Commentary and Observations from
the Medical Front Lines
Sign up to receive posts from The Exchange
CATEGORIES
Latest Health Policy and Trends Articles on PCE's The Exchange
Alternative Medicine Treatment for Skin Conditions
Posted By: 
Kristine Kucera, PA-C, MPAS, DHS
June 17, 2022
Patients often seek complementary and alternative medicine (CAM) treatments for skin conditions, including herbs, traditional Chinese medicine (TCM), dietary modifications, and mind/body interventions. Patient interest in alternative therapies has grown over the years for a variety of medical conditions; in the US, CAM tends to attract patients because it is frequently available over the counter and often is less expensive than conventional health care.
In fact, a 2012 survey by the... Continue Reading
Filed under: Dermatology, Health Policy and Trends
How Much News Is Too Much News?
Posted By: 
Mary Knudtson, DNSc, NP, FAAN
June 14, 2022
With the COVID-19 pandemic and influx of global interest in current events, many people started consuming—or starting consuming more—news stories. This i... Continue Reading
Filed under: Health Policy and Trends, Miscellaneous
Diversity in Research and the All of Us Research Program
Posted By: 
Paola Gonzalez, MPAS, PA-C
May 03, 2022
I have been working in the PA field for well over 18 years and have always thrived on knowing that I am treating my patients with evidence-based medicine. Ho... Continue Reading
Filed under: Health Policy and Trends, Miscellaneous, Women's Health
Extensions for Medicare Payment of Telehealth Services
Posted By: 
Susan Tiso, DNP, FNP-BC
April 22, 2022
The Secretary of the Department of Health and Human Services extended the public health emergency declaration for the opioid crisis on April 1, 2022. Shortl... Continue Reading
Filed under: Health Policy and Trends, Public Health
Tips on the Insurance Peer-to-Peer Process in Patient Care
Posted By: Paola Gonzalez, MPAS, PA-C
March 08, 2022
Medical care has evolved significantly since I started practicing almost 18 years ago: From paper charts to electronic records, and from local pharmacies to... Continue Reading
Filed under: Health Policy and Trends, Practice Management/Career
FDA Rules on COVID Booster Shot - 09/17/2021
Posted By: Susan Tiso, DNP, FNP-BC
September 24, 2021
In a meeting last week, a panel of advisors to the Food and Drug Administration recommended against widespread approval of a Pfizer-BioNTech COVID-19 booster... Continue Reading
Filed under: Health Policy and Trends, Infectious Diseases, Preventive Medicine, Public Health
Innovation in a Post-Pandemic World: What We Have Taught Ourselves
Posted By: 
Daniel Thibodeau, MHP, PA-C
July 30, 2021
So much has changed since January of this year. By now, most states are working to get back to some sense of normalcy while hospitals and healthcare systems... Continue Reading
Filed under: Health Policy and Trends, Miscellaneous, Practice Management/Career
Leveraging Telehealth to Improve Access to Healthcare
Posted By: 
Heather M. Hylton, MS, PA-C
July 02, 2021
While strides have been made in the overall expansion of (and reimbursement coverage for) telehealth services during the COVID-19 pandemic, there continue to... Continue Reading
Filed under: Health Policy and Trends, Practice Management/Career
COVID- 19 and Trust in Healthcare in the US: Where Has it Gone?
Posted By: Susan Tiso, DNP, FNP-BC
June 02, 2021
We are so fortunate in the United States to have access to not only the COVID- 19 vaccine, but also to options as to which vaccine to receive. Most Americans... Continue Reading
Filed under: Health Policy and Trends, Public Health
New in April: Open Notes Law Goes Into Effect
Posted By: Mary Knudtson, DNSc, NP, FAAN
April 27, 2021
The 21st Century Cures Act, passed by Congress in 2016, has gone into effect in April 2021. This gives patients the right to immediate electronic access to t... Continue Reading
Filed under: Health Policy and Trends, Practice Management/Career
New E/M Coding Definitions for 2021
Posted By: 
Lawrence Herman, DMSc, MPA, PA-C
January 12, 2021
The American Medical Association's Current Procedural Terminology 2021 codebook updates the existing guidelines developed in 1995 and 1997. For new patients,... Continue Reading
Filed under: Health Policy and Trends, Practice Management/Career
Will You Get a COVID-19 Vaccine?
