Recent statistics show that over one million children age five or less are using a psychiatric medication. Of the eight million children age 17 or younger who take psychotropic medications, half are for ADHD. In 2013 over 78 million Americans were taking a prescribed psychoactive drug.
Medication can be regarded as an invasive procedure.
By Lyn E. Beggs. PLLC
During the last biennial license renewal period for physicians licensed by the Nevada State Board of Medical Examiners, I discussed the frequent delegation of the completion of renewal applications to third parties, such as an office manager and the potential issues related to such delegation. As physicians are once again in the middle of a biennial renewal period, the time seems right for a quick reminder about delegation.
Delegation of tasks is often necessary for busy physicians to accomplish the myriad of demands placed upon them. This often includes delegating administrative tasks such as billing, ordering of both medical supplies, completion of applications and/or contracting matters. Patient care tasks are also often delegated (to the extent legally allowed) to others such as medical assistants. While delegation of tasks is certainly acceptable, and necessary, it is important to remember that ultimately the practitioner is responsible for those tasks that are delegated and can bear the consequences if something goes awry.
Below are a few examples of tasks that are often delegated and the issues practitioners should keep in mind.
Delegation of billing to an in-house administrative staff member: How has this individual been trained? Do they understand how to properly bill both private insurance and well as Medicare and Medicaid? How is this person staying current with potential changes to regulations that could impact billing?
Delegation of ordering, receiving and storing prescription drugs and/or controlled substances at a practice location:
Does the practitioner verify what has been ordered and received? Are drugs/controlled substances being stored in the legally prescribed manner and is access to drugs/controlled substances limited to the appropriate individuals as required by law? Are legally required records being kept appropriately?
Delegation of training (such as HIPAA training):
Is the individual training staff members qualified to do so? Is the practitioner aware of the extent of the training or the information provided? Is legally required training taking place in the time frame required?
While practitioners regularly delegate tasks, delegation should not equate to abdicating all knowledge and responsibility of what occurs after delegation has been made as the potential risks to a practitioner can be substantial.
Ms. Beggs, owner of the Law Offices of Lyn E. Beggs, PLLC, focuses her practice primarily on administrative and professional licensing board issues in addition to representing healthcare providers on a variety of issues. Ms. Beggs may be reached at 775-432-1918 or at firstname.lastname@example.org
By Thomas L. Schwenk, M.D., Dean of the University of Nevada, Reno School of Medicine
The School of Medicine held an extraordinary event on April 28, an event that was student-driven and community physician-focused. It was a first, at least for a long time, but it will not be the last!
We gathered at The Grove in south Reno to honor the critical contributions of community physicians and clinical teachers who have dedicated their time, their expertise and their patients to teaching the next generation of Nevada physicians.
Nearly 70 community faculty members turned out for the event hosted by the Office for Community Faculty, under the leadership of April Heiselt. We brought together the most precious resources of the University of Nevada, Reno School of Medicine—our students and their teachers—to celebrate the magic of medical education and the process by which bright students become outstanding physicians.
The faculty members honored have taken medical students into their offices and operating rooms, and under their wings (in some cases for many years), to give them the most outstanding medical teaching possible. And more than just knowledge and skills are taught and learned. Perhaps most important is the mentorship, the career guidance, the support and the formation of professional attitudes and values that will be most important to the success of these students throughout their careers.
Keely Smith, Class of 2019, and the former physicians relations officer for the Student Outreach Clinic, spoke to the community physicians as the “heart of the medical school.” She said: “You continue to sacrifice your time and energy each semester… to allow us to continue on our journey to becoming physicians. When it becomes difficult, you absorb the inconvenience. You offer the insight, the guidance and the encouragement to move us through. You take on (these responsibilities) so that we can continue to move, to learn and to grow.”
The highlight of the event was a short video prepared by the students (with a little help from our outstanding media and events staff!) that said “thank you” in many different ways. It is well worth watching here (https://tinyurl.com/kscmc2v) and will be the highlight of your day.
If you ever wondered why you contribute to the education of our medical students, in all the many ways you contribute, this video will make it clear.
Several dozen medical students showed their appreciation by passing out gifted-wrapped lapel pins in the shape of a heart with the block “N” “Medicine” logo, and recognized their mentors as being “the heart of the medical school.”
This is just the beginning of what will be many ways that we support, thank, recognize and develop our critical resource of community physician faculty members who are so important to the success of the School of Medicine in improving health and health care in Nevada.
By Andy Pasternak, M.D., WCMS President
We are approaching the home stretch for this session of the Nevada Legislature. The last few months have been an eye-opening experience for me. I’ve been involved with organized medicine for a number of years, this is the first time I’ve been involved with the NSMA legislative core group meetings from the get-go.
The committee has been meeting weekly to review the bills that may affect our patients and how we practice medicine. Staring with over 200 bills, the list is narrowing down. Our legislative team, lead by Catherine O’Mara, has targeted 30-40 bills as priorities and are following them closely in Carson City (I’m thinking for the next session, we need to budget for a pair of roller skates to help them get from session to session)
A few highlights:
AB 474 is Governor Sandoval’s bill to address Nevada’s public health crisis with narcotic prescriptions . The bill is going to establish new regulations affecting how we prescribe narcotic pain medications. Since attending the Governor’s Forum on Prescription Narcotics in Las Vegas last August, it’s been interesting to watch how the bill has improved over time, especially with NSMA input. Ultimately, this bill will make providers think a bit more if narcotics are necessary for a patient’s care and if so, how many pills to prescribe.
Another topic drawing a lot of our attention has been a couple of bills that focus on how insurance companies pay physicians for out-of- network services. This is of particular interest for emergency room physicians as well as for more hospital-based specialties.
What has struck me more than anything is that at the state level, our legislators do hear our voices. They may not always agree with us, but through our membership and contributions to our PACs, our voices are heard. Despite national skepticism about politics, I have been impressed: When we have honest conversations with our legislators of how these bills will affect our patients and our community, they have been willing to listen. I’ve been impressed by our legislative team who are listening to the legislators concerns and strive to propose solutions that address the underlying problems for all.
And for me personally, as someone who is always looking for help at ultramarathons, I was very happy to see Senator Joe “Doc” Hardy’s bill allowing physicians from out of state to volunteer at athletic events!
WCMS hosted its first public seminar of the year at Craft Wine & Beer to address heart conditions in athletes and how they differ from the general population. It was presented at no cost to more than 100 area residents and featured three cardiologists who spoke about the differences in diagnosing and treating the heart of an athlete who exercises more intensely than the average person. Go to youtu.be/GiB7C6r9WDE to view the seminar.
Presenters Included: Colin Fuller, MD
Coronary Artery Disease in Athletes, Northern Nevada Medical Center
Ivan Anderson, MD
Atrial Fibrillation in Athletes, Renown Institute for Heart and Vascular Health
Ram Challapalli, MD, FACC
Cholesterol Medications for Athletes,
Saint Mary’s Medical Group
Andy Pasternak, MD, MS
Silver Sage Center for Family Medicine, WCMS president
We were able to offer this seminar free to the public because of our sponsors, which included: Sierra Nevada Cardiology, Renown Institute for Heart and Vascular Health, St. Mary’s Cardiology Group and Silver Sage Center for Family Medicine. Pizza provided by Eclipse Pizza and Reno Wheelmen.
Lori Patch gathered raffles prizes that raised about $600 that was donated to SCAD Spontaneous Coronary Artery Dissection and the UNR sports medicine fellowship. Mary Ann McCauley, WCMS executive director, drew the winning tickets.