Naseem S. Miller

Social Networks Found Lacking

Social networking Web sites for people with diabetes vary widely in quality and safety, according to researchers at Children's Hospital Boston. The team evaluated 10 such sites and found that only half carried information consistent with clinical practice and the latest science concerning diabetes. Even fewer sites protected the participants' privacy, according to the researchers. In a statement, lead author Dr. Kenneth Mandl said that “privacy in a social network is somewhat of an oxymoron. On the whole, these networks tend to be about exposing your information online.” He and his colleagues recommended that more of the sites employ moderators and that they emphasize transparency, such as revealing ties to pharmaceutical companies. The researchers published their study in the Journal of the American Medical Informatics Association.

Inpatient Insulin Is Issue

The American College of Physicians published new guidelines saying that doctors should not use insulin therapy to strictly control blood glucose in hospitalized patients nor to normalize glucose in intensive care patients. But “insulin therapy should not be abandoned,” according to a joint statement on the guidelines from the American Association of Clinical Endocrinology and the American Diabetes Association. The two diabetes-linked groups found the college's guidelines “for the most part consistent” with their recommendations on inpatient glucose control. “Both overtreatment and undertreatment of hyperglycemia in hospitalized patients are patient-safety issues,” said Dr. Robert R. Henry, the ADA's president for medicine and science. The college's new guidelines say that if clinicians choose to use insulin therapy in intensive care unit patients, 140 to 200 mg/dL should be the blood glucose target.

Metabolic Drugs Cost Most

Spending on prescriptions to control cholesterol, diabetes, and other metabolic conditions exceeded $52 billion in 2008, according to the Agency for Healthcare Research and Quality. Such metabolic medicines cost U.S. insurers and consumers more than any other class of drug that year and accounted for 22% of spending for prescription medicines. Meanwhile, spending on central nervous system drugs totaled $35 billion. Cardiovascular drugs, including calcium channel blockers and diuretics, cost $29 billion, while antacids, antidiarrheals, and other gastrointestinal medications cost $20 billion – the same total spent on antidepressants, antipsychotics, and other psychotherapeutic drugs, according to the agency.

Group Promotes Savings Card

The American Diabetes Association announced that it will urge uninsured diabetes patients to join a program for discounted drugs and supplies. Supported by large pharmaceutical companies, Together Rx Access offers savings cards to uninsured individuals who have incomes up to $45,000. Pharmacies then give cardholders discounts up to 40% on brand-name prescription products, as well as some savings on generics. In their announcement of the effort, the ADA and the discount program estimated that 90% of uninsured Americans qualify for the savings card.

$750 Million More for Prevention

The Department of Health and Human Services will spend $750 million this year to limit tobacco use, curb chronic disease, increase immunizations, and conduct other disease-prevention activities. The new “investment in prevention” comes on top of $500 million that was disbursed in 2010, according to the HHS. Of the new money, nearly $300 million will go toward reducing tobacco use, improving nutrition and physical activity, and preventing heart disease, cancer, and diabetes. Another $182 million will focus on improving preventive care, including education on new prevention benefits in the health reform law. A total of $137 million will help local public health agencies improve their information technology and train staff, and $133 million will be used, in part, to track the effects of the reform law on the health of Americans, according to the HHS.

Social Networks Found Lacking

Social networking Web sites for people with diabetes vary widely in quality and safety, according to researchers at Children's Hospital Boston. The team evaluated 10 such sites and found that only half carried information consistent with clinical practice and the latest science concerning diabetes. Even fewer sites protected the participants' privacy, according to the researchers. In a statement, lead author Dr. Kenneth Mandl said that “privacy in a social network is somewhat of an oxymoron. On the whole, these networks tend to be about exposing your information online.” He and his colleagues recommended that more of the sites employ moderators and that they emphasize transparency, such as revealing ties to pharmaceutical companies. The researchers published their study in the Journal of the American Medical Informatics Association.

Inpatient Insulin Is Issue

The American College of Physicians published new guidelines saying that doctors should not use insulin therapy to strictly control blood glucose in hospitalized patients nor to normalize glucose in intensive care patients. But “insulin therapy should not be abandoned,” according to a joint statement on the guidelines from the American Association of Clinical Endocrinology and the American Diabetes Association. The two diabetes-linked groups found the college's guidelines “for the most part consistent” with their recommendations on inpatient glucose control. “Both overtreatment and undertreatment of hyperglycemia in hospitalized patients are patient-safety issues,” said Dr. Robert R. Henry, the ADA's president for medicine and science. The college's new guidelines say that if clinicians choose to use insulin therapy in intensive care unit patients, 140 to 200 mg/dL should be the blood glucose target.

Metabolic Drugs Cost Most

Spending on prescriptions to control cholesterol, diabetes, and other metabolic conditions exceeded $52 billion in 2008, according to the Agency for Healthcare Research and Quality. Such metabolic medicines cost U.S. insurers and consumers more than any other class of drug that year and accounted for 22% of spending for prescription medicines. Meanwhile, spending on central nervous system drugs totaled $35 billion. Cardiovascular drugs, including calcium channel blockers and diuretics, cost $29 billion, while antacids, antidiarrheals, and other gastrointestinal medications cost $20 billion – the same total spent on antidepressants, antipsychotics, and other psychotherapeutic drugs, according to the agency.

Group Promotes Savings Card

The American Diabetes Association announced that it will urge uninsured diabetes patients to join a program for discounted drugs and supplies. Supported by large pharmaceutical companies, Together Rx Access offers savings cards to uninsured individuals who have incomes up to $45,000. Pharmacies then give cardholders discounts up to 40% on brand-name prescription products, as well as some savings on generics. In their announcement of the effort, the ADA and the discount program estimated that 90% of uninsured Americans qualify for the savings card.

$750 Million More for Prevention

The Department of Health and Human Services will spend $750 million this year to limit tobacco use, curb chronic disease, increase immunizations, and conduct other disease-prevention activities. The new “investment in prevention” comes on top of $500 million that was disbursed in 2010, according to the HHS. Of the new money, nearly $300 million will go toward reducing tobacco use, improving nutrition and physical activity, and preventing heart disease, cancer, and diabetes. Another $182 million will focus on improving preventive care, including education on new prevention benefits in the health reform law. A total of $137 million will help local public health agencies improve their information technology and train staff, and $133 million will be used, in part, to track the effects of the reform law on the health of Americans, according to the HHS.

Social Networks Found Lacking

Social networking Web sites for people with diabetes vary widely in quality and safety, according to researchers at Children's Hospital Boston. The team evaluated 10 such sites and found that only half carried information consistent with clinical practice and the latest science concerning diabetes. Even fewer sites protected the participants' privacy, according to the researchers. In a statement, lead author Dr. Kenneth Mandl said that “privacy in a social network is somewhat of an oxymoron. On the whole, these networks tend to be about exposing your information online.” He and his colleagues recommended that more of the sites employ moderators and that they emphasize transparency, such as revealing ties to pharmaceutical companies. The researchers published their study in the Journal of the American Medical Informatics Association.

