Kansas governor vetoes Medicaid expansion bill

From Reuters:

The governor of Kansas on Thursday vetoed a bill expanding eligibility for Medicaid for the poor under the federal Affordable Care Act (ACA) because the measure was not fiscally responsible and would still fund Planned Parenthood.

State lawmakers in the Republican-controlled senate voted in favor of the measure on Tuesday, just days after President Donald Trump’s efforts to repeal and replace the ACA, also known as Obamacare, ended with the bill being pulled from a vote.

“You are going to put a dagger right through the heart of our small communities,” Republican Representative Leonard Mastroni, who voted in support of expansion, told the House in Topeka after Brownback’s veto.

ACEP Joins Coalition to Oppose Medical Merit Badges

From the Central Line:

March 30, 2017

The American College of Emergency Physicians is pleased to announce a historic collaboration involving nearly every major emergency medicine organization: The Coalition to Oppose Medical Merit Badges. Coalition members include the following organizations:

  • American Academy of Emergency Medicine (AAEM)
  • American Academy of Emergency Medicine/Resident and Student Association (AAEM/RSA)
  • American Board of Emergency Medicine (ABEM)
  • American College of Emergency Physicians (ACEP)
  • Association of Academic Chairs of Emergency Medicine (AACEM)
  • Council of Emergency Medicine Residency Directors (CORD)
  • Emergency Medicine Residents’ Association (EMRA)
  • Society for Academic Emergency Medicine (SAEM)

Board-certified emergency physicians who actively maintain their board certification should not be required to complete short-course certification in advanced resuscitation, trauma care, stroke care, cardiovascular care, or pediatric care in order to obtain or maintain medical staff privileges to work in an emergency department. Similarly, mandatory targeted continuing medical education (CME) requirements do not offer any meaningful value for the public or for the emergency physician who has achieved and maintained board certification. Such requirements are often promulgated by others who incompletely understand the foundation of knowledge and skills acquired by successfully completing an Accreditation Council for Graduate Medical Education–accredited emergency medicine residency program. These “merit badges” add no additional value for board-certified emergency physicians. Instead, they devalue the board certification process, failing to recognize the rigor of the ABEM Maintenance of Certification (MOC) program. In essence, medical merit badges set a lower bar than a diplomate’s education, training, and ongoing learning, as measured by initial board certification and maintenance of certification.

The Coalition finds no rational justification to require medical merit badges for board-certified emergency physicians who maintain their board certification. Our committed professional organizations provide the best opportunities for continuous professional development, and medical merit badges dismiss the quality of those educational efforts.

Opposing the requirements for medical merit badges will be a long and challenging struggle. It will take time to help administrators and regulatory bodies to better understand the rigorous standards to which we adhere as board-certified emergency physicians. In the coming months, we will develop our long-term strategy to create success and a pathway to recognize clinical excellence.

We welcome your thoughts and suggestions as to how we can best succeed. In the near future, we will ask for strong support and a loud and unified voice.

We will persist and we are up to the challenge—we are board-certified emergency physicians. Opposing medical merit badges is the right thing to do for our specialty. We will forever demonstrate a lifelong commitment to caring for anyone who is ill or injured, at any time, for any reason.

Kevin G. Rodgers, MD
President, AAEM

Mary Haas, MD
President, AAEM/RSA

Michael L. Carius, MD
President, ABEM

John J. Rogers, MD
Chair of the Board, ACEP

Richard Zane, MD
President, AACEM

Saadia Akhtar, MD
President, CORD

Alicia Kurtz, MD
President, EMRA

Andra L. Blomkalns, MD
President, SAEM

Anatomy of a Marble, What Classic Stone Statues Would Look Like If They Were In a Medical Textbook

From Laughing Squid:

Ege Islekel, an interior designer and graphic artist in Milan, Italy, created the superb “Anatomy of a Marble“, a clever photo-manipulation series that depicts classic marble statues as they would appear in medical textbooks, complete with anatomically correct images and definitive descriptions.


Swiss hospitals will start using drones to exchange lab samples

From The Verge:

A pair of hospitals in the Swiss city of Lugano have been testing the use of drones to transport laboratory samples. Since mid-March, logistics company Swiss Post has operated more than 70 tests flights between the two hospitals, and announced today that it plans to establish a regular service by 2018.


