Leaning slightly to the left, our group believes physicians, nurses and other health care providers need to take a more proactive approach to treating patients. With approximately half of all chronic diseases being linked to preventable problems including smoking, obesity, and physical inactivity and 70% of health care spending being put toward these diseases, this requires more attention to primary prevention of disease (www.healthcareproblems.org). Primary prevention is the future health of all Americans. By preventing diseases before they begin opens a door to the right direction on the issue of health care reform.
Education is another responsibility of these individuals. Many studies have shown that when patients with chronic diseases focus on their health and get involved in their own care, their overall health improves and health expenses decrease (www.pbs.org). Through education, health care providers empower their patients to take on a healthier lifestyle and proceed on a path of changing high risk behaviors.
Although education may encourage individuals to live a healthier lifestyle, access, quality, and affordability of health care are crucial to paving the way for a healthier America. Both individual and population health are closely related to having access to adequate preventive and curative health care is a key determinant of health (Shi, Shing pg. 52). About 44 million people in the United States have no health insurance, and another 38 million have inadequate health insurance. These staggering numbers create a gap in the ability to seek preventive care. A quote from Sherry Glied, PhD, Associate Professor of Public Health, Columbia University explains these three important dimensions of health care reform,
“The people who are most at risk today are those who have no health insurance at all. They’re at risk of not getting regular care when they need it. They’re at risk of not getting regular care when they need it. They’re at risk of not catching real problems before they get serous enough to not be treatable. They’re at risk of not getting the best treatment when they actually do get sick. And they’re at tremendous financial risk. They could lose everything that they’ve saved in their lives because of some even fairly minor health problem www.columbiauniversity.edu.”
As the members of our group continue on our journey of the health education program, we realize the importance of the three dimensions, access, quality, and affordability. Without having equal emphasis put on all three, the system doesn’t run as it is needed to. If one dimension of the triangle is unattainable, the other two will not be able to compensate and the system will fail.
As a member and employee of a health care facility, our group feels it is those individuals responsibility to address issues that are concerning to the public. According to Commonwealth Fund President Karen Davis, “fraud in health care is rampant” (www.hospicepatients.org). There are a few issues such as intentionally understaffing facilities, making decisions which harm to patients is known, and assigning more cases than capacity to maximize profits. These are issues that are harming the quality of care patients are getting and we feel it would have beneficial value to change the attitude from money to patient care.
The Shi and Shing text states, that “the American public’s attitudes toward improving health are based on more medical research, development of new medical technology, and spending more on high-tech medical care” (pg. 52). As our group was reading this statement we realized the shocking truth to it. As American citizens we have gone away from the belief of living a healthy lifestyle. Most feel too busy to incorporate daily exercise or even a daily intake of fruits and vegetables. This has had serious consequences to our society and it is our responsibility to have our voices heard and shift the emphasis of health care to primary prevention.
As health educators and potential health care workers, these are serious issues that we need to be educated about in order to have a positive influence. Health care reform is a high on the priority list of our influential leaders and it is important for them to know how we feel and what we, as educators and providers need to make health care affordable, accessible, and effective.

Overview/History of Workforce

“In many healthcare occupations, we face labor shortages. Yet these are also opportunities for quality jobs and rewarding careers.”
-Governor Jim Doyle
This statement issued by Wisconsin Governor Jim Doyle in the Wisconsin Healthcare Workforce Annual Report 2007 emphasizes a major problem the United States faces: a shortage of healthcare workers. According to this report healthcare is the quickest growing workforce area in the country and is expected to create 3 of every 10 jobs nationally through 2014. The healthcare workforce can include professionals ranging from physicians, registered nurses, dental hygienists, and health information technicians. With this much demand for healthcare positions, how can the shortage be solved?

The Select Committee on Healthcare Workforce Development in the group who is responsible for coming up with ideas that will help solve this massive problem. One proposed solution is working to increase clinical site capacity. Another proposal is to create an online database that will help prospective workers with position placement. The initial focus of this program would be with Registered Nurses as, according to the report, it is the career with the most projected openings through 2014. Yet another possible solution is the implementation of the tracking of employee retention rates. If hospitals work harder to keep their staff, they may not have as many issues with shortages.

Accompanying the shortage of healthcare workers is the decrease in the quality of healthcare. According to an article from the American Medical Association, the average office visit in the United States last for about 16 minutes. With this being an unofficial standard of healthcare, it is hard for patients to receive quality care when they only have access to their physician for a fraction of the time needed to discuss all of their problems. Such a short visit will almost guarantee that a discussion about prevention, possible side effects of medication, and psychosocial issues (things essential to quality healthcare) will be forgotten.

This article published by the American Medical Association and titled “So Much to Do, So Little Time” by Kevin Fiscella, MD presents an extremely comprehensive overview of a typical visit to the doctor’s office. There are many charts that present issues such as tasks and challenges for caring for patients and how our current system treats patients. Also in the article Fiscella discusses how patient treatment can be improved including physician and staff training, patient training, providing resources, and physician leadership. With three pages of outside references this is a strong article that presents a well-built case for better physician care.

In 2006 healthcare expenditures were projected to consume 16.2% of the United State’s GDP which is more spending per capita and any other nation (McKenzie, 414). The spending on healthcare is projected to increase and with that will come an increased demand for services. More services will require more healthcare workers including health service administrators (Shi and Singh, 489). Because of the increased demand for healthcare workers, it is imperative to reverse the current shortage as soon as possible.

With a shortage of healthcare workers all around, one area in particular is feeling the effects the most. In metropolitan areas the number of physicians increased by 74% while in nonmetropolitan and rural areas the number only increased by 61% with a ratio of generalists to population of 5 per 10,000 (Shi and Singh, 131). These numbers show you that it is hard for people living outside of major cities to receive access to medical care.

The issue of the healthcare workforce shortage is incredibly important. With the economy in its current state many hospital administrators may be forced to cut programs that help improve the quality of healthcare delivery and the safety of patients (Hamby, 23). With the loss of these programs not only are patients put a risk but the shortage of healthcare workers only gets worse. If this issue is not addressed and dealt with in a timely manner, many people’s health may be put in extreme jeopardy.

Many people may think that the workforce is not as important as other issues in healthcare. They may think that improving medical technology to improve the chances of patient survival is more important or they may believe that increasing primary care as opposed to secondary and tertiary is critical to the improvement of healthcare. However, without a healthcare workforce, not one of these could be put to use. It would be great to have improved technology or primary care, but without a workforce, neither could exist.


References:
Fiscella, Kevin, and Ronald M. Epstein. "So Much to Do, So Little Time." So Much to Do, So Little Time 168 (2008): 1843-852. Archives of International Medicine. 22 Sept. 2008. 15 Feb. 2009 .
Hamby, Leigh. "Beyond the Current Crisis." Modern Healthcare 39 (2009): 23-23. 02 Feb. 2009. 15 Feb. 2009 .
McKenzie, James F., Robert R. Pinger, and Jerome E. Kotecki. An Introduction to Community Health. 6th ed. New York: Jones & Bartlett, Incorporated, 2007.
Shi, Leiyu, and Douglas A. Singh. Delivering Healthcare in America : A Systems Approach.
4th ed. New York: Jones & Bartlett, Incorporated, 2007.
Wisconsin Department of Workforce Development. 15 Feb. 2009 .

Posted by Alyssa Buchman