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VIDEO: Various treatments for acne in clinical trials
LAS VEGAS – “It’s an exciting time in the treatment of acne,” Linda F. Stein Gold, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.
In the interview, Dr. Stein Gold, director of dermatology research at the Henry Ford Health System in Detroit, discussed several new developments in the field of acne, including a once-daily oral antibiotic, sarecycline, and topical minocycline drugs in different stages in the research pipeline.
Scarring can occur with any degree of acne severity, but new data suggest that patients struggling with scars may benefit from a fixed combination of adapalene gel 0.3% and benzoyl peroxide gel 2.5%, Dr. Stein Gold noted.
She disclosed relationships with multiple companies including Allergan, Anacor, Celgene, Dermira, Foamix, Galderma, LEO, Medimetriks, Novan, Novartis, Promius, Sol-gel, and Valeant.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – “It’s an exciting time in the treatment of acne,” Linda F. Stein Gold, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.
In the interview, Dr. Stein Gold, director of dermatology research at the Henry Ford Health System in Detroit, discussed several new developments in the field of acne, including a once-daily oral antibiotic, sarecycline, and topical minocycline drugs in different stages in the research pipeline.
Scarring can occur with any degree of acne severity, but new data suggest that patients struggling with scars may benefit from a fixed combination of adapalene gel 0.3% and benzoyl peroxide gel 2.5%, Dr. Stein Gold noted.
She disclosed relationships with multiple companies including Allergan, Anacor, Celgene, Dermira, Foamix, Galderma, LEO, Medimetriks, Novan, Novartis, Promius, Sol-gel, and Valeant.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – “It’s an exciting time in the treatment of acne,” Linda F. Stein Gold, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.
In the interview, Dr. Stein Gold, director of dermatology research at the Henry Ford Health System in Detroit, discussed several new developments in the field of acne, including a once-daily oral antibiotic, sarecycline, and topical minocycline drugs in different stages in the research pipeline.
Scarring can occur with any degree of acne severity, but new data suggest that patients struggling with scars may benefit from a fixed combination of adapalene gel 0.3% and benzoyl peroxide gel 2.5%, Dr. Stein Gold noted.
She disclosed relationships with multiple companies including Allergan, Anacor, Celgene, Dermira, Foamix, Galderma, LEO, Medimetriks, Novan, Novartis, Promius, Sol-gel, and Valeant.
SDEF and this news organization are owned by the same parent company.
AT SDEF LAS VEGAS DERMATOLOGY SEMINAR
VIDEO: Smartphones could ‘democratize’ EEG
SAN DIEGO – Epilepsy is a common condition, but many people live in areas too poor or underserved to benefit from electroencephalogram (EEG) testing to confirm a diagnosis. Modern technology may be changing that. Smartphones wirelessly linked to headsets can collect EEG data and potentially serve as an alternate platform for diagnosis of epilepsy.
To test the efficacy of one such system, Farrah Mateen, MD, PhD, a neurologist at Massachusetts General Hospital, Boston, conducted a study in the remote, mountainous Kingdom of Bhutan, which lies between India and China. Her group compared the signals between a smartphone EEG and standard EEG.
The sensitivity was low, at around 40%, but the device’s specificity was 90%-95%. For now, the device performs better as a confirmatory test than as a screening device, but the researchers hope to adjust the lead location to improve sensitivity.
The headset used was designed for use by video gamers, and at a cost of less than $300, it represents a low-cost entry into portable EEG.
Dr. Mateen discussed the smartphone EEG study in a video interview at the annual meeting of the American Neurological Association.
SAN DIEGO – Epilepsy is a common condition, but many people live in areas too poor or underserved to benefit from electroencephalogram (EEG) testing to confirm a diagnosis. Modern technology may be changing that. Smartphones wirelessly linked to headsets can collect EEG data and potentially serve as an alternate platform for diagnosis of epilepsy.
To test the efficacy of one such system, Farrah Mateen, MD, PhD, a neurologist at Massachusetts General Hospital, Boston, conducted a study in the remote, mountainous Kingdom of Bhutan, which lies between India and China. Her group compared the signals between a smartphone EEG and standard EEG.
The sensitivity was low, at around 40%, but the device’s specificity was 90%-95%. For now, the device performs better as a confirmatory test than as a screening device, but the researchers hope to adjust the lead location to improve sensitivity.
