Becker's Hospital Review

81 FINANCE CMO / CARE DELIVERY Malpractice Fears Are No. 1 Cause of Overtreatment, Physicians Say By Kelly Gooch P hysicians believe overtreatment is common in healthcare, according to a study in PLOS One. For the study, researchers surveyed 2,106 physicians regarding topics related to overtreatment and unnecessary healthcare. The study found physicians believed a median of 20.6 per- cent of healthcare was unnecessary, including 22 percent of prescription medications, 24.9 percent of tests and 11.1 percent of procedures. Physicians cited "fear of malpractice" (84.7 percent), "pa- tient pressure/request" (59 percent) and "difficulty access- ing medical records" (38.2 percent) as the top reasons for overtreatment. As far as potential solutions to overtreatment, more than half of respondents (55.2 percent) cited "training residents on appropriateness criteria," according to the study. Fif- ty-two percent of respondents cited "easy access to out- side health records," while a similar number (51.5 percent) cited "more practice guidelines." Additionally, nearly 71 percent of respondents said they believe unnecessary procedures are more likely when physicians profit from them. Most respondents also said they believe healthcare utilization and costs could be de- creased by placing less of a focus on fee-for-service physi- cian compensation. "From the physician perspective, overtreatment is com- mon. Efforts to address the problem should consider the causes and solutions offered by physicians," the study au- thors concluded. n 40% of Physicians Don't Seek Mental Healthcare for Fear of Losing Their License By Leo Vartorella A study by Rochester, Minn.-based Mayo Clinic found 40 percent of physicians would be reluctant to seek help for mental health issues because they fear it would affect the status of their medical license. A team of Mayo researchers — led by Liselotte Dyrbye, MD, — obtained licensure application forms from all 50 states and renewal forms from 47 states. Researchers also reviewed re- sults from 5829 physician surveys conducted between August and October 2014. Dr. Dyrbye's team found two-thirds of states have licensure renewal forms that don't limit mental health inquiries to current conditions, but also ask about past conditions. In these states, physicians were less likely to seek help for mental health problems. "Many state licensing boards ask questions about mental health diagnoses or treatment. The fact that licensing boards inquire about these dimensions is believed to be a major deterrent to help seeking among troubled physicians, many of whom have treatable dis- orders," the study's authors wrote. n Increasing Nurse's Workload by 1 Patient Ups Odds of Patient Death by 7% By Anuja Vaidya M issed nursing care and higher nurse workloads increase the risk of pa- tients dying following common hospital surgical procedures, according to a study published in the International Journal of Nursing Studies. Researchers gathered 2009 to 2011 data from the RN4CAST study. e study combined routinely collected data on 422,730 surgical patients from 300 general acute hospitals in nine countries, along with survey data from 26,516 registered nurses. Nurse staffing and missed nursing care were significantly associated with 30-day case-mix adjusted mortality. Increasing a nurse's work- load by one patient was linked to a 7 percent uptick in odds of a patient dying within 30 days of admission. Additionally, a 10 percent increase in missed nursing care was associat- ed with a 16 percent increase in the odds of a patient dying within a month of admission. "e analyses support the hypothesis that missed nursing care mediates the relationship between registered nurse staffing and risk of patient mortality. Measuring missed care may provide an 'early warning' indicator of higher risk for poor patient outcomes," study authors concluded. n

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