ACEP states case for more ER funding

From Modern Physician:

Lawmakers who want to offer a 10% Medicare reimbursement increase for emergency department care are looking to health information technology adoption of all things to offset that pay bump.

Late last month, a bipartisan group of senators and congressmen reintroduced the Access to Emergency Medical Services Act, which calls for the creation of a national bipartisan commission to examine factors that affect the delivery of care in emergency departments, and asks the CMS to develop standards, guidelines and measures to address boarding—keeping patients in emergency exam rooms or in the hallways when inpatient rooms aren’t available—and ambulance diversion. The legislation would also provide a 10% reimbursement increase to emergency department staff, including on-call specialists who often don’t get paid for emergency care.

Loan forgiveness — is it enough to lure more into primary care?

From Short White Coat:

We received an e-mail from our financial aid office this week announcing a new loan forgiveness program for those of us in the class of 2010 considering primary care, family medicine, or psychiatry — traditionally lower-paying fields. The initiative comes just a little too late for fourth- year students, who have already made their choice of fields and learn today (Match Day) where they will be practicing them.

A sum of up to $60,000 per student (provided by an anonymous donor) will be payable in parts — after the student earns her MD and after she completes residency.

Feeling penniless is as inherent to medical studenthood as highlighter-inked flashcards and blood-streaked anatomy scrubs. In some ways, the impossible bulk of the debt burden confers its own sense of freedom (compare a $15 cab ride to $200,000-plus debt, and taking the T seems a comical frugality.)

The idea is to encourage medical students who are dissuaded by this debt burden from entering critical but under-populated fields.

But cold hard cash is not the only reason medical students might avoid specialties such as primary care medicine. The role of prestige (inextricably tied to said cash) is unavoidable in Boston’s academic culture of super-specialization, and lifestyle is becoming a larger piece of the equation (the so-called R.O.A.D. to happiness includes the specialties radiology, ophthalmology, anesthesiology, and dermatology). Realistically speaking, the salary difference between a surgeon and a family doctor would easily outlap this debt relief in a year.

Business booms at discount clinics

From the Des Moines Register:

Des Moines-area clinics that provide free or discounted care are seeing extra business, apparently because of the slumping economy.

Newly laid-off workers are helping fill the waiting rooms.

The most recent federal estimate said about 10 percent of Iowans lacked health insurance, about two-thirds of the national average. But those statistics are more than a year old, and clinic administrators say they see plenty of anecdotal evidence that the problem is worsening.

At the Free Clinics of Iowa, volunteer nurses and doctors saw an 80 percent increase in patients from 2005 to 2007. Executive Director Wendy Gray said the increases have continued as the economy has dropped. “Because the need is so great, our numbers are always up, unfortunately,” she said.The 18 clinics in Gray’s network are part-time affairs that are set up as stopgap measures for people who lack access to regular medical care.

EMS Providers Urged To Clean Stethoscopes To Prevent MRSA Transmission

From MedLexicon:

Emergency medical services providers should clean their stethoscopes more frequently to prevent transmission of methicillin-resistant Staphylococcus aureus (MRSA), urges Dr. Mark Merlin, chair of the Mobile Intensive Care Unit Advisory Committee for the New Jersey Department of Health and Senior Services.

One in three stethoscopes from a sampling of emergency medical services (EMS) providers from New Jersey tested positive for MRSA in a recent UMDNJ study led by Merlin, who is an assistant professor of emergency medicine and pediatrics at the UMDNJ-Robert Wood Johnson Medical School.

“There’s a simple solution for this potentially serious problem,” Merlin said. “Provide isopropyl alcohol wipes at hospital emergency room entrances so EMS professionals can clean their stethoscopes regularly.”