Becker's Hospital Review

57 FINANCE CMO / CARE DELIVERY Missouri First in US to Let Physicians Practice Without Completing Residency By Alyssa Rege A Missouri law allowing medical school graduates to treat patients without having completed a designated residency program — the first law of its kind in the U.S. — went into effect after nearly three years, according to 41 Action News. The law created the role of "assistant physician," which applies to med- ical school graduates who, under certain rules, may be allowed to treat patients without completing residency. Former Missouri Democratic Gov. Jay Nixon signed the law into effect in 2014, but officials took nearly three years to implement it, according to the report. To become an assistant physician, medical school graduates must speak English, have passed the first two steps of the U.S. Medical Licensing Exam, enter into the primary care field, plan to practice in a medically underserved rural or urban area, and work with a collaborating physician within 50 miles of the assistant's practice. Missouri currently boasts 25 assistant physicians. However, not all medical associations are on board with the law. David Barbe, MD, president of the American Medical Association, said in a state- ment to 41 Action News, "The AMA appreciates that the intent of this law is to bridge critical gaps in the healthcare workforce, particularly those due to limited residency positions. However, we encourage states to pur- sue more practical workforce solutions, such as increasing the number of state-funded residency positions." The American Academy of Physician Assistants also voiced its opposition to the law in a statement to the television station, the report states. n Should Physicians Discuss Politics With Patients? Here's What the AMA Says By Emily Rappleye W ith midterm elections on the horizon and healthcare politics in the headlines, physicians should consider their role in discuss- ing politics with patients. With this in mind, AMA Wire published an excerpt from its Code of Med- ical Ethics to refresh patients on its guidance. The AMA encourages phy- sicians to be involved in politics as private citizens, but warns them to exercise caution when expressing views to patients and to avoid political conversations during the clinical encounter. However, if politics do come up during a visit or outside of the clinical encounter, the AMA provides the following guidance. • Consider the patient's comfort and willingness to discuss the topic • Discuss politics in context, when talking about social, civic or recreation- al activities is appropriate • Avoid political discussions when medical circumstances put emotional pressure on patients • Stay informed of proposed and needed healthcare reforms related to access, quality, medical research and public health • Advocate for patient needs n To Curb Opioid Abuse, HCA and LifePoint Warn Patients They May Feel More Pain By Brian Zimmerman N ashville, Tenn.-based Hospital Corporation of America and Brentwood, Tenn.-based LifePoint Health are working to change patients' pain expectations to help curb the na- tion's opioid overdose crisis, according to a report from Nashville Public Radio. Here are four things to know. 1. HCA is introducing a new pre-surgery protocol to help manage patient expectations of pain. Under the new protocol, physicians will tell patients they "will treat the pain, but you should expect that you're go- ing to have some pain. And you should also under- stand that taking a narcotic so that you have no pain really puts you at risk of becoming addicted to that narcotics," Michael Schlosser, MD, CMO for HCA, told Nashville Public Radio. 2. Dr. Schlosser spent a decade as a spinal surgeon at Nashville-based Centennial Medical Center, HCA's flagship hospital, where he prioritized soothing pa- tient pain. "I just wanted my patient not to be in pain, thinking I was doing the right thing for them and certainly not an outlier among my colleagues, but now look- ing back on it, I was putting them at significant risk for developing an addiction to those medications" Dr. Schlosser told Nashville Public Radio. 3. LifePoint Health is also working to change pa- tient expectations of pain management and mak- ing a special effort to identify patients presenting at the emergency department specifically to obtain opioids. "We really do have a lot of responsibility and culpa- bility and this burden, and so we have to make sure we do whatever we can to stem this tide and turn the ship in the other direction," John Young, MD, national medical director of cardiovascular services for LifePoint Hospitals, told Nashville Public Radio. 4. e new approach to managing patient expecta- tions represents a shi in care priorities. In 2001, e Joint Commission referred to pain as the fih vital sign in its "Examples of implementation" man- ual. HCAHPS patient satisfaction surveys included questions on pain management for years, potentially spurring further reliance on opioid painkillers. n

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