The Exchange

Commentary and Observations from
the Medical Front Lines

Latest Health Policy and Trends Articles on PCE's The Exchange

Anxiety and Depression Amid COVID

Anxiety and Depression Amid COVID

Lately, we've been hearing a lot about increases in anxiety and depression in the United States due to the COVID-19 pandemic. I was curious about what data we have regarding anxiety, depression, and COVID—and I found out that we do, in fact, have data to support an increase in the number of adults with depression or anxiety since the beginning of the pandemic and economic downturn. The Kaiser Family Foundation (KFF) found that the share of adults reporting anxiety or depression has increase... Continue Reading

Filed under: Health Policy and Trends, Psychiatry

The Future of the Affordable Care Act

The Future of the Affordable Care Act

We've been hearing a lot about the Affordable Care Act (ACA) and whether the Supreme Court will overturn the law or parts of the law. The Kaiser Family Found... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

Voting in the Midst of a Pandemic: What Are Some Options to Get People Registered to Vote?

Voting in the Midst of a Pandemic: What Are Some Options to Get People Registered to Vote?

Prior to the COVID-19 pandemic, US citizens who wanted to obtain a voter registration application could walk into any public library, post office, or Departm... Continue Reading

Filed under: Health Policy and Trends, Public Health

Recommending Isolation and Quarantine Timeframes for Coronavirus: Why Is There So Much Confusion?

Recommending Isolation and Quarantine Timeframes for Coronavirus: Why Is There So Much Confusion?

I have been working in a drive-through coronavirus testing site since March; part of this entails calling patients with positive COVID-19 test results to dis... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Public Health

COVID-19 Expands PA/NP Autonomy…and Scope of Practice for Other Professions, Too

COVID-19 Expands PA/NP Autonomy…and Scope of Practice for Other Professions, Too

The COVID-19 pandemic has been but one justification for expanding PA and NP autonomy in some states. In New York, Governor Andrew Cuomo's Execu... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

World Health Organization Halts Hydroxychloroquine Trial

World Health Organization Halts Hydroxychloroquine Trial

The World Health Organization (WHO) is but another organization to halt a COVID-19 therapeutic trial due to safety concerns. Specifically, WHO suspended the... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases

What’s Changed for Basic and Advanced Life Support During COVID-19

What’s Changed for Basic and Advanced Life Support During COVID-19

How we do CPR and advanced cardiac life support (ACLS) has changed in the last several months. The American Heart Association collaborated with other organiz... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases

Who Gets the Egg: The Chicken or the Rooster? Hydroxychloroquine Under the Microscope

Who Gets the Egg: The Chicken or the Rooster? Hydroxychloroquine Under the Microscope

What We Know We know that hydroxychloroquine (HCQ) is FDA approved for rheumatoid arthritis (RA), systemic lupus erythematosus... Continue Reading

Filed under: Health Policy and Trends, Public Health

Telehealth Visits During the COVID-19 Pandemic: What are the Benefits?

Telehealth Visits During the COVID-19 Pandemic: What are the Benefits?

Never before has there been such a frenzy of media exposure about an infectious disease as there has been surrounding COVID-19. We are faced with constant up... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

Game Changer: Telehealth for NPs and PAs in the Age of COVID-19

Game Changer: Telehealth for NPs and PAs in the Age of COVID-19

Having worked as a nurse practitioner for almost 30 years, I have seen so much change and evolution in health care, from practice standards to system changes... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

COVID-19 and the Curve

COVID-19 and the Curve

As of the writing of this post, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been confirm... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Public Health

My Trip to the Capitol

My Trip to the Capitol

As clinicians, we often talk about being a patient advocate, which is something that most of us probably do daily. We may be advocating for authorization of... Continue Reading

Filed under: Health Policy and Trends, Neurology

Intermittent Fasting: Is it Hype or Is There Science Behind It?

Intermittent Fasting: Is it Hype or Is There Science Behind It?

