Latest news with #physicians
Medscape
18 hours ago
- General
- Medscape
ED Work Environment Discord Affects Patient Outcomes
In a recent study, emergency nurses and physicians in approximately half of the study hospitals disagreed on the quality of the work environment. An environment rated "unfavorable" by both groups was significantly associated with worse clinician and patient outcomes. METHODOLOGY: A cross-sectional analysis included emergency department (ED) clinicians (1190 nurses and 414 physicians) from 47 Magnet hospitals who completed the 2021 US Clinician Wellbeing Study. Researchers classified hospitals into profiles according to the level of agreement between nurses and physicians regarding the hospital work environment. Researchers assessed clinician job outcomes (burnout, job dissatisfaction, and intent to leave), patient safety, and quality-of-care metrics. TAKEAWAY: Hospital profiles revealed three distinct patterns: "Agree, Unfavorable Environment" (10 hospitals); "Agree, Favorable Environment" (15 hospitals); and "Disagree, Less Favorable Environment Among Nurses" (22 hospitals). Compared with hospitals where clinicians agreed on a favorable environment, hospitals where clinicians agreed on an unfavorable environment had significantly higher rates of burnout (β, 25.8), job dissatisfaction (β, 32.5), intent to leave (β, 31.7), and unfavorable patient safety grades (β, 29.1), after adjustment for hospital characteristics ( P < .001 for all). < .001 for all). Hospitals where nurses rated the environment less favorably than physicians demonstrated increased burnout (β, 15.4; P < .001) and poorer patient safety grades (β, 11.9; P < .01), after adjustment for hospital characteristics. < .001) and poorer patient safety grades (β, 11.9; < .01), after adjustment for hospital characteristics. Compared with physicians in hospitals with an "Agree, Favorable" profile, those in hospitals rated as having an "Unfavorable" work environment showed significantly higher rates for all outcomes except burnout and patient-care quality. Similarly, nurses in hospitals with a "Disagree, Less Favorable Among Nurses" profile experienced higher rates across all job-related and patient-care outcomes. IN PRACTICE: "This cross-sectional study found that ED nurses and physicians in close to half of study hospitals disagreed on the quality of their work environment. Clinician job and patient outcomes were worse when both clinicians rated their work environment unfavorably and when nurses only reported their work environments as unfavorable," the authors wrote. "The implication of these findings is that, if two essential partners in emergency care within the same institution do not agree on the deficiencies in ED work environments, significant interdisciplinary research is needed to bridge these gaps and disparate experiences," they added. SOURCE: The study was led by Jane Muir, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia. It was published online on May 16, 2025, in BMC Health Services Research . LIMITATIONS: The study included only Magnet hospitals, which are known for favorable work environments and good physician-nurse collaboration, suggesting the findings may have underestimated the variation in clinician work environment agreement across all hospitals. The cross-sectional design prevented causal inference, and the sample had more nurses than physicians. DISCLOSURES: The research was funded by the Clinician Well-being Study Consortium and the National Institutes of Health. Additionally, it was supported by the Agency for Healthcare Research and Quality, the National Institute of Nursing Research, the National Clinician Scholars Program, and the Emergency Medicine Foundation/Emergency Nurses Association Foundation. The authors reported having no relevant conflicts of interest.
Globe and Mail
a day ago
- General
- Globe and Mail
What should I know about ticks and Lyme disease?
