Month: November 2016

National Compliance and Ethics Week offers a great opportunity to shine a spotlight on the importance of compliance and ethics at Care to Care and in the entire healthcare system at large. The culture of compliance is at the core of medicine.

This begins for doctors with the mandatory Hippocratic oath which is frequently recited at the beginning of medical school and again at its culmination, when the medical degree is received. The Hippocratic oath states the obligations and proper conduct of doctors, laying the groundwork for a career devoted to the care of others through strict adherence to medical ethics and compliance to government laws, hospital regulations, and specialty society guidelines. It is this strict obedience to an unyielding moral code that makes the physician worthy of the trust that the patient bestows on him, a trust that is essential in the physician-patient relationship.

Physicians are entrusted with the most personal information by their patients and are obligated to maintain complete privacy and security of this health care information. Our compliance with federal HIPAA laws is only one way that compliance plays an integral role in the physicians’ daily responsibilities.

Here at Care to Care, the medical directors and physician reviewers are dedicated to maintaining the highest degree of compliance and are committed to upholding the oath we took many years ago.

Rachel Title, MD
Chief Medical Officer

This October, Care to Care is proud to participate in National Breast Cancer Awareness Month. Breast Cancer is the second most common cancer in women, affecting 1 in 8 U.S. women over the course of her lifetime. In 2016, there are more than 2.8 million U.S. women with a history of breast cancer. Breast cancer is a disease that affects women of all ages, races, and ethnicities. The most significant risk factors for breast cancer are gender (being a woman) and age (risk of breast cancer increases with age). Although a woman’s risk of breast cancer almost doubles if she has a first-degree relative with breast cancer, it is important to know that an overwhelming majority (85%) of breast cancers occur in women who have no family history.

The goal of Breast Cancer Awareness Month is to increase understanding and awareness of the disease, encourage women to take the lifesaving steps to detect the disease in its early stages, and inspire others to do the same. Most women can survive breast cancer if it is found and treated early. Early detection with annual screening mammogram has been the main reason why the breast cancer death rate has decreased by 36% since 1989. The American College of Radiology (ACR) and Society of Breast Imaging (SBI) recommend that women at average risk of breast cancer get yearly mammograms starting at age 40. Women at high risk (greater than 20% lifetime risk) of breast cancer may need to begin annual screening mammogram at an earlier age and should also include annual screening Breast MRI as an adjunct to screening mammography. All women should become familiar with both the appearance and feel of their breasts and report any changes promptly to their physician. Most importantly, talk to your doctor about your risk for breast cancer and your appropriate screening plan. Early detection is your best protection!

Rachel Title, MD
Chief Medical Officer

As a Radiologist and Senior Medical Director at Care to Care, I find it my moral responsibility and professional obligation to explain the importance of a prior-authorization requirement for advanced imaging, and specifically CT examinations, for the pediatric population. Children are considerably more sensitive to radiation exposure than adults, as demonstrated by epidemiologic studies of exposed populations.

Since children have a longer life expectancy than adults, they have a larger window of opportunity for expressing radiation damage, most notably the development of cancer. As a result, the risk for developing a radiation-related cancer can be several times higher for a young child compared with an adult exposed to an identical CT scan.

A study published in the Lancet on June 7, 2012 described a clear dose-response relationship for both brain tumors and leukemia. The study found that the amount of radiation exposure from an estimated 2 to 3 head CT scans given to a child can triple the risk of brain cancer, and an estimated 5 to 10 head scans can triple the risk of leukemia.

Major national and international organizations responsible for evaluating radiation risks agree that no amount of radiation should be considered absolutely safe and that only necessary CT examinations should be performed. For these reasons, it is of utmost importance to make sure that only appropriate CT scans are being performed on children. A prior-authorization requirement will help ensure the appropriate use of CT imaging and limit its inherent harmful radiation.

Rachel Title, MD
Chief Medical Officer