It's Tough Being a Woman
The number of female cardiologists and fellows has doubled since 1996, but women are still vastly underrepresented and likely to report discrimination and difficulties because of family responsibilities, according to a survey commissioned by the American College of Cardiology's Women in Cardiology Council. Despite equal numbers of male and female medical school graduates, women account for fewer than 20% of cardiologists. The survey was initially conducted online in 1996 and repeated in 2006. In the latest version, 1,595 women and 1,950 age-matched male colleagues responded. Women were less likely to describe themselves as interventional cardiologists (11%, compared with 29% of male colleagues), and were more likely to practice in an academic setting. Marriage and family life seemed to be problematic for female cardiologists: They were less likely to be married (73% vs. 91% of men) and more likely to say that family responsibilities had a negative effect on ability to work (40% vs. 22% of men). In all, 69% of women said that they had faced discrimination, compared with only 22% of men. These figures were relatively unchanged since 1996. The new results were published in the Journal of the American College of Cardiology (2008;52:2215–26).
$60 Billion for CV Hospitalizations
The cost of treating patients with cardiovascular disease in hospitals was close to $60 billion in 2006, which was an almost 40% increase from the previous major study of the costs in 1997, according to the Agency for Healthcare Research and Quality. Most of the increase occurred between 1997 and 2003, as there has been a slight decline in cases and slower increase in cost per case since 2003, said the federal agency. The largest annual cost increase—10% a year—was for treating chest pain, which hit $3.9 billion in 2006. Cardiovascular disease treatments accounted for 18% of what hospitals spent on patient care in 2005, said the AHRQ.
Xience YouTube Ads Attacked
The Prescription Project has petitioned the Food and Drug Administration to require medical device makers, including Abbott Laboratories, to remove ads promoting their products on YouTube. The ads violate the FDA's direct-to-consumer rules because they do not include brief statements about the products' use, side effects, and contraindications, said the Boston-based health-industry watchdog. Abbott has posted four videos promoting its Xience V drug-coated stent. The petition also asks the agency to review online ads and videos, and to clarify how FDA rules apply to Internet advertising. Abbott said in a statement that it had provided links to the pertinent information, and that going forward, it would embed the side effect and use data in the videos.
Incentive Exception May Reappear
Under current Medicare and Medicaid rules governing patient referrals, physicians can't share incentive payments for quality improvement. But a proposal to make an exception may reappear, a Centers for Medicare and Medicaid Services official told the Practicing Physicians Advisory Council (PPAC) in December. The CMS proposed an exception under rules governing physician payment for 2009, but opposition—mainly from medical device manufacturers—killed it, said Lisa Ohrin, acting director of the division of technical payment policy at the CMS's Center for Medicare Management. She said, however, that allowing incentive payments is a priority for the CMS, so the agency will again propose allowing physicians to share the payments.
RAC Program Heavily Criticized
Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments—dubbed the Recovery Audit Contractor program—was lambasted by members of the PPAC. The program is currently on hold while the Government Accountability Office studies whether CMS has properly implemented it. During a demonstration project, however, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. As of July 2008, about 7% of those determinations were overturned on appeal. Once the program is restarted—expected by February—there will be limits on the number of years of claims an auditor can examine and how many records can be requested from practices of various sizes. Even with those plans, PPAC panelists recommended further limits.
Much Psoriasis Goes Undiagnosed
Current estimates are that 5 million adults have been diagnosed with psoriasis. But an analysis of the National Health and Nutrition Examination Survey for 2003–2004 published online Nov. 18 in the Journal of the American Academy of Dermatology indicates that between 600,000 and 3.6 million more have active disease that hasn't been diagnosed or treated. In a separate report, a panel of cardiologists and dermatologists said that because psoriasis is a risk factor for cardiovascular disease, patients with moderate to severe psoriasis should be told they are at risk and screened. The panel's consensus statement, published online in the American Journal of Cardiology, made 13 major recommendations on evaluating and treating the psoriasis-cardiovascular disease connection.