Data Stream
More Than an Ounce of Prevention
Think Small
Preventive services are available for nine of the 10 leading causes of death in the United States, and according
to researchers from the Centers for Disease Control and Prevention, their use varies widely – mainly depending on the
cost of the services.
Despite the changing practice landscape – toward larger hospital affiliations and non-hospital large physician
groups – it appears that most physicians actually provide care to patients in small practices.
Looking at 3,388 physician practice arrangements in 2014, researchers from the American Medical Association
found that:
In the analysis of data from the 2011 and 2012 National
Health Interview Survey, an annual cross-sectional survey
from the CDC’s National Center for Health Statistics
designed to track national health status and health-care
access, among 67,539 respondents use of the following
services was:
Hepatitis A vaccination: 12.7%
Colon cancer screening: 23.6%
Diabetes screening: 45.3%
Cervical cancer screening: 59.4%
Breast cancer screening: 61.6%
worked in practices
with 11-24 physicians
worked in practices
with 2-4 physicians
worked in practices
with 25-49 physicians
worked in practices
with 5-10 physicians
worked in practices
with 50+ physicians
Diet counseling: 26.9%
Hepatitis B vaccination: 38.8%
worked in practices
with 1 physician
Cholesterol screening:
These figures have changed very little between 2012 and 2014, even in the face of profound structural
reforms to health-care delivery, according to AMA President-elect Andrew W. Gurman, MD. “The AMA is
committed to ensuring physicians in all practice sizes and types can thrive and offers innovative strategies
and resources that address common practice challenges in the new health environment.”
Source: Kane CK. Updated data on physician practice arrangements: inching toward hospital ownership. Policy Research Perspectives,
American Medical Association, July 2015.
70%
Blood pressure screening: 82.9%
Insured people and those with incomes over twice the federal
poverty level were more likely to receive these services.
Head Over Heels in Debt
Medical residents start their careers in debt – deeply in debt – according to Medscape’s
“Residents’ Salary & Debt Report 2015: Are Residents Happy?” which surveyed more
than 1,700 medical residents in 24 specialties about their career hopes, everyday
experiences on the job, and finances.
Colon cancer screening saw the greatest disparity:
Insured people were
313%
MORE
LIKELY
than uninsured to receive these high-cost services.
Source: Fox JB, Shaw FE. Receipt of selected clinical preventive services
by adults – United States, 2011-2012. MMWR Morb Mortal Wkly Rep.
2015;64:738-42.
A lucky
22% 10% 9%
had no medical
school debt
had debt
<$50,000
had debt
$50,000 - $99,999
22% 37%
had debt
$100,000 - $200,000
had debt
>$200,000
It can’t be too bad, though. When asked if they were “still looking forward to being a doctor,”
84% of respondents said yes, 11% said undecided, and 4% said no.
Source: Medscape, “Residents’ Salary & Debt Report 2015: Are Residents Happy?”
36
ASH Clinical News
September 2015