Posts Tagged ‘primary-care physician’

When It’s Not Just a “Senior Moment”

Tuesday, November 15th, 2011

The British government has embarked on an ad campaign encouraging early diagnosis of Alzheimer’s Disease.  Experts believe there is a time when people come to the realization that a family member may have a memory problem.  As a result, they are being warned to act and seek help from the Department of Health (DH), which is launching a campaign on the issue.  In the ad campaign, the government tells the story of a man in the early stages of dementia, and his daughter, who senses that she is losing her father.  It highlights the importance of contacting a primary-care physician if you have symptoms like memory loss, confusion and anxiety.  “People are afraid of dementia,” said care services minister Paul Burstow.

According to Alzheimer’s patient Derek Wilson: ”I knew that there was something wrong with me.  Rather than face the possibility someone we love has the condition, we can wrongly put memory problems down to ‘senior moments’,” he said.  “Don’t wait until a crisis.  Being diagnosed with dementia won’t make the condition worse, but leaving it untreated will.”

Approximately 820,000 Britons have Alzheimer’s, out of a population of roughly 62 millionIt is estimated that six out of 10 people with dementia have not been diagnosed in the United Kingdom. In other words, nearly 400,000 people could need help from the National Health Service (NHS) and are not getting it.  According to Burstow, “But if we are worried, the sooner we discuss it and help the person seek support the better.  Don’t wait until a crisis.  Being diagnosed with dementia won’t make the condition worse but leaving it untreated will.”

Family members typically first notice problems when they visit relatives over Christmas, prompting a big increase in calls to the Alzheimer’s Society’s helpline. Last January it had a 43 percent increase, chief executive Jeremy Hughes said.  “It’s when you see someone you perhaps haven’t seen for a while that you can see the difference.  If their memory is going, if they’re getting confused, if they have sudden mood changes, that’s the time to say ‘maybe you should see your doctor’.”

The £2 million campaign is print, television and radio.  According to DH estimates, every general hospital has cost overruns of £6 million because of dementia, a result of the worse outcomes for length of stay, mortality and institutionalization. Better management of patients with hip fractures who also have dementia could save between £64 million and £102 million in England every year.  Professor Alistair Burns, national clinical director for dementia at the DH, said.  “Timely early diagnosis and supportive interventions allow people to plan for the future while they still can.  They have been shown to reduce care home admissions and improve the quality, not only of the life of the person with dementia, but also their family, caregivers and friends.”

Dr. Simon Ridley, head of research at Alzheimer’s Research UK, agreed that the ability to diagnose dementia is ‘crucial’ to providing effective treatment.  According to Ridley, “Although people may be fearful of the worst, a diagnosis can empower them to access the right treatments and support to preserve independence.”

HHS Has $250 Million to Train Primary-Care Physicians

Monday, July 12th, 2010

Healthcare reform provides $250 million to train primary-care physicians, physician assistants and nurse practitioners.  Medical schools and teaching hospitals that educate primary-care physicians and allied professionals can apply for $250 million in new grants through the Prevention and Public Health Fund.  According to Health and Human Services (HSS) Secretary Kathleen Sebelius, the grants are 50 percent of a $500 million fund created by healthcare reform legislation. The doctor deficit goes back to the 1980s and 1990s when medical schools capped their enrollments at 16,000 students per year because they believed that managed care would create a physician glut.

With the nation facing a shortage of 66,000 primary-care physicians just 10 years from now, including 7,000 in underserved urban and rural areas, according to HHS, the new funding is welcome news and represents a starting point to resolve the physician shortage.  The money will train approximately 1,700 new primary-care physicians, physician assistants and nurse practitioners through 2015.  Representative Lois Capps (D-CA) describes the new healthcare bill as a jobs bill because it provides funding to train new healthcare professionals.

The lion’s share of the grants — $168 million – will benefit physicians and be awarded to 105 eligible teaching hospitals and university medical schools.  An additional $32 million will fund 40 programs that train physician assistants.  Another $30 million will fund nurse practitioner training.

Although the 1,700 primary-care physicians this grant money will train is a drop in the bucket – considering that approximately 250,000 active physicians are expected to retire between now and 2020 – it represents a step in the right direction.

Healthcare Reform Underscores Primary-Care Physician Shortage

Wednesday, April 28th, 2010

United States faces a shortage of 40,000 primary-care physicians over the next 10 years.  As the ink dries on President Barack Obama’s landmark healthcare reform legislation, the nation is facing a physician shortage that will only worsen in coming years as 32 million Americans who previously lacked coverage obtain insurance coverage.  A recent report predicts a shortfall of approximately 40,000 primary-care physicians over the next 10 years. A provision in the new law is intended to provide a boon to the profession, ranging from bonus payments to expanded community health centers that will pick up the slack.

For patients, one possible solution could be a medical home, which would improve access with a physician-led team of nurses, physician assistants and disease educators.  “A lot of things can be done in the team fashion where you don’t need the patient to see the physician every three months,: according to Dr. Sam Jones of Fairfax Family Practice Centers in Virginia.  “We think it’s the right thing to do.  We were going to do this regardless of what happens with healthcare reform.”

Just 30 percent of American doctors are in primary care, with 65 million Americans living in areas designated as having a shortage of these physicians.  More than 16,600 new physicians are needed to close this gap in these mostly rural regions, according to the federal government.  One provision of the new healthcare bill is a 10 percent Medicare bonus for primary-care physicians who choose to practice in these underserved regions.

