Iowa news
Oakland, Iowa designated a physician shortage area for over 45 years
Over 180 areas in the United States have been federally designated as primary care shortage areas for at least 40 years. One of those areas is Oakland in southeast Iowa. It’s been designated a physician shortage area since June 1978. The stagnation for these areas holds even as the number of licensed U.S. physicians more than doubled from 1990 to 2022 to over 1 million, outpacing the population growth. The finding underlines the quality of physician and provider workforce data in the U.S., which is astoundingly inadequate. Even basic figures or estimates, such as national estimates of physician turnover, are not rigorously and systematically captured. (KFF Health News)
Mercy Iowa City officially becomes the University of Iowa Downtown Campus
Although the skywalk spanning Market Street connecting portions of the historic Mercy Hospital campus Wednesday morning still boasted that 150-year-old name and its teal and white colors, a sign along the street below announced Mercy’s new owner and new name: University of Iowa Health Care Downtown Campus. Sign, brand removal and replacement were among the changes underway Wednesday, closing day for the hospital’s $28 million sale to the University of Iowa, the winning bidder of a bankruptcy auction for most of Mercy’s assets. (The Gazette)
‘Perfect storm’ contributes to ongoing local health care workforce shortage
Nearly four years after COVID-19 shut down much of the world, Dubuque health care leaders continue to fight workforce challenges prompting providers to find creative solutions to complex problems. Although providers said the industry’s workforce shortages were worrisome before 2020, they agree the pandemic exacerbated preexisting issues. Factors such as health care workers retiring en masse, a rapidly growing older-adult population, higher pay in other careers and the many health care jobs available in the tri-state area compounded with the economic impacts of the pandemic to create what one local hospital official calls a “perfect storm” of challenges. (Telegraph Herald)
National news
Why aren’t more physicians prescribing Paxlovid to high-risk patients?
Recent evidence is piling up that many people at high risk for severe COVID-19 don’t receive nirmatrelvir/ritonavir (Paxlovid) or any outpatient antiviral treatment when diagnosed with a SARS-CoV-2 infection. In a new observational study, people on Medicare who were at highest risk for severe COVID-19 were less likely to receive outpatient antiviral treatments, such as nirmatrelvir/ritonavir, than Medicare beneficiaries at lower risk. For example, people 90 years and older were 36% less likely to receive the drugs compared with those 65-69. (MedPage Today)
A stealthy cholesterol is killing people, and most don’t know they’re at risk
Millions of Americans are born genetically predisposed to extremely high levels of a type of cholesterol that causes deadly heart attacks and strokes by middle age. Yet, they are almost always unaware of their risk. The cholesterol is called lipoprotein(a) or Lp(a). Like low-density lipoprotein (LDL, the “bad” cholesterol), it leads to plaque buildup in arteries. But Lp(a) has a second nasty trick that makes it even more dangerous: it causes blood clots. And unlike LDL, it’s entirely genetic, which means diet and exercise do not affect Lp(a) levels. The result is a high likelihood of life-threatening heart disease that runs in families, killing parents, aunts, uncles and siblings in their 40s and 50s. As many as 64 million Americans have elevated Lp(a) levels. (NBC News)
Care coordination and other opportunities for improvement
Every day, different things raise our hackles when we go to work. We’re working in a health care system with so many moving parts, rules, regulations and people looking over our shoulders telling us how to run our practices and care for patients. An idealized health care system would give us the tools we need, build a seamless system we and our patients can flow through and make getting to the best state of health as effortless as possible. Take coordination of care. A few weeks ago, a patient came to see me for “medical clearance” for a minor outpatient procedure, which would be done in the surgeon’s office with little or no risk to the patient. (MedPage Today)