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...
Amol Navathe Wins AcademyHealth 'Best Abstract' Award
Physician Practice Variation Under Orthopedic Bundled Payment
Joshua M. Liao, Ezekiel J. Emanuel, Gary L. Whittington, Dylan S. Small, ...
ABSTRACT [FROM JOURNAL]
Objectives: To describe the extent of and longitudinal changes in physician practice variation with respect to implant costs, institutional postacute care (PAC) provider utilization, and total episode payments, as well as to evaluate the association between physician volume and quality and these outcomes.
Study Design: Observational study.
Methods: We combined claims and internal hospital cost data for 34 physicians responsible for 3614 joint replacement episodes under bundled payment at...
Chart of the Day: Nurse Practitioners in Primary Care
A new study in Health Affairs by Hilary Barnes, Matthew McHugh, and colleagues, demonstrates the increasingly important role nurse practitioners (NPs) have in primary care in the United States.
Yelp Reviews and Opioids
Researchers are discovering that social media offers a window into the lived experience of patients and their caregivers. Using Yelp reviews about US hospitals, our team at Penn’s Center for Health Care Innovation attempted to give voice to these experiences related to pain management and opioids during recent hospital visits.
Moving Beyond Duty-Hours
If you want to start an intense debate within the medical community, just talk about duty-hours – the length of a physician-in-training’s shift.
Physician-Level Variation in Outcomes of Mechanically Ventilated Patients
Meeta Prasad Kerlin, Andrew Epstein, Jeremy M. Kahn, Theodore J. Iwashyna, ...
Abstract [from journal]
Rationale: Physicians are increasingly being held accountable for patient outcomes, yet their specific contribution to the outcomes remains uncertain....
Education Outcomes in a Duty-Hour Flexibility Trial in Internal Medicine
Sanjay V. Desai, David A. Asch, Lisa M. Bellini, Krisda H. Chaiyachati, Manqing Liu, Alice L. Sternberg, James Tonascia, Alyssa...
Abstract [from journal]
Background
Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians.
Methods
We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off...