APCblogit

Consumer-directed healthcare

How do you feel about PassportMD and other programs that allow consumers to keep track of their own healthcare? Joan Lunden is an advocate of these types of programs, which are gaining popularity in online communities.

Do nurse practitioners pose a threat to family physicians?

The December issue of Canadian Family Physician looked at this question from two perspectives. Gisèle Bourgeois-Law, MD says that NPs are more willing to provide healthcare in under serviced area and are integral to patient safety and well being. Guylaine Laguë, MD believes NPs dilute the relationship between physicians and patients.

Event update

The Society of Army Physician Assistants annual refresher course will take place in Fayette, NC, on April 20-April 24. Last year, approximately 800 individuals attended this event and represented 37 states and 2 overseas locations. Of this total, 84% were in the civilian market, and 31.1% involved in government service.

PR for NPs!

Take a look at this article about an NP's practice and how you and your colleagues can meet important community needs! Some points to consider as you evaluate your own practice: house calls for patients who can't make it to the office? focus on long-term care and disease prevention? And adding laughter and a happy office atmosphere.

New from Centers for Medicare & Medicaid Services

A new web resource for Medicare fee-for-service Advanced Practice Nurses and Physician Assistants provides useful web-based training, video/DVD resources, and other products. You'll find information on such topics as the National Provider Identifier, which you'll need if you bill for services.

RediClinic closings

APCToday.com just received word that RediClinic has closed retail clinics in Georgia, Oklahoma, and Virginia. A report from the field suggests that the NPs employed at these sites were given no advance warning.
Were you affected?
What do you think this means for the future of our profession? Let us know.

Fetal alcohol syndrome: A guide for APCs

Fetal alcohol syndrome (FAS) is the most common form of mental retardation in children. How often do you counsel pregnant patients (or patients trying to become pregnant) on the dangers of alcohol? Do you have the proper FAS resources for yourself and your patient?

Retail clinics: Expanding or limiting the role of the APC?

Across the United States, retail drug stores are choosing convenience over a doctor/patient relationship. Supporters say this will empower patients by giving them a choice; and will also take pressure off family care practices and emergency rooms. These practices must be reviewed by individual state review boards.  A recent study confirms that these clinics are only intended to treat minor conditions; all others are referred to an emergency room.

So what do you think? Would you be willing to work in a retail clinic? How do you think it will change your role as an advanced practice clinician?

PA Pay

The American Academy of Physicians recently reported pay mean total income for PAs working at least 32 hours a week in 2008. The top ranking belongs to Nevada ($104,641), followed by Mississippi ($104,241). At the bottom? North Dakota ($75,632) and Pennsylvania ($78,278).
Wow! What a range.
How are you doing? And what do you see for the future?

Physician Assistants: Improving the Efficiency of US Health Care

Do PAs increase the availability of the services offered by physicians? or do they provide additional care that actually increases the number of visits that a patient uses? That question was posed by a study conducted by Department of Community and Family Medicine at Duke University and published in the October issue of Health Services Research, which has the theme “Efficiency and Value in Healthcare.”

 “We found that, on average, PAs are replacing care that would be provided by physicians rather than offering additional or redundant services to patients,” said Perri Morgan, PhD, director of PA research for the and lead author of the study, the first of its kind to look at a nationwide sample of patients with a variety of diagnoses. “Our research showed that when PAs provided 30 percent or more of a patient’s office visits in a year, there was no increase in the total number of office visits per year. The notion that PAs might serve as an addition to physician services, instead of as a substitute, has raised questions about the true cost of PAs,” Morgan said., adding that “our research indicates that PAs are not creating redundant services or scheduling more return visits for patients than a physician would. This suggests that PAs can help fill the need for more medical providers quickly and efficiently. The findings are significant in an era where physician shortages are a reality. There is currently about one PA for every 10 - 12 physicians practicing in the U.S., and PAs are becoming even more common since they are increasing faster than physicians. This study suggests that PAs can increase the physician services available to patients by increasing the number of office visits available. Further, since the salaries for PAs are lower than those of physicians, our research suggests that PAs can provide cost-efficient health care to patients.

Vitamin D: More news for your patients

It's critical to ensure that your patients receive adequate amounts of calcium and vitamin D  to maintain bone health. See the above video for information about new research that further underscores the need for supplementation with vitamin D.

A least 80% of the patients I screen have low vitamin D levels of <30 ng/mL. I want my osteoporotic and osteopenic patients to be >40 ng/mL. I recommend 800 IU per day of vitamin D3, although there is controversy about whether or not that is enough. Many experts suggest 1,000 to 1,200 IU per day; the National Osteoporosis Foundation recommends that all individuals aged 65 and older receive 1,000 IU per day.

Vitamin D3 (cholecalciferol) is preferred because it appears to be better absorbed. In most mammals, including humans, D3 is more potent than D2 (calciferol, ergocalciferol) at increasing the total
levels of vitamin D in circulation. The problem has been obtaining supplements that provide vitamin D3 at high enough dosages.