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Policy & Practice


 

IM/FP Demand Up Again

Internists and family physicians top hospital and medical groups' list of most-requested doctors, according to a report from physician search firm Merritt, Hawkins & Associates. The company tracked close to 3,000 of its permanent, full-time physician search assignments from March 31, 2005, to April 1, 2006. In that period, the company fielded more requests for internists and family physicians than for any other type of physician; compared with the previous year, requests were up 46% for internists and 55% for family physicians. Requests for primary care physicians fell in the 1990s and early 2000s, but began to move back up last year, reaching the top this year, according to Merritt, Hawkins. Demand stems from an aging population along with a shortage of internal medicine subspecialists, the company said.

New Drugs: Confidence Drops

Physicians, pharmacists, and consumers are losing confidence in the safety of new drugs and are developing a preference for older ones, a study conducted by Forrester Research on behalf of Medco, a pharmacy benefit management company, suggests. Of physician respondents, 70% expressed increased concern about the safety of the drugs they prescribe “due to recent issues affecting several prescription drugs on the market.” One in three physicians said new or recently approved prescription drugs are less safe than drugs that have been on the market for 10 years or more, as did 29% of consumers and 26% of pharmacists, Medco said in a statement. Direct-to-consumer marketing features new drugs, so it is not surprising that consumer concerns about prescription drugs would focus on newer ones, said Duane Kirking, Ph.D., director of medication use, policy, and economics at the University of Michigan College of Pharmacy, Ann Arbor. In an interview, Dr. Kirking said Medco is the only PBM that strongly promotes generic drugs; PBMs usually make more revenue from handling newer drugs. The Medco survey, conducted in the first quarter of 2006, involved 3,200 U.S. respondents, including 2,000 consumers, 300 practicing physicians, 450 retail pharmacists, and 450 health benefit administrators.

Pick a Card, a Uniform Card

Medical practice administrators are seeking more uniformity in the information, appearance, and technology of patient identification cards, in an effort to eliminate errors and reduce claim rejections. A machine-readable card is the goal, and the Working Group on Electronic Data Interchange (WEDI) has been refining guidelines previously developed by the American National Standards Institute. WEDI, a broad-based healthcare industry coalition with information technology projects, recently received support for its efforts from the Healthcare Administrative Simplification Coalition, a public/private partnership aimed at reducing the administrative costs and complexity of health care. The coalition is composed of the Medical Group Management Association, the American Academy of Family Physicians, and others. Meanwhile, the Kansas City-based Mid-American Coalition on Health Care developed voluntary guidelines for standardizing patient ID cards. For example, the card must not have logos or other nonmember information obscuring text, must be printed on a durable material such as plastic, and should be easy to photocopy.

Clinical Trial Participation

Physicians who participate in a pharmaceutical company-sponsored trial are more likely to prescribe the sponsor's drug than are physicians who did not participate, according to a study by researchers from the University of Southern Denmark and the University of Aarhus, Denmark. But participation in drug trials did not affect adherence to international treatment guidelines, the researchers said in the study published in the Journal of the American Medical Association. The researchers performed a retrospective study comparing the behavior of physicians in 10 general practices who had participated in an AstraZeneca trial of the asthma drug Symbicort (budesonide/formoterol) with the conduct of physicians in 165 practices that were not part of the trial. After 2 years, Symbicort's share of the total prescribed volume of asthma drugs was about 6.7% higher in practices that had participated in the trial than it was in the control practices. Adherence to treatment guidelines, measured by the use of inhaled steroids in asthma patients, improved in both groups by about the same amount.

CVS Buying MinuteClinic

MinuteClinic, a company that provides certain primary care services to customers at pharmacies and other retail outlets, has been acquired by CVS Corp., parent company of CVS/pharmacy. Currently in 83 locations nationwide (66 of which are in CVS pharmacies), MinuteClinics provide diagnosis and treatment of common conditions such as strep throat and conjunctivitis. Staffed by nurse practitioners and physician assistants, MinuteClinics are “intended to be a supplement, but not a replacement, for a patient's ongoing relationship with a primary care provider,” and provide lists of physicians to patients who lack a primary care provider, CVS said in a statement. “The MinuteClinic team has proven they can work collaboratively with physicians and deliver quality care in a convenient, timely, and cost-effective manner,” Thomas Ryan, chairman, president, and chief executive officer of CVS, said in the statement. According to the company, MinuteClinic plans to continue operating in CVS pharmacies and other retail locations—including competing pharmacies—and looks to expand to corporate and government offices.

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