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College Offers Advertising Advice

It is ethical for physicians to advertise their services, but they must be careful not to mislead the public or imply a lack of competence by their competition, according to an updated policy statement from the American College of Obstetricians and Gynecologists. It advises physicians to use caution when putting together advertisements because the public can easily be mislead. For example, potential patients might assume that any obstetrician advertising under the heading “infertility” has special training or certification in that area. Physicians should also be able to substantiate their claims if they use words like “top” or “pioneer.” If a physician is voted a “top doctor” by magazine readers, that fact can be advertised. But if that designation was paid for, that must be disclosed in the ad as well, according to the ACOG policy. Also, doctors should shy away from advertising specific outcomes since treatment success often depends on patient factors. The policy, developed by the ACOG Committee of Ethics, was scheduled to be published in the November issue of Obstetrics and Gynecology.

Public Citizen Attacks Liability Caps

The medical liability reform law enacted in Texas in 2003 has failed to bring down medical costs or attract physicians to the state, according to an analysis by Public Citizen. The consumer-watchdog group said the law, which includes a $250,000 cap on noneconomic damages, benefited malpractice insurance companies and physicians, who saw premiums and payouts decrease, but not the public. The report notes that Medicare spending per beneficiary in Texas has risen 13% faster than the national average and that diagnostic-testing expenses rose 25% more than the national average. Meanwhile, the increase in physicians per capita has slowed to less than half its rate in the years before the law was enacted. But Texas Medical Association President Dr. C. Bruce Malone said in an interview that the state has not boosted its physician population much because it's difficult to attract doctors to a poor state with a large population of uninsured people. Dr. Malone also said that liability reform has improved patients' access to care, especially in obstetrics. There are now many rural areas that have ob.gyns. for the first time, and more obstetricians are willing to take on high-risk pregnancies, he said.

Defending Planned Parenthood

House Democrats are standing up for Planned Parenthood, saying that the organization is being unfairly targeted for political reasons. In September, the Republican-controlled House Energy and Commerce subcommittee on oversight and investigations launched an inquiry into how the Planned Parenthood Federation and its affiliates handle federal funds. In a letter to the subcommittee's chairman, Rep. Cliff Stearns (R.-Fla.), top Democrats on the full committee criticized the investigation as an “unfair and unjustified assault.” Rep. Henry Waxman (D.-Calif.) and Rep. Diana DeGette (D.-Colo.) wrote that the investigation was unnecessary because the Health and Human Services Inspector General and state Medicaid programs routinely audit Planned Parenthood and report their findings to the public.

Millions Get Free Mammograms

More than 4 million women have received free mammograms this year as a benefit from the Affordable Care Act. The 2010 health-reform law allows Medicare beneficiaries to receive preventive services, including mammograms and cervical cancer screening, without paying a deductible or other cost. The benefit also includes a free annual wellness visit. The Department of Health and Human Services estimated that more than 20 million Medicare beneficiaries have received some type of preventive service this year, from cholesterol screening to bone-mass measurement.

Baby-Friendly Hospitals Sought

Officials at the Centers for Disease Control and Prevention are spending $6 million over 3 years to help hospitals do a better job of supporting breastfeeding by new mothers. The goal is to get more U.S. hospitals to become “baby-friendly” facilities along the lines of a World Health Organization–UNICEF program that recognizes hospitals that follow science-based practices that increase breastfeeding rates. Currently, only about 5% of babies in the United States are born in “baby-friendly” hospitals, according to the CDC. The agency awarded its $6 million to the National Initiative for Children's Healthcare Quality, which will work with hospitals to bring in experts in breastfeeding and quality improvement to develop system-level changes.

Panel: Patients' Needs Overlooked

Even though most doctors realize that improving patient engagement can reduce costs and improve care, physicians still frequently overlook patients' needs and concerns, according to a report from the Institute of Medicine. For example, studies show that quality improves when providers listen carefully to patients and their families, according to the report based on an April workshop. However, other research has shown that physicians typically interrupt within 15 seconds of a patient beginning to raise concerns.

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