Instead of retiring at age 65, many doctors choose to continue practicing medicine well into their 70s and 80s. A national trend to test the competency of these older physicians appears to be gaining momentum, especially among some of the nation's largest hospital systems. Hospitals report growing concern that the mental and physical skills of some of their older physicians have deteriorated to the point of putting patient safety at risk. Paying special attention to "weeding out" impaired physicians once they have reached a certain age is proving to be a sensitive issue, to say the least.
The dramatic increase in Candida auris infections has received little publicity...until now. According to the CDC, nearly half of those who become infected with this nasty fungus die within 90 days. Upon gaining access to a patient's blood-stream, C. auris defies conventional treatment. Ninety percent of the time it's found to be resistant to at least one of the three commonly used anti-fungal medications and 30 percent of the time it's resistant to two or more of the drugs.There have been 587 cases of C. auris in the United States, says the CDC. To date, it's been reported in 12 states, the greatest concentration being in New York, New Jersey and Illinois. Fifty percent of residents in some Chicago nursing homes tested positive for the presence of C. auris. Its spread has become so much of a concern that the CDC has now placed C. auris on its list of germs classified as an "urgent threat."
Topics: Physician Burnout
Robotic surgery, gene therapy, and deep brain stimulation are so-called "frontiers" of medicine. Now there's a new frontier--telemedicine. "Research firm IHS Markit estimates that telemedicine visits will soar from 23 million in 2017 to 105 million by 2022" (Associated Press, 2/6/19). By then, one in ten doctors' visits could be via telemedicine. This could be an understatement if practitioners, health systems, and investors keep discovering new ways to expand telemedicine's reach.
Despite reports of burned out doctors abandoning their careers, many other doctors simply want some time off -- perhaps a year or more -- to take a breather, spend time with family, or take a sabbatical abroad. The AMA warns that leaving clinical practice for an extended period of time should not be taken lightly: "Lack of retraining before reentry raises questions about patient safety and the clinical competence of reentered physicians." Doctors need to be aware that, "getting back in the game is expensive, time-consuming, and sometimes nearly impossible. So before you take a hiatus from medicine, ask yourself--can you afford it?" (medpage.com)
Office visits to primary care physicians declined by 18 percent between 2012 and 2016, according to a recent study by the Health Care Cost Institute. The HCCI analysts limited their observations to adults younger than age 65 with employer-sponsored health insurance. When other patients were included, "they noted a 2 percent decrease in all PCP office visits from 2012 to 2016" (medscape.com). The question is "Why?"