Policy and Health Issues in the News
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Am Fam Physician. 2007 Mar 15;75(6):793-794.
Title VII Funds Increase in 2007 Continuing Appropriations Resolution
In February, Congress passed and President Bush signed legislation that will provide at least $24.6 million to family medicine training programs and will boost funding for the National Institutes of Health (NIH) and community health centers. The continuing resolution will help keep the federal government's doors open at least through September 30, when the current fiscal year ends. It sets aside more than $48.8 million for Section 747 of the Public Health Service Act, which provides funds for academic departments and programs to increase the number of primary care health professionals. Of that total, no less than $24.6 million will go toward family medicine programs. In addition, the continuing resolution increases NIH funds by $619 million and those for community health centers by $207 million. For more information, visit http://www.aafp.org/news-now/government-medicine/20070219continuingresolution.html.
Medicaid Enrollment Numbers Fall After Introduction of New Rule
Enrollment in Medicaid has fallen as a result of new federal requirements that low-income patients must show proof of citizenship before they can qualify, according to a study published on February 2 by the Center on Budget and Policy Priorities. The study reviewed Medicaid enrollment in Wisconsin, Kansas, Iowa, Louisiana, Virginia, and New Hampshire. It showed that, since implementation of the new requirement, two types of problems have surfaced: (1) Medicaid enrollment is denied or coverage is terminated because some applicants and beneficiaries cannot produce citizenship and proof-of-identity documents; and (2) states are grappling with a backlog of applications as a result of the extra time needed to obtain required documents and because eligibility workers are overloaded with new tasks associated with the requirement. For more information, visit http://www.aafp.org/news-now/government-medicine/20070216medicaidrule.html.
AAFP Responds to HPV Vaccination Requirement for School Entry
As a growing number of states consider legislation that calls for vaccination of preteen girls against human papillomavirus (HPV) as a requirement for school entry, the American Academy of Family Physicians (AAFP) has adopted a more cautious tone. The AAFP stance is that it is too early to consider mandating the vaccine in the absence of more definitive data about its use and a better understanding of the logistical issues involved in making it available to this sizable patient population. At the same time, the AAFP continues to promote its clinical recommendation for administration of the vaccine according to the Recommended Adolescent Immunization Schedule 2007. On February 2, Texas became the first state to put a mandatory HPV immunization statute on the books. The statute requires all 11- and 12-year-old girls to be immunized against HPV before they can enter the sixth grade. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20070214hpvvaccine.html.
Initiative Promises Innovation, Creativity in Residency Education
Fourteen family medicine residency programs will test training innovations as part of the Preparing the Personal Physician for Practice (P4) initiative. The Association of Family Medicine Residency Directors and the American Board of Family Medicine in conjunction with TransforMED, the AAFP's practice redesign initiative, named the family medicine residency programs that will participate in P4. The residency programs selected will look at several innovations, including four-year curricula that integrate a master of public health degree and allow additional focus on chronic disease management, new information systems, health behavior change, leadership in the specialty of family medicine, and cross-cultural health care. Other programs will look at the development of teams in which residents function as group practices, and practicing in patient-centered medical homes within the community with scheduling that enhances the continuity of care. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20070219p4residencies.html.
Survey Provides New Insights into Primary Care Encounter Trends
A survey that examined what happens during a clinical primary care encounter found that data on primary care clinicians, patients, and services in some cases differed dramatically from results of a survey in wide use, according to an article in the January/February Annals of Family Medicine. The authors of “Describing Primary Care Encounters” compared results from the Primary Care Network Survey (PRINS) with results from the National Ambulatory Medical Care Survey (NAMCS), a leading tool used to describe primary health care services. The comparison shows that larger proportions of visits according to PRINS involved preventive care and were made by children, members of racial minority groups, and individuals without private insurance. In addition, a diagnostic or other assessment service was performed for 99 percent of visits in PRINS versus 76 percent of visits in NAMCS, and a preventive or counseling/education service was provided at 64 percent of visits in PRINS versus 37 percent of visits in NAMCS. For more information, go to http://www.annfammed.org/cgi/reprint/5/1/39 or http://www.aafp.org/news-now/clinical-care-research/20070214prins.html.
