Luring Students Into Family Medicine
By STEPHANIE NOVAK
Most students going into medicine imagine that they will have daily contact with their patients; but the reality is that only a minority will end up as primary care physicians, causing what some experts say could be a critical shortage in the United States, where there are long waits in both doctors’ offices and emergency rooms.
With the Supreme Court’s decision in June to uphold the Affordable Care Act, the need for primary care doctors is expected to grow even more.
“The A.C.A. will put a stress on the system immediately,” said Dr. Russell Phillips, director of the Center for Primary Care at Harvard Medical School, where he is also a professor.
Some U.S. medical schools are now creating programs that emphasize the importance of family medicine and encourage students to collaborate more with nurses, pharmacists and specialists.
Despite the fact that about half of medical students indicate an interest in primary care on their first day of medical school, by the third year, that number decreases to 20 percent, said Dr. Andrew Morris-Singer, the president and co-founder of Primary Care Progress , an organization working to increase interest in the field.
Fewer than 20 percent of students end up working in primary care, according to the Council on Graduate Medical Education.
The actual number is probably 15 percent or less, said Dr. Marjorie A. Bowman, the Chair of the Department of Family Medicine and Community Health at the University of Pennsylvania.
This is because students who study internal or general medicine, both of which fall under the label of primary care, often go on to specialties after they complete their residency.
The Association of American Medical Colleges projects a shortage of 45,000 primary care doctors in the United States by 2020 and a shortage of 65,000 primary care doctors by 2025.
“There’s a crisis in primary care, probably much worse than most people realize,” said Dr. Steven Berk, dean of the School of Medicine at Texas Tech University.
Waiting times to see physicians are high, and emergency rooms are overcrowded, according to Dr. Morris-Singer of Primary Care Progress. “Patients are making it clear that they are having difficulty getting access to services,” he said.
But medical schools tend to steer students away from the pursuit of family medicine.
“There’s a culture of discouragement that exists in most medical schools around primary care,” Dr. Morris-Singer said. “A lot of medical schools disparage primary care. They say primary care isn’t a good use of medical school resources, and this is communicated to students in a direct way.”
Study of U.S. Health Care System Finds Both Waste and Opportunity to Improve
By ANNIE LOWREY
WASHINGTON — The American medical system squanders 30 cents of every dollar spent on health care, according to new calculations by the respected Institute of Medicine. But in all that waste and misuse, policy experts and economists see a significant opportunity — a way to curb runaway health spending, to improve medical outcomes and even to put the economy on sounder footing.
“Everybody from Paul Krugman to Paul Ryan agrees it is essential to restrain costs,” said Dr. Mark D. Smith, the president of the California HealthCare Foundation and the chairman of the committee that wrote the report, referring to the liberal economist and Op-Ed columnist for The New York Times, and the conservative Wisconsin congressman who is Mitt Romney’s vice-presidential running mate. “The health care industry agrees, too.”
The Institute of Medicine report — its research led by 18 best-of-class clinicians, policy experts and business leaders — details how the American medical system wastes an estimated $750 billion a year while failing to deliver reliable, top-notch care. That is roughly equivalent to the annual cost of health coverage for 150 million workers, or the budget of the Defense Department, or the 2008 bank bailout.
The institute’s analysis of 2009 data shows $210 billion spent on unnecessary services, like repeated tests, and $130 billion spent on inefficiently delivered services, like a scan performed in a hospital rather than an outpatient center.
It also shows the health care system wasting $75 billion a year on fraud, $55 billion on missed prevention opportunities and a whopping $190 billion on paperwork and unnecessary administrative costs. The Institute of Medicine is an independent adviser to the government and the public, and part of the National Academy of Sciences.
The report depicts a system that saves lives in miraculous fashion, but is also expensive and outmoded and in some cases downright Kafkaesque.
Maine hospitals warn of substantial job losses from federal Medicare cuts
Posted Sept. 12, 2012, at 7:08 p.m.
Maine hospitals are poised to lose hundreds of millions of dollars and thousands of jobs as the result of looming federal cuts, according to the hospitals’ lobbying group.
The Maine Hospital Association said Wednesday that Medicare cuts called for under the federal deficit reduction plan will cost Maine $21 million and nearly 3,000 jobs in 2013. The cuts are scheduled to begin next year and continue until 2021.
The jobs estimate came from a new report prepared by Pittsburgh consulting firm Tripp Umbach for the American Hospital Association, the American Medical Association and the American Nurses Association. The report measured direct job losses in health care and predicted ripple effects such as reduced spending by hospitals and their laid-off workers in other areas of the economy.
