Cut in Medicare Payments; Preventing Global Cancer Deaths; and Physicians' Bad Behavior

Medscape Staff

August 22, 2022

Medicare Pay for Physicians Is Ebbing, Not Flowing

Physicians are facing a planned cut in Medicare reimbursements in 2023, which would be on top of more cuts over the past year.

Congress may pare back that cut at the last minute, but practices are struggling with the uncertainty. Physicians say that if the cuts continue, more doctors will have no choice but to cut back on Medicare, or even opt out of it.

Long-term decline: Over the past 20 years, the costs of running a practice have increased even as Medicare payments have fallen relative to inflation.

Rise and fall: Budget neutrality means that if one group of physicians manages to get an increase, payments must fall elsewhere to compensate. The effect is to pit physicians against one another for funding.

Proposed solutions: The American Medical Association is calling on Congress to eliminate the budget neutrality requirement. They also call for a further annual increase that rises with inflation.

Nearly Half of Global Cancer Deaths Are Preventable

Nearly half of cancer deaths around the world are linked to preventable risk factors, which are largely behavioral, concludes a first-of-its-kind global report.

Smoking, alcohol, and high body mass index are the highest contributors, the study found — particularly in lower-income countries. The finding suggests that a significant portion of global cancer burden is preventable if the risk factors are addressed by policymakers.

Overall, the evaluated risk factors accounted for 44.4% of all cancer deaths.

Increases over time: Overall, the rates of cancer deaths associated with the evaluated risks increased by 20.4% between 2010 and 2019. Deaths associated with metabolic risks increased the most; those increases were driven largely by low- and middle-income countries. The researchers suggest that increased obesity may be a side effect of those countries' progress.

They also account for the relative increase of metabolic risks over behavioral ones by noting that a global campaign to reduce tobacco exposure has been relatively successful.

Physicians' Bad Behavior Seen at Work, Online by Colleagues

In a new report, more than 1500 physicians shared how often they see fellow doctors misbehaving in person or on social media.

Respondents described more frequent incidents of doctors acting disrespectfully toward patients and coworkers, taking too casual an approach to patient privacy, and even acting angrily or aggressively at work. In addition, women were seen misbehaving about one third as often as their male counterparts.

Bullying and harassment: Bullying or harassing clinicians and staff was the most common behavior, with 86% of respondents saying they'd seen it at work. Second place: disparaging patients.

Indecision about speaking up: Almost half of respondents agreed that doctors should be confronted about their bad behavior, but few reported speaking up.

Offline, online: Many people reported witnessing misbehavior outside of work, as well, including on social media. Not everyone agreed about what constitutes bad behavior on social media; though posting nonfactual, unscientific, and potentially unsafe information is clearly an ethics violation, the boundaries around posting personal peccadillos are less clear.

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