Where have all the doctors gone?

In case you missed it, a recent study commissioned by the Association of American Medical Colleges predicts that by 2025, the U.S. will face a shortage of 61,700-94,700 physicians.

Tara Courtland

Communications Director Tara Courtland

It’s not entirely surprising — the cost of education has been steadily rising anyway and the cost of medical degrees, even more so. Teens just finishing high school are thinking twice before embarking on the expensive eight-year journey necessary to practice medicine.

Of course it’s not just that there are fewer doctors — it’s also that there are more patients, since the aging Baby Boomer population has put a strain on the medical profession’s ability to handle the load.

The combined weight of the patient boom plus the doctor shortage has already started to become a problem and, the study concludes, will just keep getting worse.

So what’s to be done? Not surprisingly, the Association of American Medical Colleges, which funded the study, wants Congress to approve more federal funding for residency programs. It’s not an easy problem and whatever happens in the November election, it’s unlikely that Congress will direct a significant amount of money to fix it.

Until something changes for the better, the only answer may be for Americans to live by the “apple-a-day” adage to lighten the load on the healthcare system.

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Study shows alarming error rate in EHR documentation

I recently read some interesting statistics about the completeness and veracity of paper medical records compared to data entered into EHRs. A study was recently published in the Journal of the American Medical Informatics Association about retrospective research done on 500 progress notes from a Michigan hospital, some done on paper prior to EHR adoption and the rest after.  Findings show the rate of EHR inaccurate documentation was 24.4 percent as compared to 4.4 percent in the paper records.  At the same time, complete physical exam findings were left out of 41.2 percent of paper charts, while 17.6 percent were left out of the EHR.

NEMT CEO Linda Sullivan

The study was obviously very small but it points up the fact that when we need our complete medical record it may not be there and that can affect patient outcomes.  No one wants to be a hospital in a city away from home and not be confident that the medical record that is conveyed to the facility is complete and accurate.

Improved training is clearly needed.  At the same time, while there is increased access by patients into healthcare network portals, I’m not sure we get see enough information in there to know if our records are accurate. The little I have seen in my records showed inaccuracies.  We need to do better.

 

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Doctor reviews open up can of worms for HIPAA

I don’t know about you but when I am traveling to someplace different I almost always look at the reviews of the hotel or for a recommended restaurant. I even read the reviews when I want to download an audible book. I think that being able to read a review of something I want to purchase ahead of time is really helpful.  Most of us have bought something on Amazon, and they have reviews for everything.  Amazon depends on buyers to review the items they purchase.

Now we can also review our doctors on sites such as Yelp.  I can see the benefit of this as I can read about a doctor before I go to them or even pick one.   These types of reviews, as so much social media does, opens up a whole new issue for HIPAA.

If a doctor responds back in a personal way about a particular patient review, he could be disclosing patient data. If I rate a doctor poorly for treating my son and she or her office responds and confirms my son is a patient, they are violating HIPAA.  They cannot disclose he is a patient without my permission.

If they say anything that reveals any part of the patient care, they are also violating HIPAA.  The only allowable response a doctor or an office can post would be general statements such as “I give all my patients good care” or to apologize if office waits are long.  They can also say “We have many good reviews by our patients.”

I found all of this interesting as I had never thought about reviews affecting doctors and that they really are unable to say anything that might help clarify the situation.  If a patient writes about a doctor and puts specifics in the review, are they themselves revealing they are a patient?  According to HIAA they are, so we can’t expect doctors to answer these reviews as it could cost them a hefty fine if they answer in any way that confirms the patient’s identity even though it would help clarify a review by presenting their side.

To me this poses real food for thought.  If a patient goes on social media and reveals they are a patient and specifics of treatment, is that giving the doctor permission to answer?

 

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Windows 10 upgrade deadline approaching

Let me start by saying that I’m not encouraging anyone to upgrade to Windows 10.  The operating system you use is a personal choice like the car you choose.  There is no wrong answer.  I just want to make sure that those who decided to wait until the last minute to upgrade don’t miss the deadline.

Andrew Clarke

The primary purpose of this blog is to remind you that the end of the Windows 10 free upgrade period is close at hand.  The deadline is July 29, 2016.  As such, Microsoft will be making on last huge push to get you to upgrade if you haven’t already done so according to Digital Trends [full article at http://www.digitaltrends.com/computing/final-microsoft-windows-10-nag/].

Among other things, they say that not everyone will see this last effort by Microsoft, but my suspicion is that most people will.  The good news is that the final intrusion should come with an option to stop being notified.  Their recommendation is that you

upgrade and roll back at least one computer if you have multiple units in order to preserve your right to have Windows 10 for free after the deadline.  Doing so will get your information into the database at Microsoft as an authorized owner of Windows 10.

I don’t necessarily agree since support for Windows 7 will continue until January 14, 2020 and support for Windows 8 will continue until January 10, 2023.  In my opinion, we will all need new computers by then, which will come with Windows 10.

Detailed Windows OS life cycle information is available at https://support.microsoft.com/en-us/help/13853/windows-lifecycle-fact-sheet.  This page gives information on how long each operating system will be supported by Microsoft.

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The next new healthcare plan

Between the Democratic sit-in on the floor of the House and England’s EU Brexit vote, it was easy to miss the Republicans rolling out their healthcare plan last week.

Tara Courtland

Communications Director Tara Courtland

So in case you missed it, we’ve put together a synopsis.

The most important thing to note is that the Republican plan is still a broad concept  – there is no pricetag and there are few details yet. But in essence, it eliminates Obamacare’s mandate requiring health insurance and the tax subsidies that help low income Americans pay for it. It eliminates the requirements that large employers provide health insurance and it eliminates the Medicaid expansion, as well as national standards for health plans. It also, of course, eliminates the federal health insurance exchange.

In short, it eliminates Obamacare.

The Republican plan instead offers a refundable tax credit for those who can’t get employer insurance. It expands private health savings accounts and it allows insurance companies to charge young people less and old people more.

It also funnels the most expensive patients into subsidized “high-risk pools,” which is the opposite of the Obamacare plan. Obamacare forces broad participation in the system, ensuring that most subscribers are relatively healthy and thus subsidize those who aren’t. The GOP plan would spend $25 billion over 10 years in federal funding for the sickest patients, keeping them out of the general insurance population to keep the costs down for everyone else.

And of course, the Republican plan would restructure Medicaid and Medicare, likely by making coverage cuts, although that detail isn’t clear yet either.

The GOP didn’t put a price tag on its plan as a whole, but it’s likely less than Bernie Sanders’ recently released plan, which nonpartisans have estimated will cost $33 trillion over the next decade.

Of course it’s all an exercise in academic debate at this point. Bernie isn’t going to win the Democratic nomination and the GOP healthcare plan isn’t going anywhere, especially now that Democrats have proved willing, at least for the time being, to steal the show and seize a debate.

It does, however, show that even with everything else that politicians have to fight over — often more publicly and spectacularly — healthcare remains at the heart of the economy, the political system and the national conversation.

 

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