“Your Healthcare. Your Choice.”

by Shain Waugh

Business Entrepreneur

Who said that a physician isn’t a business entrepreneur or independent contractor? The ability to connect with patients on a personnel level is a critical point in remaining competitive, establishing practice separation, and the development of medical marketing intelligence. The ability to connect with patients on their level of thinking, assessing the demand for services, and the ability to supplying or meet the needs for those demand are critical for today’s modern day practices.

As illustrated in past posts “Choosing the Right Medical Doctor“, the greatest challenge for clients today is finding or being able to distinguish between physician practices. So, many physicians have resorted to online video to assist in promoting their business, educating patients about medical disorders, and connecting with patients on a more personal and private level.

The ability to personalize one’s medical practice with online video enables business to establish an array of core competencies such as giving patients an inside view their practice prior to coming to the medical office, understanding the medical team at hand, and develop more of an ease and understanding about a facility’s mission, vision, and practice philosophy.

The major challenge with personalizing one’s practice has been the embracement of technology, increase cost of marketing, and fear of facility misrepresentation. In addition, there are an array of active business that attempt to solve this health care misunderstanding, however, there isn’t a one consistent company or philosophy that assist in truly meeting the needs of our active clients concern with healthcare.

There are many cases were healthcare providers hire companies to produce videos, integrate business within search-engine to increase visibility, while others utilize You Tube or Medem to push the online message. As an example, when searching for a new health care provider, we as consumers ask friends, associate, or consult with insurance companies. However, there is still a limited line in addressing the major problem of identifying to correct physician practice on a globalized scale.

Summing Up

As the healthcare industry evolves and embraces video technology, it will become a standard in delivering a quality message to the general consumer. Physicians will be forced to become more competitive with there medical practice including justifying their business culture, improving quality, organization’s vision, and being health responsible for medical errors. If video becomes a standard of medical facilities then the industry will become as the hotel industry, which is viewed as if a hotel is not visible online then no customer will utilize the facilities services. In time, the government of each country must regulate and make stronger requirements in order to distinguish medical practices.

There are a great deal of consumers inquiring about a quality physician and the only information that they receive is an address, phone number, and a wish of luck. As 2008 approaches, the legacy method of identifying a physician must soon migrate into a more modern standard requirement. However, this all depends on who embraces technology, has the budget funding, government regulations standards in place, and the politicians lobbying for change.

References

http://icyou.comhttp://youtube.com/user/dramatichealth
http://www.medem.com/phy/phy_vrc.cfm
http://www.nyashgroup.com (in development)

By Shain Waugh

Primary Issue

The critical nursing personnel shortage in America is nothing new to those affected by the shortage. It is evident that the long waits in the emergency room, medical surgical or telemetry unit’s patients not being seen by a nurse for hours, patient’s given the wrong medication, nursing staff burnout, and so forth is a significant sign of the challenges involving this shortage. A study in the Journal of the American Medical Association predicted a 20% shortage in the number of nurses needed in the healthcare system by the year 2020. The U.S. Bureau of Labor Statistics reports that more than one million new and replacement nurses will be needed by 2012.

The immediate challenge is that as more than 77 million baby boomers approach retirement age, it is anticipated that the demand for healthcare, particularly home and community-based care, will almost certainly outpace the supply of quality caregivers. The key question is to determine do you trust your hospital, physician, clinic, and or pharmacy. For many, it’s a challenging question when there is no true method of evaluating these critical factors.

 Those Affected

The ratios of nurses to patients dictate the number of patients a hospital’s unit can handle in a given day. In some states these ratios have been legislated while in other, unions mandate it. There are exceptions and work conditions for nurses and patients are still poor and unsafe. As case in point, there have been studies that illustrate direct correlations between staffing of nurses and medical errors.  Example:

In the 3^rd quarter of 2007, a South Florida hospital, which will remain unknown among this document, admitted a patient to its medical surgical unit for a non-critical diagnosis. There were two nurses that called off that particular day, which mean the other nurse took on three additional patients totaling ten patients for the night. Due to the stress, limited staffing, and not enough time to evaluate patients, one patient die within the hospital. The patient was not discovered until 7 hours later. The result included the nurse losing her nursing license, hospital being suited for millions, and the facility developing a bad name within its community. The parties involved were affected simply by the shortage of nurses and/or medical professional staff that shift. So, as medical facilities struggle to fill nursing vacancies and other medical positions, the greater the chance for an unsafe working and medical practice environment.

The shortage of nurses is growing worldwide on a global scale. The immediate problem is that for many of the poorer countries such as the Philippines and South Africa, there has been a migration of nurses from these countries to other countries such as U.S., Canada, and Australia. The more financially stable countries have been trying to meet critical needs for nurses by encouraging nurses from these countries to emigrate. Unfortunately, this processes is increasing the problems and not contributing a solution.

Hospitals argue that pressures from their relationships with managed-care providers leave them no choice but to experiment with various staffing practices, which result in varied degrees of success. It is believe that medical facilities cutting back on nursing staff to achieve higher profits. As a medical professional, there have been situations where staff ratios are reduced because the acuity of the patients doesn’t call for such staff. As a case in point, if a nursing in cardiovascular ICU is use to taking care of one open heart patient at a time, then if there are three telemetry patient on the that unit then this one nurse to three patient is efficient.