Ask a Doctor is new series of physician-authored columns offering insights and advice on common health topics. It is not a substitute for seeking medical care. Spending time outdoors after our long winter is one of the best parts of warmer days in Canada. But spring is also when we start to see a rise in tick bites and Lyme disease. Cases have increased dramatically in recent years. In 2024, a record 5,239 cases of Lyme disease were reported across the country, according to the Public Health Agency of Canada – up from 522 cases in 2014. Whether you're camping, gardening, hiking or out with your dog, it's important to know how to protect yourself from tick bites – and what to do if you find one. Here are six key things I want you to know. What causes Lyme disease? Lyme disease can occur when a human is bitten by an infected blacklegged tick (also called a deer tick) or western blacklegged tick. Ticks can typically be found in brushy, grassy or wooded areas, but in recent years they've appeared in urban settings as well. (I recently had a patient come in with three ticks after walking through a city ravine.) Ticks can be active any time the weather is above 4 degrees, not just in the summer months. Young ticks can be as small as a poppy seed and easy to miss. The good news? To spread Lyme disease a tick usually needs to be attached for at least 24 hours – so early detection can make a big difference. What are the early signs of Lyme disease? Lyme disease can be difficult to diagnose as it causes myriad symptoms and not everyone gets the same ones. The classic early sign is a round rash, known as a bull's-eye rash because of its characteristic appearance. But it doesn't always happen, and it can look different on darker skin. Flu-like symptoms such as chills, body aches, fever and fatigue can develop anywhere from three to 30 days after the bite. If the infection is untreated, it can cause more severe symptoms weeks or months later, including facial paralysis, joint pain, nerve pain or abnormal heartbeat. What should I do if I'm bitten by a tick? Stay calm and try to remove the tick carefully. Grasp the tick as close to the skin as possible using fine-tip tweezers and pull it straight out (or get help from a health care provider). Clean the area with soap and water or an alcohol-based sanitizer. Consider uploading a photo of the tick to a free Canadian tool that helps identify tick species to assess your risk. If the tick was attached for more than 24 hours, or you're unsure of the timing of the bite, contact your health care provider as you may be eligible for a preventive dose of antibiotics to stop an infection before it starts. What if I suspect I've been bitten, but I'm not sure? Ticks are tiny, and their bites are often painless. If you've spent time outdoors, especially in areas where blacklegged ticks are common, and you start feeling unwell (flu-like symptoms, fatigue or that telltale rash), it's worth checking in with your health care provider. Early Lyme disease is diagnosed based on your symptoms and exposure history, not just a blood test. In the first few weeks after a bite, testing may not show anything, since the body hasn't had time to produce enough antibodies. That's why your doctor may still recommend treatment even if the test is negative. Why is Lyme disease important to treat and prevent? While most people who get Lyme disease and start treatment early will recover fully, some people may experience persistent symptoms. This can include difficulty concentrating, joint pain and fatigue that can severely impair function and daily activities. It is not clear why this happens, but it is very real for the people who experience it. These patients should not be dismissed as they deserve care, support and follow-ups. How can I prevent tick bites? The best defence against Lyme disease is prevention. Start by sharing this article with loved ones and follow the next steps to ensure you stay safe when outdoors: As we head into warmer weather, I'm looking forward to enjoying the outdoors alongside you, but let's do so safely. Being aware of Lyme disease and how to prevent it is key to protecting yourself and your loved ones. Dr. Sheila Wijayasinghe is a menopause-certified family physician practising at St. Michael's Hospital in Toronto, and the medical director of primary care outreach at Women's College Hospital. She is also the resident health expert on CTV's The Social, and co-host of The Doc Talk Podcast.
