Do Longer Shifts Affect Residents’ Sleep or Patient Safety?
Do residents need more sleep? Two new studies in the New England Journal of Medicine compare the effects of standard versus flexible duty-hours on residents’ sleep and patient safety.
The iCOMPARE trial randomized 63 internal medicine residency programs, consisting of over 5,000 trainees, to standard duty-hour policies or flexible policies. All programs were held to an 80-hour work week, but flexible policies had no limits on shift lengths and did not mandate time off between shifts.
Patient Awareness of Industry Payments to Physicians
When patients see their doctors, they expect that their health and clinical needs will be the main drivers of decisions regarding treatment. However, studies have shown that other factors may influence clinical decisions, such as doctors' interactions and relationships with drug companies. So what can patients do if they want to learn about these influences when choosing who will care for them?
Starting Opioid Use Disorder Treatment in the Emergency Department
Every day, we hear about the staggering toll of the opioid overdose crisis. This is particularly salient in Philadelphia, which has one of the highest overdose death rates among major U.S. cities. Despite effective medications for opioid use disorder, such as buprenorphine and methadone, few people receive treatment.
Twelve Penn Researchers Receive 2019 LDI Pilot Grants
Rinad Beidas Inquirer Commentary on Gun Suicides and Primary Care
MIPS APMs In The Quality Payment Program
[Reposted: Joshua M. Liao and Amol S.
Implications Of MIPS Scoring On Clinician Engagement In Value-Based Payments
[Reposted: Joshua M. Liao and Amol S.
Physician-Hospital Relationships: Integration ≠ Alignment
Penn Medicine's Justin Bekelman Featured in Washington Post
Why Your Doctor Shouldn’t Accept That Sandwich
Pharmaceutical company payments can significantly influence physician prescribing behavior, according to a recent National Bureau of Economics Research (NBER) Working Paper by LDI Senior Fellows Matthew Grennan, Ashley Swanson, and colleagues.
New Penn Scholarship Named for Penn Medicine's David Asch
Penn Team Opioid 'Sprained Ankle' Study Generates National Media Impact
Physician-Industry Interactions: Persuasion and Welfare
Matthew Grennan, Kyle Myers, Ashley Swanson, Aaron Chatterji
ABSTRACT [FROM JOURNAL]
In markets where consumers seek expert advice regarding purchases, firms seek to influence experts, raising concerns about biased advice. Assessing firm-expert interactions requires identifying their causal impact on demand, amidst frictions like market power. We study pharmaceutical firms' payments to physicians, leveraging instrumental variables based on regional spillovers from hospitals' conflict-of-interest policies and market shocks due to patent expiration. We find that the average payment increases prescribing of the focal drug by 73 percent. Our...
Factors Associated With Pediatrician Responses to Alternative Immunization Schedule Requests
Abstract [from journal]
We conducted a cross-sectional online survey among 4 chapters of the American Academy of Pediatrics from July through October 2014 to describe characteristics of pediatricians and practices associated with practice-level responses to alternative immunization schedule requests. Among 374 pediatricians, 58% reported frequent alternative immunization schedule requests and 24% reported feeling comfortable using them. Pediatricians who work in practices that accommodate alternative immunization schedule requests have increased odds of having a
...Physician Perspectives In Year 1 Of MACRA And Its Merit-Based Payment System: A National Survey
Joshua M. Liao, Judy A. Shea, Arlene Weissman, Amol S. Navathe...
ABSTRACT [from journal]
We surveyed a national sample of internal medicine physicians in March–May 2017 to explore their beliefs about the newly implemented Merit-based Incentive Payment System (MIPS). Respondents believed that their efforts in the four focus areas identified in the survey would ultimately improve the value of care. When informed that those areas represented the four MIPS domains, the majority remained positive about the likely impact on value. However, expectations varied by physicians’ characteristics and sense of control over the desired outcomes, and many...