Congress approved the Medicare cuts, which total $10.6 billion next year nationally, as part of a hastily reached budget deal that followed a standoff between the Republican-controlled U.S. House and Democratic President Barack Obama over raising the federal debt ceiling.
The plan directed a “supercommittee” of lawmakers to find more than a trillion dollars to reduce the deficit. The committee failed, and unless Congress finds the savings over the next few months, deep spending cuts will be triggered automatically in January 2013 in a process known as sequestration.
Medicare, the government health insurance program for the elderly, will be cut up to 2 percent from 2013 to 2021, costing Maine hospitals $230 million over that period, according to the Maine Hospital Association.
The debt ceiling will need to be raised again next year, because the last fight over the country’s debt obligations raised the ceiling only enough to pay the federal government’s bills through the end of this year. Maine hospitals are worried that impending fight could lead to even more rollbacks.
“Cuts of this magnitude will negatively affect access, quality and the local economy,” Steven Michaud, president of the MHA, said in a press release. “We urge policymakers to craft more sensible solutions to our nation’s budget challenges.”
More Americans got health insurance in 2011, Census says
By Maggie Fox
NBC News, Sept. 12, 2012
More Americans got health insurance coverage in 2011 as young adults jumped onto their parent’s health insurance plans, the U.S. government said Wednesday. More people also got public health insurance under the Medicare and Medicaid programs.
The number of people going without health insurance fell, from around 50 million in 2010 to 48.6 million in 2011, the Census Bureau’s David Johnson said. In 2010, 16.3 percent of the population went without health insurance. In 2011, that fell to 15.7 percent of the population, the Census said in its latest report on poverty, employment and health insurance.
One of the main goals of the 2010 health reform was to get more people covered by health insurance, but most of the provisions meant to do that don’t kick in until 2014. One of the most popular requirements did, however – the requirement that health insurance companies let parents keep their adult children on their plans until they’re 26. Johnson said the numbers show 500,000 young adults took advantage of that.
“You can see a lot of the fall is due to the 19-25 year-old age group,” Johnson told reporters on a conference call. “We also see a large increase in coverage for public coverage. I think those two things are driving the uninsured rate falling.”
About a million more people got coverage under Medicare, Medicaid, the Children’s Health Insurance Program (CHIP) and military health care, the report shows.
The Census report suggests that people stopped losing health insurance because they lost their jobs – the report shows more people were working full-time in 2011, compared to 2010.
“This is the first time in the last 10 years that the rate of private insurance coverage has not decreased,” Johnson said. As has been the case for years, most Americans are covered by a private plan -- about 55 percent were in 2011.
Liberal groups said the data showed that fears health care reform would cause employers to stop offering health care coverage are unfounded.
http://www.pnhp.org/print/news/2012/september/more-americans-got-health-insurance-in-2011-census-says
NBC News, Sept. 12, 2012
More Americans got health insurance coverage in 2011 as young adults jumped onto their parent’s health insurance plans, the U.S. government said Wednesday. More people also got public health insurance under the Medicare and Medicaid programs.
The number of people going without health insurance fell, from around 50 million in 2010 to 48.6 million in 2011, the Census Bureau’s David Johnson said. In 2010, 16.3 percent of the population went without health insurance. In 2011, that fell to 15.7 percent of the population, the Census said in its latest report on poverty, employment and health insurance.
One of the main goals of the 2010 health reform was to get more people covered by health insurance, but most of the provisions meant to do that don’t kick in until 2014. One of the most popular requirements did, however – the requirement that health insurance companies let parents keep their adult children on their plans until they’re 26. Johnson said the numbers show 500,000 young adults took advantage of that.
“You can see a lot of the fall is due to the 19-25 year-old age group,” Johnson told reporters on a conference call. “We also see a large increase in coverage for public coverage. I think those two things are driving the uninsured rate falling.”
About a million more people got coverage under Medicare, Medicaid, the Children’s Health Insurance Program (CHIP) and military health care, the report shows.
The Census report suggests that people stopped losing health insurance because they lost their jobs – the report shows more people were working full-time in 2011, compared to 2010.
“This is the first time in the last 10 years that the rate of private insurance coverage has not decreased,” Johnson said. As has been the case for years, most Americans are covered by a private plan -- about 55 percent were in 2011.
Liberal groups said the data showed that fears health care reform would cause employers to stop offering health care coverage are unfounded.
http://www.pnhp.org/print/news/2012/september/more-americans-got-health-insurance-in-2011-census-says
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