Featuring hospital and health care headlines from the media and Web from October 31-November 6.

Iowa Headlines

Hospice workers get life out of caring for dying
Joyce  Hutchison continues to use her passion and years of experience to educate others about the benefits of hospice. Part of that is overcoming fear. Going to hospice won’t make patients die any sooner, she said.  (November 4, Des Moines Register)

Genesis will demonstrate da Vinci surgery system
Da Vinci offers a precise, minimally invasive procedure for hysterectomies and prostatectomies. Patients benefit with a faster recovery time, shorter hospital stay, less pain, less scarring and quicker return to normal activities.  (November 5, Quad-City Times)

Harkin asks big insurers to explain rate practices
Sen. Tom Harkin said this week he was launching an investigation into health insurance pricing, asking four major insurers to justify their pricing practices.  An industry spokesman called the move unfair and misguided.  (November 4, Des Moines Register)

U.S.  Headlines

Costs at urban hospitals may get extra scrutiny in health bill
As Congress struggles to rein in health care costs as part of its sweeping reform efforts, hospitals in New York City and other urban areas that provide some of the most expensive care are among the primary targets.  (November 2, New York Times)

Health bills aim a light on doctors’ conflicts
As part of the health care overhaul under consideration by Congress, lawmakers have included so-called sunshine provisions intended to shed light on the financial relationships between the medical industry and doctors.  (November 3, New York Times)

Program will monitor Maryland doctors’ hand-washing
State officials said this week they’re creating teams of staff members at hospitals around the state to secretly monitor their colleagues’ hand-washing habits as part of a first-of-its-kind program. The monitors will contribute to a systemwide report on hand-washing, using $100,000 in federal stimulus money.  (November 3, Associated Press)

Texas lawmakers try to give doctor-owned hospitals a dose of help
Texas House members are mounting a late effort to delay new limits on physician-owned hospitals, putting them at odds with Democratic leaders who think the facilities drive up health care costs.  (November 5, Dallas Morning News)

Nurses union reaches deal on H1N1 safety in U.S.
The H1N1 pact, announced on Monday as part of a contract settlement between the California Nurses Association and Catholic Healthcare West, averted a one-day strike threatened by thousands of registered nurses at more than 30 hospitals.  (November 2, Reuters)

Hospitals make slow progress in harnessing the ‘social’ aspects of social media
Hospitals’ current social media activties can be classified across to five major areas: brand management, real-time public relations, volume generation, non-marketing functions and community building. But only a small amount of hospital activity in the social media space could be described as “social.”  Rather, the majority of these efforts are either one-way “monologues” or bounded two-way conversations with little staying power.   (October 31, iHealthBeat)

Approximately 25% of the U.S. population lives in rural areas, but only 10% of physicians practice in rural areas.  This maldistribution of physicians over the last several decades has occurred for many reasons:

• Medical education in the United States has become specialized, centralized and urban.
• Many practitioners emerge from medical programs with a staggering amount of debt and go on to practice in urban areas, where they often receive a higher salary.

More doctors is not the answer

Simply increasing medical school slots is not the answer. According to the Robert Graham Center: Policy Studies in Family Medicine and Primary Care, “Sizeable growth of the physician workforce in the last two decades has not resolved the maldistribution of physicians.”  On March 24, 2009 — House Energy and Commerce Committee Chairman Henry A. Waxman said that a congressional overhaul of the health care system must not only provide for universal coverage but also for more primary care doctors and nurses to ensure that an insurance card actually gives the holder access to treatment.

Physicians need to be rooted in the rural community

In a joint 2008 statement, the American Academy of Family Physicians and the National Rural Health Association stated that medical education anchored in rural places, nourished and funded through significant federal, state and local community support, and meaningfully connected to both regional academic institutions and local physicians in practice has great potential to address both present and future needs for physicians who provide care to rural populations.

DMU launches program to combat rural physician shortage with incentives

Concerned about the growing physician shortage in rural Iowa, Des Moines University (DMU) has embarked upon a “grow your own” program.  DMU and its Area Health Education Center have created the Rural Iowa Provider Education (RIPE) Program.

The RIPE Program provides specialized education, training and tools to better prepare students for service in rural, underserved areas of Iowa.  Because one of the known barriers for students choosing a rural medical practice is the tuition debt load from medical school, DMU has made an on-going commitment to annually provide the equivalent of six full tuition scholarships to students enrolled in the Rural Medicine Educational Pathway. In return, graduates agree to maintain a fulltime primary care medical practice in an approved Iowa community for a period of four years.

Are plans like DMU’s RIPE the answer to the shortage of physicians in rural areas? Are there other concerns or issues at hand? How would you bring more physicians into rural areas?

You can find more information about the RIPE Program on DMU’s website.

Many have suggested pharmacists ought to review clinicians’ medication orders to aid in preventing errors in hospitals. The problem is that hospitals in rural areas can have a difficult time providing pharmacist coverage around the clock. A group of critical access hospitals in northeast Minnesota recently tested a program called after-hours remote pharmacy order entry system (ARPOE), which lets them submit medication orders to a hub hospital that can provide 24-hour pharmacy staff.

The eight hospitals participating in the demo project used a central hospital in Duluth to review all medication orders after rural hospital pharmacists were off duty. Read more