Inpatient Insulin Is Issue

The American College of Physicians published new guidelines saying that doctors should not use insulin therapy to strictly control blood glucose in hospitalized patients nor to normalize glucose in intensive care patients. But “insulin therapy should not be abandoned,” according to a joint statement on the guidelines from the American Association of Clinical Endocrinology and the American Diabetes Association. The two diabetes-linked groups found the college's guidelines “for the most part consistent” with their recommendations on inpatient glucose control. “Both overtreatment and undertreatment of hyperglycemia in hospitalized patients are patient-safety issues,” said Dr. Robert R. Henry, the ADA's president for medicine and science. The college's new guidelines say that if clinicians choose to use insulin therapy in intensive care unit patients, 140 to 200 mg/dL should be the blood glucose target.

Metabolic Drugs Cost Most

Spending on prescriptions to control cholesterol, diabetes, and other metabolic conditions exceeded $52 billion in 2008, according to the Agency for Healthcare Research and Quality. Such metabolic medicines cost U.S. insurers and consumers more than any other class of drug that year and accounted for 22% of spending for prescription medicines. Meanwhile, spending on central nervous system drugs totaled $35 billion. Cardiovascular drugs, including calcium channel blockers and diuretics, cost $29 billion, while antacids, antidiarrheals, and other gastrointestinal medications cost $20 billion – the same total spent on antidepressants, antipsychotics, and other psychotherapeutic drugs, according to the agency.

Group Promotes Savings Card

The American Diabetes Association announced that it will urge uninsured diabetes patients to join a program for discounted drugs and supplies. Supported by large pharmaceutical companies, Together Rx Access offers savings cards to uninsured individuals who have incomes up to $45,000. Pharmacies then give cardholders discounts up to 40% on brand-name prescription products, as well as some savings on generics. In their announcement of the effort, the ADA and the discount program estimated that 90% of uninsured Americans qualify for the savings card.

$750 Million More for Prevention

The Department of Health and Human Services will spend $750 million this year to limit tobacco use, curb chronic disease, increase immunizations, and conduct other disease-prevention activities. The new “investment in prevention” comes on top of $500 million that was disbursed in 2010, according to the HHS. Of the new money, nearly $300 million will go toward reducing tobacco use, improving nutrition and physical activity, and preventing heart disease, cancer, and diabetes. Another $182 million will focus on improving preventive care, including education on new prevention benefits in the health reform law. A total of $137 million will help local public health agencies improve their information technology and train staff, and $133 million will be used, in part, to track the effects of the reform law on the health of Americans, according to the HHS.

Bipartisan support of health information technology is urgently needed so that incentives aimed at encouraging physicians and hospitals to adopt electronic health record systems remain in place, according to a report by the Healthcare Information & Management Systems Society.

“Our member-created Call-for-Action report offers policy makers concrete solutions that will help promote the adoption and use of health IT to contribute to higher-quality, more cost-effective patient care,” David Roberts, HIMSS vice president for government relations, said in a statement.

It is yet to be seen whether the federal stimulus funds for health IT will be affected during the current budget battles at the Congress.

Nevertheless, the report, 2011–2012 Public Policy Principles, encourages continued progress toward implementation of the “meaningful use” criteria, which enable physicians to receive incentives that are tied to Medicare reimbursements if their adoption of electronic health record systems meets the criteria. The provision is part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009.

“We agree with Dr. David Blumenthal,” the national coordinator for Health IT, that “these are historic times. The HITECH Act is bringing the power of electronic health records to our health care system. However, these new initiatives should not create a new form of 'digital divide' and our goal is to make sure that all constituencies benefit from these efforts,” the organization wrote in its annual report.

The report urges policy makers to make the following their top priority:

▸ Supporting the National Quality Forum's National Priorities Partnership, which aims to create a consensus on standard for measuring performance.

▸ Ensuring a consolidated communications tool and comprehensive road map for meaningful use.

▸ Defining each new meaningful use stage at least 18 months before the beginning of the next stage.

▸ Establishing grievance processes for providers seeking to fulfill meaningful use criteria.

▸ Developing an open and transparent EHR certification criteria process.

▸ Supporting the establishment of an informed patient identity solution.

▸ Expanding and making permanent current Stark exemptions and anti-kickback safe harbors for EHR users.

▸ Eliminating the HIPAA Business Associate Agreement requirement.

▸ Providing grants and other incentives to establish so-called Health IT Action Zones that demonstrate effective health IT adoption practices by providers who care for patients in medically underserved populations.

▸ Aligning federal policy to facilitate electronic business processes.

The report also calls for a “structural payment reform,” suggesting the repeal of Sustainable Growth Rate (SGR) physician payment program and bringing up Medicaid reimbursement up to that of Medicare's. Without such changes, the report warns, “all health IT initiatives are at risk as providers may choose instead to withdraw from these federal programs.”

In his proposed budget, President Obama has laid out a plan to pay for the first 2 years of the SGR so that the physician reimbursement rates will not be cut. His plan is to fix SGR in 10 years.

Bipartisan support of health information technology is urgently needed so that incentives aimed at encouraging physicians and hospitals to adopt electronic health record systems remain in place, according to a report by the Healthcare Information & Management Systems Society.

“Our member-created Call-for-Action report offers policy makers concrete solutions that will help promote the adoption and use of health IT to contribute to higher-quality, more cost-effective patient care,” David Roberts, HIMSS vice president for government relations, said in a statement.

It is yet to be seen whether the federal stimulus funds for health IT will be affected during the current budget battles at the Congress.

Nevertheless, the report, 2011–2012 Public Policy Principles, encourages continued progress toward implementation of the “meaningful use” criteria, which enable physicians to receive incentives that are tied to Medicare reimbursements if their adoption of electronic health record systems meets the criteria. The provision is part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009.

“We agree with Dr. David Blumenthal,” the national coordinator for Health IT, that “these are historic times. The HITECH Act is bringing the power of electronic health records to our health care system. However, these new initiatives should not create a new form of 'digital divide' and our goal is to make sure that all constituencies benefit from these efforts,” the organization wrote in its annual report.

The report urges policy makers to make the following their top priority:

▸ Supporting the National Quality Forum's National Priorities Partnership, which aims to create a consensus on standard for measuring performance.

▸ Ensuring a consolidated communications tool and comprehensive road map for meaningful use.

▸ Defining each new meaningful use stage at least 18 months before the beginning of the next stage.

▸ Establishing grievance processes for providers seeking to fulfill meaningful use criteria.

▸ Developing an open and transparent EHR certification criteria process.

▸ Supporting the establishment of an informed patient identity solution.

▸ Expanding and making permanent current Stark exemptions and anti-kickback safe harbors for EHR users.

▸ Eliminating the HIPAA Business Associate Agreement requirement.

▸ Providing grants and other incentives to establish so-called Health IT Action Zones that demonstrate effective health IT adoption practices by providers who care for patients in medically underserved populations.

