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	<title>HealthExecNews &#187; Communication</title>
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		<title>Are tablets and smartphones tools or distractions?</title>
		<link>http://healthexecnews.com/are-tablets-and-smartphones-tools-or-distractions</link>
		<comments>http://healthexecnews.com/are-tablets-and-smartphones-tools-or-distractions#comments</comments>
		<pubDate>Mon, 19 Dec 2011 10:00:45 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Ethics]]></category>
		<category><![CDATA[Health care/Treatment trends]]></category>
		<category><![CDATA[Healthcare Human Resources and Staffing News]]></category>
		<category><![CDATA[Healthcare Technology News]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Communication]]></category>
		<category><![CDATA[Facebook]]></category>
		<category><![CDATA[iPads]]></category>
		<category><![CDATA[smartphones]]></category>
		<category><![CDATA[tablets]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=5229</guid>
		<description><![CDATA[Is the prevalence of gadgets in health care a good thing for patient care? Or is it too much of a tempting distraction? More hospitals and practices are equipping physicians and other health care providers with tablets, smartphones and similar devices so they can stay connected and access critical data no matter where they are. [...]]]></description>
			<content:encoded><![CDATA[<p>Is the prevalence of gadgets in health care a good thing for patient care? Or is it too much of a tempting distraction? <span id="more-5229"></span>More hospitals and practices are equipping physicians and other health care providers with <a title="More hospitals using iPads at the patient bedside" href="http://healthexecnews.com./more-hospitals-using-ipads-at-the-patient-bedside" target="_blank">tablets, smartphones and similar devices so they can stay connected</a> and access critical data no matter where they are.</p>
<p>Few would argue that&#8217;s not a significant benefit. <a href="http://www.nytimes.com/2011/12/15/health/as-doctors-use-more-devices-potential-for-distraction-grows.html" target="_blank">But many experts are concerned that the growing use of the devices is increasing certain risks as well</a>. For starters, if doctors and other health care pros get too used to staring at a device for information, they may pay less attention to the patient in front of them.</p>
<p>And that assumes employees are using the devices strictly for work purposes. But some employees are inevitably tempted to access email, Facebook and other decidedly non-work-appropriate uses. And while that may seem like something only a rare few would stoop to doing, research shows quite the opposite. In fact, <a href="http://prf.sagepub.com/content/26/5/375.abstract" target="_blank">in one survey,</a> 55% of technicians who monitor bypass machines said they had talked on their cellphones during surgeries, and half said they had texted during surgery.</p>
<p>To keep the benefits of mobile devices without creating a potentially risky for patients, hospitals and practices using the devices need to write &#8212; and thoroughly train employees on &#8212; a policy that covers all aspects of the use of tablets, cell phones, etc. The policy should cover both employer-issued and private devices brought to work, as well as when/how it&#8217;s appropriate to use them on the job.</p>
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		<title>Could your doctors pass this &#8216;people skills&#8217; test?</title>
		<link>http://healthexecnews.com/could-your-doctors-pass-this-people-skills-test</link>
		<comments>http://healthexecnews.com/could-your-doctors-pass-this-people-skills-test#comments</comments>
		<pubDate>Tue, 12 Jul 2011 10:00:28 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[Ethics]]></category>
		<category><![CDATA[Health care/Treatment trends]]></category>
		<category><![CDATA[Healthcare Human Resources and Staffing News]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Patient/Client Communication]]></category>
		<category><![CDATA[medical school]]></category>
		<category><![CDATA[medical students]]></category>
		<category><![CDATA[MMI]]></category>
		<category><![CDATA[multiple mini interview]]></category>
		<category><![CDATA[Stanford University]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=3836</guid>
		<description><![CDATA[More medical schools are relying on &#8220;soft skills&#8221; testing along with grades and test scores to determine who they&#8217;ll admit as students. Anyone who&#8217;s worked in the health field knows that some doctors can be less-than-stellar at inter-personal communication. And having great technical knowledge doesn&#8217;t help all that much when a doc&#8217;s bedside manner is [...]]]></description>
			<content:encoded><![CDATA[<p>More medical schools are relying on &#8220;soft skills&#8221; testing along with grades and test scores to determine who they&#8217;ll admit as students. <span id="more-3836"></span></p>
<p>Anyone who&#8217;s worked in the health field knows that some doctors can be less-than-stellar at inter-personal communication. And having great technical knowledge doesn&#8217;t help all that much when a doc&#8217;s bedside manner is lacking. Poor communication with co-workers can have equally bad consequences for the entire health care team, and impact patients&#8217; outcomes.</p>
