Basic Health Access

A popular video on social media lists 20 areas of improvement around the planet. It lists a 50% decrease in homeless veteran numbers. The rapid declines in Veteran homeless counts in metro areas are not necessarily a positive result. The media has a hard time understanding demographics and this makes it difficult when attempting to report on positive and negative areas. Another popular poster notes that homeless veterans need attention before refugees. The fact of the matter is that many Americans are treated like refugees - as those who do well plan ways to do even better. Their designs continue to leave most Americans behind. The relevant areas to consider for Veteran situations are not immigrants. The relevant areas are declines of veteran benefits, deteriorations involving lower income, disabled, fixed income, and less healthy populations of which Veterans are part. Most important is the consideration of available and affordable housing. Factors Regarding Veteran Homeles...

Eric Levi outlines the Dark Side of Doctoring in one of the most important health care topics of our time. He was led to this blog post after another physician took his own life. The words of the widow of the physician to trace the final steps leading to this tragic loss. These words have the power to help others to understand the process that leads to death for those pledged to life. The following represent a number of resources for physicians and their families as they struggle with the Dark Side. Advice comes from the blog, the widow, 5 Regrets at the End of Life, The Antidotes of Stress, and what we should do as physicians and as a nation. The formula is not difficult to understand - Too little sleep, too many life interruptions, too little time left for family or self, feeling too important, finances too complicated, feeling too inadequate, and eventually leaving too few indications of the final act to come.  Exhaustion, interruption, marginalization, superhuman e...

In family medicine we most need change agents and least need those who remain stagnant and unable to change the course of health access, of primary care, and of health outcomes for most Americans. We fail in training and in family medicine workforce because we fail in selection and preparation in ways that training cannot address. The STFM blog highlighted the quality improvement potential of family medicine residents. There is so much more potential for those that begin efforts much earlier and work throughout their lives as change agents. The Social Beginning Is the Beginning of Change Agents Potential medical students and others preparing for health and education careers should spend age 14 to 30 years working in their communities improving health, education, and local resources in their communities. These important interactive life experiences should be the most important determinants for selection as nurses, public health officers, or family physicians. Selectio...

Annual graduates continue to increase at rates must faster than population growth or growth of the elderly, yet more sources all expanded have failed to address shortages. Where did the graduates go? Not surprisingly they follow the dollar directions shaped by health policy. GME training produces the wrong physicians for the wrong specialties and the wrong places. Residency expansions could increase the physician workforce but will not address shortages of workforce, poor retention of graduates where needed, health outcomes improvements, or access to care for Medicaid and Medicare populations falling most behind. Residency expansions will worsen health care costs and will further marginalize physicians in their contracts with employers. New medical schools, residency programs, or nurse practitioner/physician assistant programs should not be promoted as a solution for health access woes. Only substantially more dollars to support more team members in lowest concentration sett...