Posts Tagged ‘physician assistant’

Shortage of Radiation Oncologists Could Impact Cancer Patients

Monday, November 15th, 2010

Demand for radiation oncologists will outstrip supply by a factor of 10 over the next decade.  The U.S. medical community is experiencing a shortage of radiation oncologists, with demand outpacing supply by a factor of 10 over the next decade. According to a report published in The Journal of Clinical Oncology. the number of radiation oncologists joining the workforce over the next decade is expected to rise by just two percent.  During the same timeframe, the number of patients diagnosed with cancers requiring radiation therapy will rise by 22 percent, notes Dr. Benjamin Smith of the Department of Radiation Oncology at MD Anderson Cancer Center in Houston.

Adults aged 65 and older are expected to comprise 38 percent of the demand for radiology services over the next 10 years; minorities will comprise 45 percent of the demand, according to the report.  A major point of the report is that cancers need to be treated with radiation therapy as quickly as possible to reduce the size of the tumor and avoid growth.  Patients who have to wait longer for a limited number of radiation oncologists will have delayed appointments.  “Shortages mean double trouble,” Smith said.  “Since research has shown that a delay between diagnosis and the start of radiation therapy can reduce its effectiveness, oncologists and radiologists must collaborate even more so the quality of care doesn’t break down at multiple points.”

According to the report, the researchers estimated demand for radiation therapy by multiplying current use against population growth projections and current use.  Smith suggests three strategies that could make up for some of the slack.  One is to have physician’s assistants and advanced practice registered nurses help doctors increase the number of patients who can be treated at a single time.  Another is to cut the number of radiation therapy treatments, which can be equally effective as longer courses.  Smith’s third recommendation is to increase the size of residency programs to educate more radiation oncologists.

“Medical Home” – Closest Care to a House Call

Wednesday, December 30th, 2009

Medical home approach to healthcare can cut hospitalizations and ER visits.  It’s almost – but not quite – a house call.

A new healthcare concept called “medical home” is emerging across the country, especially in Illinois.  It is primary care devoted to prevention and to helping people with chronic conditions such as diabetes or arthritis manage their illness.  In a medical home, a physician oversees a team of nurses, physicians’ assistants and health coaches who make certain that their patients get the care, support and education they need.  Another benefit is that the plan frees up the doctor’s time to focus on the more serious medical issues.

Medicare recently announced a similar initiative, and healthcare reform legislation could champion medical homes.  One pioneer in the field is Group Health Cooperative, a Seattle-based HMO that plans to convert 26 clinics in Washington and Idaho to medical homes.  The pilot program, established two years ago, reduced ER visits by 29 percent and hospitalizations by 11 percent while improving the quality of care, according to a report in the September issue of the American Journal of Managed Care.

For medical homes to function properly, physician compensation will have to change, says Dr. David Swieskowski, chief executive of the Des Moines-based Mercy Clinics, Inc.  The model works optimally when physicians are full-time, salaried employees.  This payment arrangement is fairly rare, and insurance companies don’t reimburse physicians for taking extra time to talk to patients.

Medicaid introduced a version of medical homes in Illinois through Medicaid in 2006 and 2007.  During that time, Medicaid assigned 1.9 million people to physicians who agreed to coordinate care for an extra monthly fee.  As a result, immunizations, vision screenings and other types of basic care have improved, state officials say.