▸ Aligning federal policy to facilitate electronic business processes.

The report also calls for a “structural payment reform,” suggesting the repeal of Sustainable Growth Rate (SGR) physician payment program and bringing up Medicaid reimbursement up to that of Medicare's. Without such changes, the report warns, “all health IT initiatives are at risk as providers may choose instead to withdraw from these federal programs.”

In his proposed budget, President Obama has laid out a plan to pay for the first 2 years of the SGR so that the physician reimbursement rates will not be cut. His plan is to fix SGR in 10 years.

Bipartisan support of health information technology is urgently needed so that incentives aimed at encouraging physicians and hospitals to adopt electronic health record systems remain in place, according to a report by the Healthcare Information & Management Systems Society.

“Our member-created Call-for-Action report offers policy makers concrete solutions that will help promote the adoption and use of health IT to contribute to higher-quality, more cost-effective patient care,” David Roberts, HIMSS vice president for government relations, said in a statement.

It is yet to be seen whether the federal stimulus funds for health IT will be affected during the current budget battles at the Congress.

Nevertheless, the report, 2011–2012 Public Policy Principles, encourages continued progress toward implementation of the “meaningful use” criteria, which enable physicians to receive incentives that are tied to Medicare reimbursements if their adoption of electronic health record systems meets the criteria. The provision is part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009.

“We agree with Dr. David Blumenthal,” the national coordinator for Health IT, that “these are historic times. The HITECH Act is bringing the power of electronic health records to our health care system. However, these new initiatives should not create a new form of 'digital divide' and our goal is to make sure that all constituencies benefit from these efforts,” the organization wrote in its annual report.

The report urges policy makers to make the following their top priority:

▸ Supporting the National Quality Forum's National Priorities Partnership, which aims to create a consensus on standard for measuring performance.

▸ Ensuring a consolidated communications tool and comprehensive road map for meaningful use.

▸ Defining each new meaningful use stage at least 18 months before the beginning of the next stage.

▸ Establishing grievance processes for providers seeking to fulfill meaningful use criteria.

▸ Developing an open and transparent EHR certification criteria process.

▸ Supporting the establishment of an informed patient identity solution.

▸ Expanding and making permanent current Stark exemptions and anti-kickback safe harbors for EHR users.

▸ Eliminating the HIPAA Business Associate Agreement requirement.

▸ Providing grants and other incentives to establish so-called Health IT Action Zones that demonstrate effective health IT adoption practices by providers who care for patients in medically underserved populations.

▸ Aligning federal policy to facilitate electronic business processes.

The report also calls for a “structural payment reform,” suggesting the repeal of Sustainable Growth Rate (SGR) physician payment program and bringing up Medicaid reimbursement up to that of Medicare's. Without such changes, the report warns, “all health IT initiatives are at risk as providers may choose instead to withdraw from these federal programs.”

In his proposed budget, President Obama has laid out a plan to pay for the first 2 years of the SGR so that the physician reimbursement rates will not be cut. His plan is to fix SGR in 10 years.

Millions of Back Problems

Back pain is one of the most expensive conditions treated in the United States, according to the Agency for Healthcare Research and Quality. In 2008, 7.3 million emergency department visits and 2.3 million hospital stays were related to back problems. The cost of the hospital stays alone was $9.5 billion, making back pain the ninth most expensive condition in that category. People 85 years and older had the highest rates of emergency visits and hospitalizations for back problems as a primary or secondary diagnosis, but individuals 18–44 years old were most likely to visit emergency departments with back pain as their main problem.

The study showed that rural patients had the highest rates of back-related emergency department visits and inpatient stays, while patients from large metropolitan areas had the lowest. “Not only do back problems result in expensive and resource-intensive medical care, but they also result in loss of functioning, reduced quality of life, and reduced productivity in the workforce,” the researchers noted.

Stricter Standards for Stroke Care

The American Heart Association and its American Stroke Association are recommending creation of a specialized class of stroke-care centers in the United States. Called Comprehensive Stroke Centers, they would be held to stricter standards than are current Primary Stroke Centers, which would continue to exist. For instance, the comprehensive centers would be measured by the time from hospitalization to blood vessel repair for patients with ruptured aneurysms. “Initiatives such as primary and now comprehensive stroke center certification will greatly help us reach our 2020 goal” of reducing cardiac and stroke deaths by 20%, Dr. Ralph L. Sacco, president of the AHA, said in a statement. The recommendations were published in Stroke: Journal of the American Heart Association.

Medicaid Hospital Admissions Rise

Medicaid hospital admissions rose 30% between 1997 and 2008, while admissions of privately insured patients grew by 5%, the Agency for Healthcare Research and Quality found in an analysis. By 2008, Medicaid paid for 18% of the nearly 40 million hospital stays by U.S. patients. Maternity-related and newborn care accounted for half of the Medicaid-financed hospitalizations. In that year, the public insurance program spent $51 billion on hospital care, compared with $117 billion paid by private insurers and a cost of $15 billion for the care of uninsured patients.

Medicare Use is Uneven

The amount of Medicare service used by beneficiaries varies substantially across the country. Beneficiaries in high-service-use areas get Medicare-funded care about 30% more than do beneficiaries in low-service areas, according to a report from the Medicare Payment Advisory Commission. This regional variation is particularly high for postacute care, such as home health, MedPAC reported.

However, a region with high utilization for one group of services typically has high utilization overall. For instance, areas that have high service use among Medicare beneficiaries during the year before their deaths tend to have high utilization overall. Medicare drug plans also tend to have a similar pattern of utilization. “In short, the pattern of high use often extends across different services and different groups of beneficiaries,” the report said.

Stealth Grants to Advocacy Groups

Health-advocacy groups are not routinely disclosing their financial ties to pharmaceutical companies, according to a new study. Researchers led by Sheila Rothman, Ph.D., of Columbia University, New York, studied grants made by Eli Lilly to such groups in 2007. The company was the first drugmaker to disclose its payouts. During the first half of the year, Lilly gave $3.2 million to 161 organizations that were generally concerned with diseases that the company's products treat. Only 25% of those organizations acknowledged getting Lilly grants on Web sites, and none disclosed the amount. Two-thirds of the funds went to mental health groups. Only 18% of those advocacy groups identified Lilly as a corporate sponsor.

Millions of Back Problems

Back pain is one of the most expensive conditions treated in the United States, according to the Agency for Healthcare Research and Quality. In 2008, 7.3 million emergency department visits and 2.3 million hospital stays were related to back problems. The cost of the hospital stays alone was $9.5 billion, making back pain the ninth most expensive condition in that category. People 85 years and older had the highest rates of emergency visits and hospitalizations for back problems as a primary or secondary diagnosis, but individuals 18–44 years old were most likely to visit emergency departments with back pain as their main problem.

