2020 Vision Health in the 21st Century (1996) / Chapter Skim
Currently Skimming:
The Workforce for Health
The Workforce for Health
Pages 93-107
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From page 93... ...
The first is to give you some sense of the challenges to the health profession, which ~ have already been addressed by others. Then I would like to focus by looking at specific health professions and offer some comments on the academic health center and its future.
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From page 94... ...
The final value involves improving the quality of patient care outcomes. The system is moving faster now than even the most aggressive prognosticators thought possible as recently as two or three years ago.
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From page 95... ...
in, All of the professions are tied to this aging model. Medicine is overly focused on individual practitioners providing clinical service to individual patients who present with acute care treatment needs.
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From page 96... ...
These values involve particularly, a capacity to lower costs, to deliver health quality at a higher outcome, and to enhance patient satisfaction. This may or may not have anything to do with the scope of practice.
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From page 97... ...
The number of multiskilled allied health workers must increase" not the number of technically driven allied health workers, but the number of allied health workers who are multiskilled. Make education accountable for cost, time, and performance.
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From page 98... ...
The relationship must be basically different. One of the most important challenges to medicine is to create a single pathway to a generalist's career so that, rather than having general internal medicine, family medicine, and pecliatrics, we have a general medicine pathway with pediatric, geriatric, adult male, and adult female opportunities for specialization.
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From page 99... ...
SOURCES: Statistical Abstract of the United States, 1987, Bureau of the Census, page 90; The Registered Nurse Population, Findings of the National Sample Survey of Registered Nurses, March 1992, Bureau of Health Personnel, Department of Health and Human Services; and The AHA Profile of U.S. Hospitals, 1 993/94, American Hospital Association.
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From page 100... ...
On the organizational level, academic health centers will lose considerable parts of their revenue streams, not just from patient care but from research dollars and other sources. We must develop new partnerships.
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From page 101... ...
Create a virtual academic health center, not one located on a single campus, but one in which research might be spun off; patient care services might be carried out in efficient, patient-orientecl care delivery systems; and the educational mission might be carried to the research lab, the patient care delivery site, or the lecture hall. Then create a stable and sustainable financial base.
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From page 102... ...
Among these are the health status of the population, the growth of knowledge of disease and of the technology to apply that knowledge, and the paradigm shifts that medical centers will have to embrace to help them achieve their missions. HEALTH STATUS On some of these points, the Pew Commission report does not go far enough.
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From page 103... ...
WORK FORCE Notwithstanding these considerations that may influence the number and mix of health care professionals needed, it is important to acknowledge an oversupply of physicians and to discuss strategies that might be used to address the problem. The Pew Commission report calls for a limitation on the number of residency training positions, limits on the number of international medical graduates receiving training in this country, and a reduction in the number of U.S.
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From page 104... ...
This strategy must recognize the demand for foreign-educated physicians as a means of satisfying service needs in our teaching hospitals. Sufficient funds must be made available to those hospitals that provide disproportionate medical services to indigent patients and depend on residents who graduated from foreign schools to provide those services.
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From page 105... ...
their teaching hospitals of the kind that is now being played out in New York City, Boston, and the San Francisco Bay Area. CONCLUSION Finally, it is worth commenting on whether regulation, the marketplace, or both, will represent the best approach to the necessary downsizing of residency training positions.
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From page 106... ...
I am with the American Association of Dental Schools. This is just a reminder that an academic health center by definition consists of more than a medical school and a teaching hospital.
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From page 107... ...
Indeed, if 10 percent of the people account for 70 percent of the health care costs, isn't what we really need particularly given recent articles in the New England Journal of Meclic~ne and ] ~4MA that show that perhaps primary care physicians are not the best managers of chronic disease like heart disease, cancer, and so on a specialty-clominatec3 system that uses some of the multiskilled allied health professionals that you talked about?
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