Retail medical clinics are faster and cheaper, but they can cause problems for patient care, doctors say

Medical clinics located in retail establishments such as Walgreens and Walmart are becoming increasingly popular, The Courier-Journal's Laura Ungar reports.

Researching and consulting firm Merchant Medicine lists 40 retail clinics in Kentucky and anticipates more to open in 2011.

The clinics are generally operated by nurse practitioners and are in grocery, drug and department stores. Visits are generally faster and cheaper than going to a traditional doctor's office. A 2009 Annals of Internal Medicine study noted a typical visit costs an average of $110, compared to $166 in a doctor's office, $156 in an urgent care center and $570 in an emergency room, Ungar reports.

But some doctors take issue with the clinics, saying physicians provide better care and are more qualified to detect serious medical problems. "There might be something that presents as a minor complaint but is in fact the tip of the iceberg," said Dr. Gordon R. Tobin, president of the Kentucky Medical Association. "Physicians have the gold standard in education and training." (Read more)

Essay contest for grad/undergrad students, topic: 'Obamacare'

KaiserEdu.org is hosting its annual essay contest, with this year's essay topic President Obama's Patient Protection and Affordable Care Act, which the U.S. House voted yesterday to repeal.

The competition is open to all undergraduate and graduate students, with first place receiving $1,500 and second place $750. Graduate and undergraduate students will be judged separately.

In the essay, students should imagine they've just been hired as a health aide to a member of Congress of their choice. That member asks the student to summarize what the next steps on health reform should be in 1,000 words or less. The recommendations should be explained and justified and major challenges should be identified and addressed.

Submissions are due Feb. 28. (Read more)

Faith-based alliances may be exempt from health-insurance mandate; Kentucky court case part of national question

Though the health-refom law requires all Americans to be enrolled in a health-insurance plan by 2014, Christians can be exempt if they pool their risk. Such is the message being spread by Samaritan Ministries and Christian Care Ministry.

Melissa Maynard of Stateline, a nonpartisan news service of the Pew Center on the States, reports the new law "does in fact contain language exempting faith-based groups from the requirement." That's because these ministries fall under the umbrella of "health care sharing ministries," in which members pool their money and their risk to help each other cover their medical expenses.

Christian Care Ministry is hoping to target 11 million Americans "it estimates profess Christian faith and are not covered by an employer's insurance plan," Maynard reports. Currently, only 100,000 households nationwide are members of health care sharing ministries.

However, states have a major role to play in implementing the law, and last fall, the Kentucky Supreme Court ruled Christian Care Ministry should be considered a regulated insurance plan since its members pool their risk. The group says it believes an agreement can be reached with the state, Maynard reports.

The issue will be debated in Arizona, Georgia, Indiana, Maine, Montana, North Carolina and South Carolina this year, in part because conservative legislators are eager to sidestep implementation of the health reform law. (Read more)

Bowling Green commission votes 3-2 for smoking ban

After more than three years of discussion, the Bowling Green City Commission passed the first reading of a smoking ban Tuesday in a 3-2 vote.

The ban would ban smoking in "most indoor businesses in the city," reports Andrew Robinson of the Bowling Green Daily News. A second reading will be voted on at a special meeting Monday. If the measure passes, it will take effect 90 days after the vote.

Commissioner Brian "Slim" Nash said last week he wanted to get the ban passed before a new mayor (and possibly a new commissioner) takes office. Mayor Elaine Walker voted for the ban; she will soon become Kentukcy secretary of state, having been appointed by Gov. Steve Beshear to replace Trey Grayson, who resigned. The commission may choose one of its own members to replace Walker, opening up a commission seat for another appointment.

The vote was preceded by "lively debate," Robinson writes, with some citizens displeased by the proposal. "All you're trying to do is ram this down my throat, Commissioner Nash, and I don't like it," James Ackzien said.

Kim Lindgren, who presented a petition with almost 1,700 signatures supporting a smoke-free law, saw things differently. "While I get the rights of smokers," Lindgren said, she argued that she should be able to sit in a restaurant without the "overwhelming smell of smoke coming from the smoking section." (Read more)

Congressman weighs in on state issue, supporting prescription rule for cold medicines used to make methamphetamine

Republican U.S. Rep. Hal Rogers of Kentucky's 5th District is backing state legislation that would require a prescription for the sale of medicines like pseudoephedrine, a key ingredient in the manufacture of methamphetamine. The congressman, right, sent out a column to every newspaper in the state last week expressing his support.

"We can't ignore the potential for this legislation to nearly eliminate meth labs in Kentucky, as reports are showing it has already done in Oregon and Mississippi," Rogers wrote.