Forbes
2 days ago
- Business
- Forbes
As Trump Cuts Healthcare, Private Equity Gains Hold At Doctor's Office
Just two in five U.S. physicians are in doctor-owned private practice as hospitals and private equity firms gobble up physician groups thanks in part to cuts in insurance payments to medical care providers that are about to get even worse. The American Medical Association, the nation's largest physician group, says in a new report that the share of physicians working in private practice was 42.2% last year, which is a sharp decline from more than a decade ago when more than 60% -- or three in five doctors – were in private practice, which the AMA defines as a 'practice wholly owned by physicians.' The AMA's analysis blames flat to falling payments from health insurance companies and government health programs like Medicare coverage for the elderly and Medicaid coverage for low-income Americans among the reasons physicians are selling to hospitals, health systems and private equity. In addition, AMA says its data cites 'costly resources, and burdensome regulatory and administrative requirements' as 'longstanding and important drivers of this change.' 'The share of doctors working in practices wholly owned by physicians is unraveling under compounding pressures,' said AMA President Dr. Bruce A. Scott said. 'The cumulative impact of burdensome regulations, rising financial strain, and relentless cuts in payment poses a dire threat to the sustainability of private practices," Scott said. "After adjusting for inflation in practice costs, Medicare physician payment has fallen 33 percent over the past quarter century, which has severely destabilized private practices and jeopardized patients' access to care. Payment updates are necessary for physicians to continue to practice independently.' But there appears to be little interest by the Republican-controlled Congress to boost payments to physicians. The AMA report comes as Republicans in Congress and the Donald Trump White push for more cuts in federal health insurance programs, including Medicaid and Medicare, which would most certainly spill over onto doctor practices as more Americans lose health insurance. Last week, a new analysis published by the Robert Wood Johnson Foundation of the budget reconciliation bill passed by the U.S. House of Representatives shows physicians and other healthcare providers 'could lose more than $770 billion in revenue over the next decade as a result of more than 11 million people losing health coverage through Medicaid and the Affordable Care Act marketplaces.' The budget still faces approval by the U.S. Senate and would need to be signed into law by Trump. Meanwhile, more and more physicians are working for hospitals or companies owned by private equity no matter their medical discipline. 'Private practices now account for less than half of physicians in most medical specialties, ranging from 30.7 percent in cardiology to 46.9 percent in radiology,' the AMA said of its report. 'Exceptions included orthopedic surgery (54 percent), ophthalmology (70.4 percent), and other surgical subspecialties (51.2 percent).' The share of physicians working in hospital-owned practices increased to more than one-third, or 34.5 percent last year. 'Twelve percent of physicians were employed directly by a hospital (or contracted directly with a hospital), double the share (5.6 percent) in 2012,' the AMA said. 'In 2024, 6.5 percent of physicians characterized their practice as private equity-owned, higher than the shares in 2020 and 2022, which were both around 4.5 percent, the report noted.'
Forbes
3 days ago
- Health
- Forbes
Should You Be Worried If Your Doctor Uses ChatGPT?
6 years ago, I wrote a piece, 'Doctors Use Youtube And Google All The Time. Should You Be Worried?' In 2025, it's time to ask, 'Your doctor may be using ChatGPT. Should you be worried?' In a recent unscientific survey, technology entrepreneur Jonas Vollmer asked physicians how many used ChatGPT. 76% percent of the respondents answered 'yes.' According to Volmer, a physician friend also told him, 'most doctors use ChatGPT daily. They routinely paste the full anonymized patient history (along with x-rays, etc.) into their personal ChatGPT account.' My own unofficial conversations with colleagues bears this out, with younger physicians more likely to regularly use AI than older ones I think AI tools such as ChatGPT, Grok, Claude, and other LLMs can be very helpful for physicians after they take a good patient history and perform a properly thorough physical exam. The physician can describe patient signs and symptoms with appropriate medical precision for the AI to analyze In particular, the AI can frequently suggest diagnoses that would not otherwise occur to the physician. For example, Vollmer noted that in a busy urgent care clinic, a patient might be taking some 'alternative medicines' with unusual side effects that might not be widely known in the traditional medical literature, but have been discussed in recent online articles and discussion forums. Thus, ChatGPT acts as an extension to a good physician, not a replacement. As always, the physician has the final responsibility of confirming any novel hypothesis offered by the AI with their own human judgment, which might include running additional tests to confirm the diagnosis. We've already seen non-physician patients report how ChatGPT made a diagnosis on themselves or loved ones after stumping doctors for years. And there are multiple studies showing that AI tools like ChatCPT can be surprisingly good at diagnoses when offered patient case reports. Of course, physicians need to be careful to adhere to all relevant medical privacy laws in their states/countries. And they may even consider getting explicit consent from their patients ahead of time to run their (anonymized) data through AI. Currently, physicians are allowed to seek second opinions from fellow doctors all the time, as long as privacy rules are met. The same guidelines should apply to consultations with AI. In many ways, this is comparable to how AIs in driverless cars perform comparably to human drivers. Driverless Waymo taxicabs in selected cities like Los Angeles perform as safely (or better) than human drivers in appropriately restricted settings. Tesla owners who use the self-driving mode can rely on the AI to drive safely most of the time, although they still have to be prepared to take control of the wheel in an emergency. Robot cars are not yet ready to replace human drivers in all settings (such as icy Colorado mountain highways in wintertime), but they continue to improve rapidly. Similarly, we may soon reach the point that a physician who does not use an AI consultant to double-check his diagnoses will be considered practicing below the standard of care. We are not there yet, but I can see that coming in the next few years. Summary: Tools like ChatGPT can be enormously helpful for physicians, provided that the doctor retains ultimate responsibility for the final diagnosis and treatments, and respects the appropriate privacy rules.