Intermittent fasting (IF) is a form of time-restricted fasting that involves consuming foods during a specific time window and fasting for the remaining hour... Continue Reading

Filed under: Health Policy and Trends, Miscellaneous

Consent for Invasive Exams While Under Anesthesia?

Consent for Invasive Exams While Under Anesthesia?

There was an interesting article in the New York Times called "She Didn't Want a Pelvic Exam. She Received One Anyway. Continue Reading

Filed under: Health Policy and Trends, Miscellaneous

You're Darned if You Do, You're Damned if You Don't

You're Darned if You Do, You're Damned if You Don't

Sorry, but I believe we are past the point of being worried about scaring people about the novel coronavirus 2019, now simply COVID-19 (in various forms of c... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Public Health

Coronavirus Update: Transmission – What Do We Know?

Coronavirus Update: Transmission – What Do We Know?

On January 30, 2020, the first confirmed case of person-to-person 2019 novel coronavirus (2019-nCoV) transmission was reported in the United States. Also on... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Public Health

Coronavirus Update: Thoughts on Its Origin

Coronavirus Update: Thoughts on Its Origin

We've known for years that influenza virus occurs in both humans and animals—including swine and birds—and... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Public Health

Cancer Screening Guidelines 2020: Let’s Recap!

Cancer Screening Guidelines 2020: Let’s Recap!

We now have screening tools and methodologies for several of the most common types of cancer. Each year, the American Cancer Society (ACS) publishes updated... Continue Reading

Filed under: Health Policy and Trends, Oncology/Hematology, Preventive Medicine

Millennials and Healthcare

Millennials and Healthcare

Millennials, also known as Generation Y, are those born between 1981 and 1996. They currently comprise one-fourth of all Americans and seem to look at health... Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career

Should We Accommodate Discriminatory Requests from Patients?

Should We Accommodate Discriminatory Requests from Patients?

As medical providers, we took an oath to provide the same quality of care to all our patients regardless of their race, gender, religion, sexual orientation,... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

Mistakes in the Ambulatory Care Setting

Mistakes in the Ambulatory Care Setting

A report published in late October entitled "Deep Dive: Safe Ambulatory Care, Strategies for Patient Safety and Risk Reduction" Continue Reading

Filed under: Health Policy and Trends, Practice Management/Career, Public Health

Do Physician Assistants and Nurse Practitioners Know What They Bill?

Do Physician Assistants and Nurse Practitioners Know What They Bill?

As a practicing clinician, do you know what you bill for? Do you know how much is asked for in the bills that are sent to your patients? The truth of the mat... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

CMS Final Rule: NP and PA Preceptor Documentation Updates – Success!

CMS Final Rule: NP and PA Preceptor Documentation Updates – Success!

On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule final rule, which will positively affe... Continue Reading

Filed under: Health Policy and Trends

Prescription Drug Misuse in the United States

Prescription Drug Misuse in the United States

Narcotic prescription medications have important medical uses, but they also stimulate the reward center of the brain. In susceptible individuals, this can l... Continue Reading

Filed under: Health Policy and Trends, Substance Abuse

Management of Patients with Suspected EVALI

Management of Patients with Suspected EVALI

Over the last several years there has been a dramatic spike in individuals vaping, and we have witnessed the associated injuries—including bur... Continue Reading

Filed under: Health Policy and Trends, Pulmonary Medicine

Women in Oncology

Women in Oncology

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 w... Continue Reading

Filed under: Health Policy and Trends, Oncology/Hematology, Practice Management/Career

How Have Carcinogens Tainted Our Generic Drug Supply?

How Have Carcinogens Tainted Our Generic Drug Supply?

