Friday, February 17, 2017

On Call by Casey Ross & Max Blau
Good morning! On Call will be off duty on Presidents Day, but we'll see you back here on Tuesday. Here's the latest news affecting hospitals and health care. For more coverage, follow us at @statnews@bycaseyross, and @maxblau on Twitter; or like us on Facebook.

GOP leaders on Obamacare: Once more unto the breach!

GOP leaders are still trying to reconcile divisions over their latest blueprint for replacing Obamacare. Yesterday, HHS Secretary Tom Price said to fellow Republicans, "Let's not miss this opportunity. Let's go shoulder to shoulder, arm to arm.” The GOP is planning to introduce legislation by the end of the month. Here are a few tidbits:
  • A Medicaid overhaul that gives states a fixed amount of funding and flexibility in using it. This will likely lead to a reduction in coverage, fewer paying customers for hospitals, and higher uncompensated care costs.
  • A Medicaid expansion roll back, and a restoration of disproportionate share payments that were cut under Obamacare. 
  • An Obamacare insurance subsidy replacement featuring tax credits, money for high risk pools, and an expansion of health savings accounts. GOP supporters say this will lower the cost of health care, while Democrats say far fewer people will be able to access what they need.

Match results show gaps in geriatrics, reliance on foreign graduates

National Resident Matching Program
Despite a record number of applicants in 2017, US residency programs still struggled to fill positions in geriatrics, nephrology, infectious diseases, and several pediatric specialities, according to a new report.

The biggest gap was in geriatric medicine, where less than half of the positions were filled and 107 programs reported at least one open slot. Given an aging US population, that could add to critical gaps in care for seniors.

Overall, more than 10,400 medical school graduates applied for residencies this year. While the number of applicants from US schools increased, internationally-trained applicants will still fill about 40 percent of the positions, including several from the countries represented in President Trump’s travel ban. The ban has been blocked in federal court, but the president has hinted he may sign a new executive order. The uncertainty is likely to linger through Match Day on March 17, when students find out which programs accepted them.

Sponsor content by Tufts Medical Center

Father, son cardiologists change narrative on a once grim genetic disease

Fifty years ago receiving a diagnosis of Hypertrophic Cardiomyopathy (HCM) was virtually a death sentence. Categorized by thickening of the heart muscle, HCM may be best recognized as the most common cause of sudden death in young athletes. But due to the life’s work of a father and son physician team now at Tufts Medical Center in Boston, HCM is not only treatable, but patients with proper management can achieve normal life expectancy. Read more.

Today In STAT: Caribbean medical schools try to shake off their bad rap

Dania Maxwell for stat

The Caribbean’s for-profit medical schools suffer from high dropout rates and a reputation as a dumping ground for students who couldn’t make it into American medical schools. But some of these island schools are trying to change that narrative by churning out more doctors who are willing to work in rural and underserved parts of the US.

STAT’s Usha Lee McFarling reports on how that effort is unfolding in Moreno Valley, Calif., where patients aren’t so quick to dismiss the doctors who are helping to counteract a desperate shortage of physicians.


A hospital’s dirty laundry leads to a series of wrongful death lawsuits

Researchers last year noted that medical errors are the third-highest source of deaths in the US. Fatalities caused by the more complex aspects of patient care — from surgical complications to medication errors — are inevitable. But basic parts of a hospital’s operations can also prove fatal.

Several recent lawsuits have alleged that a mold outbreak at University of Pittsburgh Medical Center hospitals is responsible for at least six deaths over the past three years. TribLive's Ben Schmitt told On Call that UPMC was getting its linens from a contractor with a mold-filled cleaning facility that serves hospitals in several states. The fallout has prompted hospital systems like Allegheny Health Network, a competitor of UPMC, to review its procedures.


  • Study highlights potential financial conflicts for doctors on Twitter (Advisory Board)
  • Tennessee hints of chaos if ACA left in limbo (Bloomberg)
  • Flu vaccine only offering moderate protection this year (STAT)
  • At hearing, Trump’s CMS pick gives slippery answers on drug pricing (STAT Plus)

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