Question

fundamentals of us health care
what is

amentals of U.S Health Care: Principles and Perspect optometrists, and often seek alternative therapies from providers such as tors. With the longevity of the growing aging U.S. population, it is expected thfe services provided by these professionals will be in greater demand. Questions 1. What is the projected demand for workers in the health care field over the he 2. How does the aging of the population, health insurance reimbursement, and 3. How does the projected physician shortage affect the manner in which patients 4. What are your ideas for solutions to the heavy load of indebtedness that physicians 20 years? consumer demand impact the practice patterns of health care clinicians? will receive primary care services? carry upon graduation from medical school? Should this financial obligation influence their choice of practice? 5. Should the federal government have the authority to regulate physician selection 6. What are your ideas for improving the image of nursing among high 7. Should there be a limit on damages for pain and suffering in medical malpractice 8. How has the risk from medical malpractice suits influenced the manner in which of practice specialty? - Ref students? cases? physicians practice medicine? u were the CEO of a hospital, how would you provide incentives to nurses to work at your hospital and, once they were there, remain? 9. If yo 10. How is patient demand for alternative therapies influencing the demand for care from non-physician practitioners such as podiatrists and chiropractors? Resources Academy of General Dentistry: www.agd.org American Academy of Family Physicians: http:/linignet American Academy of Oral and Maxillofacial Re tiology American Academy of Pediatric Dentistry American Academy of Periodontology American Academy of Prosthodon

Answer 1

1. Between 2014 and 2024, 20 of the 30 fastest-growing occupations nationally are projected to be in health care occupations, including occupational therapy assistants (43%), physical therapy assistants (41%), physical therapy aides (39%), home health aides (38%), and nurse practitioners (35%). The health occupations projected to grow the most between 2014 and 2024 include personal care aides (458,100), registered nurses (439,300), home health aides (348,400), nursing assistants (262,000), and medical assistants (138,900). nearly 440,000 new registered nurse (RN) jobs are expected to be added, while more than 600,000 existing RN jobs will need to be filled due to RNs leaving these positions.

The demands for the health care field is continuously increasing. While Anesthesiology !! Especially in Pain management. Pain management is one of the most crucial aspects in the management of any disease is it cancer benign or malignant any type of chronic disease, pain due to trauma or injury etc. the list is endless. I mean the pain is one of the most common symptoms that patient presents with and is probably the most common indicator that something is wrong with the body also it is one of the key indicators that determine the quality of patient life including the patient that is terminally ill. And in coming years there is only going to be more demand for this specialty as the quality of patient life is a key concern of the physician as well as family!

2. Older adults have one major payer for their health care services, so services to older adults are in large part structured by Medicare reimbursement. Although many older adults have some sort of supplementary coverage, Medicare reimbursement policies can affect both supply of health care workers (by providing incentives or disincentives to serve older adults) and demand for services (by providing incentives or disincentives to older adults to obtain certain services.)

Factors such as reimbursement are associated with the influx of new health care entrants into occupations and into geriatric settings and specializations. Some health professions are more attractive to young people than others, and these professions will be better able to withstand large numbers of retirements, as the retirees will be quickly replaced. (Geriatric sub-specialties in medicine, for example, are not popular among new medical school graduates. These specialties are also poorly reimbursed compared to others.)

3. Primary care physicians have been shown to play an important role in the general health of the communities in which they serve. In spite of their importance, however, there has been a decrease in the number of physicians interested in pursuing primary care fields, while the proportion of specialists continues to increase. The prediction of an overall physician shortage only augments this issue in the US, where this uneven distribution is particularly evident. As such, serious effort to increase the number of practicing primary care physicians is both necessary and beneficial for meeting this country's health care needs.

The demand for physicians is projected to grow by 17 percent by 2025, due primarily to the growth in population size and the aging population. The population below 18 years is projected to grow by 5%, whereas the elderly population over 65, who typically require more care from physicians, is expected to grow by 41%.

