September 28, 2023

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2 min read

Medical doctors, patients try to disgrace insurers on-line to reverse authorization denials

1 month ago Sechan

Sally Nix was furious when her overall health coverage enterprise refused to shell out for the infusions she demands to ease her continual agony and exhaustion.

Nix has struggled with a blend of autoimmune diseases due to the fact 2011. Mind and spinal surgical procedures didn’t simplicity her signs or symptoms. Nothing worked, she reported, until she began intravenous immunoglobulin infusions late previous 12 months. Normally named IVIG, the cure bolsters her compromised immune program with healthy antibodies from other people’s blood plasma.

“IVIG turned out to be my excellent hope,” she mentioned.

That’s why, when Nix’s well being insurer began denying payment for the remedy, she turned to Fb and Instagram to vent her outrage.

“I was increasing Cain about it,” said Nix, 53, of Statesville, North Carolina, who said she was compelled to pause therapy due to the fact she could not manage to spend extra than $13,000 out of pocket each four months. “There are instances when you simply just need to get in touch with out wrongdoings,” she wrote on Instagram. “This is a single of individuals instances.”

Prior authorization is a typical price tag-reducing resource made use of by overall health insurers that involves sufferers and doctors to protected approval ahead of shifting ahead with several assessments, strategies, and prescription medications. Insurers say the procedure allows them command expenses by protecting against medically unwanted treatment. But individuals say the normally time-consuming and frustrating guidelines make hurdles that hold off or deny accessibility to the remedies they will need. In some circumstances, delays and denials equivalent dying, medical doctors say.

That is why determined sufferers like Nix — and even some medical professionals — say they have turned to publicly shaming coverage corporations on social media to get exams, medicine, and remedies accepted.

“Unfortunately, this has grow to be a routine exercise for us to vacation resort to if we really do not get any headway,” said Dr. Shehzad Saeed, a pediatric gastroenterologist at Dayton’s Children’s Medical center in Ohio. In March, he tweeted a photo of an oozing pores and skin rash, blaming Anthem for denying the biologic remedy his affected individual required to ease her Crohn’s illness signs or symptoms.

In July, Dr. Eunice Stallman, a psychiatrist centered in Idaho, joined X, previously acknowledged as Twitter, for the initial time to share how her 9-thirty day period-outdated daughter, Zoey, had been denied prior authorization for a $225 pill she demands to acquire twice a working day to shrink a large brain tumor. “This really should not be how it is finished,” Stallman reported.

The federal federal government has proposed strategies to reform prior authorization that would require insurance coverage corporations to provide much more transparency about denials and to pace up their response instances. If finalized, individuals federal changes would be applied in 2026. But even then, the guidelines would apply only to some groups of health insurance policies, including Medicare, Medicare Edge, and Medicaid plans, but not employer-sponsored well being

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3 min read

How Americans View Use of AI in Health Care and Medicine by Doctors and Other Providers

6 months ago Sechan

Yet many see promise for artificial intelligence to help issues of bias in medical care

Pew Research Center conducted this study to understand Americans’ views of artificial intelligence (AI) and its uses in health and medicine. For this analysis, we surveyed 11,004 U.S. adults from Dec. 12-18, 2022.

Everyone who took part in the survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way, nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology.

Here are the questions used for this report, along with responses, and its methodology.

This is part of a series of surveys and reports that look at the increasing role of AI in shaping American life. For more, read “Public Awareness of Artificial Intelligence in Everyday Activities” and “How Americans view emerging uses of artificial intelligence, including programs to generate text or art.”

A new Pew Research Center survey explores public views on artificial intelligence (AI) in health and medicine – an area where Americans may increasingly encounter technologies that do things like screen for skin cancer and even monitor a patient’s vital signs.

The survey finds that on a personal level, there’s significant discomfort among Americans with the idea of AI being used in their own health care. Six-in-ten U.S. adults say they would feel uncomfortable if their own health care provider relied on artificial intelligence to do things like diagnose disease and recommend treatments; a significantly smaller share (39%) say they would feel comfortable with this.

One factor in these views: A majority of the public is unconvinced that the use of AI in health and medicine would improve health outcomes. The Pew Research Center survey, conducted Dec. 12-18, 2022, of 11,004 U.S. adults finds only 38% say AI being used to do things like diagnose disease and recommend treatments would lead to better health outcomes for patients generally, while 33% say it would lead to worse outcomes and 27% say it wouldn’t make much difference.