The study showed that rural patients had the highest rates of back-related emergency department visits and inpatient stays, while patients from large metropolitan areas had the lowest. “Not only do back problems result in expensive and resource-intensive medical care, but they also result in loss of functioning, reduced quality of life, and reduced productivity in the workforce,” the researchers noted.

Stricter Standards for Stroke Care

The American Heart Association and its American Stroke Association are recommending creation of a specialized class of stroke-care centers in the United States. Called Comprehensive Stroke Centers, they would be held to stricter standards than are current Primary Stroke Centers, which would continue to exist. For instance, the comprehensive centers would be measured by the time from hospitalization to blood vessel repair for patients with ruptured aneurysms. “Initiatives such as primary and now comprehensive stroke center certification will greatly help us reach our 2020 goal” of reducing cardiac and stroke deaths by 20%, Dr. Ralph L. Sacco, president of the AHA, said in a statement. The recommendations were published in Stroke: Journal of the American Heart Association.

Medicaid Hospital Admissions Rise

Medicaid hospital admissions rose 30% between 1997 and 2008, while admissions of privately insured patients grew by 5%, the Agency for Healthcare Research and Quality found in an analysis. By 2008, Medicaid paid for 18% of the nearly 40 million hospital stays by U.S. patients. Maternity-related and newborn care accounted for half of the Medicaid-financed hospitalizations. In that year, the public insurance program spent $51 billion on hospital care, compared with $117 billion paid by private insurers and a cost of $15 billion for the care of uninsured patients.

Medicare Use is Uneven

The amount of Medicare service used by beneficiaries varies substantially across the country. Beneficiaries in high-service-use areas get Medicare-funded care about 30% more than do beneficiaries in low-service areas, according to a report from the Medicare Payment Advisory Commission. This regional variation is particularly high for postacute care, such as home health, MedPAC reported.

However, a region with high utilization for one group of services typically has high utilization overall. For instance, areas that have high service use among Medicare beneficiaries during the year before their deaths tend to have high utilization overall. Medicare drug plans also tend to have a similar pattern of utilization. “In short, the pattern of high use often extends across different services and different groups of beneficiaries,” the report said.

Stealth Grants to Advocacy Groups

Health-advocacy groups are not routinely disclosing their financial ties to pharmaceutical companies, according to a new study. Researchers led by Sheila Rothman, Ph.D., of Columbia University, New York, studied grants made by Eli Lilly to such groups in 2007. The company was the first drugmaker to disclose its payouts. During the first half of the year, Lilly gave $3.2 million to 161 organizations that were generally concerned with diseases that the company's products treat. Only 25% of those organizations acknowledged getting Lilly grants on Web sites, and none disclosed the amount. Two-thirds of the funds went to mental health groups. Only 18% of those advocacy groups identified Lilly as a corporate sponsor.

Millions of Back Problems

Back pain is one of the most expensive conditions treated in the United States, according to the Agency for Healthcare Research and Quality. In 2008, 7.3 million emergency department visits and 2.3 million hospital stays were related to back problems. The cost of the hospital stays alone was $9.5 billion, making back pain the ninth most expensive condition in that category. People 85 years and older had the highest rates of emergency visits and hospitalizations for back problems as a primary or secondary diagnosis, but individuals 18–44 years old were most likely to visit emergency departments with back pain as their main problem.

The study showed that rural patients had the highest rates of back-related emergency department visits and inpatient stays, while patients from large metropolitan areas had the lowest. “Not only do back problems result in expensive and resource-intensive medical care, but they also result in loss of functioning, reduced quality of life, and reduced productivity in the workforce,” the researchers noted.

Stricter Standards for Stroke Care

The American Heart Association and its American Stroke Association are recommending creation of a specialized class of stroke-care centers in the United States. Called Comprehensive Stroke Centers, they would be held to stricter standards than are current Primary Stroke Centers, which would continue to exist. For instance, the comprehensive centers would be measured by the time from hospitalization to blood vessel repair for patients with ruptured aneurysms. “Initiatives such as primary and now comprehensive stroke center certification will greatly help us reach our 2020 goal” of reducing cardiac and stroke deaths by 20%, Dr. Ralph L. Sacco, president of the AHA, said in a statement. The recommendations were published in Stroke: Journal of the American Heart Association.

Medicaid Hospital Admissions Rise

Medicaid hospital admissions rose 30% between 1997 and 2008, while admissions of privately insured patients grew by 5%, the Agency for Healthcare Research and Quality found in an analysis. By 2008, Medicaid paid for 18% of the nearly 40 million hospital stays by U.S. patients. Maternity-related and newborn care accounted for half of the Medicaid-financed hospitalizations. In that year, the public insurance program spent $51 billion on hospital care, compared with $117 billion paid by private insurers and a cost of $15 billion for the care of uninsured patients.

Medicare Use is Uneven

The amount of Medicare service used by beneficiaries varies substantially across the country. Beneficiaries in high-service-use areas get Medicare-funded care about 30% more than do beneficiaries in low-service areas, according to a report from the Medicare Payment Advisory Commission. This regional variation is particularly high for postacute care, such as home health, MedPAC reported.

However, a region with high utilization for one group of services typically has high utilization overall. For instance, areas that have high service use among Medicare beneficiaries during the year before their deaths tend to have high utilization overall. Medicare drug plans also tend to have a similar pattern of utilization. “In short, the pattern of high use often extends across different services and different groups of beneficiaries,” the report said.

Stealth Grants to Advocacy Groups

Health-advocacy groups are not routinely disclosing their financial ties to pharmaceutical companies, according to a new study. Researchers led by Sheila Rothman, Ph.D., of Columbia University, New York, studied grants made by Eli Lilly to such groups in 2007. The company was the first drugmaker to disclose its payouts. During the first half of the year, Lilly gave $3.2 million to 161 organizations that were generally concerned with diseases that the company's products treat. Only 25% of those organizations acknowledged getting Lilly grants on Web sites, and none disclosed the amount. Two-thirds of the funds went to mental health groups. Only 18% of those advocacy groups identified Lilly as a corporate sponsor.

Bipartisan support of health information technology is urgently needed so that incentives aimed at encouraging physicians and hospitals to adopt electronic health records systems remain in place, according to a report by the Healthcare Information & Management Systems Society.

It is yet to be seen whether the federal stimulus funds for health IT will be affected during the current congressional budget battles.

Nevertheless, the report, 2011-2012 Public Policy Principles, encourages continued progress toward implementation of the “meaningful use” criteria, which enable physicians to receive incentives tied to Medicare reimbursements if their adoption of EHR systems meets the criteria. The provision is part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009.

“The HITECH Act is bringing the power of electronic health records to our health care system. However, these new initiatives should not create a new form of 'digital divide' and our goal is to make sure that all constituencies benefit from these efforts,” the organization wrote in its annual report. The report urges policy makers to make the following their top priority:

▸ Supporting the National Quality Forum's National Priorities Partnership, which aims to create a consensus on standard for measuring performance in health care.

▸ Ensuring a consolidated communications tool and comprehensive road map for meaningful use.