The headset used was designed for use by video gamers, and at a cost of less than $300, it represents a low-cost entry into portable EEG.
Dr. Mateen discussed the smartphone EEG study in a video interview at the annual meeting of the American Neurological Association.
SAN DIEGO – Epilepsy is a common condition, but many people live in areas too poor or underserved to benefit from electroencephalogram (EEG) testing to confirm a diagnosis. Modern technology may be changing that. Smartphones wirelessly linked to headsets can collect EEG data and potentially serve as an alternate platform for diagnosis of epilepsy.
To test the efficacy of one such system, Farrah Mateen, MD, PhD, a neurologist at Massachusetts General Hospital, Boston, conducted a study in the remote, mountainous Kingdom of Bhutan, which lies between India and China. Her group compared the signals between a smartphone EEG and standard EEG.
The sensitivity was low, at around 40%, but the device’s specificity was 90%-95%. For now, the device performs better as a confirmatory test than as a screening device, but the researchers hope to adjust the lead location to improve sensitivity.
The headset used was designed for use by video gamers, and at a cost of less than $300, it represents a low-cost entry into portable EEG.
Dr. Mateen discussed the smartphone EEG study in a video interview at the annual meeting of the American Neurological Association.
AT ANA 2017
Are we on the verge of a cocaine epidemic?
Beyond medication for the Tx of chronic pain
Associate Director,
Chronic Pain and Fatigue Research Center
University of Michigan, Ann Arbor
Associate Director,
Chronic Pain and Fatigue Research Center
University of Michigan, Ann Arbor
Associate Director,
Chronic Pain and Fatigue Research Center
University of Michigan, Ann Arbor
Barbara Vickrey, MD, MPH
VIDEO: Rapid influenza test obviates empiric antivirals
TORONTO – A test that only requires a maximum 2-hour wait for results was highly accurate at detecting influenza and respiratory syncytial virus infection in lung transplant patients, according to research presented at the CHEST annual meeting on Oct. 30.
This rapid and highly accurate test for detecting three common respiratory viruses has dramatically cut the need for empiric treatments and the risk for causing nosocomial infections in lung transplant patients who develop severe upper respiratory infections, Macé M. Schuurmans, MD, noted during the presentation.
This study involved 100 consecutive lung transplant patients who presented at Zurich University Hospital with signs of severe upper respiratory infection. The researchers ran the rapid and standard diagnostic tests for each patient and found that, relative to the standard test, the rapid test had positive and negative predictive values of 95%.
The number of empiric treatments with oseltamivir (Tamiflu) and ribavirin to treat a suspected influenza or respiratory syncytial virus infection (RSV) has “strongly diminished” by about two-thirds, noted Dr. Schuurmans, who is a pulmonologist at the hospital.
Until the rapid test became available, Dr. Shuurmans and his associates used a standard polymerase chain reaction test that takes 36-48 hours to yield a result. Using this test made treating patients empirically with oseltamivir and oral antibiotics for a couple of days a necessity, he said in a video interview. The older test also required isolating patients to avoid the potential spread of influenza or RSV in the hospital.
The rapid test, which became available for U.S. use in early 2017, covers influenza A and B and RSV in a single test with a single mouth-swab specimen.
“We now routinely use the rapid test and don’t prescribe empiric antivirals or antibiotics as often,” Dr. Schuurmans said. “There is much less drug cost and fewer potential adverse effects from empiric treatment.” Specimens still also undergo conventional testing, however, because that can identify eight additional viruses that the rapid test doesn’t cover.
Dr. Schuurmans acknowledged that further study needs to assess the cost-benefit of the rapid test to confirm that its added expense is offset by reduced expenses for empiric treatment and hospital isolation.
He had no disclosures. The study received no commercial support.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
TORONTO – A test that only requires a maximum 2-hour wait for results was highly accurate at detecting influenza and respiratory syncytial virus infection in lung transplant patients, according to research presented at the CHEST annual meeting on Oct. 30.
This rapid and highly accurate test for detecting three common respiratory viruses has dramatically cut the need for empiric treatments and the risk for causing nosocomial infections in lung transplant patients who develop severe upper respiratory infections, Macé M. Schuurmans, MD, noted during the presentation.
