Hot Topics in Medicine: 5 Things You May Have Missed

What recent medical developments or other healthcare news might affect your practice, or your patients?  

Staff Care offers the following summaries of hot topics in medicine to help permanent and locum tenens physicians and advanced practitioners stay informed.

Cardiovascular Disease Mortality Rates Have Plateaued 
There’s still work to be done in terms of getting people to change their behavior to be more heart-friendly. According to a recent report from the Centers for Disease Control and Prevention (CDC), cardiovascular disease (CVD) mortality rates have plateaued, despite the efforts of the five-year Million Hearts 2022 initiative to target people with risk factors. The report, entitled Vital Signs: Prevalence of Key Cardiovascular Disease Risk Factors for Million Hearts 2022, reviewed U.S. data from 2011-2016. The researchers noted that some subgroups of people have even logged an uptick in CVD mortality recently.

In order to turn the tide, researchers note that the medical community will need to focus more on successfully implementing strategies that are proven to reduce a person’s risk of developing (and dying from) cardiovascular disease. For example, there are still 54 million adults who could benefit from a smoking cessation program, and many adults still do not have their blood pressure and cholesterol under control. “Evidence-based strategies for preventing acute cardiovascular events exist, with 213 million opportunities for better risk factor prevention and management,” the report’s authors noted. “It will require a concerted national implementation effort to prevent one million acute cardiovascular events by 2022.” 

Hurricane Florence Responsible for Rare Hospital Evacuations 
As Hurricane Florence approached the East Coast this week, bearing down on the Carolinas and surrounding states, government and health officials urged citizens to evacuate. A few hospitals and other healthcare facilities in the region also had to make the difficult decision to move their patients, even some that were critically ill. The Grand Strand Medical Center in Myrtle Beach, South Carolina, was among those evacuated. Charleston’s Post and Dispatch newspaper reported that these evacuations put a strain on local ambulance services and patients, with some transfers taking several hours.

The Myrtle Beach Sun News website reported that Grand Strand completed their evacuations late Wednesday night, Sept. 12, transporting more than 300 patients to more than 32 facilities in South Carolina and other southeastern states. The medical center is now operating a 24/7 family reunification phone line for those hoping to locate loved ones. 

Job Outlook Bright for Hospital-Based Physician Assistants 
The American Academy of PAs (AAPA) has good news for physician assistants who work in hospitals. According to the recently released 2018 AAPA Salary Report, PAs who work in hospitals tend to get more opportunities for leadership development and better benefits than PAs who work in doctors’ offices. They also tend to earn more money. 

Currently there are more PAs practicing in physician practices--about 46%, compared to 34.9% who work in hospitals. But those hospital-employed PAs earned a median base salary last year of $107,000, compared to the $101,000 earned by the PAs working in physician practices. 

Challenges and Opportunities on the Horizon with a Changing Workforce 
In a recent article for NEJM Catalyst titled “Growing Ranks of Advanced Practice Clinicians — Implications for the Physician Workforce,” David I. Auerbach, PhD, Douglas O. Staiger, PhD, and Peter I. Buerhaus, PhD, RN, analyzed the growing role of the advanced practice clinician and how that trend may impact the physician workforce.

“The number of NPs and PAs is growing rapidly, in part because of shorter training times for such providers as compared with physicians and fewer institutional constraints on expanding educational capacity,” the researchers wrote.

As a result, more and more practitioners entering the workforce in the next 12 years will fall into one of those categories, they predicted. And medical practices will have to adjust. “Physicians, NPs, and PAs will all need to be trained and prepared for this new reality,” they noted.

RELATED: NP and CRNA Scope of Practice: 2018 Updates & The Future of PA Practice Authority 

FDA: Teen E-Cigarette Use Reaching Epidemic Levels
The Food and Drug Administration (FDA) is sounding the alarm about what Commissioner Scott Gottlieb, MD, calls “an epidemic of e-cigarette use among teenagers.” 

“E-cigs have become an almost ubiquitous ‒ and dangerous ‒ trend among teens,” he wrote in a recent statement in which he announced a new  coordinated tobacco compliance effort, one that is the largest that the FDA has ever undertaken.

The FDA is cracking down on the makers of five e-cigarette brands including JUUL, a brand especially popular among teens. The FDA is now requiring these manufacturers to produce and submit plans for how they will reduce and prevent the use of their products by teenagers. Additionally, Gottlieb noted that the FDA is even considering a ban on flavored products that especially appeal to kids. “We know that the flavors play an important role in driving the youth appeal. And in view of the trends underway, we may take steps to curtail the marketing and selling of flavored products. We’re now actively evaluating how we’d implement such a policy,” he wrote.

RELATED: Educating Patients on the Risks of Vaping

Hot Topics in Medicine: As of September 14, 2018 

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