Showing posts from 2019

Physicians Are All Alone Together

It is a time of great change and challenge in health care. The challenges are best seen in those who deliver the health care. Marginalization of nursing has been present for decades. Financial designs have long resulted in pressures for fewer nurses doing more as patient care gets more complex. Now this is seen in physicians and across those in health care. 

The chronic provocations of the broken-down 
healthcare "delivery system" relegates physicians into a chronic 
and unsustainable fight-or-flight mode. (Hood) It is indeed a cruel irony that we are all alone – together. (RCB)

Innovation and disruption discussions have been converted into policies, regulation, and the push for digitalization. This rapid change focus is fixed on fixing health care. Instead the relentless bandwagon of disruptive innovation has rolled over those who deliver health care. 
Rapid regressive changes are taking the humanity out of health care. They are taking the health out of those who deliver healt…

For Burnout Relief Focus on Fixing the Financial

With additional decades, with time away from academic influences, with time away from conferences, and with more interactions with practice and practicing physicians - it is possible to see with a different perspective. The leaders and staff shaped by the above may be quite limited in their critical abilities. The newest and most innovative approaches are given free reign. Meanwhile back in the real world of practice, there are consequences.
Conferences to address burnout - this is the nominee for the first Focus on Fixing the Financial post.
Conferences on burnout appear to be a good thing For associations to appear that they are addressing member needs, especially those failing to address the financial design or the innovations, regulations, and digitalizations that make practice worseFor association leaders to raise up their flags to also appear to focus on important areasFor association financesFor advertisers associated with association conferencesFor advertisers hoping to market…

Open Letter to Family Medicine Leaders Regarding Expansion of FM

Please reconsider your plans to devote major resources to expand family medicine graduates. We must work together for FM, but we must be effective. Effective efforts must be specificity to address the problem. The problem in primary care cannot be solved by training. More reports, conferences, staff resources, and association resources would waste time, effort, and energy.
It is meaningless to attempt to expand any primary care, generalist, or general specialty workforce without the dollars specific to support more delivery team members. Only a major improvement of the financial design can support more team members in more locations - especially where most Americans have the least by design.
The lack of effectiveness of more graduates is obvious and has been for decades. New sources of primary care and massive expansions of four sources have not resolved deficits of primary care or workforce where needed. The glut of workforce created will make matters worse.
The financial capacity f…

The Glut of Health Workforce Exposed But Ignored

When you spend a decade or more preparing and training for a career as a physician or as a nurse practitioner, you expect that you life will improve with your new employment. This is no longer a reliable expectation. Decades of overproduction of NP, PA, DO, and MD graduates will have consequences for graduates as well as for our nation.

High debt from tuition, higher cost of living, the challenges of becoming a young health professional, and the difficulties dealing with employers that hold all the cards - will collaborate for worsening outcomes. The burnout, turnover, productivity, and suicide issues will intensify.

Slowing Population Growth Magnifies Overproduction

The new census figures indicate a slowing of population growth. This translates to a glut of health care workforce even worse than previously projected. Previous calculations of expansions used 0.72% as the annual growth rate from older census data. The newer figures are 0.62%. The decline will continue to 0.6% or lower.