This study involved 100 consecutive lung transplant patients who presented at Zurich University Hospital with signs of severe upper respiratory infection. The researchers ran the rapid and standard diagnostic tests for each patient and found that, relative to the standard test, the rapid test had positive and negative predictive values of 95%.
The number of empiric treatments with oseltamivir (Tamiflu) and ribavirin to treat a suspected influenza or respiratory syncytial virus infection (RSV) has “strongly diminished” by about two-thirds, noted Dr. Schuurmans, who is a pulmonologist at the hospital.
Until the rapid test became available, Dr. Shuurmans and his associates used a standard polymerase chain reaction test that takes 36-48 hours to yield a result. Using this test made treating patients empirically with oseltamivir and oral antibiotics for a couple of days a necessity, he said in a video interview. The older test also required isolating patients to avoid the potential spread of influenza or RSV in the hospital.
The rapid test, which became available for U.S. use in early 2017, covers influenza A and B and RSV in a single test with a single mouth-swab specimen.
“We now routinely use the rapid test and don’t prescribe empiric antivirals or antibiotics as often,” Dr. Schuurmans said. “There is much less drug cost and fewer potential adverse effects from empiric treatment.” Specimens still also undergo conventional testing, however, because that can identify eight additional viruses that the rapid test doesn’t cover.
Dr. Schuurmans acknowledged that further study needs to assess the cost-benefit of the rapid test to confirm that its added expense is offset by reduced expenses for empiric treatment and hospital isolation.
He had no disclosures. The study received no commercial support.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
TORONTO – A test that only requires a maximum 2-hour wait for results was highly accurate at detecting influenza and respiratory syncytial virus infection in lung transplant patients, according to research presented at the CHEST annual meeting on Oct. 30.
This rapid and highly accurate test for detecting three common respiratory viruses has dramatically cut the need for empiric treatments and the risk for causing nosocomial infections in lung transplant patients who develop severe upper respiratory infections, Macé M. Schuurmans, MD, noted during the presentation.
This study involved 100 consecutive lung transplant patients who presented at Zurich University Hospital with signs of severe upper respiratory infection. The researchers ran the rapid and standard diagnostic tests for each patient and found that, relative to the standard test, the rapid test had positive and negative predictive values of 95%.
The number of empiric treatments with oseltamivir (Tamiflu) and ribavirin to treat a suspected influenza or respiratory syncytial virus infection (RSV) has “strongly diminished” by about two-thirds, noted Dr. Schuurmans, who is a pulmonologist at the hospital.
Until the rapid test became available, Dr. Shuurmans and his associates used a standard polymerase chain reaction test that takes 36-48 hours to yield a result. Using this test made treating patients empirically with oseltamivir and oral antibiotics for a couple of days a necessity, he said in a video interview. The older test also required isolating patients to avoid the potential spread of influenza or RSV in the hospital.
The rapid test, which became available for U.S. use in early 2017, covers influenza A and B and RSV in a single test with a single mouth-swab specimen.
“We now routinely use the rapid test and don’t prescribe empiric antivirals or antibiotics as often,” Dr. Schuurmans said. “There is much less drug cost and fewer potential adverse effects from empiric treatment.” Specimens still also undergo conventional testing, however, because that can identify eight additional viruses that the rapid test doesn’t cover.
Dr. Schuurmans acknowledged that further study needs to assess the cost-benefit of the rapid test to confirm that its added expense is offset by reduced expenses for empiric treatment and hospital isolation.
He had no disclosures. The study received no commercial support.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
AT CHEST 2017
Key clinical point:
Major finding: The rapid test had positive and negative predictive values of 95%.
Data source: A single-center observational study of 100 consecutive lung transplant recipients who presented with severe, acute respiratory infection.
Disclosures: Dr. Schuurmans had no disclosures. The study received no commercial support.
VIDEO: Back off on screening colonoscopy after nonadvanced adenomas
ORLANDO – Evidence supports “backing off” from screening colonoscopies every 5 years for patients who had one or two nonadvanced adenomas removed during a prior colonoscopy, Thomas F. Imperiale, MD, AGAF, said at the World Congress of Gastroenterology at ACG 2017.
He reported findings from more than 66,000 U.S. veterans followed at any one of 13 Veterans Affairs medical centers for an average of more than 7 years. The 10,220 patients who underwent a second screening colonoscopy after an index colonoscopy that led to removal of one or two nonadvanced adenomas had 0.16% colorectal cancer mortality, compared with 0.13% among 8,718 patients with a similar history who did not receive follow-up colonoscopy. The rate of colorectal cancer death was 0.12% among 47,629 control veterans who had no adenomas removed during their index colonoscopy.