Doctor shortage could hurt Ohio rural areas

From Dayton Business:

“Ohio needs doctors. Doctors from Muslim-majority countries have responded to that need. It seems likely that a Trump travel ban will turn that win-win into a loss,” Policy Matters researchers wrote in a recent blog post.

The judges that blocked the ban cited Trump’s own statements about Muslims and noted that his campaign referred to the travel restrictions as a “Muslim ban,” which would be unconstitutional on the grounds of religious freedom.

Trump called their rulings “overreach,” and said he will take the case to the Supreme Court, which could ultimately determine whether the ban remains in place.

“If it does stay in place, it’s going to negatively impact the access to prmiary care for a lot of areas of the country that depend on these international graduates to provid their health care,” Hakkila said

Uncompensated care makes hospitals vulnerable

From the Clarion-Ledger:

Last year, the Mississippi Business Journal looked at the prospects for Mississippi local hospitals in the changing national and state health care policy environment. MHA’s Center for Rural Health director Mendal Kemp told the publication:

“The payer mix dictates how you are doing financially. Some of the small rural hospitals particularly depend heavily on Medicare and Medicaid. They have no private commercial insurance patients to speak of. That is why the (federal reimbursement) cuts are doubly bad for the small rural hospitals. Those are the ones at the greatest risk of closure.”


New study reveals economic burden of emergency department visits for traumatic brain injury

From News-Medical:

A new study that looked at nearly 134,000 emergency department visits for traumatic brain injury, including concussion, during a one year period in Ontario estimated that those visits had a total cost of $945 million over the lifetimes of those patients.

Medical treatments accounted for $292 million (31 per cent) of the estimated lifetime costs, and lost productivity amounted to $653 million (69 per cent), according to the report, published online in the Canadian Journal of Neurological Science.

Policy makers are increasingly using cost-of-illness studies such as this one to guide resource allocation and identify opportunities for improving health-care sustainability, said Dr. Michael Cusimano, a neurosurgeon at St. Michael’s Hospital and a senior author of the study.

Lacking E.M.T.s, an Aging Maine Turns to Immigrants

From the NY Times:

Jolly Ntirumenyerwa ran her fingers over the stethoscope that she had slung around her neck. It was a comforting connection to her career as a physician in her home country, the Democratic Republic of Congo, where she worked in emergency medicine.

Her credentials did not transfer when she moved to the United States in 2012, and she could not work as a doctor. So, she took jobs as a health aide in an assisted living facility.

Now, thanks to an unusual program that is training immigrants to become emergency medical technicians, she is preparing to make better use of her medical background and, she hopes, work her way up to becoming a physician assistant if not, someday, a doctor.


Tele-behavioral health care reaches rural residents

From NACO:

Under a joint powers agreement, Carlton, Cook, Lake, Koochiching and St. Louis counties — collectively as the Arrowhead Health Alliance — worked with state agencies to create the Arrowhead Telepresence Coalition (ATC). County commissioners comprise the joint powers board. It provides behavioral health care through remote diagnosis and treatment of patients using internet video and audio.

The largely rural Arrowhead region makes up 23 percent of the state’s land but only 6 percent of its population. “So what we needed to do early on was to find more innovative ways to deliver services,” said Dave Lee, a psychologist and director of Carlton County Public Health and Human Services. The region takes its moniker from its pointed shape on the map, wedged between Canada and Lake Superior. Duluth is its most populous city.

Rural Minnesota faces a critical shortage of mental health providers; seven counties in the Arrowhead region have been designated as mental health professional shortage areas, according to ATC.

“In taking the lead for the region,” Lee said, “I didn’t see any other way to start to solve some of these access problems without having tele-mental health capabilities.” Carlton county did a successful “mini-pilot” before the initiative launched regionwide.

Five states with the most rural hospital closures

From Becker’s:

Of the 25 states that have seen at least one rural hospital close since 2010, those with the most closures are in the South, according to research from the North Carolina Rural Health Research Program.

For its analysis, the NCRHRP defined a hospital closure as the cessation in the provision of inpatient services. As of March 27, all of the facilities listed below no longer provided inpatient care. However, some of them still offered other services, including outpatient care, imaging, urgent care or rehabilitation services.

Since 2010, 78 rural hospitals have closed. Here are the five states with the most rural hospital closures since 2010, according to the analysis.