While the study had a number of scientific limitations; the two most significant were: 1) although the response rate of interns that volunteered to participate was 80%, those that did participate may not have been representative; and 2) the case-crossover analysis cannot account for the contribution of within-person factors that may have been co-variables with exposure status.
As a result of the related research, hospitals will be using medical resident interns as a means of making up for the lack of doctors caused by financing concerns. The redistribution of medical interns was expected to be completed before the next residency training year starts July 1, 2005, however, it remains currently underway. The Association of American Medical Colleges has stated that the health care system would be better off if the cap were lifted so hospitals could respond to the needs of their communities, such as adding a new cardiology program or expanding emergency medicine. However, as Croasdale (2004) indicates, it is unclear though, what this would cost. The federal government, through CMS, spends roughly $8 billion a year on graduate medical education or $80,000 per resident (Croasdale, 2004). These factors affect small rural hospitals even more, since physicians are affluent and in short supply, they tend to locate where they want to live.
An example of how this directly affects my clinical setting, a small rural 200 bed facility, can be described by the following example. Jackson Hospital, a 120-bed hospital in Marianna, Florida, located in a small town of 6,200 is in need of an urologist, a radiologist, an ear, nose and throat specialist and a gynecologist. According to the hospital administrator Charles Ellis, "it's supply and demand, and it's hard to get doctors here (Cauchon, 2005)." Additional research supports the conclusion that particularly scarce are old-fashioned specialists, such as general surgeons, radiologists, anesthesiologists, that have a wide range of duties. For example, Jackson Hospital has one radiologist who does the work of two or three doctors, working 15 to 18 hours a day.
Furthermore, new radiologists are not very interested in traditional radiology, and prefer cutting-edge radiology using catheters to treat cancer, blood clots and other problems, which is more lucrative and have predictable hours (Cauchon, 2005). According to Croasdale (2004), the rules CMS has set up for the audit will unfairly penalize some hospitals;...
faces at least a decade of severe physician shortages, a desperate situation that must be resolved now, since it takes a long time to train a doctor. This has caused a lack of needed doctors in smaller facilities, and the federal programs responsible for paying and subsidizing medical positions for students are in a financial state of crisis. As a result of the financial crisis, medical student interns must work longer hours, at a detriment to their safety and the safety of others. The safety of others that is placed at risk involves the general public as well as the patients that the over-tired medical student is supporting or treating. In an effort to address the uneven distribution of physicians in the United States, the Centers for Medicare & Medicaid Services, which heavily subsidizes graduate medical education, is tracking down unused resident positions and reallocating them to hospitals it deems the most in need of more physicians.
However, a review of the literature indicates that this may not be a permanent solution, as it causes additional problems to surface. For example, more physicians may drive up the cost of medical care, not make it cheaper and more accessible. This will occur by physicians ordering more tests, more procedures and more drugs, without improving the public's health. Thus, without some necessary reforms, the financial state of the medical profession remains threatened.
Barger, L., Cade, E., Ayas, N., Cronin, J., Rosner, B., Speizer, F. & Czeisler, C. (2005).
Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns. NEJM
Cauchon, D. (2004). Medical Miscalculation Creates Doctor Shortage. USA Today,
Croasdale, M. (2004). Residency Slots Reallocated to Relieve Doctor Shortages.
Retrieved April 23, 2007, at http://www.ama-ass.org.
Ellenbogen, J. (2005). Cognitive benefits of sleep and their loss due to sleep deprivation.
Neurology 64, E25-E27.
Fletcher, K., Underwood, W., Davis, S., Mangrulkar, R. Mcmahon,…
The documents we provide are to be used as a sample, template, outline, guideline in helping you write your own paper, not to be used for academic credit. All users must abide by our "Student Honor Code" or you will be restricted access to our website.
It could be argued that modern technology created the need for healthcare insurance in the first place: before technology, including new medications, became effective, to go to a hospital was regarded as a death sentence and the wealthy died at home, under the care of their personal physicians. Life spans were shorter, and patent medicines of dubious value were the main ways of treating illnesses. "What we recognize as modern
Health Care in the U.S. And Spain What Can the U.S. Learn About Health Care from Spain? In 2009, Spain's single-payer health care system was ranked the seventh best in the world by the World Health Organization (Socolovsky, 2009). By comparison, the U.S. health care system ranted at 37 (Satiroglou, 2009). The Spanish system offers coverage as a right of citizenship that is constitutionally guaranteed. Spanish residents pay no expenses out-of-pocket, with
Therefore in the economic sense many institutions have been viewed to lay back. Knowledge and Expertise in Telemedicine Another challenge has to do with the limited knowledge and expertise in telemedicine as well as the need for enhanced and modified telemedicine systems. In this sense, little knowledge currently exists among medical practitioners on how to effectively and practically use various forms of telemedicine. This knowledge gap on insight into telemedicine, in
(Worcestershire Diabetes: a New model of care Stakeholder event, 2007) The continuum of care for the diabetic patient is shown in the following illustration labeled Figure 1. Diabetes: Continuum of Care Source: Worcestershire Diabetes: a New model of care Stakeholder event (2007) The continuum of care for diabetes begins at the moment that the individual is found to have diabetes and continues across the individual's health care providers and across the varying stages
Specialist doctors will normally examine only those patients who have been referred to their clinic by a general practitioner. (U.S. Department of State, n. d.) The Government of Netherlands is not responsible or the ongoing management of the healthcare system on a daily basis which is offered by private healthcare service providers. However the government is charged with the accessibility and ensuring appropriate standards of the healthcare. A new healthcare
Surgeons in Canada report that, for heart patients, the danger of dying on the waiting list now exceeds the danger of dying on the operating table. Emergency rooms there are so overcrowded that patients awaiting treatment frequently line the corridors. Not only is there a long wait for care, but care is frequently denied to patients who prognosis is poor. In Britain kidney dialysis is generally denied patients over