In current U.S. practice, many gastroenterologists perform follow-up colonoscopy about 5 years after removing one or two nonadvanced adenomas during a screening colonoscopy, Dr. Imperiale said during a video interview. Deferring follow-up colonoscopy in the absence of any clinical indication seems advisable, he said, especially for older patients with two or more comorbidities who had a high-quality index colonoscopy with good preparation and good colonic visibility.
“We just can’t do colonoscopy for surveillance on this subgroup continuously; it doesn’t make sense,” he said.
No randomized trial results have documented the need for stepped up colonoscopies in patients with a history of one or two nonadvanced adenomas, and these new observational findings are consistent with prior observational reports.
“These data need to be integrated with common sense,” he said. An extended interval before repeat surveillance seems particularly appropriate for patients with a higher risk for adverse effects from the colonoscopy preparation and for patients more likely to die from a cause other than colorectal cancer.
Backing off on repeat colonoscopy “minimizes the harm from surveillance. As patients get older they don’t tolerate the prep as well. It grows more onerous, and the returns diminish,” Dr. Imperiale said.
The patients included in the review had their index colonoscopy performed during 2002-2009, when they averaged about 61 years old, and about 95% were men. Their average Charlson comorbidity index was about 1.3. The incidence of colorectal cancer during follow-up after the index colonoscopy was 0.18% in patients with one or two nonadvanced adenomas in their index examination and no follow-up colonoscopy, 0.71% in those with nonadvanced adenomas who had one or more subsequent colonoscopies, and 0.31% in the people with no adenomas removed during the index procedure.
The rates of all-cause death during follow-up of the three subgroups were notably different: 34% in those with nonadvanced adenomas and no repeat colonoscopy, 13% in patients with nonadvanced adenomas and repeat colonoscopy, and 21% in those without nonadvanced adenomas. Dr. Imperiale discounted the significance of comparing rates of all-cause mortality, stressing that the most relevant primary endpoint is colorectal cancer mortality.
Dr. Imperiale reported having no disclosures.
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
ORLANDO – Evidence supports “backing off” from screening colonoscopies every 5 years for patients who had one or two nonadvanced adenomas removed during a prior colonoscopy, Thomas F. Imperiale, MD, AGAF, said at the World Congress of Gastroenterology at ACG 2017.
He reported findings from more than 66,000 U.S. veterans followed at any one of 13 Veterans Affairs medical centers for an average of more than 7 years. The 10,220 patients who underwent a second screening colonoscopy after an index colonoscopy that led to removal of one or two nonadvanced adenomas had 0.16% colorectal cancer mortality, compared with 0.13% among 8,718 patients with a similar history who did not receive follow-up colonoscopy. The rate of colorectal cancer death was 0.12% among 47,629 control veterans who had no adenomas removed during their index colonoscopy.
In current U.S. practice, many gastroenterologists perform follow-up colonoscopy about 5 years after removing one or two nonadvanced adenomas during a screening colonoscopy, Dr. Imperiale said during a video interview. Deferring follow-up colonoscopy in the absence of any clinical indication seems advisable, he said, especially for older patients with two or more comorbidities who had a high-quality index colonoscopy with good preparation and good colonic visibility.
“We just can’t do colonoscopy for surveillance on this subgroup continuously; it doesn’t make sense,” he said.
No randomized trial results have documented the need for stepped up colonoscopies in patients with a history of one or two nonadvanced adenomas, and these new observational findings are consistent with prior observational reports.
“These data need to be integrated with common sense,” he said. An extended interval before repeat surveillance seems particularly appropriate for patients with a higher risk for adverse effects from the colonoscopy preparation and for patients more likely to die from a cause other than colorectal cancer.
Backing off on repeat colonoscopy “minimizes the harm from surveillance. As patients get older they don’t tolerate the prep as well. It grows more onerous, and the returns diminish,” Dr. Imperiale said.
