Physician survey shows strained relationships with hospitals

• A new survey of nearly 9,000 physicians found 32% of them do not see Medicaid patients, or they limit the number they do see. Some 88% of physicians said some, many or all of their patients are impacted by social determinants of health.
• The Physicians Foundation survey also yielded some revealing results about the workplace. It found that 78% of those polled experience burnout, while 46% said relations between themselves and hospitals are somewhat or mostly negative. Only 31% identified themselves as independent practice owners, down from 33% in 2016 and 48.5% in 2012.
• Just 10% of physicians surveyed feel they’re able to significantly influence the healthcare system, and 55% described their morale as somewhat or very negative. Nearly half (46%) plan to change careers in some capacity.

It’s far from the only research finding physician dissatisfaction. According to a Medscape survey of 15,000 practicing physicians published at the beginning of the year, nearly two-thirds of U.S. physicians report feeling burned out (42%), depressed (15%) or both (14%). The highest rates of burnout, according to that survey, is among family physicians, intensivists, internists, neurologists and OB-GYNs. A more recent report in the Journal of the American Board of Family Medicine found that physician burnout isn’t nearly as much of a problem in small, independent primary care practices.

The overarching theme of the survey results can be summarized in one question about how physicians describe their professional morale and their feelings about the current state of the medical profession. Only 7% reported feeling “very positive,” 37.7% feel “somewhat positive,” 37.4% feel “somewhat negative” and 17.9% feel “very negative.”

Further, the majority of physicians surveyed (42.4%) feel “somewhat negative/pessimistic” about the future of the medical profession, an incremental increase compared to 41.4% in 2016 and 39.5% in 2014. On burnout, 23.9% of physicians said they are overextended and overworked, while 55.6% said they are at full capacity.

Respondents were also critical of hospitals. As the foundation points out, “the interests of hospitals and physicians have not always aligned and the relationship between physicians and hospitals can be a contentious one.” According to the results, that contention remains.

Only 2.7% of respondents “strongly agree” with the idea that hospital employment of physicians is likely to enhance quality of care and decrease costs, down from 8.1% in 2016, and 10.6% “agree,” down from 25.7% in 2016. Conversely, 29.6% “disagree” with that idea, up from 29.2% in 2016, but 27.9% “strongly disagree,” down from 37% in 2016. Some of the skewering in the results from 2016 to 2018 may be because of the lack of a “neither agree nor disagree” option before this year’s survey.

Despite the frustration with hospitals, the number of physicians who own their own practice has dropped since 2012. According to the survey, 31.4% of respondents identify as independent practice partners or owners, down from 48.5% in 2012. The number of physicians who identify as hospital or medical group employees has risen since 2012, from 43.7% to 49.1%, but dropped from a survey-high 57.9% in 2016.

https://www.healthcaredive.com/news/physician-survey-shows-strained-relationships-with-hospitals/532663/

Athenahealth extends acquisition bid deadline

• Athenahealth has postponed the deadline for bids to acquire the company until Sept. 26 to allow more time for a potential buyer to prepare its bid.
• A source close to the matter said the late comer is considered a strategic buyer, possibly a competitor or supplier, and joins other parties interested in the cloud-based health IT vendor.
• At the same time, Elliott Management, which sent athenahealth an unsolicited offer of $160 a share — or a $6.9 billion — in early May, plans to submit a bid by the new deadline. The New York Post had reported Monday that the fund manager may be backing off its earlier offer.

In a May financial filing, athenahealth’s largest shareholder, Janus Henderson Group, revealed it had urged the company to put itself up for sale. The filing noted concerns over athenahealth’s management and execution of strategic initiatives.

Elliott Management’s unsolicited bid received the silent treatment, prompting a terse letter to athenahealth’s board of directors complaining of the company’s “lack of communication.”

The following month, after allegations of domestic abuse forced President and CEO Jonathan Bush to step down, athenahealth said it would explore strategic alternatives.

As Wall Street tried to read the tea leaves on athenahealth’s latest move, Jefferies’ analysts speculated that Elliot got cold feet after tepid bookings numbers in the first two quarters of the year and also seeing the exit of Bush boosting attrition.

“Given the recent bookings performance … higher ambulatory attrition levels, continued struggles in inpatient and departure of founder Jonathan Bush, there’s little reason to expect revenue growth stabilizes over the coming year(s),” the analysts wrote in an investor note.

Athenahealth did not respond to a request for comment. Elliott Management officials were not available to discuss the matter.