Massachusetts Physicians Give a Thumbs Up to Mandatory Healthcare Insurance

Monday, November 9th, 2009

Massachusetts Physicians Give a Thumbs Up to Mandatory Healthcare InsuranceAs Massachusetts begins its fourth year under a law that requires almost every citizen to have healthcare insurance – only three percent are not insured, the lowest rate in the nation – let’s look at how mandatory coverage is working in the Bay State.  Although critics claim it costs too much and creates too many newly insured patients, the fact remains that a majority of the state’s physicians think the program is succeeding and strongly support it.

A case in point is primary-care physician Dr. Phil Treffletti, whose practice is in Chelsea, MA, a working-class town just north of Boston.  Addressing the critics who claim that accessibility to physicians is an issue, new patients wait an average of just three weeks for an appointment with Dr. Treffletti.  “It’s certainly nicer for me to be able to be available to more patients in my community.  I can’t say that we’ve been swamped or overwhelmed,” Treffletti said.

A poll conducted by the Harvard School of Public Health and published in the New England Journal of Medicine backs up Dr. Treffletti’s opinion.  The poll showed that 70 percent of the state’s physicians favor the law and overwhelmingly want it continued.  Earlier polls have found that while the state’s residents like the mandatory insurance law, Massachusetts physicians are even more supportive.

According to Dr. Robert Blendon, Harvard Professor of Health Policy and Political Analysis who conducted the poll, “They were just quite impressed, both in their own practice and statewide, that the uninsured problem has essentially disappeared from their lives.”

Healthcare’s Best-Kept Secret: Nurse Practitioners

Thursday, August 13th, 2009

If healthcare reform is to successfully overcome the realities of Washington politics, there is one problem in covering the millions of Americans who lack insurance coverage – the physician shortage.  Currently, there is a 30 percent shortage of primary-care physicians, and with less than 10 percent of 2008 medical school graduates choosing that career track.  When Massachusetts enacted mandates for universal health insurance in 2006, the state’s primary-care physicians48019286 were overwhelmed.  A similar scenario could occur on a national scale.

Nurse practitioners — who have advanced nursing degrees, are licensed by the state and often are allowed to prescribe medications — may fill that void because they can treat and diagnose patients at less cost than physicians.  Medicare reimburses nurse practitioners at 80 percent of what they pay doctors for similar services.

Nurse practitioners are vital to healthcare reform because they focus on patient-centered care and preventive medicine.  The House of Representatives has listed nurse practitioners as primary-care providers on their healthcare reform legislation bill.  The profession lobbied intensely to include this legislative language so they can play an important role in a revamped health system.

“We seem to be healthcare’s best-kept secret,” said Jan Powers, health policy director for the Academy of Nurse Practitioners.  Although nurse practitioners typically have less medical education than physicians, they are well trained in skills such as bedside manner and counseling.  “In the United States, we are so physician-centric in our health system.  But it should be about wellness and prevention, not about procedures and disease management,” said Rebecca Patton, president of the American Nursing Association.

Marcus Welby, M.D., May Be Healthcare Reform Solution

Tuesday, July 7th, 2009

Marcus Welby may be making a comeback – not to your television screen – but to your doctor’s office.  Partisans on both sides of the healthcare reform issue in Congress agree that general practitioners should play a starring role in unifying America’s disorganized delivery system.1

“Patient-centered medical home” – meaning a primary-care physician’s office that people visit for most of their medical needs – is the name being give to this vision.  This GP would monitor everything from flu shots to chronic disease management to weight loss and organize care with other practitioners.  According to a 2004 study, if every patient had a healthcare home, the resulting efficiencies could cut costs by 5.6 percent, or $67 billion per year.

This surprisingly simple solution streamlines a wasteful system that consumes 18 percent of the American GDP and a responsibility that falls primarily on private industry, which covers 60 percent of people with healthcare insurance.  IBM, which last year spent $1.3 billion on its employees’ healthcare – the equivalent of one month of the company’s income – has already bought into the concept.

Critics caution that the medical home is overly reminiscent of the “gatekeeper” model of 1990s managed care programs.  Supporters counter that this concept is intended to benefit patients versus insurers.  It’s more akin to practicing medicine 1950s-style, but with digital technology such as electronic medical records to assure a 21st century twist.

Stimulus Bill Boosts Healthcare for the Uninsured and Underserved

Thursday, July 2nd, 2009

Tucked into the Obama Administration’s stimulus bill is $200 million to support student loan repayments for primary-care physicians, dentists and mental health specialists who devote two years to working at National Health Service Corps sites.  Approximately 3,300 awards are being made to individuals serving in health centers, rural health clinics and healthcare facilities that treat the uninsured and people living in under served areas.23285

Department of Health and Human Services Secretary Kathleen Sebelius, notes that the American Recovery and Reinvestment Act “has laid the foundation for health reform and is supporting our effort to give more people access to the quality, affordable healthcare they need.  National Health Service Corps has helped protect the health and well-being of millions of Americans.  Now, we are doubling the Corps and putting doctors and clinicians in the communities where they are desperately needed.”

The additional funding should double the number of corps members “and the number of patients they care for, and spark economic growth in communities hard hit by the economic turndown,” according to Mary Wakefield, administrator of the Health Resources and Services Administration, which manages the corps.