4. Every year, the Association of American Medical Colleges (AAMC) conducts a comprehensive survey of graduating allopathic medical students. In 2011, 89 percent of graduating students carried outstanding loans, the average amount of which was $161,290 .More than three times the median annual income of U.S. households in that year. While this is already an overwhelming amount of debt for most to consider, it does not even reflect the true burden. Compound interest on these loans adds significantly to the total debt, particularly considering that physicians are often unable to start repaying their student loans until after residency and fellowship training. Neither does this debt figure take into account the high cost of licensing, board examinations, and maintenance of certification.

Many suggestions have been proposed, but few appear to be feasible. Through strong advocacy from the AMA, incremental changes have been achieved, but broader reform is still necessary. For example, a decade ago, some public medical schools began a process of implementing mid-year and even retroactive tuition increases to help defray their educational costs. With leadership from its medical student section, the AMA effectively advocated against these unfair tuition increases, helping to stem the tide of escalating student debt for some. While important and necessary, advocacy such as this is only a Band-Aid slapped over the much greater problem—the rapidly rising cost of medical education.

Education debt is driving medical school graduates away from service in physician-poor communities and primary care, both of which our country will sorely need in the coming years. We are all awaiting a visionary who will introduce a bill in Congress to address the crisis in financing residency training programs for our future physicians.

5. Despite the numerous entities that “govern” the lives of physicians, few have formal federal recognition and legal jurisdiction. The Liaison Committee on Medical Education (LCME) and the American Osteopathic Association (AOA) are recognized by the US Department of Education as accrediting bodies for medical education programs leading to an MD or DO degree, respectively. The state medical boards, which govern physician licensure, and the Drug Enforcement Administration, which authorizes physicians and other health professionals to prescribe controlled substances, both have legal standing.

While these entities are involved with the overall general governance of medicine and physicians, numerous other organizations are involved with professionalism in medicine. For instance, the American Medical Association (AMA) was founded in 1847 as a volunteer organization of physicians in the United States and perhaps was best known for supporting the Flexner report in 1910, which led to radical changes in medical education. In 1847, the AMA produced its first Code of Medical Ethics, which has been updated periodically and is considered one of the most influential documents governing physician conduct. Later in the 19th and 20th centuries, numerous other professional organizations were established including the Association of American Medical Colleges (founded in 1876), the American Association of Colleges of Osteopathic Medicine (1898), and the Federation of State Medical Boards (FSMB) (1912). Subsequently, other venerable professional medical associations, societies, and organizations were founded, among them the American College of Physicians (1915), the American College of Surgeons (1913), and the American Academy of Pediatrics (1930). Other organizations, such as The Joint Commission (founded in 1951) and the American Hospital Association (1898), also have important roles in the professional lives of physicians.

Today, these and other governing bodies and professional associations represent an extensive collection of medical organizations in the United States. Although these organizations continue to exist and proliferate, and many provide critically important oversight functions, relatively little substantial change has occurred in the organizational structure of self-governance for more than 5 decades, with a few exceptions. As an example of a recent change, organized by the FSMB in 2013, a team of state medical board representatives and experts from the Council of State Governments (CSG) developed and drafted a framework for an Interstate Medical Licensure Compact — a new licensing option under which qualified physicians seeking to practice in multiple states would be eligible for expedited licensure in all states participating in the compact.

6. To lay the foundation of strategy development for improving the nurse image of the future by grasping the recognition and image of a nurse of high school students and to provide the basic data for promoting the application of excellent students to nursing by grasping the high school students who will select nursing and the awareness which can affect their careers. By grasping the recognition and image of nurses from the high school students who are in the stage of a career choice in a rapidly changing medical, societal environment, we have to lay the foundation of strategy development for improving the image of nurses, and by grasping the high school students who will select nursing and the awareness which can affect their career, it is aimed to provide basic data for promoting the application of excellent high school students to nursing.

