Readers Name Biggest Medical Stories of 2015

December 03, 2015

The switch to International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), diagnostic codes in all their granular glory on October 1 ranked as the biggest medical news of 2015 in an online survey of Medscape readers.

Thirty-nine percent of readers put the debut of the new code set at the top of the list. Supporters of the ICD-10 codes, which are longer and five times as numerous as their ICD-9 predecessors, say their greater precision will accommodate new diagnoses and procedures and aid population-based medicine. The American Medical Association and other societies complain, however, that converting to ICD-10 has cost physicians time and money without really benefitting patients in the process. Physicians had feared widespread glitches in claims processing at the onset that would delay payments from public and private payers, but so far, such a cash flow crisis has not materialized.

The second biggest medical story of 2015 for Medscape readers (28%) was the approval of physician-assisted suicide (also called assisted dying) in California, making it the fifth state in the country where this practice is legal. California's new law, based on Oregon's trailblazing Death with Dignity Act, could create momentum for similar legislation to pass in more states.

Other major stories for readers in 2015 were the repeal of Medicare's sustainable growth rate formula for setting physician reimbursement (13%), the release of final rules for the federal government's program to promote meaningful use of electronic health records (5%), and an HIV outbreak in Indiana (2%).

Medscape also asked readers to name the stories of 2015 they found most exciting — the good news, as it were. The hands down winner, chosen by 46% of readers, was the possible demise of the 10-year maintenance of certification (MOC) exam conducted by the American Board of Internal Medicine. In response to fierce criticism that its MOC program had become too time-consuming, too expensive, and irrelevant, the American Board of Internal Medicine announced in September that it would consider replacing the exam with shorter, more frequent tests that physicians could take at home or in the office. Days earlier, the American Board of Anesthesiology said it would drop its 10-year MOC exam in favor of continuous online testing in 2016.

Rounding out the good news story roster were expanded Medicare reimbursement for telemedicine (17%), outcomes in a promising clinical trial in a reader's specialty (12%), and approvals by the US Food and Drug Administration of new drugs (9%) and new medical devices (5%) in a reader's field.

Runaway Drug Prices the Most Frustrating News of 2015

In contrast, some headlines in 2015 made clinicians wince. The most frustrating news by far for Medscape readers — named by 35% — was the increasingly high cost of certain drugs. That subject turned red hot in September, when Turing Pharmaceuticals acquired the rights to a 62-year-old antiparasitic drug called pyrimethamine (Daraprim), which treats toxoplasmosis encephalitis, and raised the per pill price from $13.50 to $750.00. The much-derided company later announced it would cut the price by as much as half for hospitals, but not before members of Congress said they would investigate pharmaceutical pricing.

Other news items that bothered clinicians included the transition to ICD-10 diagnostic codes (16%), the Supreme Court ruling that upheld premium subsidies under the Affordable Care Act in all states (16%), the response of television personality Mehmet Oz, MD, to criticism of his medical recommendations (9%), and a Medicare pay cut in 2016 despite the promise of a raise in sustainable growth rate repeal legislation (8%).

Then there are the medical stories with the biggest "wow" factor for Medscape readers. The discovery that prenatal blood testing could identify presymptomatic cancer in pregnant women came in at number one (35%). Diana Bianchi, MD, executive director of the Mother Infant Research Institute at Tufts Medical Center in Boston, Massachusetts, told Medscape that positive test findings could accelerate treatment for women and save lives.

Second from the top in terms of the most surprising medical news or advance in 2015 was new evidence that frequent ejaculation can reduce the risk for prostate cancer (23%). Vending machines for medical marijuana (20%) and a new medical cannabis registry to monitor users (10%) rounded out the top four stories.

Medscape conducted its top story survey among readers in November and received 402 complete responses.

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