Posts Tagged ‘healthcare system’
Tuesday, July 21st, 2009
Patrick Sweeney, M.D., spinal surgeon, inventor and owner of the Center for Minimally Invasive Surgery in Mokena, IL, believes that private 
practitioners are under enormous stress right now, primarily in terms of overhead and contracting with insurance companies and other referral sources. Dr. Sweeney says there is a strong possibility that traditional private practitioners may become a thing of the past over the next five to 10 years, given the way the healthcare system is evolving.
In a recent interview for the Alter+Care Podcasts on Healthcare, Dr. Sweeney noted that “A few powerful payers control a good share of our reimbursement market.” Reimbursement issues also are luring younger physicians to work in large hospital-owned practices — where the financial risk is limited — and in lower-pressure specialties with less legal exposure and shorter work hours. That’s bad news because it means that fewer new physicians are choosing to specialize in essential fields like general surgery, OB/GYN, ENT and neurosurgery, areas where critical shortages already exist.
To listen to Dr. Sweeney’s full interview on the challenges facing today’s and tomorrow’s physicians, please click here.
Tags: Dr Patrick Sweeney, ENT, financial risk, healthcare system, hospital-owned practices, Illinois, insurance company, inventor, Mokena, neurosurgery, OB/GYN, physicians, private practitioners, referral sources, reimbursement market, spinal surgeon
Posted in General, Healthcare, Hospital Systems, Wellness Centers | No Comments »
Tuesday, July 21st, 2009
The Republican National Committee’s (RNC) response to the Obama Administration’s and Congressional Democrats’ efforts to pass healthcare reform legislation was to sponsor a “Hillarycare revisited” fund raising effort.
The RNC warned against “Obamacare” and pointed out that the government “already run
s car companies, banks and mortgage companies. Republicans believe that the last thing the American people want is government telling them when and where – or even whether – they can get medical treatment for their families.” “Hillarycare” refers to former President Bill Clinton’s failed attempt at reforming healthcare during the 1990s, an effort led by his wife, Hillary Clinton.
Republicans like John Boehner (R-OH) have raised the specter of a “bureaucrat standing between you and your doctor.” Perhaps it’s worth considering that we currently have an insurance company bureaucrat performing the same role. Also, government administered health options are almost uniformly popular. The World Health Organization ranks France’s healthcare system as the world’s finest, contrasted to the United States, which scored 37th. The United Kingdom’s combination of publicly and privately funded healthcare ranked 18th in the World Health Organization’s survey.
Tags: American, banks, bureaucrat, car companies, Congressional Democrats, doctor, France, government, government administered health, Healthcare, healthcare reform, healthcare system, Hillary Clinton, Hillarycare, insurance company bureaucrat, John Boehner, legislation, mortgage companies, Obama administration, Obamacare, President Bill Clinton, R-OH, Republican National Committee, Republicans, RNC, United Kingdom, United States, WHO, World Health Organization
Posted in Economics, Healthcare, Hospital Systems | No Comments »
Tuesday, June 30th, 2009
The solution to America’s healthcare crisis might just lie in deviant thinking. This is the message of Dr. Atul Gawande, this year’s commencement speaker at the University of Chicago’s Pritzker School of Medicine. Gawande is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, an associate director of their Center for Surgery and Public Health, an associate professor at the Harvard School of Public Health and at Harvard Medical School.
His concept of positive deviants identifies those communities and physicians who discover innovative ways to reduce costs and improve care to deliver better outcomes.
Gawande cites a nutritionist who spent his career attempting to reduce hunger in Vietnamese villages. This man asked villagers to identify which families had the best-nourished children to determine a “positive deviance” from the norm. The answer was that those children’s mothers did not act in accordance with accepted village wisdom had the best outcomes. Rather, they fed their children even when they had diarrhea; fed them several small meals daily rather than one or two large ones; and fed their children foods that others considered low class but were nutritious such as sweet potato greens.
In the American healthcare system, the positive deviants resist the tendency to view patients primarily as revenue streams – but as human beings. Rather, these physicians deliver high-value healthcare without focusing too strongly on their practices’ bottom lines; they neither over-treat nor under-treat their patients with extraneous but profitable tests and procedures.