The patients included in the review had their index colonoscopy performed during 2002-2009, when they averaged about 61 years old, and about 95% were men. Their average Charlson comorbidity index was about 1.3. The incidence of colorectal cancer during follow-up after the index colonoscopy was 0.18% in patients with one or two nonadvanced adenomas in their index examination and no follow-up colonoscopy, 0.71% in those with nonadvanced adenomas who had one or more subsequent colonoscopies, and 0.31% in the people with no adenomas removed during the index procedure.
The rates of all-cause death during follow-up of the three subgroups were notably different: 34% in those with nonadvanced adenomas and no repeat colonoscopy, 13% in patients with nonadvanced adenomas and repeat colonoscopy, and 21% in those without nonadvanced adenomas. Dr. Imperiale discounted the significance of comparing rates of all-cause mortality, stressing that the most relevant primary endpoint is colorectal cancer mortality.
Dr. Imperiale reported having no disclosures.
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
ORLANDO – Evidence supports “backing off” from screening colonoscopies every 5 years for patients who had one or two nonadvanced adenomas removed during a prior colonoscopy, Thomas F. Imperiale, MD, AGAF, said at the World Congress of Gastroenterology at ACG 2017.
He reported findings from more than 66,000 U.S. veterans followed at any one of 13 Veterans Affairs medical centers for an average of more than 7 years. The 10,220 patients who underwent a second screening colonoscopy after an index colonoscopy that led to removal of one or two nonadvanced adenomas had 0.16% colorectal cancer mortality, compared with 0.13% among 8,718 patients with a similar history who did not receive follow-up colonoscopy. The rate of colorectal cancer death was 0.12% among 47,629 control veterans who had no adenomas removed during their index colonoscopy.
In current U.S. practice, many gastroenterologists perform follow-up colonoscopy about 5 years after removing one or two nonadvanced adenomas during a screening colonoscopy, Dr. Imperiale said during a video interview. Deferring follow-up colonoscopy in the absence of any clinical indication seems advisable, he said, especially for older patients with two or more comorbidities who had a high-quality index colonoscopy with good preparation and good colonic visibility.
“We just can’t do colonoscopy for surveillance on this subgroup continuously; it doesn’t make sense,” he said.
No randomized trial results have documented the need for stepped up colonoscopies in patients with a history of one or two nonadvanced adenomas, and these new observational findings are consistent with prior observational reports.
“These data need to be integrated with common sense,” he said. An extended interval before repeat surveillance seems particularly appropriate for patients with a higher risk for adverse effects from the colonoscopy preparation and for patients more likely to die from a cause other than colorectal cancer.
Backing off on repeat colonoscopy “minimizes the harm from surveillance. As patients get older they don’t tolerate the prep as well. It grows more onerous, and the returns diminish,” Dr. Imperiale said.
The patients included in the review had their index colonoscopy performed during 2002-2009, when they averaged about 61 years old, and about 95% were men. Their average Charlson comorbidity index was about 1.3. The incidence of colorectal cancer during follow-up after the index colonoscopy was 0.18% in patients with one or two nonadvanced adenomas in their index examination and no follow-up colonoscopy, 0.71% in those with nonadvanced adenomas who had one or more subsequent colonoscopies, and 0.31% in the people with no adenomas removed during the index procedure.
The rates of all-cause death during follow-up of the three subgroups were notably different: 34% in those with nonadvanced adenomas and no repeat colonoscopy, 13% in patients with nonadvanced adenomas and repeat colonoscopy, and 21% in those without nonadvanced adenomas. Dr. Imperiale discounted the significance of comparing rates of all-cause mortality, stressing that the most relevant primary endpoint is colorectal cancer mortality.
Dr. Imperiale reported having no disclosures.
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
AT THE WORLD CONGRESS OF GASTROENTEROLOGY
Key clinical point:
Major finding: Colorectal cancer mortality was 0.13% in patients without follow-up colonoscopy and 0.16% in patients who had a second colonoscopy.
Data source: Review of 66,567 people at 13 U.S. VA Medical Centers.
Disclosures: Dr. Imperiale reported having no disclosures.
VIDEO: Burnout affects half of U.S. gastroenterologists
ORLANDO – Nearly half of U.S. gastroenterologists who responded to a recent survey had symptoms of burnout that seemed largely driven by work-life balance issues.
Burnout appeared to disproportionately affect younger gastroenterologists, those who spend more time on chores at home including caring for young children, physicians who were neutral toward or dissatisfied with a spouse or partner, and clinicians planning to soon leave their practice, Carol A. Burke, MD, said at the World Congress of Gastroenterology at ACG 2017.