▸ Defining each new meaningful use stage at least 18 months before the beginning of the next stage.

▸ Developing an open and transparent EHR certification criteria process.

▸ Expanding and making permanent the current Stark exemptions and anti-kickback safe harbors for EHR users.

▸ Eliminating the HIPAA Business Associate Agreement requirement.

▸ Providing incentives to establish Health IT Action Zones that demonstrate effective health IT adoption practices by providers who care for patients in medically underserved populations.

▸ Aligning federal policy to facilitate electronic business processes.

In his proposed budget, President Obama has laid out a plan to pay for the first 2 years of the SGR so that the physician reimbursement rates won't be cut. His plan is to fix SGR in 10 years.

Bipartisan support of health information technology is urgently needed so that incentives aimed at encouraging physicians and hospitals to adopt electronic health records systems remain in place, according to a report by the Healthcare Information & Management Systems Society.

It is yet to be seen whether the federal stimulus funds for health IT will be affected during the current congressional budget battles.

Nevertheless, the report, 2011-2012 Public Policy Principles, encourages continued progress toward implementation of the “meaningful use” criteria, which enable physicians to receive incentives tied to Medicare reimbursements if their adoption of EHR systems meets the criteria. The provision is part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009.

“The HITECH Act is bringing the power of electronic health records to our health care system. However, these new initiatives should not create a new form of 'digital divide' and our goal is to make sure that all constituencies benefit from these efforts,” the organization wrote in its annual report. The report urges policy makers to make the following their top priority:

▸ Supporting the National Quality Forum's National Priorities Partnership, which aims to create a consensus on standard for measuring performance in health care.

▸ Ensuring a consolidated communications tool and comprehensive road map for meaningful use.

▸ Defining each new meaningful use stage at least 18 months before the beginning of the next stage.

▸ Developing an open and transparent EHR certification criteria process.

▸ Expanding and making permanent the current Stark exemptions and anti-kickback safe harbors for EHR users.

▸ Eliminating the HIPAA Business Associate Agreement requirement.

▸ Providing incentives to establish Health IT Action Zones that demonstrate effective health IT adoption practices by providers who care for patients in medically underserved populations.

▸ Aligning federal policy to facilitate electronic business processes.

In his proposed budget, President Obama has laid out a plan to pay for the first 2 years of the SGR so that the physician reimbursement rates won't be cut. His plan is to fix SGR in 10 years.

Bipartisan support of health information technology is urgently needed so that incentives aimed at encouraging physicians and hospitals to adopt electronic health records systems remain in place, according to a report by the Healthcare Information & Management Systems Society.

It is yet to be seen whether the federal stimulus funds for health IT will be affected during the current congressional budget battles.

Nevertheless, the report, 2011-2012 Public Policy Principles, encourages continued progress toward implementation of the “meaningful use” criteria, which enable physicians to receive incentives tied to Medicare reimbursements if their adoption of EHR systems meets the criteria. The provision is part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009.

“The HITECH Act is bringing the power of electronic health records to our health care system. However, these new initiatives should not create a new form of 'digital divide' and our goal is to make sure that all constituencies benefit from these efforts,” the organization wrote in its annual report. The report urges policy makers to make the following their top priority:

▸ Supporting the National Quality Forum's National Priorities Partnership, which aims to create a consensus on standard for measuring performance in health care.

▸ Ensuring a consolidated communications tool and comprehensive road map for meaningful use.

▸ Defining each new meaningful use stage at least 18 months before the beginning of the next stage.

▸ Developing an open and transparent EHR certification criteria process.

▸ Expanding and making permanent the current Stark exemptions and anti-kickback safe harbors for EHR users.

▸ Eliminating the HIPAA Business Associate Agreement requirement.

▸ Providing incentives to establish Health IT Action Zones that demonstrate effective health IT adoption practices by providers who care for patients in medically underserved populations.

▸ Aligning federal policy to facilitate electronic business processes.

In his proposed budget, President Obama has laid out a plan to pay for the first 2 years of the SGR so that the physician reimbursement rates won't be cut. His plan is to fix SGR in 10 years.

Demand for temporary physicians, known as “locum tenens” positions, is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. “Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find,” according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. “This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles,” according to the survey.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

▸ In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest “that the downturn in physician utilization caused by the recession may be reversing,” according to the survey.

▸ Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

▸ Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was “worth the cost,” compared with 79% in 2009.

▸ Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

▸ Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

▸ Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

▸ The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

▸ In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

▸ Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

Demand for temporary physicians, known as “locum tenens” positions, is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. “Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find,” according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. “This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles,” according to the survey.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

▸ In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest “that the downturn in physician utilization caused by the recession may be reversing,” according to the survey.

▸ Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

▸ Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was “worth the cost,” compared with 79% in 2009.

▸ Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

▸ Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

▸ Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

▸ The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

▸ In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

▸ Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

Demand for temporary physicians, known as “locum tenens” positions, is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. “Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find,” according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. “This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles,” according to the survey.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

▸ In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest “that the downturn in physician utilization caused by the recession may be reversing,” according to the survey.

▸ Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

▸ Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was “worth the cost,” compared with 79% in 2009.

▸ Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

▸ Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

▸ Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

▸ The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

▸ In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

▸ Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

The demand for temporary physicians working in "locum tenens" positions is rising, according to a survey of temporary physicians and the hospitals and health groups that use them.

The findings suggest a shift in the reasons for hiring staff on a temporary basis. "Historically, locum tenens doctors have been used to hold a place for ill, vacationing, or otherwise absent doctors pending their return. Today, national doctor shortages have prompted hospitals, medical groups, and others to use temporary doctors to maintain services in lieu of permanent doctors, who may be difficult to find," according to the survey, which was conducted by Staff Care Inc., a company that matches temporary health care providers with medical institutions.

The number of facilities using locum tenens physicians rose from 72% in 2009 to 85% in 2010. Meanwhile, a slightly higher percentage of locum tenens physicians (33%) reported having less than 1 year of experience in 2010, compared with those in 2009 (30%), suggesting that locum tenens is attracting new physicians, according to the survey.

Demand was higher for physicians in certain specialties, especially in behavioral health, which topped the list for the type of temporary physicians requested most by health care groups, at 22%. Primary care physicians were the next most requested (20%), and temporary physicians were used to fill internal medicine slots in 12% of the cases.

The company surveyed 626 locum tenens physicians and 105 groups that use temporary physicians, via e-mail in 2010.

Staff Care estimates that 30,000-40,000 physicians worked on a locum tenens basis in 2010. "This number could grow significantly in the next several years as health reform and other challenges push physicians to seek alternative practice styles," according to the survey.

Dr. Robert T. London, who has been practicing psychiatry for 35 years, said that he regularly receives calls from staffing agencies for locum tenens opportunities. "It pays very [well]. They provide you with room and board and sometimes a car. ... Some people seem to like it," he said in an interview.

Dr. London, who practices in New York City and is not a locum tenens physician, said that being a temporary physician is sometimes a good opportunity for older physicians who no longer want to work full time.