The source told Healthcare Dive that Elliott Management’s initial bid was based on public filings. It’s possible the investment manager will revise that bid now that potential buyers have access to all of athenahealth’s financial and company records.

https://www.healthcaredive.com/news/athenahealth-extends-acquisition-bid-deadline/532694/

Google’s Nest said to have healthcare ambitions

• Google-owned Nest, which makes connected home devices, secretly acquired Seattle startup Senosis Health in the summer of 2017 with an eye toward building its digital health capabilities, GeekWire reports.
• Google was originally reported to have bought Senosis, a University of Washington spin-off that makes smartphone-based monitoring systems, but no mention was made of Nest’s involvement. Nest and university officials declined to comment to the news site.
• Senosis makes products for monitoring hemoglobin counts, lung function, newborn jaundice and osteoporosis. ts apps — SpiroSmart, SpiroCall, HemaApp and OsteoApp — were under FDA review at the time of the sale. Those products are subject to nonexclusive licenses, meaning companies other than Nest can license the technology.

The tech site learned of the transaction after obtaining financial documents and internal communications through a public records request.

Nest joins a growing field of digital health startups and established companies that have been eyeing the sector from the get go.

At the time of the deal, Nest — which Google purchased in 2014 — was operating independently under parent Alphabet’s “Other Bets” category. It has since been rolled back into Google’s hardware unit.

The acquisition of Senosis suggests that Nest is looking to diversify its home thermostat and securities offerings and grab a piece of the ever-expanding digital health market. In addition to hot areas like disease monitoring and population health, there is a growing market in digital tools to monitor and assist the elderly in living at home. That could be good fit with Nest’s current business line.

Google has often been secretive about its healthcare-related exploits. Nest reportedly is following suit and shedding no light on its plans. It apparently doesn’t want people poking around until it is ready to launch a new product line.

Alphabet, through Google, has continued to cast its net over healthcare. Current projects range from releasing sterilized mosquitoes to reduce the spread of infectious diseases to diabetes management and artificial intelligence.

Google’s Deep Brain is working with the U.K.’s National Health Service and Cancer Research UK Center at Imperial College London on early breast cancer detection. The unit is also looking at using AI to improve radiotherapy mapping for head and neck cancers.

Through its Verily life sciences arm, Google is working to develop tools for doctors. Google is also interested in honing voice technology to improve the doctor-patient experience.

Nest, should it develop a line of digital health tools, could be another feather in Google’s healthcare cap. But the startup faces tough competition from other big names like Apple already in the game.

https://www.healthcaredive.com/news/googles-nest-has-healthcare-ambitions-report-says/532892/

A behavioral intervention for cancer patients that works

This is a story about something rare in health psychology: a treatment that has gone from scientific discovery, through development and testing, to dissemination and successful implementation nationwide.

In a new study, researchers found that a program designed at The Ohio State University to reduce harmful stress in cancer patients can be taught to therapists from around the country and implemented at their sites, and effectively improves mood in their patients.

“It’s challenging to take a treatment and scale it up to where it will work with a diverse group of therapists and patients under a wide variety of circumstances,” said Barbara L. Andersen, lead author of the study and professor of psychology at Ohio State.

“This study documents a remarkable success story.”

The study appears online in the journal American Psychologist and will be published in a future print edition.

The program, now called Cancer to Health, was developed by Andersen and colleagues in the early 2000s. It teaches patients how to think about stress, communicate with doctors and others about their treatment, seek social support, become physically active and take other actions to reduce their stress, improve their mood and enhance quality of life. It consists of 18 weekly sessions and eight monthly maintenance sessions, as well as homework assignments for patients.

Dealing with stress is important because research by Andersen’s group and others has found that high levels of stress can lead to not just depression, lower quality of life and negative health behaviors, but also lower immunity and faster disease progression.

“We need to help cancer patients deal with their stress, because it has effects on their physical as well as their mental health,” Andersen said.

In several studies published between 2004 and 2010, Andersen and her colleagues tested the Cancer to Health program and found it effective with breast cancer patients at the Arthur G. James Cancer Hospital at Ohio State. Results showed that patients who went through the program felt better and also had significantly improved immune responses and a lower risk of breast cancer recurrence.

This new study aimed to see if some of the results could be duplicated around the country. It involved therapists who work with cancer patients at 15 sites, from California to Iowa to Maine. Most were associated with local hospitals or cancer support communities. All of the therapists came to Ohio State to learn how to implement the Cancer to Health program.

They then took the program to their sites, where it was tested with 158 patients with a variety of different types of cancer.