Factors not linked with burnout included their type of practice, whether the gastroenterologists worked full or part time, their location, and their compensation, said Dr. Burke, director of the Center for Colon Polyp and Cancer Prevention at the Cleveland Clinic.
The life issues that appeared most strongly linked to burnout “speak to a problem for physicians to balance” their professional and personal lives, Dr. Burke said in a video interview. Several interventions exist that can potentially mitigate burnout, and the American College of Gastroenterology, which ran the survey, is taking steps to make information on these interventions available to members, noted Dr. Burke, the organization’s president.
Dr. Burke and her associates sent a 60-item survey to all 11,080 College members during 2014 and 2015 and received 1,021 replies including 754 fully completed responses. Their prespecified definition of burnout was a high score for emotional exhaustion or for depersonalization, or both, on the Maslach Burnout Inventory. The results showed that 45% of respondents had a high score for emotional exhaustion, 21% scored high on depersonalization, and overall 49% met the burnout criteria set by the investigators. The Inventory answers also showed that 18% had a low sense of personal accomplishment.
A multivariate analysis showed that significant links with burnout were younger age, more time spent on domestic chores, having a neutral or dissatisfying relationship with a spouse or partner, and plans for imminent retirement from gastroenterology practice, Dr. Burke reported.
The main reasons for planning imminent retirement were reimbursement, cited by 32% of this subgroup, regulations, cited by 21%, recertification, cited by 16%, and electronic medical records, cited by 10% as the main reason for leaving practice.
Strategies and resources aimed at better dealing with burnout were requested by 60% of all survey respondents, and the College is in the process of making these tools available, Dr. Burke said.
A recent study conducted by the AGA Institute Education and Training Committee and reported in AGA Perspectives supports these findings. Read more here and join the discussion on the AGA Community.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
ORLANDO – Nearly half of U.S. gastroenterologists who responded to a recent survey had symptoms of burnout that seemed largely driven by work-life balance issues.
Burnout appeared to disproportionately affect younger gastroenterologists, those who spend more time on chores at home including caring for young children, physicians who were neutral toward or dissatisfied with a spouse or partner, and clinicians planning to soon leave their practice, Carol A. Burke, MD, said at the World Congress of Gastroenterology at ACG 2017.
Factors not linked with burnout included their type of practice, whether the gastroenterologists worked full or part time, their location, and their compensation, said Dr. Burke, director of the Center for Colon Polyp and Cancer Prevention at the Cleveland Clinic.
The life issues that appeared most strongly linked to burnout “speak to a problem for physicians to balance” their professional and personal lives, Dr. Burke said in a video interview. Several interventions exist that can potentially mitigate burnout, and the American College of Gastroenterology, which ran the survey, is taking steps to make information on these interventions available to members, noted Dr. Burke, the organization’s president.
Dr. Burke and her associates sent a 60-item survey to all 11,080 College members during 2014 and 2015 and received 1,021 replies including 754 fully completed responses. Their prespecified definition of burnout was a high score for emotional exhaustion or for depersonalization, or both, on the Maslach Burnout Inventory. The results showed that 45% of respondents had a high score for emotional exhaustion, 21% scored high on depersonalization, and overall 49% met the burnout criteria set by the investigators. The Inventory answers also showed that 18% had a low sense of personal accomplishment.
A multivariate analysis showed that significant links with burnout were younger age, more time spent on domestic chores, having a neutral or dissatisfying relationship with a spouse or partner, and plans for imminent retirement from gastroenterology practice, Dr. Burke reported.
The main reasons for planning imminent retirement were reimbursement, cited by 32% of this subgroup, regulations, cited by 21%, recertification, cited by 16%, and electronic medical records, cited by 10% as the main reason for leaving practice.
Strategies and resources aimed at better dealing with burnout were requested by 60% of all survey respondents, and the College is in the process of making these tools available, Dr. Burke said.
A recent study conducted by the AGA Institute Education and Training Committee and reported in AGA Perspectives supports these findings. Read more here and join the discussion on the AGA Community.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
ORLANDO – Nearly half of U.S. gastroenterologists who responded to a recent survey had symptoms of burnout that seemed largely driven by work-life balance issues.