Among surveyed locum tenens physicians, the top reasons for working on a temporary basis were the ability to have freedom and flexibility and not to have to deal with medical politics. Being away from home and the uncertainty of the assignments were the top two drawbacks.

Groups that hired temporary physicians listed continuity of care and prevention of revenue loss as the top two benefits of bringing in locum tenens providers. Cost and lack of familiarity with the department or practice were the top two drawbacks.

Among the other survey findings were the following:

• In all, 41% of facilities were seeking locum tenens physicians in 2010, up from 40% in 2009. The slight uptick may suggest "that the downturn in physician utilization caused by the recession may be reversing," according to the survey.

• Locum tenens physicians are mostly accepted by patients, colleagues, and administrators.

• Of groups that hired locum tenens physicians, 84% said that bringing them to their facility was "worth the cost," compared with 79% in 2009.

• Some 55% of health care groups reported using one to three locum tenens physicians in a typical month; 37% reported using none, 7% reported using four to six, and 1% reported using seven or more.

• Of surveyed physicians, 80% said they find working on a locum tenens basis to be as satisfying as or more satisfying than conventional practice.

• Overall, 60% of the physicians said they plan to practice on a locum tenens basis for more than 3 years.

• The largest percentage of locum tenens physicians (28%) reported primary care as their specialty.

• In all, 68% of physicians reported having 21 or more years of experience; 16% had 11-20 years; 7% had 6-10 years; 7% had 1-5 years, and 2% had less than 1 year.

• Some 63% of physicians surveyed reported taking on one to three locum tenens assignments per year; 19% reported taking on four to six assignments annually, and 18% took on seven or more.

WASHINGTON – Child obesity and overweight are exacerbating the crisis in untreated child mental illness, according to an expert panel of physicians and health leaders.

Nearly 17% of U.S. children and adolescents aged 2-19 years are obese, according to the Centers for Disease Control and Prevention. Meanwhile, an estimated 20% are affected by some type of mental disorder during the lifetime, according to a recent survey by the National Institute of Mental Health. Yet, only about half of young people with a mental health disorder were treated for that disorder in the past year, according to data from the National Health and Nutrition Examination Survey.

"In addition to the increased medical problems associated with being overweight, these children and adolescents suffer from a higher prevalence of psychological problems resulting in poor academic performance, low self-esteem, depressive disorders, and a greater number of suicide attempts," according to officials at Arizona State University, Phoenix, who organized the panel.

"We should not forget that obesity and mental health affects every single segment of our society," said former Surgeon General Richard H. Carmona during the event, titled "America’s Children at Peril: Solving the Child Obesity and Mental Health Epidemics."

"What is lacking in the national agenda is dealing with the mental health and the overweight issue," said Bernadette Mazurek Melnyk, Ph.D., dean and distinguished foundation professor in nursing at ASU.

There are other barriers, including primary care physician shortage, lack of incentives, poor reimbursement, and lack of training, according to the panelists.

Many primary care physicians haven’t been trained in treating children’s mental illness and hence avoid tackling it, said Dr. Peter S. Jensen, president of the REACH Institute and cochair of division of child psychiatry and psychology at the Mayo Clinic, Rochester, Minn. "It’s the fear of the unknown."

Dr. Mazurek Melnyk noted that primary care physicians sometimes avoid diagnosing mental illness, "because if I screen and I find something, I have no one else to refer them to, and I can’t treat them," she said, relating a sentiment she said she often hears at workshops on integrating mental health care into primary care.

She noted that high-profile events like the Tucson, Ariz., shooting that injured Rep. Gabrielle Giffords (D-Ariz.), killed 6 people, and wounded 13 others, remind the nation "that we have a problem. But, [the problem is] highlighted for a week or 2 by the media and then it goes away. It’s always around these events that [the issue] gets attention, but it doesn’t lead to change. [Untreated mental illness] needs high-profile visibility."

Dr. Kyu Rhee, chief public health officer at the Health Resources and Services Administration, said that several factors are needed to help integrate mental health care into primary care:

• research to see what works.

• education on how the health-care workforce is trained and on taking a team-based approach.

• policies on integration from the federal level down to the individual practice level.

Both "mental health and [body mass index] need to be considered as vital signs," Dr. Rhee said. "You need to screen for them, and you need to have a team-based approach. Think about the spectrum of people working with you, from nurses to the front-desk staff, so even though patients have 15 minutes with you, they usually have an hour, an hour and half in the office."

Having a transdisciplinary team is another way to eliminate the lag time between diagnosis of a mental health issue and proper treatment, said Dr. Mazurek Melnyk. "It creates a seamless system."

Dr. Rhee urged physicians to be a part of the solution to the crisis of untreated mental illness. "Approach it as one patient or one community at a time. Build transectoral partnerships with schools and businesses. Think broader than just the exam room. Think more about the prevention paradigm," he urged.

WASHINGTON – Child obesity and overweight are exacerbating the crisis in untreated child mental illness, according to an expert panel of physicians and health leaders.

Nearly 17% of U.S. children and adolescents aged 2-19 years are obese, according to the Centers for Disease Control and Prevention. Meanwhile, an estimated 20% are affected by some type of mental disorder during the lifetime, according to a recent survey by the National Institute of Mental Health. Yet, only about half of young people with a mental health disorder were treated for that disorder in the past year, according to data from the National Health and Nutrition Examination Survey.

"In addition to the increased medical problems associated with being overweight, these children and adolescents suffer from a higher prevalence of psychological problems resulting in poor academic performance, low self-esteem, depressive disorders, and a greater number of suicide attempts," according to officials at Arizona State University, Phoenix, who organized the panel.

"We should not forget that obesity and mental health affects every single segment of our society," said former Surgeon General Richard H. Carmona during the event, titled "America’s Children at Peril: Solving the Child Obesity and Mental Health Epidemics."

"What is lacking in the national agenda is dealing with the mental health and the overweight issue," said Bernadette Mazurek Melnyk, Ph.D., dean and distinguished foundation professor in nursing at ASU.

There are other barriers, including primary care physician shortage, lack of incentives, poor reimbursement, and lack of training, according to the panelists.

Many primary care physicians haven’t been trained in treating children’s mental illness and hence avoid tackling it, said Dr. Peter S. Jensen, president of the REACH Institute and cochair of division of child psychiatry and psychology at the Mayo Clinic, Rochester, Minn. "It’s the fear of the unknown."

Dr. Mazurek Melnyk noted that primary care physicians sometimes avoid diagnosing mental illness, "because if I screen and I find something, I have no one else to refer them to, and I can’t treat them," she said, relating a sentiment she said she often hears at workshops on integrating mental health care into primary care.

She noted that high-profile events like the Tucson, Ariz., shooting that injured Rep. Gabrielle Giffords (D-Ariz.), killed 6 people, and wounded 13 others, remind the nation "that we have a problem. But, [the problem is] highlighted for a week or 2 by the media and then it goes away. It’s always around these events that [the issue] gets attention, but it doesn’t lead to change. [Untreated mental illness] needs high-profile visibility."

