The board’s lengthy backlog of disciplinary cases “puts your family at risk,” Barry Cranfill, a nurse anesthetist appointed to the board in 2010, told state legislators. “We can’t do it with the resources we have now.”

Cranfill’s testimony came before a special House committee studying dozens of professional licensing boards to find ways to streamline their work. The boards, which fall under Secretary of State Brian Kemp, have struggled in recent years with smaller budgets and new responsibilities to ensure they do not issue licenses to illegal immigrants.

The nursing board, which regulates more than 150,000 nurses across the state, is the largest and perhaps most troubled of the boards. This summer The Atlanta Journal-Constitution spent weeks examining nurse disciplinary files and how the board deals with them.

The investigation found that the board takes an average of 15 months to handle disciplinary cases, creating a huge backlog of complaints and enabling nurses to continue treating patients while their cases languish. Most of the cases involve nurses who have been accused of stealing and abusing narcotics, often multiple times.

The board’s complaint system is so archaic that officials have a hard time even quantifying the backlog. Officially there are more than 3,300 open cases, but officials in Kemp’s office think that includes an unknown number closed cases that were never removed from the system.

In his blunt opening comments, Cranfill said Kemp and the board have done what they can to streamline the process but they need more staff.

“There is no other way to fix this problem except to throw money at it,” he said. “We’re not asking for a blank check. I’m just asking for the resources to do what we have to do.”

The board generates about $4 million in licensing fees from nurses across the state and receives about half that amount back in budget. Cranfill said the board could function properly if the Legislature returned all of the fees paid into the system by nurses.

Debbie Hackman, CEO of the Georgia Association of Nurses, said the board can’t handle its responsibilities with the resources it has now.

“We’d like to see that turned around,” she said. “It’s a serious problem. It’s one of patient safety.”

The Georgia Realtors Association sued the state in the 1970s over a similar funding issue with the Georgia Real Estate Commission and won in federal court. Now the commission retains most of its fees, which Cranfill said is ideal.

“I would love it if someone would sue me,” he said.

Cranfill also said the board is considering cutting its fees in half to match its budget, citing his reading of a state law that requires boards to set fees to match their expenses.

Cranfill’s testimony came in the second day of a two-day session in which representatives from more than three dozen licensed professions were invited to explain what their board does.

Committee Chairman Ed Rynders, R-Albany, said he has heard some, if not all, of Cranfill’s testimony before and said the committee will take it into account when it comes up with recommendations for the boards.

“Nobody wants Georgians to be at risk or be harmed or have people installing air-conditioners who don’t know what they are doing,” he said. “Trying to find that balance is key to this.”

Cranfill’s unvarnished approach did not sit well with everyone. Rynders said lawmakers can look beyond the emotion for solutions, but “I do think there is a protocol.”

“There’s a saying in South Georgia — you don’t have to date my sister, but you don’t have to call her ugly,” he said. “I think Barry has a way of calling people’s sisters ugly sometimes.”

Cranfill said he has been pushing the issue for two years now. It’s time the public knows how bad it is, he said.

“I have said the exact same thing now at least 15 times. I’ve said it in that room at least five times,” he said, referring to the committee room. “We had no alternative except to bring this to the light of day.”

Kemp’s spokesman Jared Thomas said the secretary of state was interested in working with the committee to find solutions. Thomas said Kemp recently assigned two more staffers to the board to help move through the backlog.

Cranfill and other members of the nursing board met with Gov. Nathan Deal Wednesday to talk about the problem as well.

“It is an important issue and it needs to get fixed,” said Deal spokesman Brian Robinson. Robinson said Kemp also was in the governor’s office Wednesday on the topic.

The study committee heard hours of speeches from physical therapists, librarians and contractors this week. Often they heard the board had tightened its belt but needed help.

David Rawson, who heads the board regulating utility contractors, said the board often gets complaints about unlicensed contractors, but by the time an investigator gets assigned to the case the violator has finished the job and is gone.

“You’ve got to have more investigators. You’ve got to have investigators who know our industry,” he said.

House passes bill to delay health care subsidies | www.ajc.com

Wednesday, September 11, 2013

COGME Recommends Increase in GME Funding for General Surgery

COGME Recommends Increase in GME Funding for General Surgery

The Council on Graduate Medical Education (COGME) recently released its 21st report, “Improving Value in Graduate Medical Education.” In the report, COGME recommends increasing Graduate Medical Education (GME) funding for high-priority specialties, including general surgery, family medicine, geriatrics, general internal medicine, certain pediatric subspecialties, and psychiatry.

The report acknowledges that GME is facing many challenges, such as poor geographic distribution of physicians in relation to population needs and increasing specialization, and that primary care remains under-resourced. According to the report, part of the problem is that many teaching hospitals have yet to recognize the need for greater emphasis on primary care training, and their curriculum is often inadequate in terms of outcomes for groups of individuals, care coordination, team-based practice, and other aspects of new systems of care.

To address these and other challenges, COGME calls for increasing partnerships between training programs, teaching hospitals, accreditation organizations, state and federal governments, and other stakeholders to accelerate change. COGME assumes improving value in GME funding means better targeting of public GME money and more effective training models.
Authorized by Congress, COGME provides ongoing assessments of physician workforce trends, training issues, and financing policies and recommends appropriate federal and private sector efforts to address identified needs. The American College of Surgeons (ACS) continues to advocate for increased GME funding. View information on recent ACS advocacy efforts related to GME.

Thursday, September 5, 2013

American College of Surgeons and Commission on Cancer Release Lists of Commonly Used Tests and Treatments for Patients to Discuss With Their Surgeons | American College of Surgeons

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