“Your Healthcare. Your Choice.”

by Shain Waugh

General Consumer

The cost of health care in the United States of America is continue to rise. With the integration of health retail clinics into the health care community, has saved the general consumer millions of dollar by simply staying out of the emergency room. Most clinics accept insurance, walk-ins, and for simple procedures patients are usually seen within 15 minutes.

The general consumer’s view of healthcare is changing on a globalized scale. The consumer is expecting more information access, embracing globalize medical tourism, better access to medical facilities, and improved customer service. The health care industry has responed strongly to the demands and desired trends of the community by integrating retail health centers in shopping malls, grocery stores, and pharmacies. The availability of such clinics have created a new business market for the general consumer, in turn, empowering the general public decision on healthcare.

Changing the System

In the changing of the systems, the clinic are orchastrated by nurse practitioners, which are nurses with advanced degrees who can write prescriptions. The salary of a nurse practitioners is usually half the cost of an internal medicine physician. The clinics are typically open 7 days a week and patient, 15 minute visit, and prescriptions can be obtained prior to leaving the facility.

Embracing Change

The American Medical Association, the American Academy of Family Physicians and the American Academy of Pediatrics, which opposes retail clinics as a source of medical care for children of all ages, have issued similar guidelines related to retail clinics. All three organizations are particularly concerned about increased fragmentation of care.

The three association recommends that its 100,000 plus physician to expand office offer, embrace same-day appointment, and take part in the general community in order to compete with the retail clinics. The health systems currently face a few options in embracing retail clinics. The options entail either medical facilities choose not to become competitive or find methods to integrate into the retail clinic arena.

Summing Up

As retail health centers continue to evolve, and as more organizations test the market, multiple clinical and business models will provide health care organizations the opportunity to evaluate alternatives. Rather than viewing retail clinics as a threat, hospital and other medical facilities leaders should view the clinics as revolution for health care.

By Shain Waugh

China’s Emperors

According to ancient history, emperors of great wealth compensated physicians only when the emperors were well, and charge them when sick. The development of illness at this time meant the medicine did not work and the physician was failing at their job. The emperors vision was to remain health at all times regards of the efforts of the physician. In many cases, the influences of the great emperor’s vision exist in an array of universal healthcare system such as England, which the government compensates the physician for the total number of patients that remain healthy (i.e. stopping smoking).

United States

In the United States, the concept of the informed consumer will in turn lead to enhance quality of service within a medical facility. This means that purchaser, consumer, or general public will get better care if the proper care is designed to meets one’s needs and expectations. The vision for the health care industry is that health plans, clinicians, and institutions will provide better care to attract more patients. However, in most cases, the process still doesn’t make a significant difference. (Refer to Right Medical Physician)

What is Health Care Quality?

As a health care provider, there are an array of definitions of health care quality and the definition lye in the perception of the evaluator. There are some cases that good quality involves the wait time to see the doctor, the quality of food within the hospital, doctor response in calling back, type of medication prescribed, number of referrals from other doctors, or the amount of time the doctor spends with the patient.

The quality of healthcare must be evaluated as taking your brand new 2008, red, GMC Arcadia to the dealership to evaluate an abnormal sound coming from the engine. The technicians in the shop are the nurses, doctors, pharmacists, and physical therapists for this vehicle. These people are either friendly or not, knowledgeable or not, license or not, but the true questions is if they can fix the car right the first time or over time with multiple visits.

Oregonian Reports

According to the Oregonian reports, there are an array of hospitals and physician practices that are increasingly releasing cost and quality data, but reports along with surveys illustrate that the data is not yet affecting the consumer decisions The performance ratings remain crude, potentially misleading, and difficult for experts to understand. For example, “Oregon’s hospital quality rating Web site details hospitals’ experience with procedures, but consumers are limited when trying to select a top performer, in large part because mortality ratings for hospitals are similar.” In most cases, a medical facility with a high morality rates doesn’t make the facility a bad, unsafe, and dangerous facility to be admitted.

The reasoning is that most facilities with high morality are trauma centers and/or crisis centers that are best fit to address a critical situation. On the other hand, facilities with low morality isn’t a good indicator as well because many of these facilities push patients out once stabilized. In recent studies, New York and California showed that public reporting barely affected the flow of patients to hospitals with high death rates and that some hospitals with low death rates did not increase their patient flow.

According to studies, “most patients are not aware of quality comparisons and that those who are familiar with them seem distrustful and find them confusing.” The challenge with this quote from the Oregonian reports is that the general public is over load with healthcare information and left without a reliable source of information involving healthcare trends, changes, and helpful information. It’s proven via surveys that patients prefer advice from trusted friends, family, and personal physicians over published data or government sources.

Tying it Up

The health care providers including the U.S. government, insurance companies, and many pharmaceutical are working to improve the quality of healthcare today. However, the challenge will be for the general community to play a strong role in demanding the level of quality for yourself, friends, and family members. According to a 2004 study of 12 large U.S. communities, 54.9% of the people actually received the care the they designed, needed, and researched.

The Oregonian reports are a true indicator of how the U.S. health industry is in an uncontrolled status of confusion. We as a health community are so concerned with rising health cost, large premiums, medical errors, and so forth that we as a community become overwhelmed with unreliable healthcare information. Health information should come from one reliable source regulated by the government in a sense. These are many of the challenge the American people face within the land of opportunity, but the quality health care helps people feel better and enjoy a better quality of life, which is what is most important.

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. 

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.

by Shain Waugh

Since the dawn of time, one of the most critical elements in being satisfied with your health care experience is choosing the right physician. The relationship one has with their health care provider should mean better communication, effective treatment, and life longevity. The challenge that we face today is selecting the right doctor. There is an array of reference sites such as the American Board of Medical Specialties, American Medical Association, Administrators in Medicine, WebMD, Mayo Clinic, etc.

However, these references only provide information on a physician’s qualifications, physical location, specialty of practice, insurance, etc. There is no true method of evaluating a physicians performance besides referrals or viral reporting (word of mouth). In past survey studies of the general public, three out of every five people are unhappy with their current physician and three out of every five people are actively looking for a new physician.

The question for this dialogue is what do we do as a community to become more informed about physician’s medical practices? What are some tactical strategies that you the reader have utilized successfully? Your feedback provides great insight to those of us struggling to address this question each day.