Burnout appeared to disproportionately affect younger gastroenterologists, those who spend more time on chores at home including caring for young children, physicians who were neutral toward or dissatisfied with a spouse or partner, and clinicians planning to soon leave their practice, Carol A. Burke, MD, said at the World Congress of Gastroenterology at ACG 2017.
Factors not linked with burnout included their type of practice, whether the gastroenterologists worked full or part time, their location, and their compensation, said Dr. Burke, director of the Center for Colon Polyp and Cancer Prevention at the Cleveland Clinic.
The life issues that appeared most strongly linked to burnout “speak to a problem for physicians to balance” their professional and personal lives, Dr. Burke said in a video interview. Several interventions exist that can potentially mitigate burnout, and the American College of Gastroenterology, which ran the survey, is taking steps to make information on these interventions available to members, noted Dr. Burke, the organization’s president.
Dr. Burke and her associates sent a 60-item survey to all 11,080 College members during 2014 and 2015 and received 1,021 replies including 754 fully completed responses. Their prespecified definition of burnout was a high score for emotional exhaustion or for depersonalization, or both, on the Maslach Burnout Inventory. The results showed that 45% of respondents had a high score for emotional exhaustion, 21% scored high on depersonalization, and overall 49% met the burnout criteria set by the investigators. The Inventory answers also showed that 18% had a low sense of personal accomplishment.
A multivariate analysis showed that significant links with burnout were younger age, more time spent on domestic chores, having a neutral or dissatisfying relationship with a spouse or partner, and plans for imminent retirement from gastroenterology practice, Dr. Burke reported.
The main reasons for planning imminent retirement were reimbursement, cited by 32% of this subgroup, regulations, cited by 21%, recertification, cited by 16%, and electronic medical records, cited by 10% as the main reason for leaving practice.
Strategies and resources aimed at better dealing with burnout were requested by 60% of all survey respondents, and the College is in the process of making these tools available, Dr. Burke said.
A recent study conducted by the AGA Institute Education and Training Committee and reported in AGA Perspectives supports these findings. Read more here and join the discussion on the AGA Community.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
mzoler@frontlinemedcom.com
On Twitter @mitchelzoler
AT THE 13TH WORLD CONGRESS OF GASTROENTEROLOGY
Key clinical point:
Major finding: Forty-nine percent of surveyed U.S. gastroenterologists showed a high level of emotional exhaustion, depersonalization, or both.
Data source: Survey results from 754 members of the American College of Gastroenterology.
Disclosures: The American College of Gastroenterology funded the survey. Dr. Burke had no relevant disclosures.
MACRA Monday: Screening for hypertension
If you haven’t started reporting quality data for the Merit-Based Incentive Payment System (MIPS), there’s still time to avoid a 4% cut to your Medicare payments.
Under the Pick Your Pace approach being offered this year, the Centers for Medicare & Medicaid Services allows clinicians to test the system by reporting on one quality measure for one patient through paper-based claims. Be sure to append a Quality Data Code (QDC) to the claim form for care provided up to Dec. 31, 2017, in order to avoid a penalty in payment year 2019.
Consider this measure:
Measure #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
This measure is aimed at capturing the percentage of patients aged 18 years and older who were screened for high blood pressure and given a follow-up plan.
What you need to do: Check the patient’s blood pressure and recommend follow-up care – lifestyle modifications, additional testing, or medication, as appropriate – and document that plan.
Eligible cases include patients aged 18 years and older on the date of the encounter and a patient encounter during the performance period. Applicable codes include (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 90839, 90845, 90880, 92002, 92004, 92012, 92014, 96118, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99281, 99282, 99283, 99284, 99285, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, D7140, D7210, G0101, G0402, G0438, G0439 without telehealth modifier: GQ or GT.
To get credit under MIPS, be sure to include a QDC that shows that you successfully performed the measure or had a good reason for not doing so. For instance, code G8783 indicates that a normal blood pressure reading was documented and follow-up is not required, while code G8950 indicates that the patient had a pre-hypertensive or hypertensive blood pressure reading documented and the appropriate follow-up was documented. Exclusion code G9744 should be used if the patient is not eligible due to an active diagnosis of hypertension.
CMS has a full list measures available for claims-based reporting at qpp.cms.gov. The American Medical Association has also created a step-by-step guide for reporting on one quality measure.
Certain clinicians are exempt from reporting and do not face a penalty under MIPS:
- Those who enrolled in Medicare for the first time during a performance period.
