Princess Health and Like nurse practitioners in medical field, dental profession needs mid-level providers, expert argues.Princessiccia

Princess Health and Like nurse practitioners in medical field, dental profession needs mid-level providers, expert argues.Princessiccia

dentistry dentists oral health

Gusty 11:48 Add Comment

With 50 million Americans living in poor or rural areas where there are no dentists to go to � and that number expected to rise by more than 5 million if the Affordable Care Act stands � states and the federal government should be training dental therapists to help solve the problem, argues Louis W. Sullivan, a physician and former secretary of the Department of Health and Human Services, in an op-ed piece in The New York Times.

"We have two years to prepare before millions of children will be entitled to access to dental care," he writes of the impending eligibility expansion under the ACA. "Access means more than having an insurance card; it means having professionals available to provide care. Public officials should foster the creation of these mid-level providers � and dentists should embrace the opportunity to broaden the profession so they can expand services to those in need."

Dental therapists provide preventive care and "routine procedures like sealants, fillings and simple extractions outside the confines of a traditional dentist's office," Sullivan writes. While they are "common worldwide," only Alaska and Minnesota allows them to practice. Legislation is pending in five other states. Generally, dentists have been opposed to such changes.

Sullivan points to Alaska as a model example for how these therapists can fill gaps in places like remote villages "only accessible by plane, snowmobile or dogsled, where high school seniors once graduated with full sets of dentures." In 2003, the state sent students to New Zealand to be trained as therapists. Now, therapists serve 35,000 Alaskans. They "travel to small clinics and schools, often carrying their equipment with them. They consult with a supervising dentist from the region but do most procedures themselves. Many were raised in the communities in which they now work, so they understand the culture," Sullivan writes.

Sullivan points out dental disease is the No. 1 chronic childhood disease in the country, responsible for more children needing treatment than asthma. In 2009, more than 830,000 visits to the emergency room were due to preventable dental problems across the nation, he points out. But dentists are in short supply and will be even harder to see if the ACA is upheld by the U.S. Supreme Court. "In a nation obsessed with high-tech medicine, people are not getting preventive care for something as simple as tooth decay," he writes. (Read more)

Princess Health and UK doctors first to perform triple ablation, a special form of cardiac catheterization.Princessiccia

Princess Health and UK doctors first to perform triple ablation, a special form of cardiac catheterization.Princessiccia

cardiac care heart health University of Kentucky

Gusty 11:00 Add Comment

Ollie Whitaker of Whitesburg is the first known patient to have undergone triple ablation surgery, in which a catheter is inserted through a patient's blood vessels to remove a faulty electrical pathway and tissue from the patient's heart. The procedure was performed at the University of Kentucky's Gill Heart Institute.  (UK photo of Whitaker, Dr. Sammy Claude Elayi and Dr. Gustavo Morales)

"Typically, the catheter is placed into the patient's femoral artery, internal jugular or subclavian vein. The catheter is guided toward the heart, and high-frequency electrical impulses are used to induce the arrhythmia and then destroy (or ablate) the abnormal tissue causing it," reports Jodi Whitaker for UK Public Relations.

"Performing two ablations during one procedure is commonly done, but three with this complexity is basically unheard of," said Dr. Sammy Claude Elayi, a UK cardiologist. "But in this patient's case, despite the risk, I believed that we could perform three ablations."

"I'm so very pleased," said Whitaker, who had a massive heart attack 30 years ago at age 42 and had been suffering severe after-effects ever since. "I can work in my flower bed outside and do more around the house." (Read more)

Princess Health and Two gene variants identified as risk factors for childhood obesity.Princessiccia

Princess Health and Two gene variants identified as risk factors for childhood obesity.Princessiccia

childhood obesity genetics research

Gusty 08:40 Add Comment

The largest ever genome-wide study has identified two new gene variants that increase the risk of common childhood obesity.

"We have definitively identified and characterized a genetic predisposition to common childhood obesity," said lead investigator Struan F.A. Grant, associate director of the Center for Applied Genomics at The Children's Hospital of Philadelphia.

The analysis included 14 previous studies "encompassing 5,530 cases of childhood obesity and 8,300 control subjects, all of European ancestry," reports research-reporting service Newswise.