A Rogers ally, state Sen. Tom Jensen, R-London, filed the bill Jan. 4. It would require a prescription for ephedrine, pseudoephedrine and phenylpropanolamine, which are now sold over the counter. It would also prohibit a practitioner from dispensing more than 9 grams of the medicines to a user within a 30-day period.

Roger Alford of The Associated Press reports Republicans and Democrats alike support the bill, but industry groups like the Consumer Healthcare Products Association strongly oppose it and have been running large newsppaer ads against it. (Read more)

Vaccine against measles, mumps and rubella doesn't cause autism, so get your children immunized, UK doctor says

A University of Kentucky psychiatrist is encouraging parents to get their children vaccinated for measles, mumps and rubella (MMR) now that scientists have found no connection between the vaccine and autism. "I really want the word out there that vaccines do not cause autism," Dr. Paul Glaser, right, told the Lexington Herald-Leader's Mary Meehan.

Glaser's message comes after the British Medical Journal published a report debunking Dr. Andrew Wakefield's 12-year-old assertion of a link between vaccinations and autism. Investigators found that Wakefield "misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study," Meehan reports. Wakefield's assertions led to a substantial decrease in the number of children who got the MMR shot. In the United Kingdom, vaccination rates decreased to below 80 percent from 92 percent.

The first dose of the MMR vaccine is generally given to children when they are toddlers. The second dose is administered before children start kindergarten. (Read more)

White House officials blast effort to repeal health-care reform

As House Republicans planned to pass a bill tomorrow that would repeal last year's Affordable Care Act for health care and health insurance, officials of a freshly business-friendly Obama administration said today that repeal makes "bad business sense."

Small Business Administration Administrator Karen Mills and Rebecca Blank, acting deputy secretary of commerce, hosted a conference call with journalists today to discuss the effects of repealing the act. The newly Republican House is expected to vote in favor of repeal, but Senate Majority Leader Harry Reid has said it will be "dead on arrival" in the Democratic-majority Senate.

Republicans have repeatedly called the health care reform "job-killing," an assertion that the nonpartisan accountability service FactCheck.org has judged to be inaccurate. Administration officials argued likewise today, in the call with Kentucky Health News and other news outlets.

"The Affordable Care Act really supports our nation's entrepreneurs and entrepreneurial spirit," Mills said. Repealing the law would take away tax credits — a 35 percent deduction for business owners that pay 50 percent of their employees' coverage. In 2013, that credit jumps to 50 percent. Repeal would also "stifle innovation" by creating "job lock," Mills said, which happens when people stay in a job they no longer want for fear of losing their health insurance.

The act provides coverage for dependent children until they turn 26 and does not allow discrimination against enrollees who have pre-existing conditions. Mills said more than 100 million people have pre-existing conditions nationwide.

Repeal would also "add $1 trillion to the federal deficit," Mills said. Republicans dispute that.

Since 2009, Mills said the number of small businesses that are offering health insurance coverage to their employees has increased — by 9 percent in businesses with less than 200 employees and 13 percent in businesses with less than 10 employees.

Mills stressed there is "no mandate, no requirement" penalizing small business owners with less than 50 workers who don't offer health insurance.

Blank spoke of the "simply unsustainable" rising costs of health care before the act took effect, saying in 1960 less than 1 percent of the payroll was spent on health care. By the mid-2000s, that number had jumped to 10 percent. "That's a runaway cost train that had absolutely no mechanism to put on the brakes," she said.

Blank added widening insurance coverage is "designed to move toward a system in which doctors and insurers are rewarded for the quality of care, rather than just the quantity." The act, Blank said, will "rein in costs," "improve American global competition" and "spur job growth."

New program aims to get more physicians practicing in rural Ky.

A new program in Morehead aims to get more physicians practicing in rural areas and improve access to health care.

The Rural Physician Leadership Program is the result of a partnership between the University of Kentucky College of Medicine, St. Claire Regional Medical Center and Morehead State University. UK and the RPLP work together to identify and recruit students interested in rural medicine. "We approach potential students when they're in college, sometimes even in high school," Dr. Anthony Weaver, assistant dean for RPLP, told The Morehead News.

Students accepted in the program spend their first two years of college at UK taking basic science courses. They also are part of groups in which rural and community medicine is discussed. In their third year, they go to Morehead to work with physicians in clinics, nursing homes and hospitals, mainly St. Claire. In the fourth year they are exposed to specialties such as internal medicine, neurology and gynecology. Students also have rotations in family medicine.