- Those who have Medicare Part B allowed charges of $30,000 or less.
- Those who have 100 or fewer Medicare Part B patients.
- Those who are significantly participating in an Advanced Alternative Payment Model (APM).
If you haven’t started reporting quality data for the Merit-Based Incentive Payment System (MIPS), there’s still time to avoid a 4% cut to your Medicare payments.
Under the Pick Your Pace approach being offered this year, the Centers for Medicare & Medicaid Services allows clinicians to test the system by reporting on one quality measure for one patient through paper-based claims. Be sure to append a Quality Data Code (QDC) to the claim form for care provided up to Dec. 31, 2017, in order to avoid a penalty in payment year 2019.
Consider this measure:
Measure #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
This measure is aimed at capturing the percentage of patients aged 18 years and older who were screened for high blood pressure and given a follow-up plan.
What you need to do: Check the patient’s blood pressure and recommend follow-up care – lifestyle modifications, additional testing, or medication, as appropriate – and document that plan.
Eligible cases include patients aged 18 years and older on the date of the encounter and a patient encounter during the performance period. Applicable codes include (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 90839, 90845, 90880, 92002, 92004, 92012, 92014, 96118, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99281, 99282, 99283, 99284, 99285, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, D7140, D7210, G0101, G0402, G0438, G0439 without telehealth modifier: GQ or GT.
To get credit under MIPS, be sure to include a QDC that shows that you successfully performed the measure or had a good reason for not doing so. For instance, code G8783 indicates that a normal blood pressure reading was documented and follow-up is not required, while code G8950 indicates that the patient had a pre-hypertensive or hypertensive blood pressure reading documented and the appropriate follow-up was documented. Exclusion code G9744 should be used if the patient is not eligible due to an active diagnosis of hypertension.
CMS has a full list measures available for claims-based reporting at qpp.cms.gov. The American Medical Association has also created a step-by-step guide for reporting on one quality measure.
Certain clinicians are exempt from reporting and do not face a penalty under MIPS:
- Those who enrolled in Medicare for the first time during a performance period.
- Those who have Medicare Part B allowed charges of $30,000 or less.
- Those who have 100 or fewer Medicare Part B patients.
- Those who are significantly participating in an Advanced Alternative Payment Model (APM).
If you haven’t started reporting quality data for the Merit-Based Incentive Payment System (MIPS), there’s still time to avoid a 4% cut to your Medicare payments.
Under the Pick Your Pace approach being offered this year, the Centers for Medicare & Medicaid Services allows clinicians to test the system by reporting on one quality measure for one patient through paper-based claims. Be sure to append a Quality Data Code (QDC) to the claim form for care provided up to Dec. 31, 2017, in order to avoid a penalty in payment year 2019.
Consider this measure:
Measure #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
This measure is aimed at capturing the percentage of patients aged 18 years and older who were screened for high blood pressure and given a follow-up plan.
What you need to do: Check the patient’s blood pressure and recommend follow-up care – lifestyle modifications, additional testing, or medication, as appropriate – and document that plan.
Eligible cases include patients aged 18 years and older on the date of the encounter and a patient encounter during the performance period. Applicable codes include (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 90839, 90845, 90880, 92002, 92004, 92012, 92014, 96118, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99281, 99282, 99283, 99284, 99285, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, D7140, D7210, G0101, G0402, G0438, G0439 without telehealth modifier: GQ or GT.
To get credit under MIPS, be sure to include a QDC that shows that you successfully performed the measure or had a good reason for not doing so. For instance, code G8783 indicates that a normal blood pressure reading was documented and follow-up is not required, while code G8950 indicates that the patient had a pre-hypertensive or hypertensive blood pressure reading documented and the appropriate follow-up was documented. Exclusion code G9744 should be used if the patient is not eligible due to an active diagnosis of hypertension.
CMS has a full list measures available for claims-based reporting at qpp.cms.gov. The American Medical Association has also created a step-by-step guide for reporting on one quality measure.
Certain clinicians are exempt from reporting and do not face a penalty under MIPS:
- Those who enrolled in Medicare for the first time during a performance period.
- Those who have Medicare Part B allowed charges of $30,000 or less.
- Those who have 100 or fewer Medicare Part B patients.
- Those who are significantly participating in an Advanced Alternative Payment Model (APM).