The study team identified two novel loci, or specific locations of a gene or DNA sequence on a chromosome. One is near the OLFM4 gene on Chromosome 13, the other in the HOXB5 gene on Chromosome 17. There was a degree of evidence for two other gene variants as well. "The known biology of three of the genes hints at a role of the intestine, although their precise functional role in obesity if currently unknown," Newswise reports. (Read more)

Princess Health and Chiropractic clinic to pay $650K for Medicaid and Medicare fraud.Princessiccia

Princess Health and Chiropractic clinic to pay $650K for Medicaid and Medicare fraud.Princessiccia

chiropractors crime fraud Medicaid Medicare

Gusty 08:20 Add Comment

A chiropractic clinic in Williamsburg will pay $650,000 to settle claims it improperly billed Medicare and Medicaid, reports Trent Knuckles for The News Journal of Corbin. (News Journal graphic)

Ho Medical Clinic, Kenneth Ho and Ana Moreno allegedly filed false claims when they billed for physician services, though they were performed by a chiropractor (chiropractors are not medical doctors); billed for unnecessary and unreasonable MRI and X-ray services; billed for work performed by unqualified personnel; and received funds for being a rural health clinic when it did not meet Medicare requirements.

Of the $650,000, $525,000 will go to the Medicare and Medicaid trust fund. The remaining sum will go to Danette Freeman, who sued the company under the False Claims Act. The investigation was conducted by the Kentucky attorney general's office, the Department of Health and Human Services' Office of Inspector General and the U.S. attorney's office. (Read more)

Princess Health and Doctors' lobby still working for changes in 'pill mill' legislation.Princessiccia

Princess Health and Doctors' lobby still working for changes in 'pill mill' legislation.Princessiccia

doctor shopping doctors drugs General Assembly legislation legislature lobbying physicians prescription drug abuse prescription drugs privacy

Gusty 09:15 Add Comment

By Al Cross
Kentucky Health News

The Kentucky Medical Association, historically one of the most powerful lobbying interests at the General Assembly, has mounted a last-ditch attempt to change or perhaps kill the bill that would crack down on "pill mills" that contribute to prescription drug abuse.

The bill would require pain clinics to be owned by doctors, require doctors to participate in the state's prescription-tracking system, and move the system to the attorney general's office from the Kentucky Board of Medical Licensure, which is made up almost entirely of doctors and has done little to curb the growing problem.

The tracking system remains the central concern for the KMA, which issued a "call to action" for physicians to contact legislators and argue that it "could infringe on privacy and lead to excessive oversight of legitimate medical practices," reports Mike Wynn of The Courier-Journal. "Other critics have said the bill could make doctors reluctant to provide pain medication for legitimate patients."

KMA President Shawn Jones told Wynn, �We would like to see something come out of this session. We would just like to make sure that it is something that addresses both the needs of law enforcement and at the same time is not overreaching in its imposition on our ability to practice medicine in a professional way.�

The KMA�s call notes that the system "tracks medications such as Xanax, Valium and Klonopin and was placed under the cabinet�s responsibility partly for patient privacy and protection," Wynn notes. Jones told him, �The access to that data really should be limited to government agencies that are charged with public health, and not law enforcement.�

Moving the tracking system to the attorney general's office is "pretty much a cornerstone of this legislation," Senate Majority Floor Leader Robert Stivers, R-Manchester, left, told Ryan Alessi Friday night on cn|2's "Pure Politics" program. He said the medical licensure board "hasn't done a whole lot" about prescription drug abuse, and indicated that part of the bill would stand.

However, Stivers said he and other supporters of the bill might drop the bill's 30-day limit on the length of painkiller prescriptions because of concerns that it would raise costs to patients. Those concerns helped delay the bill on the 59th day of the legislature's 60-day session. House Speaker Greg Stumbo "has said the issue could be resolved with a simple fix in the bill�s language," Wynn notes.

Stivers and Stumbo were among a group of bipartisan political leaders, led by Gov. Steve Beshear, who issued a statement Friday calling on the General Assembly to pass the bill Thursday, when it is scheduled to reconvene. The legislature is in recess, pending possible vetoes of other legislation by Beshear.