The program also has a business component, teaching students how to pinpoint and work with community organizations.

"There is no other program quite like this one, where the collaboration between a medical school, a teaching hospital and a regional university has been so carefully planned as to create opportunities to improve patient care in rural areas," Weaver told the News. (Read more)

Health reform will be difficult to implement, as faceoff between insurers and state official showed

Huffington Post contributor Don McNay, right, of Richmond, writes that states will adopt health-care reform "kicking and screaming," as shown by the Kentucky insurance commissioner's recent face-off with insurance companies over children's health coverage.

Under the reform act's mandate, insurance companies that offer "child only" policies "cannot deny coverage to a child due to any preexisting condition present in that child," McNay notes. In response, when the provision took effect Sept. 23, 2010, insurance companies stopped offering that type of policy in Kentucky.

State Insurance Commissioner Sharon Clark conducted a hearing on the matter Oct. 13, 2010 and determined that "insurance companies are very concerned about suddenly getting a number of 'bad risks' that they had not planning for in their pricing," McNay reports to his international audience. Clark also determined that if insurance companies stopped offering "child only" policies, the Kentucky Access program for the uninsured would be overwhelmed with new enrollees.

As a result, Clark "ordered all insurers selling individual health insurance policies in Kentucky to offer an annual enrollment each January for children under age 19," McNay notes. "It took strong action by the Kentucky insurance commissioner to get this first part of health reform implemented for a very small part of the population. It's a small battle in a small state for a small set of the population, but a big glimpse of how implementing health care reform nationwide is going to go." (Read more)

Kentucky doctors' offices are the least digitized in the country; increase expected nationwide

Kentucky has the lowest percentage of doctors' offices who have adopted electronic health record systems, says a survey released by the Office of the National Coordinator for Health Information Technology.

Just 38.1 percent of Kentucky health clinics are digitized, compared to 51 percent nationwide. Louisiana (39.1 percent) and Florida (39.4 percent) were second and third lowest, respectively. Minnesota tops the list, with 80.2 percent of its offices paperless, followed by Massachusetts (77.3 percent) and Wisconsin (75.4 percent). The survey data were compiled by the National Center for Health Statistics.

Those numbers are expected to grow nationwide. Hospitals and physicians can now register for the Medicare and Medicaid EHR incentive programs, which give federal funds to facilities that have adopted EHRs. Kentucky physicians and hospitals are among the first nationwide to be eligible to receive incentives from both programs. University of Kentucky HealthCare and Central Baptist Hospital in Lexington were the first hospital systems in the country to receive funds — which totaled $4.1 million — from the incentive programs. Another 25 Kentucky providers have started the application process.

Interest in EHR systems, which are believed to improve the quality of health care and patient outcomes, is growing nationwide. A survey by the American Hospital Association found that 81 percent of the nation's hospitals plan to take advantage of the incentive programs. NCHS numbers showed 41 percent of office-based physicians are planning to do the same. (Read more)

The changeover is expected to create a substantial surge in EHR software technology. World Market Media reports the market for electronic health record software is expected to reach $3.8 billion by 2015. (Read more)

Private information of Owensboro-area patients found on Web

The private information of thousands of people who visited the Green River District Health Department has been mistakenly available for perusal online since October.

Owensboro's Messenger-Inquirer found 9,986 names and personal information, including birth dates and Social Security numbers, of Daviess County residents last week after receiving a tip by Mickey Franzman, who stumbled on the information while doing a Google search on one of her relatives. The information included a database of health department clients.

The problem was fixed immediately by Intregranetics after the company was informed of it. "The information that was out there from the health department, it was nothing they did," President Michael Hobson told reporter James Mayse. "It was my responsibility ... It wasn't anything done intentionally."

Debbie Fillman, health department director, said Thursday that steps were in place to inform people who could have been affected. (Read more)

Health advocacy organizations reluctant to acknowledge grant money from drug companies, study finds

A study by the American Journal of Public Health shows not-for-profit groups like the American Diabetes Association get grant money from drug companies but don't necessarily acknowledge it.

Marian Wang of ProPublica, the nonprofit investigative news service, highlighted the results of the study, which examined 160-plus health advocacy organizations that got funding in 2007 from Eli Lilly & Co., a global pharmaceutical company.

The report found that, as a whole, "25 percent of health advocacy organizations acknowledged Lilly funding anywhere on their Web site. Eighteen percent acknowledged Lilly in their 2007 annual report, 1 percent acknowledged Lilly on a corporate sponsors page, and 10 percent acknowledged Lilly as the sponsor" of a grant event reported in the Lilly Grant Registry. (Read more)