Study Shows Link Between Career Satisfaction, Patient Satisfaction
According to “Congruent Satisfaction,” an article in the January issue of Medical Care, geographic areas where physicians experience career satisfaction can be linked to areas where patients express a high level of satisfaction with their care. The study did not match physicians with their own patients but analyzed responses to general questions about satisfaction by patients and physicians within their geographic areas. The authors found that physicians' satisfaction with their overall careers correlated highly with patients' satisfaction with their overall health care, with their choice of a primary care physician, and with their trust that their primary care physician would put patients' medical needs above all other considerations in treatment decisions. In addition, there was a high correlation between patients' satisfaction with their overall health care and primary care physicians' ability to obtain referrals to other specialists who provide high-quality care. For more information, visit http://www.lww-medicalcare.com or http://www.aafp.org/news-now/clinical-care-research/20070216satisfaction.html.
Survey Reveals Areas of Concern in Physican-Patient Relationships
In a survey of patients and primary care physicians published in February's Consumer Reports, primary care physicians' most common complaints about patients were noncompliance with prescribed treatments (59 percent) and waiting too long before making an appointment (41 percent). Other complaints included patients' reluctance to talk about their symptoms and their requests for unnecessary tests and prescriptions. More than one half of physicians surveyed said patient encounter times had been shortened in the previous five years so that their practices could meet their target incomes; the same proportion said they saw too many patients to provide the most effective care. Most patients in the survey were highly satisfied with their physicians and said their conditions improved under their physicians' care. Patients also thought that they were treated with respect, patiently listened to and understood, and encouraged to ask questions, and that their physicians made an effort to get to know them. However, two thirds of patients said their physicians never discussed the cost of treatments and tests with them, and only 26 percent said their physicians had asked them about any emotional stress the conditions were causing. Nine percent of respondents said they didn't get enough time with their physicians, 7 percent said test results weren't returned promptly, and 6 percent said their physicians didn't respond promptly to their phone calls. For more information, visit http://www.aafp.org/news-now/professional-issues/20070214consumerreportssurvey.html.
AAFP Adds Module to METRIC Performance Improvement Program
The AAFP has introduced a new module in its performance improvement program METRIC (Measuring, Evaluating and Translating Research Into Care). The chronic obstructive pulmonary disease (COPD) module, COPD: Improving Patient Care, is designed to help physicians and their office staff use a team approach and think in a systematic way about the care patients with COPD should get every time they come into the office. The AAFP hopes that working through the COPD module will help physicians improve their diagnostic approach to COPD—for example, by using pulmonary function testing rather than relying on radiographic findings alone —and develop a systematic approach to its treatment. For more information, visit http://www.aafp.org/news-now/cme-lifelong-learning/20070220metriccopd.html.
NIH Launches Web Site to Help Patients Understand Genetics
In partnership with the AAFP and several other associations, the NIH's National Library of Medicine has launched Genetics Home Reference, a free, patient-friendly Web site that includes entries on more than 500 topics related to genetic conditions. Information on the site may prove particularly helpful to new parents concerned about the genetic screening their infants undergo. The site includes information on genetic conditions; the normal function and health effects of more than 300 genes; and chromosomes, mitochondrial DNA, and associated health conditions. It also features a handbook on understanding genetics, a glossary of terms, and links to other resources. For more information, visit http://ghr.nlm.nih.gov/ or http://www.aafp.org/news-now/health-of-the-public/20070202nihgeneticssite.html.
—AFP and AAFP NEWS NOW staff
For more news, visit AAFP News Now at http://www.aafp.org/news-now.
Copyright © 2007 by the American Academy of Family Physicians.
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