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The Morning Report provides a quick look at today’s medical news, research and features.  









Ebola Guidelines for Doctors’ Offices are Vague
In Texas, doctors are told the best protection against the Ebola virus is not an impermeable suit, face mask or double set of gloves. It’s the telephone. Every patient who calls for an appointment at a doctor’s office should be asked about symptoms and travel history before arriving and mingling with other patients. If Ebola is suspected, the patient should be sent immediately to a hospital emergency room.

But that advice did not come from the Centers for Disease Control and Prevention. The Texas Medical Association drew up the recommendations, and other states are offering different advice to their doctors. While federal officials have been preoccupied with revamping hospital protocols for handling Ebola patients, critics say guidelines for doctors’ offices, walk-in clinics, blood-testing centers and other outpatient settings have remained spotty and vague.

That has often left local officials and medical associations to fill in the gaps and develop their own policies. Outpatient facilities are unlikely to have a room with a private bathroom where a possible Ebola patient can be isolated, as recommended by the C.D.C.

Dr. Jay Varma, the deputy commissioner for disease control at New York City’s Department of Health and Mental Hygiene, said the chances of an acutely ill patient seeking help at a private doctor’s office were exceedingly low. Most of these patients will probably go to a hospital emergency room, he said. (NYT)

Aspiring Docs Should Prepare for the New MCAT
The MCAT is changing and pre-med should be aware of the new topics if they want to get in to medical school. Just about every medical school in the U.S. requires students to take the Medical College Admission Test (MCAT), the one-day standardized test taken by 85,000 aspiring doctors each year. The April 2015 MCAT will feature the first major changes to the test in nearly 20 years.

The last significant revision to the MCAT added a writing skills section, which was removed from the test last year. The new MCAT will include a section called “Psychological, Social, and Biological Foundations of Behavior,” which focuses on the humanities and social studies.

“That section tests concepts from psychology, sociology and biology that provide the foundation for learning in medical school about the behavioral and socio-cultural determinants of health,” said Karen Mitchell, senior director for the MCAT at the Association of American Medical Colleges.

Current and future physicians must be able to handle issues that may not have been emphasized in past generations including an increasingly diverse population and the impact of behavior on health. (Continued at Physicians News)

A Small Practice’s Fight to Stay Independent
A six-physician primary care practice in Chicago would rather fight than join. Primary Care Medical Associates (PCMA), serving the city’s North Side, decided to buck the trend toward consolidation of medical groups and the urge to sell to a large health system. Their strategy is gutsy, and it entailed some trial and error — but it has been working out for them and could possibly work for you too.

“We were really losing business to urgent care and walk-in clinics,” says internist and PCMA founder Robert G. Perlmuter, MD. Four years ago, in response to the proliferation of convenience clinics at retail pharmacies and urgent care centers, the practice switched the early part of the workday to walk-in service five days a week. On weekdays from 8:00 to 8:45 AM, established patients can come in without an appointment for treatment of specific acute conditions, such as cold and flu symptoms, rashes, urinary tract infections, and sprained ankles. Appointments start at 9 AM Monday-Saturday.

PCMA started the walk-in program with a physician assistant, who then left shortly thereafter. Still, the practice kept the early-morning window free of appointments, despite reservations from some of the physicians.

During winter 2013, when traffic was lagging during the first hour of the workday, the practice sent out a mailing to all of its established patients touting the walk-in hours, hoping to reinforce the value of having a regular primary care physician. Business for minor, emergent issues picked up almost immediately. On Mondays and days after holidays, the practice gets about eight walk-ins in that 45-minute period. Perlmuter says the practice may expand walk-in hours soon, though it will continue to limit this service to patients with whom the physicians already have a relationship.  (Medscape)


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