Becker's ASC Review

28 HEALTHCARE NEWS 28 We don't have 27 hours in a day, physicians remind guideline-makers By Erica Carbajal I t may not come as a surprise that in today's healthcare landscape, there's simply not enough time in the day for physicians to provide guideline-recommended care. As a result, many physicians want time and usefulness to be considered in the creation of guidelines, e New York Times reported Feb. 14. Last August, a study published in the Journal of General Internal Medicine made an astounding estimate: It would take nearly 27 hours a day for primary care physicians to provide guideline-recommended care for an average number of patients. Take away the recommended chronic and acute care as well as administrative work, and physicians would still need 8.6 hours per day just to follow the preventive care checklist recommended by the U.S. Preventive Services Task Force. "A lot of guidelines may seem reasonable when considered in isolation," Dr. Minna Johansson, a general practitioner in Sweden, told the Times. "But the cumulative burden of all guideline recommendations combined is absurd." Dr. Johansson has studied the matter with researchers from the U.S. and Canada, who say the issue affects medical systems across North America and Western Europe. While physicians recognize the good intent behind care recommendations, they argue that some guidelines that lack evidence to long-term health improvements could be scrapped. In the U.S., physicians aren't expected to check off every guideline recommendation in a single visit, according to the USPSTF. "Clinicians do not — and would never be expected to — implement all of the suggested screenings, counseling services, and preventive medications in a single visit," Carol Mangione, MD, chair of the task force, told the Times, adding the task force does consider time when developing guidelines. "When caring for patients, clinicians use both their judgment and the information obtained during conversations with each patient to prioritize which preventive services should be offered during each visit," she said. Still, "Deciding what to prioritize in a busy primary care practice is a big challenge," Daniel Jonas, MD, director of the division of general internal medicine at the Ohio State University in Columbus, told the Times. n More hospitals, health systems begin to walk back mask mandates By Ashleigh Hollowell A head of the ending COVID-19 emergency, several hospitals and health systems have begun to walk back their mask rules. Intermountain Health, based in Salt Lake City, is the latest system to announce it is reversing mask protocols for its facilities across Utah, Idaho, Nevada, Colorado, Montana, Wyoming and Kansas beginning March 15. Masks will still be required in certain cases and for surgical procedures, according to the news release. Two Colorado-based systems, Denver Health and UCHealth in Aurora, also recently announced that they would lift mask requirements across facilities, with UCHealth saying it is "safe to no longer mandate masking" but that it would reassess as needed going forward. It is a trend that may continue across other systems as the nation approaches the end of the COVID-19 public health emergency come May. These announcements also follow on the heels of September 2022 news from the CDC announcing that masking in healthcare settings was no longer needed unless transmission rates were high. In February, however, Norton Healthcare in Louisville, Ky., did the opposite and brought back its mask mandates after the University of Louisville had announced its plan to remove mandates beginning Jan 30. n Cuban's pharmacy may save US $1.2B annually with 9 drugs: Vanderbilt study By Paige Twenter M ark Cuban Cost Plus Drug Co. has the potential to save some patients $1.29 billion a year, according to a study led by Vanderbilt University Medical Center researchers that evaluated 2020 Medicare Part D expenses for the nine most popular urological drugs. The online pharmacy opened about a year ago, but if Medicare recipients had the option to pay Cost Plus Drug's prices in 2020, some prostate cancer treatments and bladder drugs would have been between 48.7 percent and 99.2 percent cheaper, the Nashville, Tenn.-based medical center said in a Feb. 9 post. With these reduced prices, taxpayers would save $1.29 billion each year, the researchers found. The prostate cancer drug abiraterone would have been $656 million less expensive for Medicare spending, and it was 52 percent of the potential savings for urological drugs for 30-day and 90- day prescription models, according to the study. "The impact of this could be astronomical across all cancers," lead author Ruchika Talwar, MD, a urologic oncology fellow at VUMC, said in the post. "Any sort of oral, generic drug available through Mark Cuban's company can be a lot cheaper for many patients, not just Medicare patients, through this program." n

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