7. When a doctor, surgeon, nurse, dentist, or other health care professional neglect to meet the legal duty of care by failing to provide a level of service at or above the acceptable standard of practice in the medical industry, it is often the patient who will suffer. If a patient suffers injury or harm as a direct result of a health care professional’s negligence. Each state imposing med-mal caps has its own laws governing the maximum damages a victim can recover in a medical malpractice lawsuit. While some states simply cap the non-economic damages a victim can seek (e.g., pain and suffering damages). These caps on damages not only harm injured patients and their loved ones by artificially limiting their full and fair monetary recovery but, according to recent studies, they are harming overall medical care for everyone.

8. Over the past 20 years, malpractice litigation has increased dramatically, affecting both the medical profession and the larger community. Despite the fact that litigation and claims appeared to peak around 1985, the number of claims and suits could still be described as an epidemic. This alarming increase has not only led to greater awareness of liability issues on the part of the public and the medical profession but has also triggered widespread (and not always realistic) fear.
Malpractice lawsuits have high visibility, particularly those resulting in large awards. To make matters worse, a lawsuit for a large amount of money constitutes front page news, whereas a physician's exoneration in a lawsuit is often a back page entry. This asymmetry persists despite the fact that, of the approximately 6% of malpractice cases that actually get to court, 80% are won by the defendant physician.
As noted elsewhere in this volume, claims of malpractice occur when "bad outcomes" are combined with "bad feelings." Litigation has become a common response to a bad outcome. All doctors-even those who practice good medicine-are vulnerable to litigation. Although many physicians continue to believe that litigation is something that happens "to the others," most are keenly aware of the risks.
One of the major effects is a distinctly defensive approach to practice, with the patients seen as adversaries long before any hint of litigation supervenes. Frequent attention in the media to the issue of malpractice may increase the level of paranoia among practitioners, in which doctor-patient relationships become doctor-customer relations or-at worst-defendant-litigant relations; and medical services are viewed as some kind of product with concomitant warranties and guarantees. Defensive practice may also usurp the clinical judgment of practitioners, and doctors may lose enthusiasm for attending to the needs of patients because of a perceived loss of autonomous control over the interaction. Nationwide, physicians have left the high-risk areas of practice (obstetrics, orthopedics, and emergency medicine) or have abandoned the field of medicine entirely. Emergency rooms are difficult to staff, and insurance companies are accused of profiteering.
In striking contrast, the American Trial Lawyers Association has reported that there is no crisis. The inference of this remarkable statement is that doctors are in no greater danger of being sued than anyone else in society and that complaints to the contrary are both unwarranted and self-serving. From the viewpoint of this association of plaintiff's attorneys, the notion of a crisis is a fantasy cooked up by physicians anxious to invoke various legal protections and to justify higher fees. Besides highlighting a source of significant disagreement between the medical and legal professions, this statement and public reaction to it account in part for the decline in the quality of the patient-practitioner relationship and for the increase in the practice of defensive medicine.

9. The financial incentives provided to health workers fall into three main categories. First, there are the basic wages and conditions that are offered to staff related to their role description and work classification. Second, there are additional payments or bonuses that are linked to the achievement of performance outcomes, with access to the payment either specified in advance or retrospectively assessed as part of a staff review or supervision process. Third, there may be additional financial incentives that are not directly related to the performance of the person’s duties, such as access to financial services or fellowships.

Human resources are a key element of service delivery. Even in the most well resourced and technologically advanced countries, the interactions between health professionals and their patients remain at the heart of service provision. Accordingly, staff costs dominate health services expenditure and ongoing shortages in the availability of health professionals present a real and direct threat to the continued delivery and development of health care services. Incentives, both financial and non-financial, provide one tool that governments and other employer bodies can use to develop and sustain a workforce with the skills and experience to deliver the required care. This demands not just political will and continued hard work, but an acknowledgment by all key stakeholders of the commitment, skills and health benefits provided by health professionals worldwide. A health service’s greatest asset is its staff. The implementation of effective incentive packages represents an investment through which that vital asset can be protected, nurtured and developed.

10. The chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic has disappeared. Despite chiropractic's longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime, the podiatric medical profession, during approximately the same time period, has been far more successful in developing itself into a respected profession that is well integrated into mainstream health care and society.