To quote Gawande, “Look for those in your community who are making healthcare better, safer and less costly. Pay attention to them. Learn how they do it. And join with them.”
Tags: America, best-nourished, Boston, Brigham and Women's Hospital, Center for Surgery and Public Health, children, community, cost reduction, Dr Atul Gawande, endocrine surgeon, family, general surgeon, Harvard Medical School, Harvard School of Public Health, healthcare crisis, healthcare system, improved care, innovation, low class, nutritionist, patients, physician, postive deviance, Pritzker School of Medicine, reduce hunger, University of Chicago, Vietnamese villages
Posted in Economics, General, Healthcare, Hospital Systems, Wellness Centers | No Comments »
Thursday, June 18th, 2009
Congress is drafting historic legislation intended to restructure the American healthcare system. At a time when healthcare costs total $2.4 trillion annually (an average of $7,868 per person), are projected to rise to $4 trillion by 2016 and 46 million Americans lack any insurance coverage, the legislation is badly needed. According to a draft outline, the legislation might call for mandatory insurance requirements, which could conceivably be sold either through a national or state-based exchange. The bill is also likely to include a government-backed plan to control 
costs.
The Joint Committee on Taxation opined that the size of the savings might fall under several taxation arrangements, which could be essential in determining how to pay for the reform bill. The legislation includes an opportunity to drop the Sustainable Growth Rate formula, which is perceived by many as fatally flawed.
The legislation also will bring provider payments into line with recommendations from the Medicare Advisory Payment Commission, and allow payment alternatives for healthcare systems that offer coordinated care and focus on preventative health. Medicaid would be expanded, with subsidies available to pay for coverage.
A quick analysis concludes that the House draft will cost more than legislation currently under consideration in the Senate. So far, neither Democrats nor Republicans have been able to decide how to pay for the bill, which could total more than $1 trillion over the next 10 years.
Tags: American, Congress, cost control, Democrats, government-backed plan, Healthcare, healthcare costs, healthcare system, historic legislation, insurance coverage, insurance requirements, Joint Committee on Taxation, Medicaid, Medicare Advisory Payment Commission, national, reform bill, Republicans, state-based exchange, Sustainable Growth Rate formula, taxation
Posted in Economics, Healthcare | No Comments »
Monday, April 6th, 2009
As 78 million aging baby boomers deal with more chronic conditions, the country is facing a serious shortage of physicians. Compounding the crisis is the fact that between 1985 and 2006, the percentage of physicians aged 55 and older climbed from 27 percent to 34 percent, according to statistics from the Association of American Medical Colleges (AAMC). Approximately 250,000 active physicians are expected to retire between now and 2020. These shortages are especially critical among surgeons and family medicine practitioners.
The doctor deficit has its roots in the 1980s and 1990s when medical schools capped their enrollments at 16,000 students per year because they believed that managed care would create a physician glut. 
The exact opposite has happened and medical schools were “woefully wrong” in their assessment, according to Josef Fischer, chairman of surgery at Beth Israel Deaconess Medical Center in Boston. “It’s going to be tough in this situation to make it better.”
Accordingly, medical educators have identified the problem and are finally accepting more applicants. During 2008, nearly 17,800 students started medical school — the largest class ever. By 2015, medical schools hope to achieve a 30 percent increase in enrollment over 2002 levels. Still, Fischer warns of “a perfect storm” forming, because it takes three to seven years to train physicians at a time when the number of senior citizens in the United States is growing fast. With training for surgeons often exceeding seven years and few pre-med students focused on primary care as a career, additional enrollments are only a first step in the right direction.
Many doctors would prefer a career in primary medicine, focused on prevention and health, but the reality of medicine in today’s environment is that reimbursement for physician services is decreasing. The healthcare system itself is discouraging the very best and brightest talent from pursuing primary care. Fixing what is broken in the system at a time when prevention should be more important than ever requires fast action if we are to meet our needs in the next decade.
Tags: AAMC, Association of American Medical Colleges, baby boomers, Beth Israel Deaconess Medical Center, chronic conditions, doctor deficit, health, healthcare system, managed care, physician glut, physician shortage, physicians, pre-med students, prevention, primary care, primary medicine
Posted in General | No Comments »
