Second Look—Advocacy

Self-employed physicians
According to a report released by the American Medical Association (AMA), about 60 percent of physicians still work in physician-owned practices, and 53.2 percent of physicians were self-employed during 2012. The report notes a trend toward more hospital employment during the last 5 years, with 29 percent of physicians either working directly for a hospital or for a practice at least partially owned by a hospital compared to 16.3 percent of physicians in 2007/2008. The percentage of physicians in solo practice during 2012 dropped 6 points from the 2007/2008 report.

Hospital recruitment of physicians rising
A report released by search firm Merritt Hawkins & Associates finds that 64 percent of physician search assignments from April 1, 2012, to March 31, 2013, came from hospitals. In 2004, hospitals generated just 11 percent of physician searches. Demand for primary care and emergency physicians has increased, while demand for radiologists and anesthesiologists has decreased. Most (75 percent) search assignments featured a salary with production bonus, and a growing number of production formulas featured quality-based metrics.

ER/LA opioid analgesics label changes
The U.S. Food and Drug Administration (FDA) has announced plans to initiate class-wide safety labeling changes and new postmarket study requirements for all extended-release and long-acting (ER/LA) opioid analgesics intended to treat pain. An updated indication states that ER/LA opioids are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate, and further clarifies that, because of the risks of addiction, abuse and misuse, overdose, and death, such drugs should be reserved for use in patients for whom alternative treatment options are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. ER/LA opioid analgesics are not indicated for as-needed pain relief. The agency will begin requiring a new boxed warning on ER/LA opioid analgesics to caution that chronic maternal use of these products during pregnancy can result in life-threatening neonatal opioid withdrawal syndrome.

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