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      Specialty Focus   
                                                                                    
Volume VI | Issue 25                                                                                
June 20, 2017  
 
        Practice specific news, analysis and commentary 
      for Florida's Medical Specialists
                            From the publisher of FHIweekly & FloridaHealthIndustry.com

Despite pressure over prices, the drug industry is coasting on Capitol Hill
Erin Mershon | STAT

Less than six months ago, President Trump stood at a podium and roiled the pharmaceutical industry with an emphatic declaration that its executives are "getting away with murder."

If Congress has its way, the same president will soon sign into law a massive package that is at the top of the industry's wish list: a reauthorization of drug makers' funding agreements with the Food and Drug Administration.

At least so far, the powerful pharmaceutical industry has managed to keep the package that is speeding toward Trump's desk free of any controversial policy changes that could threaten the industry's business model - as well as any partisan add-ons that could jeopardize its smooth, overwhelmingly bipartisan trip through the policymaking process.
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More trips to the ED but fewer are uninsured
Entitled Effect of the Affordable Care Act Medicaid Expansion on Emergency Department Visits: Evidence From State-Level Emergency Department Databases and posted yesterday to the Annals of Emergency Medicine website, the authors examine the effect of Medicaid expansion on the ED. The authors found that states that expanded Medicaid experienced increased ED utilization. This is contrary to the outcomes expected by many proponents of the expansion effort. Many pundits predicted ED utilization would be reduced as covered individuals would seek care through PCPs, specialists and/or urgent care clinics rather than visit the ED. 
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Even though genetic information is available, doctors may be ignoring important clinical clues
The Conversation

With the availability of home genetic testing kits from companies such as 23andMe and Ancestry DNA, more people will be getting information about their genetic lineage and what races and ethnicities of the world are included in their DNA.

Geneticists, meanwhile, are also getting more tailored information about disease risk and prevalence as genetic testing in medical research centers continues.

Physicians accept that cystic fibrosis, for example, is much more common in people with Northern European ancestry and that sickle cell disease occurs dramatically more often in people with African origins. These commonly accepted racial and ethnic differences in disease prevalence are just the tip of the iceberg when looking at clinical differences that vary based on genetics.

But there's a problem, a recent study from the National Institutes of Health found.  Many physicians and other providers are uncomfortable discussing race with their patients, and also reticent to connect race or ethnicity to genetics and clinical decision-making, the study suggested.
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3 points on dialysis John Oliver forgot to make
Katherine Kwon, MD | KevinMD

Dear John Oliver,
John Oliver on Dialysis
John Oliver on Dialysis

First of all, thank you for your recent segment on dialysis. Kidney disease deserves much more attention and discussion than it currently receives. Thank you also for your full-throated support of transplantation and the need for more kidney donors. As a practicing nephrologist, there is nothing better than hearing that one of my patients has been given a transplant. Finally, thank you for pointing out that end-stage renal disease is the lone pocket of universal health care in this country. We've been the government's testing ground for years, and we have a lot of experience to share.

Most of the nephrologists I spoke with felt your show brought to light some uncomfortable truths, but also lacked nuance around several controversial topics. Hey, I get it. You only have twenty-three minutes, and you've also got to include jokes about horse porn, cantaloupes, ferrets and Taco Bell. You blame "bad incentives, high costs and profiteering" for the poor outcomes compared to the high expenditures. I don't disagree with that, but I think there are some larger lessons to learn.
FHIcommunications

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