Participating therapists were allowed to modify the program for local needs and shorten it if necessary.

Results showed that 60 to 70 percent of patients received the core components of the main program.

Two-thirds of the sites offered some of the monthly maintenance sessions, but averaged only one-third of what was in the original program.

Most importantly, Cancer to Health worked with patients. Results showed that patients showed significant improvement on a measure of mood after completing the program.

In addition, patients became more physically active after Cancer to Health, with the average participant going from “moderately active” before the treatment to “active” afterward.

“That’s significant because 71 percent of the patients were still receiving cancer treatment when they began our study, and maintaining, resuming or beginning physical activity during this period is difficult,” Andersen said.

Moreover, most patients thought the program was helpful and reported that their therapists were very supportive. When asked to rate the program on a scale of 0 to 4, the average overall score was 3.48.

Andersen said other research suggests there is a gap of about 20 years between development of a new health treatment and wider implementation in the medical community.

“If we want to speed that up, we have to train providers. There have not been many studies like this one that involve actually training providers and then testing to see if they could not only implement what they had learned, but could also get their patients to improve,” she said.

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Story Source:

Materials provided by Ohio State University. Original written by Jeff Grabmeier. Note: Content may be edited for style and length.

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Journal Reference:

1. Jamile A. Ashmore, Kirk W. Ditterich, Claire C. Conley, Melissa R. Wright, Peggy S. Howland, Kelly L. Huggins, Jena Cooreman, Priscilla S. Andrews, Donald R. Nicholas, Lind Roberts, Larissa Hewitt, Joan N. Scales, Jenny K. Delap, Christine A. Gray, Lynelle A. Tyler, Charlotte Collins, Catherine M. Whiting, Brittany M. Brothers, Marlena M. Ryba, Barbara L. Andersen. Evaluating the effectiveness and implementation of evidence-based treatment: A multisite hybrid design.. American Psychologist, 2018; DOI: 10.1037/amp0000309

https://www.sciencedaily.com/releases/2018/09/180920160946.htm

IntriCon price target raised to $70 from $65 at Stifel

Stifel analyst Jonathan Block raised his price target on IntriCon (IIN) to $70 from $65 by assigning what he called “relatively conservative sales multiples” to his forecasts for the company’s Medical and Hearing businesses, but he also contends that margin expansion will play an important part to IntriCon’s story in the coming years, giving the stock a path toward $100 per share. Block, who believes IntriCon’s traction with Medtronic (MDT) gives it a long runway for growth, keeps a Buy rating on the shares.

https://thefly.com/landingPageNews.php?id=2793854

Protalix reports ‘positive’ preliminary data from Fabry Disease study

Protalix reports ‘positive’ preliminary data from Fabry Disease study  Protalix announced “positive” preliminary data from the BRIDGE study of pegunigalsidase alfa for the treatment of Fabry disease, stating that additional data will be released at the 1st Canadian Symposium on Lysosomal Diseases 2018. Preliminary data from the first sixteen patients enrolled in the trial demonstrated an improvement in kidney function when switched from agalsidase alfa to pegunigalsidase alfa, the company said. Based on available historical serum creatinine and study 3 month screening period values for approximately 2 years while treated with agalsidase alfa before switching to pegunigalsidase alfa treatment, the annualized estimated glomerular filtration rate slope for patients on Replagal was -6.8ml/min/1.73m. The mean eGFR slope for the same patients following six months of treatment with pegunigalsidase alfa was changed to be +3.7ml/min/1.73m , these results were statistically significant. Baseline characteristic of these patients were: mean estimated glomerular filtration rate 75.40 and 86.03 mL/min/1.73m2 for males and females, with annualized eGFR slope of -8.0 and -5.1 mL/min/1.73m2/year, respectively.

https://thefly.com/landingPageNews.php?id=2793926

Sarepta negative CHMP re-exam opinion widely anticipated, says H.C. Wainwright

H.C. Wainwright analyst Debjit Chattopadhyay said the CHMP confirming its negative opinion for a Conditional Marketing Application for Sarepta’s eteplirsen was widely anticipated given the prior negative CHMP opinion disclosed on June 1. While a CHMP nod would have represented further upside on the commercial front, the company’s calendar is “chalk full of value drivers” over the next 12 to 18 months, said Chattopadhyay, who remains a buyer on the CHMP-related pullback. He keeps a Buy rating and $267 price target on Sarepta shares, which are down 2% to $149.60 in late morning trading.

https://thefly.com/landingPageNews.php?id=2793952