<p>Which is why <a href="http://www.nytimes.com/2011/07/11/health/policy/11docs.htm" target="_blank">some medical schools are starting to use multiple mini interviews</a> (MMIs) to help weed out students who&#8217;ve applied.</p>
<p>The MMIs require students to do nine brief interviews designed to test their social skills and overall ability to communicate. MMIs are being used by at least 21 medical schools in North America, including Stanford University.</p>
<p>A typical interview would present a prospective student with an ethical question on a topic ranging from insurance co-pays to using unproven alternate therapies. The interviewee then has eight minutes to discuss the topic with the interviewer.</p>
<p>The questions have no set right/wrong answer. Instead, candidates are scored on more subjective criteria such as how well they react to the emotional response of the interviewer, how they respond when they&#8217;re disagreed with, and if they jump to conclusions or fail to listen to another viewpoint.</p>
<p>Advocates of the MMI say the scores on these interviews tend to correlate closely with the licensing tests doctors take when they finish school.</p>
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		<title>Patients&#8217; 5 most common deathbed confessions</title>
		<link>http://healthexecnews.com/patients-5-most-common-deathbed-confessions</link>
		<comments>http://healthexecnews.com/patients-5-most-common-deathbed-confessions#comments</comments>
		<pubDate>Thu, 07 Jul 2011 10:00:46 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Patient/Client Communication]]></category>
		<category><![CDATA[hospice]]></category>
		<category><![CDATA[terminal illness]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=3631</guid>
		<description><![CDATA[Working in health care provides a real education &#8212; in human nature as much as in biology. One former hospice worker has written a book about what she&#8217;s learned from talking to her terminally ill patients. Here she shares their five most common deathbed &#8220;confessions.&#8221; I wish I&#8217;d had the courage to live a life [...]]]></description>
			<content:encoded><![CDATA[<p>Working in health care provides a real education &#8212; in human nature as much as in biology.</p>
<p><span id="more-3631"></span>One former hospice worker has written a book about what she&#8217;s learned from talking to her terminally ill patients. <a href="http://www.inspirationandchai.com/Regrets-of-the-Dying.html" target="_blank">Here</a> she shares their five most common deathbed &#8220;confessions.&#8221;</p>
<ol>
<li>I wish I&#8217;d had the courage to live a life true to myself, not the life others expected of me.</li>
<li>I wish I didn&#8217;t work so hard.</li>
<li>I wish I&#8217;d had the courage to express my feelings.</li>
<li>I wish I had stayed in touch with my friends.</li>
<li>I wish that I had let myself be happier.</li>
</ol>
<p>What life lessons have you learned from your time in the health care field? Share your insights in the comments.</p>
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		<title>5 HIPAA-friendly ways to use social media</title>
		<link>http://healthexecnews.com/5-hipaa-friendly-ways-to-use-social-media</link>
		<comments>http://healthexecnews.com/5-hipaa-friendly-ways-to-use-social-media#comments</comments>
		<pubDate>Wed, 20 Apr 2011 10:00:23 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[Ethics]]></category>
		<category><![CDATA[Health care/Treatment trends]]></category>
		<category><![CDATA[Healthcare Human Resources and Staffing News]]></category>
		<category><![CDATA[Healthcare Legal & Compliance]]></category>
		<category><![CDATA[Healthcare Technology News]]></category>
		<category><![CDATA[Hospital Management]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Patient/Client Communication]]></category>
		<category><![CDATA[Practice Management]]></category>
		<category><![CDATA[Avvo]]></category>
		<category><![CDATA[Facebook]]></category>
		<category><![CDATA[HIPAA]]></category>
		<category><![CDATA[patient communication]]></category>
		<category><![CDATA[social networking]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=3229</guid>
		<description><![CDATA[Many health care providers are worried that social networking&#8217;s main selling point &#8212; ease of sharing info &#8212; will lead them astray of HIPAA rules by sharing too much info with the wrong audience. Patients and their health care providers yearn for better communication tools to share info. But the resources other industries use don&#8217;t [...]]]></description>
			<content:encoded><![CDATA[<p>Many health care providers are worried that social networking&#8217;s main  selling point &#8212; ease of sharing info &#8212; will lead them astray of HIPAA  rules by sharing too much info with the wrong audience.</p>
<p><span id="more-3229"></span>Patients and their health care providers yearn for better communication  tools to share info. But the resources other industries use don&#8217;t  translate easily to a health care setting. Social media in particular is overwhelmingly popular among patients, and many health care pros use it &#8212; at least in their private lives. But using sites like Facebook and Twitter at a hospital or private practice is tricky.</p>