These findings come as public attitudes toward AI continue to take shape, amid the ongoing adoption of AI technologies across industries and the accompanying national conversation about the benefits and risks that AI applications present for society. Read recent Center analyses for more on public awareness of AI in daily life and perceptions of how much advancement emerging AI applications represent for their fields.

Asked in more detail about how the use of artificial intelligence would impact health and medicine, Americans identify a mix of both positives and negatives.

On the positive side, a larger share of Americans think the use of AI in health and medicine would reduce rather than increase the number of mistakes made by health care providers (40% vs. 27%).

And among the majority of Americans who see a problem

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3 min read

ChatGPT Won’t Fix Healthcare, But It Might Save Doctors Some Time

7 months ago Sechan

In a healthcare industry still burdened with 1960s technology, generative AI may offer a little relief — but companies are still working to overhaul a broken system that’s keeping doctors and nurses more focused on paperwork than patients.

By Katie Jennings and Rashi Shrivastava, Forbes Staff

Every week, Eli Gelfand, chief of general cardiology at Beth Israel Deaconess Medical Center in Boston, wastes a lot of time on letters he doesn’t want to write — all of them to insurers disputing his recommendations. A new drug for a heart failure patient. A CAT scan for a patient with chest pain. A new drug for a patient with stiff heart syndrome. “We’re talking about appeal letters for things that are life-saving,” says Gelfand, who is also an assistant professor at Harvard Medical School.

So when OpenAI’s ChatGPT began making headlines for generally coherent artificial intelligence-generated text, Gelfand saw an opportunity to save some time. He fed the bot some basic information about a diagnosis and the medications he’d prescribed (leaving out the patient’s name) and asked it to write an appeal letter with references to scientific papers.

ChatGPT gave him a viable letter — the first of many. And while the references may sometimes be wrong, Gelfand told Forbes the letters require “minimal editing.” Crucially, they have cut the time he spends writing them down to a minute on average. And they work.

Gelfand has used ChatGPT for some 30 appeal letters, most of which have been approved by insurers, he says. But he’s under no illusion that ChatGPT or the AI that powers it is going to save the U.S. healthcare system anytime soon. “It’s basically making my life a little easier and hopefully getting the patients the medications they need at a higher rate,” Gelfand says. “This is a workaround solution for a problem that shouldn’t really exist.”

That problem: The U.S. spends more money on healthcare administration than any other country. In 2019, around a quarter of the $3.8 trillion spent on healthcare went to administrative issues like the ones bemoaned by Gelfand. It’s estimated around $265 billion of that was “wasteful” — unnecessary expenditures necessitated by the antiquated technology that undergirds the U.S. healthcare system. Gelfand can use a chatbot to electronically generate an appeal letter. But he has to fax it to the insurer. And that encapsulates the challenge facing companies hoping to build time-saving AI back-office tools for a healthcare system stuck in the 1960s.

Cut The “Scut”

The fax machine isn’t going away anytime soon, says Nate Gross, cofounder and chief strategy officer of Doximity, a San Francisco-based social networking platform used by two million doctors and other healthcare professionals in the U.S. That’s why Doximity’s new workflow tool, DocsGPT, a chatbot that helps doctors write a wide range of letters and certificates, is connected to its online faxing tool.

“Our design thesis is to make it as easy as possible for doctors to interface with

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3 min read

Why doctors don’t openly defy abortion laws, even when patients are at risk : Shots

8 months ago Sechan

American Medical Association President Dr. Jack Resneck recently recounted how doctors around the country are facing difficulties practicing medicine in states that ban abortion.

Nicole Xu for NPR


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Nicole Xu for NPR

American Medical Association President Dr. Jack Resneck recently recounted how doctors around the country are facing difficulties practicing medicine in states that ban abortion.

Nicole Xu for NPR

Since Roe v. Wade was overturned, 13 states have banned abortion except in the case of a medical emergency or serious health risk for the pregnant patient. But deciding what cases qualify for a medical exception can be a difficult judgement call for doctors.

News reports and court affidavits have documented how health care workers sometimes deny women abortion procedures in emergency situations – including NPR’s story of a woman who was initially not treated for her miscarriage at an Ohio ER, though she’d been bleeding profusely for hours.

In Missouri, hospital doctors told a woman whose water broke at 18 weeks that “current Missouri law supersedes our medical judgment” and so she could not receive an abortion procedure even though she was at risk of infection, according to a report in the Springfield News-Leader.

