Closer Look
Opinion: Psychiatrists' inboxes are overflowing
Adobe
If you're a psychiatrist working in a clinic, you're busy. Since the pandemic began, demand for mental health care has soared. And it's not just about seeing patients — it's the messaging via electronic health records, Simone Bernstein and Jessi Gold write in a STAT First Opinion. Looking back to 2011-2014, clinicians spent as much or more time answering patient messages as they did in face-to-face care. The authors' new study in JAMA Network Open found an 861.5% increase in monthly message volume from pre-pandemic.
The route to burnout is short, and it hurts patients, too, in more medical errors. And that time spent responding to patients is not reimbursed. Billing some patients or paying psychiatrists for that time could work. "If we don't create a solution soon, we run the risk of further breaking a mental health system already in crisis, and increasing the rates of clinician burnout." Read more.
health insurance
Medicare Advantage plans fined for overcharging
They may look like slaps on the wrist followed by penalties that amount to pennies under a couch cushion, as STAT's Bob Herman puts it, but the federal government may have symbolism on its side. The Centers for Medicare and Medicaid Services fined three different Medicare Advantage plans this month for the same problem: faulty technology systems that make people pay more for care and coverage than they should. The message to the plans can be read this way: Clean up compliance and IT infrastructure before regulators come knocking on their doors again.
The three Medicare Advantage plans — AultCare, EmblemHealth, and Moda Health Plan — were dinged for different violations, but "just the knowledge that CMS will be back one day and that you better have this fixed, I think, does have a sentinel effect," said Philip Legendy, an attorney at Ballard Spahr who represents Medicare Advantage plans. Read more on the infractions and one response.
health
How much edible cannabis it takes to harm kids
It's not hard to imagine children eating cannabis edibles like candy. A new study in Pediatrics looking at one hospital's 151 cases of edible cannabis ingestion in kids under 6 found that more than half of the kids had harmful exposures. They came in with drowsiness, abnormal heartbeat, loss of muscular coordination, and vomiting. More worrisome were the low blood pressure, coma, shallow breathing, and seizures in fewer than 2.5% of kids.
Allowing for how difficult it can be to discern what "dose" the children ate from gummies or other edibles, the researchers came up with a threshold for significant toxicity: 1.7 milligrams of THC (the active ingredient) per kilogram (2.2 pounds) of weight. Eating 10mg of THC — a common serving size in packages of 10 — would be unlikely to cause severe toxicity, but the researchers warn that each additional milligram of THC per kilogram of body weight tripled the odds of severe or prolonged symptoms.
The final episode of "Color Code," season two, delves into how housing — and today's housing crisis — intersects with health care. Listen here.
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