<p>That leaves physicians, hospitals and other health care organizations on the sidelines of a lot of opportunities. But there are HIPAA-friendly ways to integrate social media into a professional health care setting.</p>
<p>Not using the tools at all is an over-reaction.</p>
<p>Social media experts at <a href="http://www.avvo.com" target="_blank">Avvo </a>offered these 5 tips on how to take advantage of the benefits of social media while steering clear of the potential risks.</p>
<ol>
<li><strong>Use email, SMS and social media messaging</strong>. These are acceptable tools for making outreach to patients, the media, medical industry influencers, and other doctors.  HIPAA regulations actually encourage the use of alternative communication methods, especially as patients express their preference for a particular mode of communication.</li>
<li><strong>Share information with other providers.</strong> Many health professionals set up unnecessary procedures that make it harder to share patient information with other providers. If you need input from another provider, you don’t have to worry about HIPAA compliance. HIPAA guidelines specifically permit the sharing of information with other providers (freely and without patient consent) for the purposes of patient treatment.</li>
<li><strong>Answer general patient questions</strong>. There&#8217;s no HIPAA bar to providing this information.</li>
<li><strong>Keep family members in the loop.</strong> There&#8217;s no need to let HIPAA prevent family members  from being engaged and involved in a patient&#8217;s care.  There is wide latitude under HIPAA to inform a patient’s family members about his or her status – and this extends to electronic communication with family members, too.</li>
<li><strong>Use common sense </strong>and reasonable practices to ensure the privacy and security of communication with patients. This general rule of thumb applies whether the communication is by email, SMS, fax or instant message &#8212; just like it would for phone or face-to-face communication.</li>
</ol>
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		<title>See no evil, speak no evil: The health risk most providers ignore</title>
		<link>http://healthexecnews.com/see-no-evil-speak-no-evil-the-health-risk-most-providers-ignore</link>
		<comments>http://healthexecnews.com/see-no-evil-speak-no-evil-the-health-risk-most-providers-ignore#comments</comments>
		<pubDate>Wed, 13 Apr 2011 10:00:46 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[Healthcare Human Resources and Staffing News]]></category>
		<category><![CDATA[Healthcare Technology News]]></category>
		<category><![CDATA[Hospital Management]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Patient/Client Communication]]></category>
		<category><![CDATA[Practice Management]]></category>
		<category><![CDATA[American Association of Critical-Care Nurses]]></category>
		<category><![CDATA[Association of periOperative Registered Nurses]]></category>
		<category><![CDATA[patient care]]></category>
		<category><![CDATA[patient safety]]></category>
		<category><![CDATA[research]]></category>
		<category><![CDATA[safety]]></category>
		<category><![CDATA[VitalSmarts]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=3175</guid>
		<description><![CDATA[Just because a health care provider sees something that could harm a patient doesn&#8217;t mean they&#8217;ll speak up about it. That&#8217;s the sad finding of the study, &#8220;The Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives.&#8221; According to the researchers, although 85% of health care workers said they had been alerted [...]]]></description>
			<content:encoded><![CDATA[<p>Just because a health care provider sees something that could harm a patient doesn&#8217;t mean they&#8217;ll speak up about it. <span id="more-3175"></span></p>
<p>That&#8217;s the sad finding of the study, &#8220;<a href="http://www.silenttreatmentstudy.com/" target="_blank">The Silent Treatment</a>: Why Safety Tools and Checklists Aren’t Enough to Save Lives.&#8221;</p>
<p>According to the researchers, although 85% of health care workers said they had been alerted to a potential patient risk by a safety tool, 58% of those who had received a warning admitted they hadn&#8217;t mentioned it to other health staff or resolved the problem.</p>
<p>Respondents cited three main reasons that safety issues were difficult to bring up: Other staffers&#8217; dangerous shortcuts, incompetence and disrespect were seen as &#8220;undiscussable.&#8221;</p>
<p>While safety devices have an important role to play, their usefulness is hampered when health care staff have such difficulty communicating with each other.</p>
<p>The study was a joint project of the American Association of Critical-Care Nurses, the Association of  periOperative Registered Nurses and VitalSmarts.</p>
]]></content:encoded>
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		<title>Wrong-site errors: Why do they still happen so often?</title>
		<link>http://healthexecnews.com/wrong-site-errors-why-do-they-still-happen-so-often</link>
		<comments>http://healthexecnews.com/wrong-site-errors-why-do-they-still-happen-so-often#comments</comments>