In July 2018, the FDA announced that a known carcinogen, called N-Nitrosodiumdimethylamine, or NDMA, had been found in valsartan manufactured by Zhejiang Hua... Continue Reading

Filed under: Health Policy and Trends, Public Health

The Real Risks of Vaping: All Clinicians Must Ask the Right Questions and Warn Patients

The Real Risks of Vaping: All Clinicians Must Ask the Right Questions and Warn Patients

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 aw... Continue Reading

Filed under: Health Policy and Trends, Substance Abuse

New Statement Related to Hospitalized Heart Failure Patients

New Statement Related to Hospitalized Heart Failure Patients

The American College of Cardiology has issued a new Expert Consensus Decision Pathway for the management of patients with heart failure. This newly released... Continue Reading

Filed under: Cardiometabolic, Health Policy and Trends, NPs & PAs

Update: State Regulatory Environment for Opioid Prescribing

Update: State Regulatory Environment for Opioid Prescribing

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 w... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Substance Abuse

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

The American Geriatrics Society (AGS) 2019 Updated Beers Criteria—updated from 2015—are designed to reduce older adults' drug-related problems including,... Continue Reading

Filed under: Health Policy and Trends, Preventive Medicine

Team-Based Care: Latest Data on Family Physician, PA, and NP Practices

Team-Based Care: Latest Data on Family Physician, PA, and NP Practices

A recent study published in Family Medicine demonstrates the positive impact on practice capacity and scope of practice of family physicians (FPs) w... Continue Reading

Filed under: Health Policy and Trends

Preceptors and Tax Credits—Interprofessional Policy Change

Preceptors and Tax Credits—Interprofessional Policy Change

This blog is information only and not to be construed for legal tax advice—you must consult your tax professional regarding personal tax advice. Continue Reading

Filed under: Health Policy and Trends, NPs & PAs

How Do Drug Pricing Systems Work? If There Is More Competition, Shouldn’t the List Price Go Down?

How Do Drug Pricing Systems Work? If There Is More Competition, Shouldn’t the List Price Go Down?

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... Continue Reading

Filed under: Health Policy and Trends, Rheumatology

Choose Wisely As To When You Schedule Your Medical Care

Choose Wisely As To When You Schedule Your Medical Care

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... Continue Reading

Filed under: Health Policy and Trends

Consider Deprescribing in Our Older Adults

Consider Deprescribing in Our Older Adults

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 nearin... Continue Reading

Filed under: Health Policy and Trends, Preventive Medicine, Public Health

Advanced Practice Providers and Liability Risk

Advanced Practice Providers and Liability Risk

It is a misconception that advanced practice providers (APPs) can’t get sued because any errors are a physician’s responsibility. PAs and NPs can and do... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

National Stop the Bleed Month

National Stop the Bleed Month

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 “... Continue Reading

Filed under: Health Policy and Trends, Miscellaneous, Preventive Medicine, Public Health

Hypertension in the Pediatric Population

Hypertension in the Pediatric Population

The prevalence of systemic hypertension (HTN) in the pediatric population is now commonly observed to be increasing, especially in view of the growing popula... Continue Reading

Filed under: Cardiometabolic, Health Policy and Trends, Preventive Medicine

Using Policy to Impact HPV Vaccine Rates

Using Policy to Impact HPV Vaccine Rates

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 whe... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Preventive Medicine, Women's Health

Universal Influenza Vaccine Begins Phase I Clinical Trials

Universal Influenza Vaccine Begins Phase I Clinical Trials

The National Institutes of Health have begun the first clinical trial of an innovative universal influenza vaccine candidate. A Phase I trial will examine th... Continue Reading

Filed under: Allergy/Immunology, Health Policy and Trends, Public Health

Patient Autonomy: Keeping Our Patients’ Self-Determination Preserved

Patient Autonomy: Keeping Our Patients’ Self-Determination Preserved

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 dec... Continue Reading

Filed under: Health Policy and Trends, Public Health

States' Involvement With Medicaid Expansion

States' Involvement With Medicaid Expansion

For a little over 50 years, Medicaid has provided healthcare as a stopgap to millions of people. With passage of the Affordable Care Act (ACA), few states ut... Continue Reading

Filed under: Health Policy and Trends, Public Health

Here We Go Again: Measles in Seattle This Time

Here We Go Again: Measles in Seattle This Time

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 outb... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Preventive Medicine

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