Dr. Kyu Rhee, chief public health officer at the Health Resources and Services Administration, said that several factors are needed to help integrate mental health care into primary care:

• research to see what works.

• education on how the health-care workforce is trained and on taking a team-based approach.

• policies on integration from the federal level down to the individual practice level.

Both "mental health and [body mass index] need to be considered as vital signs," Dr. Rhee said. "You need to screen for them, and you need to have a team-based approach. Think about the spectrum of people working with you, from nurses to the front-desk staff, so even though patients have 15 minutes with you, they usually have an hour, an hour and half in the office."

Having a transdisciplinary team is another way to eliminate the lag time between diagnosis of a mental health issue and proper treatment, said Dr. Mazurek Melnyk. "It creates a seamless system."

Dr. Rhee urged physicians to be a part of the solution to the crisis of untreated mental illness. "Approach it as one patient or one community at a time. Build transectoral partnerships with schools and businesses. Think broader than just the exam room. Think more about the prevention paradigm," he urged.

WASHINGTON – Child obesity and overweight are exacerbating the crisis in untreated child mental illness, according to an expert panel of physicians and health leaders.

Nearly 17% of U.S. children and adolescents aged 2-19 years are obese, according to the Centers for Disease Control and Prevention. Meanwhile, an estimated 20% are affected by some type of mental disorder during the lifetime, according to a recent survey by the National Institute of Mental Health. Yet, only about half of young people with a mental health disorder were treated for that disorder in the past year, according to data from the National Health and Nutrition Examination Survey.

"In addition to the increased medical problems associated with being overweight, these children and adolescents suffer from a higher prevalence of psychological problems resulting in poor academic performance, low self-esteem, depressive disorders, and a greater number of suicide attempts," according to officials at Arizona State University, Phoenix, who organized the panel.

"We should not forget that obesity and mental health affects every single segment of our society," said former Surgeon General Richard H. Carmona during the event, titled "America’s Children at Peril: Solving the Child Obesity and Mental Health Epidemics."

"What is lacking in the national agenda is dealing with the mental health and the overweight issue," said Bernadette Mazurek Melnyk, Ph.D., dean and distinguished foundation professor in nursing at ASU.

There are other barriers, including primary care physician shortage, lack of incentives, poor reimbursement, and lack of training, according to the panelists.

Many primary care physicians haven’t been trained in treating children’s mental illness and hence avoid tackling it, said Dr. Peter S. Jensen, president of the REACH Institute and cochair of division of child psychiatry and psychology at the Mayo Clinic, Rochester, Minn. "It’s the fear of the unknown."

Dr. Mazurek Melnyk noted that primary care physicians sometimes avoid diagnosing mental illness, "because if I screen and I find something, I have no one else to refer them to, and I can’t treat them," she said, relating a sentiment she said she often hears at workshops on integrating mental health care into primary care.

She noted that high-profile events like the Tucson, Ariz., shooting that injured Rep. Gabrielle Giffords (D-Ariz.), killed 6 people, and wounded 13 others, remind the nation "that we have a problem. But, [the problem is] highlighted for a week or 2 by the media and then it goes away. It’s always around these events that [the issue] gets attention, but it doesn’t lead to change. [Untreated mental illness] needs high-profile visibility."

Dr. Kyu Rhee, chief public health officer at the Health Resources and Services Administration, said that several factors are needed to help integrate mental health care into primary care:

• research to see what works.

• education on how the health-care workforce is trained and on taking a team-based approach.

• policies on integration from the federal level down to the individual practice level.

Both "mental health and [body mass index] need to be considered as vital signs," Dr. Rhee said. "You need to screen for them, and you need to have a team-based approach. Think about the spectrum of people working with you, from nurses to the front-desk staff, so even though patients have 15 minutes with you, they usually have an hour, an hour and half in the office."

Having a transdisciplinary team is another way to eliminate the lag time between diagnosis of a mental health issue and proper treatment, said Dr. Mazurek Melnyk. "It creates a seamless system."

Dr. Rhee urged physicians to be a part of the solution to the crisis of untreated mental illness. "Approach it as one patient or one community at a time. Build transectoral partnerships with schools and businesses. Think broader than just the exam room. Think more about the prevention paradigm," he urged.

WASHINGTON – Child obesity and overweight are exacerbating the crisis in untreated child mental illness, according to an expert panel of physicians and health leaders.

Nearly 17% of U.S. children and adolescents aged 2-19 years are obese, according to the Centers for Disease Control and Prevention. Meanwhile, an estimated 20% are affected by some type of mental disorder during the lifetime, according to a recent survey by the National Institute of Mental Health. Yet, only about half of young people with a mental health disorder were treated for that disorder in the past year, according to data from the National Health and Nutrition Examination Survey.

"In addition to the increased medical problems associated with being overweight, these children and adolescents suffer from a higher prevalence of psychological problems resulting in poor academic performance, low self-esteem, depressive disorders, and a greater number of suicide attempts," according to officials at Arizona State University, Phoenix, who organized the panel.

"We should not forget that obesity and mental health affects every single segment of our society," said former Surgeon General Richard H. Carmona during the event, titled "America’s Children at Peril: Solving the Child Obesity and Mental Health Epidemics."

"What is lacking in the national agenda is dealing with the mental health and the overweight issue," said Bernadette Mazurek Melnyk, Ph.D., dean and distinguished foundation professor in nursing at ASU.

There are other barriers, including primary care physician shortage, lack of incentives, poor reimbursement, and lack of training, according to the panelists.

Many primary care physicians haven’t been trained in treating children’s mental illness and hence avoid tackling it, said Dr. Peter S. Jensen, president of the REACH Institute and cochair of division of child psychiatry and psychology at the Mayo Clinic, Rochester, Minn. "It’s the fear of the unknown."

Dr. Mazurek Melnyk noted that primary care physicians sometimes avoid diagnosing mental illness, "because if I screen and I find something, I have no one else to refer them to, and I can’t treat them," she said, relating a sentiment she said she often hears at workshops on integrating mental health care into primary care.

She noted that high-profile events like the Tucson, Ariz., shooting that injured Rep. Gabrielle Giffords (D-Ariz.), killed 6 people, and wounded 13 others, remind the nation "that we have a problem. But, [the problem is] highlighted for a week or 2 by the media and then it goes away. It’s always around these events that [the issue] gets attention, but it doesn’t lead to change. [Untreated mental illness] needs high-profile visibility."

Dr. Kyu Rhee, chief public health officer at the Health Resources and Services Administration, said that several factors are needed to help integrate mental health care into primary care:

• research to see what works.

• education on how the health-care workforce is trained and on taking a team-based approach.

• policies on integration from the federal level down to the individual practice level.

Both "mental health and [body mass index] need to be considered as vital signs," Dr. Rhee said. "You need to screen for them, and you need to have a team-based approach. Think about the spectrum of people working with you, from nurses to the front-desk staff, so even though patients have 15 minutes with you, they usually have an hour, an hour and half in the office."