		<pubDate>Thu, 21 Oct 2010 10:00:08 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[Health care/Treatment trends]]></category>
		<category><![CDATA[Hospital Management]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Practice Management]]></category>
		<category><![CDATA[Archives of Surgery]]></category>
		<category><![CDATA[medical errors]]></category>
		<category><![CDATA[wrong-patient]]></category>
		<category><![CDATA[wrong-site surgery]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=2432</guid>
		<description><![CDATA[Despite hospitals&#8217; best efforts, wrong-site errors still happen far more often than anyone would like. New research sheds light on the root causes. According to a recent study published in the Archives of Surgery, most wrong-site errors were caused at least in part by errors in judgment (85%) and the failure to use a &#8220;time-out&#8221; [...]]]></description>
			<content:encoded><![CDATA[<p>Despite hospitals&#8217; best efforts, wrong-site errors still happen far more often than anyone would like. New research sheds light on the root causes.</p>
<p><span id="more-2432"></span></p>
<p>According to a recent study published in the <a href="http://archsurg.ama-assn.org/cgi/content/short/145/10/978" target="_blank">Archives of Surgery,</a> most wrong-site errors were caused at least in part by errors in judgment (85%) and the failure to use a &#8220;time-out&#8221; to confirm procedures (72%). By contrast, wrong-patient errors were more often caused by miscommunication (100%) and misdiagnosis (56%).</p>
<p>Interestingly, nonsurgical specialties were about as likely to be responsible for wrong-site and wrong-patient errors as surgical specialties.</p>
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		<title>Study: Why docs won&#8217;t email their patients</title>
		<link>http://healthexecnews.com/study-why-docs-wont-email-their-patients</link>
		<comments>http://healthexecnews.com/study-why-docs-wont-email-their-patients#comments</comments>
		<pubDate>Tue, 19 Oct 2010 10:00:36 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[EMR & EHR - Electronic Health Records]]></category>
		<category><![CDATA[Health care/Treatment trends]]></category>
		<category><![CDATA[Healthcare Human Resources and Staffing News]]></category>
		<category><![CDATA[Healthcare Technology News]]></category>
		<category><![CDATA[Hospital Management]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Patient/Client Communication]]></category>
		<category><![CDATA[Practice Management]]></category>
		<category><![CDATA[Center for Studying Health System Change]]></category>
		<category><![CDATA[e-mail]]></category>
		<category><![CDATA[EHRs]]></category>
		<category><![CDATA[research]]></category>
		<category><![CDATA[telehealth]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=2402</guid>
		<description><![CDATA[Only 7% of physicians regularly use e-mail to interact with patients. Why don&#8217;t more busy docs use this time-saving tool? One reason: 65% of doctors don&#8217;t have e-mail access to patients to begin with. That&#8217;s one of the takeaways from the recent survey conducted by the Center for Studying Health System Change. Many in the [...]]]></description>
			<content:encoded><![CDATA[<p>Only 7% of physicians regularly use e-mail to interact with patients. Why don&#8217;t more busy docs use this time-saving tool? <span id="more-2402"></span></p>
<p>One reason: 65% of doctors don&#8217;t have e-mail access to patients to begin with.</p>
<p>That&#8217;s one of the takeaways from the recent survey conducted by the <a href="http://www.hschange.org/CONTENT/1156/#table1" target="_blank">Center for Studying Health System Change</a>.</p>
<p>Many in the health care field thought that as electronic health records (EHRs) became more common, use of e-mail as a way to communicate with patients would grow as well. That hasn&#8217;t really been the case: Doctors using EHRs are more likely to use e-mail &#8212; but the increase hasn&#8217;t nearly kept pace with the usage of EHRs.</p>
<p>The researchers believe the lack of reimbursement for e-mail consultations with patients is a big barrier for most physicians. Doctors most likely to use e-mail were part of a large group practices or HMOs and those working in medical school-owned offices, clinics or hospital staffs. Solo practitioners were least likely to communicate with patients via e-mail.</p>
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		<title>Patients have less trust in doctors with accents</title>
		<link>http://healthexecnews.com/patients-have-less-trust-in-doctors-with-accents</link>
		<comments>http://healthexecnews.com/patients-have-less-trust-in-doctors-with-accents#comments</comments>
		<pubDate>Mon, 02 Aug 2010 10:00:14 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[In this week's e-newsletter]]></category>
		<category><![CDATA[Latest News & Views]]></category>
		<category><![CDATA[Patient/Client Communication]]></category>
		<category><![CDATA[Journal of Experimental Psychology]]></category>
		<category><![CDATA[research]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=1972</guid>