Posted By: Lawrence Herman, DMSc, MPA, PA-C
November 27, 2020
In a post earlier this week, I wrote about public skepticism concerning COVID-19 vaccines, with some surveys showing an estimated 50-50 split in terms of whe... Continue Reading
Filed under: Allergy/Immunology, Health Policy and Trends, Infectious Diseases, Preventive Medicine, Public Health
Anxiety and Depression Amid COVID
Posted By: Mary Knudtson, DNSc, NP, FAAN
October 30, 2020
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 w... Continue Reading
Filed under: Health Policy and Trends, Psychiatry
The Future of the Affordable Care Act
Posted By: Mary Knudtson, DNSc, NP, FAAN
October 27, 2020
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?
Posted By: Susan Tiso, DNP, FNP-BC
August 21, 2020
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?
Posted By: Susan Tiso, DNP, FNP-BC
August 18, 2020
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
Posted By: 
Lawrence Herman, PA-C, MPA
July 14, 2020
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
Posted By: Lawrence Herman, PA-C, MPA
May 29, 2020
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
Posted By: 
Debra A. Danforth, DNP, APRN, FAANP
May 22, 2020
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
Posted By: 
Richard S. Pope, PA-C, MPAS
April 24, 2020
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?
Posted By: Susan Tiso, DNP, FNP-BC
April 17, 2020
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
Posted By: Susan Tiso, DNP, FNP-BC
April 14, 2020
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
Posted By: Daniel Thibodeau, MHP, PA-C
March 31, 2020
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
Posted By: 
Carol A. Barch, MN, FNP-BC
March 17, 2020
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?
Posted By: Mary Knudtson, DNSc, NP, FAAN
March 10, 2020
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?
Posted By: Mary Knudtson, DNSc, NP, FAAN
March 06, 2020
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
Posted By: Lawrence Herman, PA-C, MPA
February 28, 2020
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?
Posted By: Susan Tiso, DNP, FNP-BC
February 14, 2020
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
Posted By: Susan Tiso, DNP, FNP-BC
February 12, 2020
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!
Posted By: 
Beth Sandy, MSN, CRNP
January 24, 2020
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
Posted By: Debra A. Danforth, DNP, APRN, FAANP
January 17, 2020
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?
Posted By: 
Ben Taylor, PA-C, PhD, DFAAPA
January 07, 2020
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
Posted By: Lawrence Herman, PA-C, MPA
December 31, 2019
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?
Posted By: Daniel Thibodeau, MHP, PA-C
December 10, 2019
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!
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 affe... Continue Reading
Filed under: 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 l... Continue Reading
Filed under: Health Policy and Trends, Substance Abuse
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 bur... Continue Reading
Filed under: Health Policy and Trends, Pulmonary Medicine
Women in Oncology
Posted By: Beth Sandy, MSN, CRNP
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 w... Continue Reading
Filed under: Health Policy and Trends, Oncology/Hematology, Practice Management/Career
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 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
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 aw... Continue Reading
Filed under: Health Policy and Trends, Substance Abuse
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... Continue Reading
Filed under: Cardiometabolic, Health Policy and Trends, NPs & PAs
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 w... Continue Reading
Filed under: Health Policy and Trends, NPs & PAs, Substance Abuse
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 (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
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 (FPs) w... Continue Reading
Filed under: Health Policy and Trends
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. 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?
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... Continue Reading
Filed under: Health Policy and Trends, Rheumatology
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... Continue Reading
Filed under: Health Policy and Trends
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 nearin... Continue Reading
Filed under: Health Policy and Trends, Preventive Medicine, Public Health
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 (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
Posted By: Debra A. Danforth, DNP, APRN, FAANP
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 “... Continue Reading
Filed under: Health Policy and Trends, Miscellaneous, Preventive Medicine, Public Health
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 popula... Continue Reading
Filed under: Cardiometabolic, Health Policy and Trends, Preventive Medicine
Using Policy to Impact HPV Vaccine Rates
Posted By: Susan Tiso, DNP, 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 whe... Continue Reading
Filed under: Health Policy and Trends, Infectious Diseases, Preventive Medicine, Women's Health
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 th... Continue Reading
Filed under: Allergy/Immunology, Health Policy and Trends, Public Health
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 dec... Continue Reading
Filed under: Health Policy and Trends, Public Health
States' Involvement With Medicaid Expansion
Posted By: Daniel Thibodeau, MHP, PA-C
February 05, 2019
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
Posted By: Susan Tiso, DNP, 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 outb... Continue Reading
Filed under: Health Policy and Trends, Infectious Diseases, Preventive Medicine