The Next Time You See Your Doctor Could Be Online

By Christine Vestal, Stateline

The next time you see your doctor could be onlineDemand for doctors – whether in person or via a computer screen – is expected to surge as millions more Americans become insured under the Affordable Care Act. About 10 million people already rely on telemedicine, often from doctors who live in another state.

As a result, more physicians are applying for medical licenses in multiple states – a costly and time-consuming proposition for some. Without a license to practice medicine in the patient’s state of residence, both doctors and patients may be at legal risk.

Many states are embracing telemedicine by encouraging it in their Medicaid programs and requiring private insurers to pay for it. But they have made little progress in removing medical licensing barriers that proponents of the technology say have kept doctors and hospitals from expanding even more.

Telemedicine was once the purview of small town doctors who needed to consult with specialists available only in larger urban areas. Today, telemedicine technology is even being used to conduct surgeries using robotics, typically only in emergency situations such as during war.

Most telemedicine consists of video teleconferencing between a doctor and a patient. Doctors also routinely use telemedicine technology to transmit and discuss diagnostic images and to remotely monitor patients with chronic diseases so they don’t have to leave their homes or nursing facilities.

For some consumers, it is the primary way they receive medical care. Using Skype on a computer or FaceTime on an iPhone, patients discuss their symptoms and show their doctors any visible evidence of their conditions, such as a swollen eye or skin rash. Patients most often conduct these consultations from home or their workplace. In some cases, patients go to a medical facility and use high-end, secure equipment to teleconference with a doctor in another location.

Much of the growth in telemedicine is expected to be in remote monitoring of patients with heart and lung diseases and diabetes, who have recently been discharged from a hospital. The aim is to detect health problems early enough to prevent them from being sent back to the hospital.

States have argued that easing licensing requirements could jeopardize patient safety. If doctors practice in a state without obtaining a license there, regulators maintain that they have no power to conduct an investigation or explore a consumer complaint. Also, these doctors would not benefit from any legal protections the state may have against malpractice lawsuits.

Proponents of telemedicine argue that since doctors take standardized national exams and most requirements are set by federal agencies such as the U.S. Department of Health and Human Services, states should recognize other state licenses. They say state medical boards are simply trying to shield doctors from out-of-state competition and preserve state revenues from licensing fees.

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Preventing Medical Errors in Speech-Language Pathology

Over the past 20 years, medical errors that result in patient injury or even death have become the focus of attention in both popular and professional publications. The Institute of Medicine (IOM) defines a medical error as: “The failure to complete a planned action as intended or the use of a wrong plan to achieve an aim.” Medical errors – which can occur in either the planning stage or the execution stage – are frequently communication errors, which are, unfortunately, very common in health care.

A 2011 Consumer Reports Poll on Hospital Safety interviewed 1,026 adults ages 18+ using a nationally representative probability sample. The results:

  • 77% expressed high or moderate concern re: harm by hospital infection during hospital stay
  • 71% expressed high or moderate concern re: harm by a medication error
  • 65% were similarly concerned about surgical errors


Preventing Medical Errors in Speech-Language PathologyIn the State of Florida, speech-language pathologists and other health professionals are required to complete a course on the prevention of medical errors each time they renew their license. Preventing Medical Errors in Speech-Language Pathology is designed to help SLPs be vigilant to the kinds of medical errors that can occur in their practice and take proactive steps to prevent them. This course addresses the impact of medical errors on today’s healthcare with a focus on root cause analysis, error reduction and prevention, and patient safety. Multiple scenarios of real and potential errors in the practice of speech-language pathology are included, along with recommended strategies for preventing them. Evidence shows that the most effective error prevention occurs when a partnership exists among care facilities, health care professionals, and the patients they treat. Suggested strategies for preventing errors address all three elements: (1) models for changing the culture in care facilities, (2) lifelong learning for SLPs that is focused on ethical, evidence-based, culturally competent practice and (3) tools for educating and empowering patients. * This course satisfies the medical errors requirement for biennial relicensure of Florida speech-language pathologists and audiologists. Course #20-77 | 2013 | 35 pages | 21 posttest questions | ASHA credit expires 4/20/2016.

One the most common medical procedures in which speech-language pathologists have a primary role is the evaluation and treatment of swallowing and feeding disorders. Because of the nature of swallowing disorders, treatment is frequently complex, and a number of dysphagia management issues have become very contentious. In addition, the potential for error, adverse outcomes and litigation is significant.

“This newly revised course teaches everyday strategies for preventing errors that can occur in the practice of speech-language pathology,” says Leo Christie, President and CEO of Professional Development Resources. “Rather than targeting individuals when a medical error happens, efforts today are focused upon those elements in the work environment like fatigue or distraction that can lead medical errors. This approach of focusing on system error over human error has proved to be useful in reducing the risk of patient injury.”

