The Exchange
Commentary and Observations from
the Medical Front Lines
Sign up to receive posts from The Exchange
CATEGORIES
Health Policy and Trends
CMS Final Rule: NP and PA Preceptor Documentation Updates – Success!
Posted By: 
Susanne J. Phillips, DNP, APRN, FNP-BC | November 29, 2019
On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule final rule, which will positively affect the NP and PA preceptor documentation burden. For those of you providing clinical teaching rotations for advanced practice registered nurse (APRN) and/or PA students, you may be aware that in March 2018 CMS reduced the documentation burden for physician preceptors. This change authorized teaching physicians to verify and sign student documentation components of evaluation and management (E/M) services rather than have to re-document the work themselves. Unfortunately, this created unintended consequences for APRN and PA preceptors and the students they supervise. more >
Found in: Health Policy and Trends
Prescription Drug Misuse in the United States
Posted By: 
Ben Taylor, PA-C, PhD, DFAAPA | November 08, 2019
Narcotic prescription medications have important medical uses, but they also stimulate the reward center of the brain. In susceptible individuals, this can more >
Management of Patients with Suspected EVALI
Posted By: Ben Taylor, PA-C, PhD, DFAAPA | November 05, 2019
Over the last several years there has been a dramatic spike in individuals vaping, and we have witnessed the associated injuries—including burns and lung more >
Women in Oncology
Posted By: 
Beth Eaby-Sandy, MSN, CRNP, OCN | November 01, 2019
As a nurse practitioner, I practice in a predominantly female profession. However, I have seen a wave of symposia at recent major conferences that focus on more >
How Have Carcinogens Tainted Our Generic Drug Supply?
Posted By: 
Lawrence Herman, MPA, PA-C | October 11, 2019
In July 2018, the FDA announced that a known carcinogen, called N-Nitrosodiumdimethylamine, or NDMA, had been found in valsartan manufactured by Zhejiang more >
The Real Risks of Vaping: All Clinicians Must Ask the Right Questions and Warn Patients
Posted By: 
Daniel Thibodeau, MHP, PA-C | October 04, 2019
Most of us have seen the recent news regarding the alarming rise of respiratory-related illnesses and deaths due to e-cigarettes, or vaping. For those not more >
New Statement Related to Hospitalized Heart Failure Patients
Posted By: Daniel Thibodeau, MHP, PA-C | October 01, 2019
The American College of Cardiology has issued a new Expert Consensus Decision Pathway for the management of patients with heart failure. This newly released more >
Update: State Regulatory Environment for Opioid Prescribing
Posted By: Susanne J. Phillips, DNP, APRN, FNP-BC | September 20, 2019
As prescribers for patients with acute and chronic pain in primary care, NPs and PAs are very much aware of the national opioid epidemic, including ways in more >
Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
Posted By: Ben Taylor, PA-C, PhD, DFAAPA | July 22, 2019
The American Geriatrics Society 2019 Updated Beers Criteria—updated from 2015—are designed to reduce older adults' drug-related problems including, but not more >
Team-Based Care: Latest Data on Family Physician, PA, and NP Practices
Posted By: Susanne J. Phillips, DNP, APRN, FNP-BC | July 12, 2019
A recent study published in Family Medicine demonstrates the positive impact on practice capacity and scope of practice of family physicians when more >
Preceptors and Tax Credits—Interprofessional Policy Change
Posted By: Susanne J. Phillips, DNP, APRN, FNP-BC | July 09, 2019
This blog is information only and not to be construed for legal tax advice—you must consult your tax professional regarding personal tax advice. If more >
How Do Drug Pricing Systems Work? If There Is More Competition, Shouldn’t the List Price Go Down?
Posted By: 
Richard S. Pope, PA-C, MPAS | June 22, 2019
Have you ever noticed how much more expensive drug prices become every year? I think we have all noticed this increase, so this week I decided to look in to more >
Choose Wisely As To When You Schedule Your Medical Care
Posted By: Lawrence Herman, MPA, PA-C | June 05, 2019
Most of us tend to need a pick-me-up—perhaps a cup of coffee—around mid- to late-afternoon. But a new study published by JAMA on May 10, 2019 in more >
Consider Deprescribing in Our Older Adults
Posted By: Daniel Thibodeau, MHP, PA-C | June 01, 2019
We all have patients in our practices who are older and on numerous medications. They are stabilizing their problems but are faced with the reality of nearing more >
Advanced Practice Providers and Liability Risk
Posted By: Ben Taylor, PA-C, PhD, DFAAPA | May 21, 2019
It is a misconception that advanced practice providers can’t get sued because any errors are a physician’s responsibility. PAs and NPs can and do make more >
National Stop the Bleed Month
Posted By: 
Debra A. Danforth, DNP, APRN | May 17, 2019
Did you know that May 2019 is the first ever National Stop the Bleed Month? Also, May 23 is the second annual Stop the Bleed® Day. So what is “stop the more >
Hypertension in the Pediatric Population
Posted By: Ben Taylor, PA-C, PhD, DFAAPA | May 07, 2019
The prevalence of systemic hypertension (HTN) in the pediatric population is now commonly observed to be increasing, especially in view of the growing more >
Using Policy to Impact HPV Vaccine Rates
Posted By: 
Susan M. Tiso, DNP, APRN, FNP-BC | May 02, 2019
For more than 10 years we have had a safe and effective vaccine that can prevent several types of cancer. I understand the reluctance to accept a vaccine when more >
Universal Influenza Vaccine Begins Phase I Clinical Trials
Posted By: Lawrence Herman, MPA, PA-C | April 09, 2019
The National Institutes of Health have begun the first clinical trial of an innovative universal influenza vaccine candidate. A Phase I trial will examine the more >
Patient Autonomy: Keeping Our Patients’ Self-Determination Preserved
Posted By: Daniel Thibodeau, MHP, PA-C | March 12, 2019
If you’ve practiced in medicine for at least 20 years, you may remember the case of Terri Schiavo, a woman in her 20s who was in a coma for more than a more >
States' Involvement With Medicaid Expansion
Posted By: Daniel Thibodeau, MHP, PA-C | February 05, 2019
For a little over 50 years, Medicaid has provided health care as a stop gap to millions of people. With the passage of the Affordable Care Act (ACA), few more >
Here We Go Again: Measles in Seattle This Time
Posted By: Susan M. Tiso, DNP, APRN, FNP-BC | January 31, 2019
As of January 31, 2019, there were 42 confirmed cases of measles in the Pacific Northwest. This includes 41 cases in Clark County, the epicenter for the more >