Top 10 Stories of the Year in Medicine

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ICD-10 Is In: The country made the switch in October from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures. The change is designed to help providers capture more details about their patients’ health status in order to improve patient care and public health surveillance. The medical codes used for diagnosis and billing had not been updated for more than 35 years and contained outdated, obsolete terms. The monitoring process of the ICD-10 transition is ongoing.

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For Drug Pricing, the Sky’s the Limit: Turing Pharmaceuticals CEO Martin Shkreli acquired Daraprim, a toxoplasmosis drug, and quickly boosted its price-from $13.50 to $750 per pill! Then, in spite of public outrage, Shkreli expressed regret that he had not raised the price even more. He did claim he would use Daraprim sales revenues for R&D. That will bear watching.

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Blood Pressure Control Ranks High on To-do List: A new nationwide initiative addressed the growing burden of high blood pressure in the United States. Target: BP™ supports physicians and care teams in helping patients with high blood pressure reach a blood pressure goal of lower than 140/90 mm Hg, based on current American Heart Association guidelines. Interdisciplinary work is encouraged to raise awareness about high blood pressure and commit to high levels of control in various populations.

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Thumbs Down for Electronic Health Records: Roughly half of surveyed physicians reported a negative impact in response to questions about how their EHR system improved costs, efficiency, or productivity, and more physicians reported dissatisfaction than 5 years ago. Primary care physicians were more likely than specialists to report satisfaction with various aspects of the EHR system and to indicate a positive impact on practice, probably because they had used their systems longer.

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Stronger Cigarettes-Death Link Identified: Cigarette smoking may kill tens of thousands more persons from diseases not currently included in US surgeon general estimates, a study showed. About 17% of excess deaths in smokers were caused by diseases that at least doubled the risk of death from renal failure, intestinal ischemia, hypertensive heart disease, infections, and respiratory diseases other than COPD. A greater focus on helping people quit, not new conditions linked to smoking, was suggested.

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For Physician Shortage, the Future Is Now: A shortage of up to 90,000 physicians and 31,100 primary care physicians in the United States by 2025 was predicted in a physician workforce projection report. An additional 3000 residency slots each year from 2015 to 2025 was called for to meet the health care needs of the country’s growing and aging population, at an estimated cost of about $10 billion

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New Breast Cancer Guidelines: The American Cancer Society released new recommendations: women with an average risk of breast cancer should begin yearly mammograms at age 45 years; women should be able to start the screening as early as age 40 years; at 55 years, women should have mammograms every other year; regular mammograms should continue for as long as a woman is in good health; self- or MD-conducted breast exams are no longer recommended; women at high risk need to begin screening earlier or more often.

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Physicians Voice Biggest Worries: Patient care does not rank among primary care physicians’ biggest worries, a survey showed. Instead, they’re most concerned about insurance companies and new performance measurements. Physicians recognize the long-term benefits of payment reform and performance measurements but struggle to make so many practice changes in a short period.

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A Call for Diabetes Screening: Screening for abnormal blood glucose levels to prevent type 2 diabetes in adults aged 40 to 70 years who are overweight or obese was recommended in a US Preventive Services Task Force statement. Clinicians are urged to offer or refer patients with abnormal blood glucose levels to intensive behavioral counseling interventions to promote healthful diet and physical activity.

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Blueprint for Medical School of the Future: Twenty medical schools were selected to join the AMA’s Accelerating Change in Medical Education Consortium to create the medical school of the future. The new schools are helping build on current projects to train medical students to care for patients in a rapidly changing health care environment. The goal: accelerate systemic change throughout medical education to disseminate innovative curriculum models to more schools and improve future care.