Preventing Medical Errors in Speech-Language Pathology also includes a section on race and ethnicity. The authors point out that there is an increasing need for bilingual health professionals to serve the rapidly growing ethic segments of our population. According to the U.S. Census Bureau (2012), minorities comprise 37% of the U.S population. When professionals are not familiar with the cultural norms, customs, and languages of their patients, miscommunications can arise and cause serious diagnostic and treatment errors.

The course describes in detail a number of patient safety goals and concludes with a series of recommendations for improving interpersonal communication in order to prevent medical errors. Recommended strategies include the following:

  1. Slow down, speak slowly and spend a small amount of additional time with each patient
  2. Use plain, nonmedical language. Explain things as you would to your own grandmother.
  3. Show or draw pictures to help your patient understand and remember.
  4. Limit the amount of information provided, and repeat it.
  5. Use the “teach-back” technique to confirm that the patient understands.
  6. Create a shame-free environment by encouraging questions.
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Acupuncture and Oriental Medicine Day

Acupuncture and Oriental Medicine Day is observed annually on October 24. It is part of an effort designed to increase public awareness of the progress, promise, and benefits of acupuncture and Oriental medicine.

Acupuncture and Oriental Medicine DayAn estimated 36% of U.S. adults use some form of complementary and alternative medicine (CAM), according to a survey by the National Center for Complementary and Alternative Medicine, a component of the National Institutes of Health. When megavitamin therapy and prayer specifically for health reasons is included in the definition of CAM, the number of U.S. adults using some form of CAM in the past year rises to 62%. Among the common CAM practices identified by the survey were acupuncture, acupressure, herbal medicine, tai chi and qi gong.

A survey by the National Certification Commission for Acupuncture and Oriental Medicine found that approximately one in ten adults had received acupuncture at least one time and 60% said they would readily consider acupuncture as a potential treatment option. Nearly half (48%) of the individuals surveyed who had received acupuncture reported that they were extremely satisfied or very satisfied with their treatment. In addition, one in five (21%) of the total NCCAOM survey respondents reported that they had utilized some other form of Oriental medicine besides acupuncture, such as herbs or bodywork (e.g., shiatsu).

These studies and others like them clearly demonstrate that CAM therapies such as acupuncture and Oriental medicine are common practice in today’s health care system. They also support the need for consumers to be provided accurate and reliable information regarding their treatment options. Source:

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New CE Courses Address Complementary and Alternative Medicine (CAM)

new CE courses address complementary and alternative medicine

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We (Professional Development Resources) have expanded our course catalog to include a variety of new continuing education (CE) courses dealing with various aspects of complementary and alternative medicine. New topics include mindfulness meditation, yoga as medicine, self-healing through breathing exercises, and the use of herbal medicines. The courses are intended to introduce health professionals to the healing power of traditional approaches to health and wellness.

According to the National Center for Complementary and Alternative Medicine (NCAAM), defining complementary and alternative medicine (CAM) is not easy. It is generally considered to be a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. “Complementary medicine” refers to use of CAM together with conventional medicine, such as using acupuncture in addition to usual care to help lessen pain. “Alternative medicine” refers to use of CAM in place of conventional medicine. “Integrative medicine” (also called integrated medicine) refers to a practice that combines both conventional and CAM treatments for which there is evidence of safety and effectiveness.

“We think it is important for clinicians to be familiar with these approaches for two reasons,” says Leo Christie, PhD, CEO of Professional Development Resources. “First, many of the clients we see are using such treatments, so we need to know about them. A recent survey indicated that about 38% of adult Americans use CAM. Are the treatments safe? Do they work? We need to worry about interactions between certain herbal supplements and prescription medications. Second, researchers are starting to produce a body of scientific evidence on the efficacy of complementary and alternative approaches. As new and effective treatments become available, we need to be in a position to discuss them with our clients.”

Among the new courses offered are:

Christie adds “we emphasize in our courses that – as with any medical treatment – there can be risks with CAM therapies.” These general precautions from NCAAM can help to minimize risks:

  • Select CAM practitioners with care. Find out about the practitioner’s training and experience.
  • Be aware that some dietary supplements may interact with medications or other supplements, may have side effects of their own, or may contain potentially harmful ingredients not listed on the label. Also keep in mind that most supplements have not been tested in pregnant women, nursing mothers, or children.
  • Tell all your health care providers about any complementary and alternative practices you use.
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Operation “Goodbye Books” Week 12

The Last Book

The Last Book

Gina holding the last book!

The stock room is empty – except for this one last book!

Who wants to order our very last mail order course?

Evidence-Based Practice in Communication Disorders offers 6 hours of continuing education credits for only $89, plus shipping/handling. This course is ASHA-approved for 0.6 CEUs.

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