that have wide-ranging implications on medical care.

In addition to its comprehensive coverage of the health reform oral arguments, American Medical News reported on these recent Supreme Court decisions of great interest to physicians and other health professionals. The justices struck down patents on a medical test that measures patients’ metabolite levels. They sent a lawsuit by California physicians and others against Medicaid pay cuts back to a lower court for further consideration. And justices sided with drugmakers in separate cases involving the sale of physician information and liability for labeling errors.

see AMAnews article for details: http://www.ama-assn.org/amednews/2012/04/09/edsa0409.htm

Can a specialty practice be a patient-centered medical home?

Should cardiologists, oncologists, endocrinologists and other specialists providing care for long-term chronic conditions have patient-centered medical homes?

Should they say “yes” when a primary care practice asks, “Won’t you be my neighbor?” and invites them to be part of a medical home neighborhood?

The patient-centered medical home is viewed as a possible strategy for improving patient outcomes and reducing health care spending. Ongoing health system reform means there may be additional payment for specialty practices to participate in some way in this model, although not always.

http://www.ama-assn.org/amednews/2012/04/09/bica0409.htm