Possible Solution

In evaluating solutions, there is an array of theories to assist with the challenge. If we take the model of New Jersey hospital, it consists of a two-year program where the students attend one 12-hour clinical day per week at a participating hospital, and the hospital is responsible for training the student. The remaining part of the program consists of online classes.  

The promotion of the nursing profession to men is critical. The nursing profession has a women dominated culture. There are approximately 5.4% of the 2.1 million registered nursed employed in the United States that are men. This is according to the National Sample Survey of Registered Nurses.

The initiation of incentive by the government would assist in the promotion of nurses. A suggestion would be to reduce the amount of taxes that nurse are required to pay. If the normal tax bracket is between 25%-30%, then nurse should be required to pay only 15% tax. This tax reduction will increase a nurse salary without forcing the hospitals or medical facilities to increase wages.

In 2002 the Nursing Reinvestment Act was signed by President Bush to address the problem of our nation’s nursing shortage. This initiative was intended to promote people to enter and remain in nursing careers, thus reducing the growing shortage. The law establishes scholarships, loan repayments, public service announcements, retention grants, career ladders, and grants for nursing faculty. The challenge with this Act is that it has stipulations and not all individuals that become a registered nurse are able to utilize or benefit from the act. 

According to Forbes magazine, medical tourism will be a $40 billion industry by 2010. This is a promising illustration of how people concerned with rising health care cost are able to manage their health care crisis. The soaring medical cost in America are forcing Americans to travel abroad for elective and/or major surgeries. The abroad physicians and hospitals are willing to conduct procedures at 10% to 30% of the cost in America. Its estimate that 750,000 Americans traveled abroad for medical care in 2007.

Medical Cost in U.S. versus Other Countries:

• Bone Marrow transplant $ 400,000 versus $30,000*
• Liver Transplant $500,000 versus $40,000*
• Heart-valve Replacement $200,000 versus $10,000*
• Open Heart Surgery $50,000 versus $44,400*
• Neurosurgery $29,000 versus $8,000*
• Knee Surgery $16,000 versus $4,500*
• Metal Dental Bridge $5,500 versus $500*
• Full Face Lift $20,000 versus $ 1,250*

*South Africa, India, and Thailand.

There are an array of medical tourism companies that assist travels find the hospital, clinics, or medical facilities that find the desired procedure. These hospitals are accredited under the international arms of JCAHO, which also regulates U.S. hospitals. Medical tourism presents important concerns and challenges as well as potential opportunities. This trend will have a significant impact on the health care landscape in industrialized and developing countries around the world.

India has been known for their rejuvenating treatments such as yoga and ayurvedic massage, but the quality of their heart by-pass surgery has draw the attention of many throughout the world. According to economist, for the cost of a face lift in the U.S., one can due the following

• Passport U.S. $ 130
• Indian Visiting Visa $ 150
• Flight to India $1,500
• Hotel (6-10 day) $1,000
• Accommodations $1,000
• Face Lift $1,250

Total $ 5,010
Savings $14,990 (approximately)

The most significant aspect of undergoing treatment in India is the low cost compared to either the U.S.A. or Britain. There is a great deal of money that’s saved with medical tourism such as 60% over the normal cost. The treatments includes the procedure, treatment, transportation, and hospital stay as illustrated above. It appears that India found a significant niche in improving its economy, visitors, and technological health integrations with medical tourism.

by Shain Waugh 

The United States is identified as the only industrialized nation without a universal health care system (UHCS). UHCS is a state in which all residents of a geographic or political entity have their health care paid for, regardless of medical condition or financial status. It is approximated that 45 million American are without health insurance, which 80% (36 million) are employed. The challenges facing the 45 million involves the inability to fill prescription, get medical advice, and preventive care.The challenge with the U.S. healthcare system is that the country spends $2 trillion on health care every year, health care costs are skyrocketing, health insurance premiums are rising, lack of affordable health care availability, and there are major flaws in quality with health care providers. As an example, over 100K Americans dies from medical error each year.

With this in mind, the philosophy of universal health care is successfully practiced in many countries such as Canada, the United Kingdom, France, Italy, Argentina, Australia, Brazil, Cuba, Sweden, Germany, and an array of other countries.Sweden as an example is a country of about 9.1 million people on the Scandinavian Peninsula of Northern Europe. Geographically, it is slightly larger than California, U.S.A. It is a single-payer system of health care in which the government pays the majority of all health care costs. The country has struggled in the past with health care expenses causing a strain on government budgets, rationing health care, instituting waiting lists for medical appointments and surgery. 

Canadians as another example, strongly support the core values including equality, compassion, and social solidarity. The interesting concept is that the country’s medical system is built from the understanding of citizenship as opposed to social programs. The system is largely government-funded, with most services provided by private enterprises. The challenge with this system includes long waiting time for major non-emergency surgery, technological adaptations, and challenges with coverage during travel.