CTV News
5 days ago
- Health
- CTV News
Canadian Medical Association files lawsuit challenging gender-care legislation
Aerial shot of the Alberta legislature on Monday, May 26, 2025. (Cam Wiebe/CTV News Edmonton) The Canadian Medical Association (CMA) and three Alberta physicians are pursuing a judicial review of Bill 26, known as the province's gender-care legislation. A statement from the CMA said the bill directs physicians on how to deliver gender-affirming care to people under 18, down to which medications they can use. 'This is a historic and unprecedented government intrusion into the physician-patient relationship and requires doctors to follow the law rather than clinical guidelines, the needs of patients and their own conscience,' said the statement issued Wednesday morning. The CMA said it has filed an application with the Court of King's Bench for the judicial review of Bill 26, the Health Statutes Amendment Act, 2024 and its proposed changes to the Health Professions Act R.S.A 2000. Bill 26 was introduced on Oct. 31, 2024, to preserve choice for minors identifying as transgender while refocusing the health-care system, according to the province. 'Medicine is a calling. Doctors pursue it because they are compelled to care for and promote the well-being of patients,' said CMA president Joss Reimer in a statement. 'When a government bans specific treatments, it interferes with a doctor's ability to empower patients to choose the best care possible. The CMA said the legislation renders physicians powerless in providing independent expertise, clinical guidance and treatment options when it comes to gender-affirming care. Jake Donaldson, a Calgary-based family physician who provides gender-affirming care to about 40 adolescents, said the legislation has put him and his colleagues in a state of 'moral crisis.' 'These patients are a vulnerable group that already face significant and disproportionate discrimination, violence and mental health challenges,' said Donaldson in a CMA statement. 'Bill 26 commands physicians to stand on the sidelines and watch them suffer.' Since the bill and other transgender legislation was introduced, advocacy groups and families have protested and taken legal action against the province, arguing that Bill 26 violates gender-diverse young people's section 7 right to security of the person, their section 12 right to be free from cruel and unusual treatment and their section 15 right to equality. Part of Bill 26 prohibits gender-affirming 'top' surgeries for minors which went into effect when the bill received royal assent in December 2024. The legislation also bans puberty blockers and hormone therapy for those with gender dysphoria. Egale Canada and Skipping Stone, both LGBTQ2S+ advocacy groups, have requested for an injunction to block the denial of health care for gender diverse youth while the bill faces a constitutional test. Sarah Hoffman, NDP shadow minister of health, said she is pleased to see doctors stand with their patients in opposing UCP law. 'When medical experts and parents agree on safe medical treatment, the government shouldn't be preventing it,' said Hoffman in an emailed statement. 'The new CMA legal challenge to Bill 26 is about defending parental and human rights.' CTV News Edmonton reached out to the Ministry of Justice for comment.
