Experts: Greater effort needed for successful pay-for-performance | CDC: Childhood vaccination rates remain high in U.S. | Read the AAFP's list of 2014 recommended childhood, adolescent and catch-up immunization schedules.
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October 17, 2014
Family Medicine SmartBrief

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Experts: Greater effort needed for successful pay-for-performance
More aggressive efforts, including greater use of incentives, are needed to make pay-for-performance initiatives succeed, health policy experts said at an Alliance for Health Reform briefing. Pay-for-performance plans still face challenges in reimbursing physicians for services that are not directly linked to a CPT billing code, they said. AAFP News (10/16)
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Clinical News
CDC: Childhood vaccination rates remain high in U.S.
Immunization coverage among kindergartners was above 93% for recommended doses of whooping cough, chickenpox, and measles, mumps and rubella vaccines during the 2013-2014 school year, CDC researchers found. Nearly 2% of children were left unvaccinated because their parents refused to give them shots. The findings appear in the agency's Morbidity and Mortality Weekly Report. HealthDay News (10/16)
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No link found between diabetes, HCV in U.S. population study
Research in the journal Hepatology found no correlation between the prevalence of diabetes and hepatitis C in the U.S. "Elevated liver enzyme activities were associated with both diabetes and with [insulin resistance]. We suggest that previous reports of relationships of HCV with diabetes may, in large measure, have been the result of this effect of elevated liver enzymes," researchers noted. Healio (free registration)/HCV Next (10/16)
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IBD patients at higher risk after heart attack, study says
Inflammatory bowel disease patients who have a first heart attack are at increased risk of short-term mortality and adverse cardiovascular events, according to a study in Circulation: Cardiovascular Quality and Outcomes. The study found patients were at particularly high risk during times of IBD flare-ups. Healio (free registration)/Gastroenterology (10/14)
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Study links depression, obesity in adults
Study data showed that 43% of adults with depression also were obese, and 55% of patients taking antidepressants were obese. Researchers from the National Center for Health Statistics said the data did not suggest a reason for the association, but Tony Tang of the University of Pennsylvania said obesity may be linked to self-esteem, social and health problems that could lead to depression. HealthDay News (10/16)
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Study: Many pediatric fracture splints not applied correctly
Study data showed that up to 93% of splints put on pediatric fractures at urgent care centers or pediatric emergency departments were misapplied. University of Maryland researchers said at the American Academy of Pediatrics annual meeting that incorrectly applied splints can lead to complications and poor healing. Medscape (free registration) (10/12)
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Research evaluates tonsil measurement tools, tonsillectomy complications
Using the Brodsky scale to determine children's tonsil size may provide more consistent results, compared with other measurements, according to a study in JAMA Otolaryngology-Head and Neck Surgery. A second study in the same journal found that the risk of complications from tonsillectomy was higher for black and Hispanic children and those from poor families. Medscape (free registration)/Reuters (10/16), HealthDay News (10/17)
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Practice Management
Primary care practice sees success with walk-in hours
Primary Care Medical Associates in Chicago created a morning walk-in program for established patients as a way to make the practice more competitive. The practice helped boost patient volume by sending mailers to current patients advising them of walk-in times, and it is considering expanding the program's hours. Medscape (free registration) (10/16)
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Researchers say older antibiotic is effective for Staph
University of Nebraska researchers are advising physicians that vancomycin, an older antibiotic, still works against Staphylococcus aureus bloodstream infections. The report in the Journal of the American Medical Association said physicians do not necessarily have to choose a newer antibiotic to treat these infections. HealthDay News (10/17)
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Health Policy & Legislation
Report: U.S. may need special centers for Ebola care
The U.S. may need a regional system of specialized centers for treating Ebola patients staffed by clinicians trained to deal with unfamiliar pathogens, researchers from the Uniformed Services University of the Health Sciences wrote in the Annals of Internal Medicine. The authors said there are challenges to providing high-containment care for Ebola patients in traditional health care settings. Texas Health Presbyterian Hospital said its care of Ebola patient Thomas Eric Duncan has "sidelined" many ICU staff who are being monitored because of potential exposure to the pathogen. MedPage Today (free registration) (10/16)
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Inside the AAFP
Latest study of resident work restrictions doesn't settle debate
Fresh Perspectives
A new study shows no decline in mortality for patients under the care of physicians who trained with 80-hour workweek restrictions, but the issue is far from settled. Gerry Tolbert, M.D., offers his opinion in the latest Fresh Perspectives blog post.
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People are like stained-glass windows. They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is a light from within."
-- Elisabeth Kubler-Ross,
American psychiatrist
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About AAFP
This news roundup is provided as a timely update to AAFP members and other health care professionals about family medicine topics in the news media. Links to articles are provided for the convenience of family physicians who may find them of use in discussions with patients or colleagues. Opinions expressed in Family Medicine SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American Academy of Family Physicians. On occasion, media articles may include or imply incorrect information about the AAFP and its policies, positions or relationships. For clarification on AAFP positions and policies, we refer you to
External Resources are not a part of the AAFP website. AAFP is not responsible for the content of sites that are external to the AAFP. Linking to a website does not constitute an endorsement by AAFP of the sponsors of the site or the information presented on the site.
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