Physician Practice Roundup—Malpractice caps influence doctors’ decisions; Comprehensive care physician model lowers hospitalization

An illustration of a heart monitor
Limits on medical malpractice damages influence how doctors diagnosis and treat coronary artery disease. (Getty/Ariel Berger)

Malpractice caps influence doctors’ testing, treatment decisions

Doctors who practice in states that have adopted malpractice damage caps order fewer invasive tests to diagnose and treat coronary artery disease.

Researchers at George Washington University found that doctors’ testing and treatment decisions changed after the states where they practice adopted caps to limit malpractice damages, “suggesting physicians will tolerate more clinical uncertainty when they face lower malpractice risk,” according to a new study published in JAMA Cardiology.

Compared with doctors in other states without malpractice caps, doctors in nine states with limits on damages reduced invasive testing with angiography as a first diagnostic test, performed more noninvasive stress tests, referred fewer patients for angiography following a stress test and reduced procedure rates to treat a narrowed or blocked coronary artery after evaluation. (JAMA Cardiology study)

Comprehensive care physician model improves care, lowers hospitalization

A program in which doctors oversee patients both in and out of the hospital improved care and cut hospitalizations for high-risk patients.

Known as comprehensive care physicians, the University of Chicago Medicine tested the model after receiving funding from a Health Care Innovation Award from the Center for Medicare & Medicaid Innovation.

The model, in which comprehensive care physicians lead a team of nurse practitioners, social workers, care coordinators and other specialists, was able to improve the continuity of patient care, especially during and after a hospital stay. It also strengthened the relationship between doctor and patient. (UChicagoNews announcement)  

Atlanta doctor, who allegedly danced during surgeries, charged in lawsuits

An Atlanta dermatologist faces lawsuits from at least seven women who have charged her with negligence and other allegations after their plastic surgeries.

The lawsuits against Windell Davis Boutté, M.D., gained notoriety because of about two dozen videos posted to her clinic’s YouTube Channel, which showed her dancing and rapping over her patients, apparently during their procedures, the Washington Post reported. (Washington Post article)

Patients seek mental health visits with psychiatrist, rather than primary care

Although primary care physicians can serve as the main source of treatment for patients with mental health issues, more than half of visits are with psychiatrists, according to a new Centers for Disease Control and Prevention report.

The CDC analysis found patients seeking care for mental health issues are more likely to see a psychiatrist than seek help from a primary care doctor. From 2012-2014, an estimated 30 million mental health-related physician office visits were made by U.S. adults. About 55% of those visits were to psychiatrists, 32% to primary care physicians and 13% to other specialists. The exception was for adults aged 65 and over, who are as likely to visit a primary care physician for mental health-related issues as a psychiatrist. (CDC data brief)