Having a transdisciplinary team is another way to eliminate the lag time between diagnosis of a mental health issue and proper treatment, said Dr. Mazurek Melnyk. "It creates a seamless system."

Dr. Rhee urged physicians to be a part of the solution to the crisis of untreated mental illness. "Approach it as one patient or one community at a time. Build transectoral partnerships with schools and businesses. Think broader than just the exam room. Think more about the prevention paradigm," he urged.

WASHINGTON – Child obesity and overweight are exacerbating the crisis in untreated child mental illness, according to an expert panel of physicians and health leaders.

Nearly 17% of U.S. children and adolescents aged 2-19 years are obese, according to the Centers for Disease Control and Prevention. Meanwhile, an estimated 20% are affected by some type of mental disorder during the lifetime, according to a recent survey by the National Institute of Mental Health. Yet, only about half of young people with a mental health disorder were treated for that disorder in the past year, according to data from the National Health and Nutrition Examination Survey.

"In addition to the increased medical problems associated with being overweight, these children and adolescents suffer from a higher prevalence of psychological problems resulting in poor academic performance, low self-esteem, depressive disorders, and a greater number of suicide attempts," according to officials at Arizona State University, Phoenix, who organized the panel.

"We should not forget that obesity and mental health affects every single segment of our society," said former Surgeon General Richard H. Carmona during the event, titled "America’s Children at Peril: Solving the Child Obesity and Mental Health Epidemics."

"What is lacking in the national agenda is dealing with the mental health and the overweight issue," said Bernadette Mazurek Melnyk, Ph.D., dean and distinguished foundation professor in nursing at ASU.

There are other barriers, including primary care physician shortage, lack of incentives, poor reimbursement, and lack of training, according to the panelists.

Many primary care physicians haven’t been trained in treating children’s mental illness and hence avoid tackling it, said Dr. Peter S. Jensen, president of the REACH Institute and cochair of division of child psychiatry and psychology at the Mayo Clinic, Rochester, Minn. "It’s the fear of the unknown."

Dr. Mazurek Melnyk noted that primary care physicians sometimes avoid diagnosing mental illness, "because if I screen and I find something, I have no one else to refer them to, and I can’t treat them," she said, relating a sentiment she said she often hears at workshops on integrating mental health care into primary care.

She noted that high-profile events like the Tucson, Ariz., shooting that injured Rep. Gabrielle Giffords (D-Ariz.), killed 6 people, and wounded 13 others, remind the nation "that we have a problem. But, [the problem is] highlighted for a week or 2 by the media and then it goes away. It’s always around these events that [the issue] gets attention, but it doesn’t lead to change. [Untreated mental illness] needs high-profile visibility."

Dr. Kyu Rhee, chief public health officer at the Health Resources and Services Administration, said that several factors are needed to help integrate mental health care into primary care:

• research to see what works.

• education on how the health-care workforce is trained and on taking a team-based approach.

• policies on integration from the federal level down to the individual practice level.

Both "mental health and [body mass index] need to be considered as vital signs," Dr. Rhee said. "You need to screen for them, and you need to have a team-based approach. Think about the spectrum of people working with you, from nurses to the front-desk staff, so even though patients have 15 minutes with you, they usually have an hour, an hour and half in the office."

Having a transdisciplinary team is another way to eliminate the lag time between diagnosis of a mental health issue and proper treatment, said Dr. Mazurek Melnyk. "It creates a seamless system."

Dr. Rhee urged physicians to be a part of the solution to the crisis of untreated mental illness. "Approach it as one patient or one community at a time. Build transectoral partnerships with schools and businesses. Think broader than just the exam room. Think more about the prevention paradigm," he urged.

WASHINGTON – Child obesity and overweight are exacerbating the crisis in untreated child mental illness, according to an expert panel of physicians and health leaders.

Nearly 17% of U.S. children and adolescents aged 2-19 years are obese, according to the Centers for Disease Control and Prevention. Meanwhile, an estimated 20% are affected by some type of mental disorder during the lifetime, according to a recent survey by the National Institute of Mental Health. Yet, only about half of young people with a mental health disorder were treated for that disorder in the past year, according to data from the National Health and Nutrition Examination Survey.

"In addition to the increased medical problems associated with being overweight, these children and adolescents suffer from a higher prevalence of psychological problems resulting in poor academic performance, low self-esteem, depressive disorders, and a greater number of suicide attempts," according to officials at Arizona State University, Phoenix, who organized the panel.

"We should not forget that obesity and mental health affects every single segment of our society," said former Surgeon General Richard H. Carmona during the event, titled "America’s Children at Peril: Solving the Child Obesity and Mental Health Epidemics."

"What is lacking in the national agenda is dealing with the mental health and the overweight issue," said Bernadette Mazurek Melnyk, Ph.D., dean and distinguished foundation professor in nursing at ASU.

There are other barriers, including primary care physician shortage, lack of incentives, poor reimbursement, and lack of training, according to the panelists.

Many primary care physicians haven’t been trained in treating children’s mental illness and hence avoid tackling it, said Dr. Peter S. Jensen, president of the REACH Institute and cochair of division of child psychiatry and psychology at the Mayo Clinic, Rochester, Minn. "It’s the fear of the unknown."

Dr. Mazurek Melnyk noted that primary care physicians sometimes avoid diagnosing mental illness, "because if I screen and I find something, I have no one else to refer them to, and I can’t treat them," she said, relating a sentiment she said she often hears at workshops on integrating mental health care into primary care.

She noted that high-profile events like the Tucson, Ariz., shooting that injured Rep. Gabrielle Giffords (D-Ariz.), killed 6 people, and wounded 13 others, remind the nation "that we have a problem. But, [the problem is] highlighted for a week or 2 by the media and then it goes away. It’s always around these events that [the issue] gets attention, but it doesn’t lead to change. [Untreated mental illness] needs high-profile visibility."

Dr. Kyu Rhee, chief public health officer at the Health Resources and Services Administration, said that several factors are needed to help integrate mental health care into primary care:

• research to see what works.

• education on how the health-care workforce is trained and on taking a team-based approach.

• policies on integration from the federal level down to the individual practice level.

Both "mental health and [body mass index] need to be considered as vital signs," Dr. Rhee said. "You need to screen for them, and you need to have a team-based approach. Think about the spectrum of people working with you, from nurses to the front-desk staff, so even though patients have 15 minutes with you, they usually have an hour, an hour and half in the office."

Having a transdisciplinary team is another way to eliminate the lag time between diagnosis of a mental health issue and proper treatment, said Dr. Mazurek Melnyk. "It creates a seamless system."

Dr. Rhee urged physicians to be a part of the solution to the crisis of untreated mental illness. "Approach it as one patient or one community at a time. Build transectoral partnerships with schools and businesses. Think broader than just the exam room. Think more about the prevention paradigm," he urged.