"Health & Medical News"

Better vigilance is needed to ensure medical research on human subjects is not flawed by financial conflicts of interest, according to the Assn. of American Medical Colleges and the Assn. of American Universities.

In March, the two organizations issued a report that calls on medical schools and research universities to put into place conflict-of-interest policies within two years. Such policies should cover how to identify, evaluate and manage financial conflicts, the report said.

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Advanced-practice nurses are the focus of a new wave of scope-of-practice bills that are making their way to state lawmakers.

At least 24 states are already considering bills or are expecting measures to be introduced this year. Measures address issues such as independent practice, doctor supervision of nurses, prescribing authority, or extended prescribing, including of controlled substances.

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CALPIRG released a new analysis today examining drug companies’ self-imposed limits on their marketing to doctors – efforts that include lavish wining-and-dining and thousands of dollars worth of gifts. The report, Playing By Their Own Rules: An Analysis of Drug Company Gifts to Doctors, finds that these limits are riddled with exceptions, and that some companies have evaded even the least restrictive limits on their marketing.   
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Depressed medical residents make six times more medication errors than residents who are not depressed, according to a U.S. study published online Feb. 7 in the British Medical Journal.

“Depression is a significant problem for residents as well as for their patients,” said lead study author Amy Fahrenkopf, MD, MPH. “The fact that it’s a problem for both needs to be addressed.”

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A California appeals court dealt another blow to health plans over their policy cancellation tactics.

The 4th District Court of Appeal unanimously said insurers have a responsibility to make sure patients’ policy applications are complete and accurate before issuing coverage — not after expensive claims come in the door. Judges said plans cannot revoke patients’ policies unless they fully investigate pre-enrollment forms up front or insurers show patients intentionally misled them.

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Large physician groups have long had a head start on solo and small practices in the medical marketplace because they can negotiate better health plan contracts. Now, a rising tide of evidence indicates that size also confers a quality advantage.

Researchers admit that the medical literature emerging on the relationship between group size and quality is far from a slam dunk. They argue, however, that bigger physician groups can pool capital to pay for electronic medical records systems and other quality initiatives that help them more reliably deliver guideline-based care.

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The next big respiratory disease epidemic could be in the form of the annual flu or something more exotic. But it is coming, and doctors should change what their offices look like in order to ensure they don’t contribute to its spread. Plans also need to be in place to make it more likely that care will be provided to the usual cadre of patients along with those infected by this pathogen, whatever it may be, according to several presentations at the American Academy of Family Physicians’ annual scientific assembly last month in Chicago.

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