The U.S. Health Systems should focus on prevention and public health from its communities perspectives. Politicians such as Presidential hopeful Barack Obama “Every American should have health care coverage within six years.” The challenge with the statement is that mandates will be required. With mandates comes increased expenses and conservatives, which means there will be an array opposers to universal health systems causing misleading attacks, resistance, and a long-winded acceptance process. For Senator Clinton, her plan is to secure health insurance for all Americans while severely limiting the ability of insurers to deny coverage or charge higher premiums to people with chronic illnesses or other medical problems. The plan would preserve a large role for private insurance companies, which will promote the use of health information technology, and low-cost generic drugs.At present, the U.S. health care system faces an unmeasurable struggle in addressing universal health care.

The U.S. politicians hold the strategic and tactical keys in integrating and improving the countries health care system, but how influential will their influence be in making a change. Obama’s plan creates mechanisms to make both private and public health insurance readily available, individual mandate, and focuses on children. Clinton’s plan does the same, but requiring every American to buy health insurance. Which country’s or U.S. politician’s integration strategy is the most efficient, is still up for globalized discussion.

by Shain Waugh

I remember visiting my great grandmother a few months back at her nursing home, which is located in West Palm Beach, FL. The feeling of security, assurance, and a piece of mind was there with me once visiting the actual facility. The facility was well manicured, pleasant aroma, highly recommended by others, and located in a safe neighborhood. However, the quality of patient care was extremely poor, unprofessional, inappropriate, and bewildering to me as a medical professional. If a patient has ‘drop foot’, that foot must be supported by a non-pressure heel support boot for example, and not left unsupported.

Over the years, nursing homes have declined in its quality of care, value, and public image due to a decline in government funding, nursing shortages, and employee’s desensitization to patient’s needs. The decline in quality has de-compensated so greatly that its has become a primary factor for Medicare and Medicaid. According to the Des Monies Register, there are approximately 128 nursing homes within the U.S.A. that does not meet health and safety regulations. However, only 54 have been made public, which leaves this game of “Nursing Home Russian Roulette” open to all patient’s family members.

Presidential hopeful Senator Obama has voice serious concern and objections to the retention of this list. Since there are 16,000 active nursing home in the U.S.A, there may be others that should be migrated on this list. Most nursing homes have some deficiencies, but the ones illustrated poses immediate threats to the patients well beings.

An intermediate solution for family is to evaluated these facilities personally, obtain second opinions, consult physicians, research nursing home blogs, contact medicare/medicade, understand the facilities plans for quality, and remember your family member comes first.

by Shain Waugh

The integration of technology has obviously revolutionized the legacy methods of diagnosing patient, improve treatment tactics, and reduce length of hospital stay care. In a survey with medical facility’s executives, 50% (70 total participants) believe that the integrated technologies improve patient’s safety and operational functionalities. It is obvious that on a global scale there is a significant opportunity to transform health care by integrating technology, but implementation has been long-winded for many healthcare systems.

Of the large healthcare organization within U.S. with annual information technology budgets over $100 million, 30% have deployed some level of technology as opposed to 13 percent of smaller institutions with technology deployment. This in turns develops a system of mixed technology, which includes great technological advances in one area of the region as opposed to traditional legacy systems in another. Experts believe that the long-wind of technological integration into many of the healthcare systems is a result of financial roadblocks. In fact, 46 percent of survey participants (70 participants) stated that funding is a major issue.

The leaders within the healthcare community must transform health care and improve patient safety by better leveraging information technology to improve the efficiency, accuracy, and effectiveness of our healthcare system. This embracement will in turn assist in improving the patient’s longevity, improving our globalized healthcare system, and improve the medical professional shortage worldwide.

by Shain Waugh

The health systems worldwide are faced with challenges that will either force the embracement of new trends or result in organizational unsustainability. The confluence of trends include increasing demand for medical service, decrease in medical professionals, rising costs of service, uneven practice quality, increase of the uninsured, and misaligned incentives for medical facility by the respective country’s government. As a case in point of unsustainability, the United States of America’s healthcare system is ranks 1st in the world with the greatest amount of monies spent per person on healthcare case; however, U.S. is ranked 37th in the world for overall quality of service and 50 million of its citizens cannot afford health insurance according to the World Health Organization.

In fact, Americans are migrating internationally for better quality health, while emerging middle-classes of India and China are traveling to the Middle East for higher quality care. It is reported that fewer people are coming to the United States for their medical needs, which is in part due to American hospitals establishing foreign outposts to meet a growing demand as incomes and expectations rise.The globalize trend continues with the deficit of 2.4 million too few physicians, nurses, and midwives to provide medical intervention according to the World Health Organization. The situation will only worsen with the aging population, alteration in medial program standards, and increase in visa requirements. However, the migration of medical professionals such as nurse and physicians from countries as India, South African, America, Canada, and so forth has made efforts to stabilized the “sinking ship.”

Per globalize experts, the solution to the immediate trends are to encourage medical professionals to remain in their respective countries and to assist in improving the healthcare system. However, this encouragement will be a challenge within itself, cost billions in potential revenues for other countries, increase instability, and may simply not work.