		<description><![CDATA[Health care providers with accents will have a harder time earning credibility in patients&#8217; eyes. And there may be little anyone can do about it. That&#8217;s the takeaway of a recent study published in the Journal of Experimental Psychology (PDF). Researchers found that non-native speakers had lower credibility scores &#8212; not due to prejudice or [...]]]></description>
			<content:encoded><![CDATA[<p>Health care providers with accents will have a harder time earning credibility in patients&#8217; eyes. And there may be little anyone can do about it. <span id="more-1972"></span></p>
<p>That&#8217;s the takeaway of a recent study published in the <a href="http://news.uchicago.edu/files/newsrelease.20100719.accents.pdf" target="_blank">Journal of Experimental Psychology</a> (PDF).</p>
<p>Researchers found that non-native speakers had lower credibility scores &#8212; not due to prejudice or suspicion of their background, but because it&#8217;s simply a little harder to understand them.</p>
<p>The study&#8217;s authors theorize that the accents slow the listener&#8217;s processing speed, which unconsciously makes the information seem less credible.</p>
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		<title>Report warns e-mailing patients may have hidden downside</title>
		<link>http://healthexecnews.com/report-warns-e-mailing-patients-may-have-hidden-downside</link>
		<comments>http://healthexecnews.com/report-warns-e-mailing-patients-may-have-hidden-downside#comments</comments>
		<pubDate>Thu, 27 May 2010 10:00:06 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
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		<guid isPermaLink="false">http://healthexecnews.com/?p=1626</guid>
		<description><![CDATA[Docs using e-mail to connect with patients may seem like nothing but good news for patients, but new research reveals some groups benefit much more than others. A recent study asked parents of pediatric patients to rate how often they use e-mail to communicate, if the ability to e-mail a doctor would be helpful, and [...]]]></description>
			<content:encoded><![CDATA[<p>Docs using e-mail to connect with patients may seem like nothing but good news for patients, but new research reveals some groups benefit much more than others. <span id="more-1626"></span></p>
<p>A recent study asked parents of pediatric patients to rate how often they use e-mail to communicate, if the ability to e-mail a doctor would be helpful, and if parents would prefer to have that option.</p>
<p>Overwhelming majorities said they use e-mail frequently and said doctors should offer that option. But two groups, African-Americans and parents from low-income households, said e-mail wouldn&#8217;t be useful to them.</p>
<p><a href="http://www.abstracts2view.com/pas/view.php?nu=PAS10L1_116" target="_blank">The report authors</a> warned that practices that e-mail patients could wind up creating health disparities in the level of communication provided to different groups.</p>
<p>One possible solution: Making sure practices/clinicians don&#8217;t rely on e-mail to communicate important health information, and use it only when patients have already initiated the process.</p>
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		<title>Will health reform cause docs to unionize?</title>
		<link>http://healthexecnews.com/will-health-reform-cause-docs-to-unionize</link>
		<comments>http://healthexecnews.com/will-health-reform-cause-docs-to-unionize#comments</comments>
		<pubDate>Wed, 21 Apr 2010 10:00:25 +0000</pubDate>
		<dc:creator>Carol Katarsky</dc:creator>
				<category><![CDATA[Communication]]></category>
		<category><![CDATA[Healthcare Finance]]></category>
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		<category><![CDATA[union]]></category>

		<guid isPermaLink="false">http://healthexecnews.com/?p=1442</guid>
		<description><![CDATA[Physicians may not seem like the most likely group of employees to want to unionize, but there are solid reasons to think more of them will be looking into it in the near future.   Notoriously independent physicians may feel they have no choice but to band together in the wake of changes ushered in [...]]]></description>
			<content:encoded><![CDATA[<p>Physicians may not seem like the most likely group of employees to want to unionize, but there are solid reasons to think more of them will be looking into it in the near future.   <span id="more-1442"></span></p>
<p>Notoriously independent physicians may feel they have no choice but to  band together in the wake of changes ushered in by the health reform  bill.</p>
<p>Already, some doctors who work in government health care organizations are organized, and residents and interns have been known to unionize &#8212; or at least attempt to.</p>
<p>While it may seem far-fetched for established physicians to unionize, some experts are taking the possibility seriously.</p>
<p>In its 2010 Health Care Labor Report, the American Hospital Association included increased influence of unionized doctors as one issue to keep an eye on.</p>
<p>If more physicians wind up joining unions, it could have a serious effect on hospitals &#8212; far more complicated than other labor groups. Doctors have more intricate payment and incentive systems to take into account, and could make demands for shorter hours, limits on the number of doctors (or other staff) per patient, etc.</p>
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