Question

1. briefly describe the difference in training between a PA and NP.

2. identify some of the challenges facing the U.S healthcare delivery system.

3. what are the factors leading to shortages in physicians and nurses, and what measures might be taken to address these problems ?

4. what is unique in the U.S healthcare system related to patterns of physicians practice and specialization?

5. how do these characteristics affect patient care ?

Answer 1

( 1 )

( 2 ) These challenges frame the problemsmanagers of delivery organizations are currently facing. They include a burgeoning gap between demand andsupply. Demand for health care services is increasing as the population ages, chronic diseases become more common, and medicaltechnology increases.

Nurse Practitioner (NP) Physician Assistant (PA) Education/Training Baccalaureate Degree in Nursing Minimum of 1-2 years work experience as a Registered Nurse (RN) Attend Nursing school, completing a Master's or Doctoral degree program with specialist training and a minimum of 500 direct supervised clinical hours Patient Centered Model of Learning incorporating holistic, preventive care and health promotion Examinations, Certification & State License 2 years of college coursework in basic and behavioral sciences Accumulated healthcare experience Attend Medical School, completing a Master's Degree program with specialist training and a minimum of 2000 clinical hours Disease Centered Model of Learning3 focusing on the science behind the condition/disease Examinations, Certification & State License

( 3 ) The main causes of nursing shortagesare highlighted: inadequate workforce planning and allocation mechanisms, resource constrained undersupply of new staff, poor recruitment, retention and 'return' policies, and ineffective use of available nursing resources through inappropriate skill mix and utilisation, poor recruitment ,retention and return policies, ineffective use of nursing resources through inappropriate skill mix and utilization ,poor incentive services and inadequate career support.

( 4)
• The state of physician morale. How many
physicians would recommend medicine as a
career, or choose to be physicians again?
• The practice plans of today’s physicians. How
many will retire? Work part-time? Seek
employment with a hospital? Switch to a
“concierge” practice?
• Physician practice models. How many are
independent? Employed? In solo practice? In
large groups?
• Physician practice patterns. How many patients do
physicians see? How many hours do they work?
• Physician payment models. How many are paid
on “value?” How many are in ACOs or medical
homes? What do they know about the Medicare
Access and CHIP Reauthorization Act (MACRA)?
• Medicare and Medicaid acceptance rates. How many
physicians still see Medicare and Medicaid patients?
• The effect of ICD-10. Have the new codes enhanced
or detracted from efficiency and patient care?
• The Accountable Care Act. What grade do
physicians give the ACA?
• Differences among physicians. How do physician
perspectives differ by age, gender,
practice status, and specialty?
• Patient access. How do physician practice patterns
affect the ability of patients to access care?
With an error rate of +/- 0.766%, and with comparisons
to data from surveys conducted by The Physicians
Foundation in 2012 and 2014, the 2016 Survey of
America’s Physicians is the source of insight and
analysis into the perspectives, practice plans and
practice patterns of today’s physicians.
The state of physician morale. How many
physicians would recommend medicine as a
career, or choose to be physicians again?
• The practice plans of today’s physicians. How
many will retire? Work part-time? Seek
employment with a hospital? Switch to a
“concierge” practice?
• Physician practice models. How many are
independent? Employed? In solo practice? In
large groups?
• Physician practice patterns. How many patients do
physicians see? How many hours do they work?
• Physician payment models. How many are paid
on “value?” How many are in ACOs or medical
homes? What do they know about the Medicare
Access and CHIP Reauthorization Act (MACRA)?
• Medicare and Medicaid acceptance rates. How many
physicians still see Medicare and Medicaid patients?
• The effect of ICD-10. Have the new codes enhanced
or detracted from efficiency and patient care?
• The Accountable Care Act. What grade do
physicians give the ACA?
• Differences among physicians. How do physician
perspectives differ by age, gender,
practice status, and specialty?
• Patient access. How do physician practice patterns
affect the ability of patients to access care?
With an error rate of +/- 0.766%, and with comparisons
to data from surveys conducted by The Physicians
Foundation in 2012 and 2014, the 2016 Survey of
America’s Physicians is the source of insight and
analysis into the perspectives, practice plans and
practice patterns of today’s physicians.

( 5 ) Effect of a physician surplus on quality of health care as indeterminate on average, although data cited earlier with respect to certain specialties and volume-outcome relationships clearly point to problems that might arise with excess numbers of physicians. The consequences of "too many" physicians in this area may be governed in large measure by a variety of factors that the committee cannot predict with confidence—among them the extent of managed care and how tightly such systems control access to physicians, the choices that doctors in training as well as those in practice make about primary or specialty practice, and the underlying proportion of physicians in the country who are schooled in foreign institutions. In the end, it seemed as if overall levels of quality of care will be driven by traditional professional attitudes, consumer expectations, and effective quality improvement programs more than by sheer numbers of practitioners today or tomorrow, but the committee nonetheless notes that the pipeline for producing physicians is a very long one, so lack of action today may have real and undesirable consequences for tomorrow.