KMA "also takes issue with a $50 fee that the attorney general would be able to charge doctors to fund the program," Wynn reports. "Jones said the amount will only continue to climb in coming years to address a societal problem that doctors did not create. Proponents contend that the fee is nominal and is capped by statute except for inflation adjustments." (Read more)

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and In bipartisan way, political leaders push passage of 'pill mill' bill.Princessiccia

Princess Health and In bipartisan way, political leaders push passage of 'pill mill' bill.Princessiccia

doctor shopping doctors drugs General Assembly legislation legislature physicians prescription drug abuse prescription drugs state governments

Gusty 13:34 Add Comment

A bipartisan group of political leaders issued a call today "to pass a bill that will help the state battle one of its most significant threats � prescription drug abuse," a press release from Gov. Steve Beshear's office said. Beshear, Attorney General Jack Conway, House Speaker Greg Stumbo, Senate Republican Floor Leader Robert Stivers, Sen. Jimmy Higdon, R-Lebanon, and House Judiciary Committee Chairman John Tilley, D-Hopkinsville, said the legislature should pass House Bill 4 when it returns to Frankfort for its final day April 12.

"Since the beginning of 2012, more than 400 Kentuckians have been hospitalized because of prescription drug overdoses � a statistic that the leaders say underscores the crucial need to pass this bill in this legislative session," the release said. "Kentucky has the nation�s sixth-highest rate of prescription drug overdose deaths, at nearly 18 deaths per 100,000."

Conway said in the release, �I'm hopeful everyone, including the medical community, can get on board with House Bill 4 to ensure that we don't lose another generation in Kentucky to prescription drug abuse.� The bill would move the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system to Conway's office from the Kentucky Board of Medical Licensure, which is controlled by doctors and has done little to rein in "pill mills" that churn out prescriptions for painkillers.

"Law enforcement members warn that Ohio, Tennessee, West Virginia and Florida have passed legislation similar to HB 4 to address pill mills, and failing to pass similar legislation could create a diversion effect in which Kentucky could become a source state for prescription painkillers," the release said.

Stumbo, who preceded Conway as attorney general, said in the release, �Given the true epidemic we are seeing, we cannot afford to wait another year to try to pass this again.� In October, Stumbo, Beshear and Conway "announced creation of an advisory board of physicians, dentists, nurses, and pharmacists to work with KASPER officials and law enforcement professionals to create guidelines for generally accepted prescribing practices among different medical disciplines," the release said. "These criteria will be used as a guide for when a prescriber or dispenser�s KASPER reports may be flagged for unusual prescribing activity."

The bill would require all prescription providers to register and use KASPER, require pain management clinics to be owned by a licensed medical practitioner, make medical licensure boards investigate prescribing complaints within four months. 

Princess Health and Body-mass index fails to identify some as obese, mainly women.Princessiccia

Princess Health and Body-mass index fails to identify some as obese, mainly women.Princessiccia

gender disparities obesity

Gusty 13:15 Add Comment

Many Americans, particularly women, are actually obese though they think their weight is healthy because of weaknesses in the body-mass index formula.

A study comparing people's BMIs to a blood test and body scan found that the height-to-weight ratio formula was wrong in half of women and 1 in 4 men.

"It's commonly acknowledged that the BMI can produce inaccurate results for athletes and others with a lot of muscle mass,"  Misti Crane reports for The Columbus Dispatch . "But this research illuminates a problem on the other end of the scale: people who think they're fine but are carrying a lot of fat and little muscle."

"Particularly women, as they age, their muscles become inserted with fat, even though they stay thin and beautiful in a dress," said Dr. Eric Braverman, a New York physician who co-wrote the study.

Braverman and co-author New York State Health Commissioner Nirav R. Shah propose that the BMI cutoff for determining obesity should be 24 for women and 28 for men. Now, it's 30 for both sexes. "They also say that doctors should consider blood tests to measure leptin, a hormone that goes up with increased body fat, and DXA scans. The scans are commonly used to assess bone density but can be used to analyze body fat," Crane reports.

Though experts know the BMI calculation is not perfect, there is one major advantage: It's free. "You have to understand that BMI is an estimate of fatness, it's not a measure of fatness. But there are very few screening-tool estimates we have that are as simple to use," said Dr. Patricia Choban, medical director of the bariatric-surgery problem at Mount Carmel West Hospital. (Read more)