That hospital is now under investigation for violating a federal law that requires doctors to treat and stabilize patients during a medical emergency.

And a survey by the Texas Policy Evaluation Project found clinicians sometimes avoided standard abortion procedures, opting instead for “hysterotomy, a surgical incision into the uterus, because it might not be construed as an abortion.”

“That’s just nuts,” Dr. Matthew Wynia says. He’s a physician who directs the Center for Bioethics and Humanities at the University of Colorado. “[A hysterotomy is] much more dangerous, much more risky – the woman may never have another pregnancy now because you’re trying to avoid being accused of having conducted an abortion.”

Her miscarriage left her bleeding profusely. An Ohio ER sent her home to wait

Reports like these prompted Wynia to publish an editorial in the New England Journal of Medicine in September, calling for physicians and leading medical institutions to take a stand against these laws through “professional civil disobedience.” The way he sees it, no doctor should opt to do a procedure that may harm their patient – or delay or deny care – because of the fear of prosecution.

“I have seen some very disturbing quotes from health professionals essentially saying, ‘Look, it’s the law. We have to live within the law,'” he says. “If the law is wrong and causing you to be involved in harming patients, you do not have to live [within] that law.”

These issues have raised a growing debate in medicine about what to do in the face of laws that many doctors feel force them into ethical quandaries.

Medical organizations raise the issue

At the American Medical Association’s November meeting, president Dr. Jack Resneck gave an address to the organization’s legislative body, and recounted how doctors around the country have run into difficulty practicing medicine in states that ban abortion.

“I never imagined colleagues would find

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3 min read

2 medical doctors lifeless next Smith County dental business office taking pictures

1 year ago Sechan

TYLER, Texas (KLTV) – Equally doctors shot in a Smith County dental office incident have died, according to the sheriff’s business.

The adult males ended up shot by Steven Alexander Smith, 40, who is billed with capital murder, in accordance to sheriff’s office environment spokesman Larry Christian. Smith is held on a total of $3 million bond.

Steven Alexander Smith is held on a full of $3M bond.(Smith County Sheriff’s Business office)

The sheriff’s office states the victims are Dr. Blake G. Sinclair, 59, of Tyler, and Dr. Jack E. Burroughs, 75, of Tyler.

At about 2:45 p.m. Wednesday, the Smith County Sheriff’s Office environment acquired a 911 contact about a capturing at Economical Dentures, positioned at 3081 Hwy 31 East close to Tyler. Upon the arrival of deputies, two male victims had been positioned within just the organization suffering from gunshot wounds.

The first investigation disclosed that Smith was a affected individual at the clinic. He grew to become offended at clinic employees and retreated to his pickup, positioned in the parking whole lot. He then returned and entered into the lobby region in which he was satisfied by clinic staff. Smith had a handgun and in the long run shot two physicians who had been functioning inside of the small business, according to the sheriff’s workplace.

“He was not happy with the excellent of operate performed on the dentures that he experienced been equipped with,” Sheriff Larry Smith claimed.

Equally victims ended up taken to a Tyler medical center. Smith was later on arrested at a property in south Tyler.

Witness to capturing said she hid guiding lobby wall

Sheriff Larry Smith reported the two victims died quickly right after arriving at the hospital.

Steven Smith is also billed with aggravated assault. That demand stems from the suspect for pointing the gun at a nurse, who pleaded with him, stating she experienced small children.

“And there is no way for us know he meant to shoot her or not, but she pleaded with him that she had a kid,” Sheriff Smith reported. “So he didn’t shoot her but he did point the pistol at her.”

Sheriff Smith reported a fast-pondering employee took a photograph of the suspect’s license plate, which was presented to a first-arriving deputy. The deputy sent that facts together to dispatch, enabling authorities to observe down the deputy’s handle. A deputy arrived just as the suspect was arriving at the residence in south Tyler, Sheriff Smith mentioned.

The man’s mothers and fathers have been inside of the household, but came out immediately after becoming persuaded to be negotiators. Then they convinced the suspect to come out a handful of minutes afterwards.

Authorities observed two handguns in the household, which were being the exact caliber as the gun applied in the taking pictures, Sheriff Smith mentioned.

Sheriff Smith claimed the two medical doctors ended up observed inside of the right doorway, about 15 toes or so inside of. The sheriff also said he thinks the

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