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Am Fam Physician. 2004 Mar 15;69(6):1343-1345.

IOM Report Advises Increasing Diversity in Health Care Professions

A recent report by the Institute of Medicine (IOM) urges educators and other groups to focus more attention on strategies for reducing barriers that deny minorities access to careers in the health professions. Some of the barriers discussed include lack of preparation for and access to advanced education, challenges to affirmative action policies, and the financial burden. The report, “In the Nation’s Compelling Interest: Ensuring Diversity in the Health Care Workforce,” presents the benefits of diversifying the workforce and offers options that could help increase the number of minority professionals, including blacks, Hispanics, and Native Americans. The strategies include restructuring admissions policies, reducing the cost of training, revising accreditation standards, and improving institutional climates. A summary of recommendations also is included in the report. To read the full report, go online to http://www.nap.edu/books/030909125X/html.

HHS Announces National Network of Smoking ‘Quitlines’

The U.S. Department of Health and Human Services (HHS) announced plans for a national network of smoking cessation hotlines that patients can call for counseling. This year, HHS will establish a new toll-free telephone number that will serve as a single access point to the network, providing one easy-to-remember number. States with existing quitlines will receive additional funding for expanding hours of operation, hiring bilingual counselors, or adding to referral sources. States without quitlines will receive grants to establish a hotline, and counselors from the National Cancer Institute (NCI) will provide assistance to patients in these states. The HHS Web site, http://www.smokefree.gov, complements the quitlines by offering an online guide to quitting and instant messaging with an NCI counselor. For more information on the program, go to http://www.hhs.gov/news/press/2004pres/20040203.html. Other sites with information about smoking cessation include http://www.familydoctor.org for patient education materials, and http://www.tarwars.org for prevention programs.

FDA Issues Regulation Prohibiting Sale of Dietary Supplements Containing Ephedra

The U.S. Food and Drug Administration (FDA) recently issued a final rule prohibiting the sale of dietary supplements containing ephedra because these supplements present an unreasonable risk of illness or injury. The rule will become effective April 1, 2004. This ruling was made after the FDA conducted a comprehensive review of ephedra’s pharmacology, its safety and effectiveness, associated adverse effects, and health risks reported by the public. Ephedra was shown to raise blood pressure and stress the circulatory system—effects that are linked to adverse outcomes such as myocardial infarction and stroke. Until the final rule goes into effect, the FDA reiterates its warning to consumers about the risks of using supplements containing ephedra. More information on ephedra is available online at http://www.cfsan.fda.gov/~dms/ds-ephed.html.

National Survey Results Are Positive for Family Medicine

Results from the Medical Economics Continuing Survey and the American Academy of Family Physician’s (AAFP’s) 2003 Practice Profile Study show that family physicians have increasingly controllable hours and lower overall medical liability premiums than some other specialists. In addition, the results noted slightly higher take-home pay than family physicians have had in the past. Both surveys reported family physicians worked an average of 50 hours per week, which is 10 hours less than what was reported in the 1989 AAFP survey. In the Medical Economics survey, the average income after expenses for family physicians was $150,000 in 2002. In the AAFP survey, the average income after expenses was listed as $142,400 in 2002, which was up from $134,000 in 2001. According to the AAFP survey, members paid a median of $9,600 in medical liability premiums in 2002, which is a 21 percent increase since 1998. Premiums for general surgeons and internists increased by as much as 130 percent from 1999 to 2003.

SCHIP Enrollment Increased to 5.8 Million Children in 2003

According to statistics from the HHS’s Centers for Medicare and Medicaid Services, approximately 5.8 million children were enrolled in the State Children’s Health Insurance Program (SCHIP) at some point during the fiscal year 2003, which was a 9 percent increase from the 5.3 million children who were enrolled at some point during the fiscal year 2002. The SCHIP program was created in 1997 to improve children’s access to health insurance. Many of these children come from working families with income too high to qualify for Medicaid but too low to afford private health insurance. The SCHIP law appropriated $40 billion in federal funds over 10 years. For a listing of SCHIP enrollment by state, go online to http://www.cms.gov/schip/enrollment.

AAFP Publishes Guide for Self-Monitoring of Blood Glucose Levels

The AAFP recently released a guideline about treatment and self-care for patients with type 2 diabetes. The monograph, “Self-Control: A Physician’s Guide to Blood Glucose Monitoring in the Management of Diabetes,” focuses on the current evidence-based guidelines for glycemic goals, guidance for achieving glycemic control, practical options for helping patients manage and control diabetes, and information about glucose monitors. The AAFP panel notes the importance of active involvement from patients and their families, what is reasonable to address during office visits, and that more research is needed to determine the optimal frequency of testing. The complete guide is available online at http://www.aafp.org/smbgmonograph.xml. A patient information handout, “Blood Tests to Help You Manage Your Diabetes,” also is available online at http://www.aafp.org/PreBuilt/smbgmonograph_pated-eng.pdf (Spanish— http://www.aafp.org/PreBuilt/smbgmonograph_pated-esp.pdf).


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