One problem is the shift that started back in the 1980s toward limits to exactly what is the definition of 'a doctor visit'.
When the managed care model came into vogue patient care really started a down hill slide. I notice things like this more easily than a person who hasn't been in the health care industry, perhaps more so because I've been both a provide and an administrator.
Today you can see your doctor for one issue only. That means if you happen to have a headache and a sore knee you have to make two appointments. This of course increases billable hours and the bottom line. It also fragments care.
If you are in an HMO or similar managed care you might not always get the same doctor so continuity of care is out the window.
Insurance regulations contribute to this. Pharmaceutical control and restrictive licensing issues are factors.
And then there is the factor relating to the inability to provide high quality care to people with chronic health problems, and a focus on prevention and cure.
Perhaps we need to get on a track to lead health care to a system as if people mattered.
Another way of looking at this is to get on a train to education so you can learn what measures you can take to improve your health and increase the use of natural care in your health maintenance options.
Certainly we need to overhaul USDA and FDA controls on health care options. We also need to have a level approach to health care where everyone gets the same basic coverage.
Now everyone in Congress, everyone employed or corporate fat cats will all get the same services.
In the mean time I am going to continue taking my vitamins and other herbs and supplements, in spite of news reports saying otherwise.
This protects my health. It can protect yours too!
Many doctors plan to quit or cut back Tue Nov 18, 2008
WASHINGTON (Reuters) – Primary care doctors in the United States feel overworked and nearly half plan to either cut back on how many patients they see or quit medicine entirely, according to a survey released on Tuesday.
And 60 percent of 12,000 general practice physicians found they would not recommend medicine as a career.
"The whole thing has spun out of control. I plan to retire early even though I still love seeing patients. The process has just become too burdensome," the Physicians' Foundation, which conducted the survey, quoted one of the doctors as saying.
The survey adds to building evidence that not enough internal medicine or family practice doctors are trained or practicing in the United States, although there are plenty of specialist physicians.
Health care reform is near the top of the list of priorities for both Congress and president-elect Barack Obama, and doctor's groups are lobbying for action to reduce their workload and hold the line on payments for treating Medicare, Medicaid and other patients with federal or state health insurance.
The Physicians' Foundation, founded in 2003 as part of a settlement in an anti-racketeering lawsuit among physicians, medical societies, and insurer Aetna, Inc., mailed surveys to 270,000 primary care doctors and 50,000 practicing specialists.
The 12,000 answers are considered representative of doctors as a whole, the group said, with a margin of error of about 1 percent. It found that 78 percent of those who answered believe there is a shortage of primary care doctors.
More than 90 percent said the time they devote to non-clinical paperwork has increased in the last three years and 63 percent said this has caused them to spend less time with each patient.
Eleven percent said they plan to retire and 13 percent said they plan to seek a job that removes them from active patient care. Twenty percent said they will cut back on patients seen and 10 percent plan to move to part-time work.
Seventy six percent of physicians said they are working at "full capacity" or "overextended and overworked".
Many of the health plans proposed by members of Congress, insurers and employers's groups, as well as Obama's, suggest that electronic medical records would go a long way to saving time and reducing costs.
(Reporting by Maggie Fox; editing by Chris Wilson)
Copyright © 2008 Reuters Limited.
U.S. Trails Other Nations in Chronic Illness Care
By Will Dunham
WASHINGTON (Reuters) Nov 13 - Chronically ill Americans are more likely to forgo medical care because of high costs or experience medical errors than patients in other affluent countries, according to a study released on Thursday.
The study comparing the experiences of patients in eight nations reflected poorly on the U.S. health care system as President-elect Barack Obama and his allies work on plans to rein in health costs and extend insurance to more people.
The researchers questioned 7,500 adults in Australia, Canada, France, Germany, Netherlands, New Zealand, Britain and the United States. Each had at least one of seven chronic conditions: high blood pressure, heart disease, lung disease, diabetes, cancer, arthritis and depression.
Dutch patients had the fewest complaints, while the Americans had plenty, according to the study by the Commonwealth Fund, a New York-based health policy research group.
Fifty-four percent of Americans surveyed said high costs prevented them at some point from getting recommended medical care, filling prescriptions or seeing a doctor when ill. Seven percent of the Dutch cited cost as a barrier to treatment.
In addition, 41 percent of the U.S. patients said they spent more than $1,000 over the past year on out-of-pocket medical costs. That compared to lows of 4 percent in Britain and 5 percent in France.
A third of U.S. patients said they were given the wrong medication or dosage, experienced a medical error, received incorrect test results or faced delays in hearing about test results, more than any of the other countries.
WASTED TIME
Almost half of the U.S. patients said their time had been wasted because of poorly organized care or had received care of little or no value during the past two years. These views were lowest in the Netherlands and Britain.
Only Canadians reported visiting an emergency room at higher rates in the past two years than the Americans.
The Commonwealth Fund's Cathy Schoen, who worked on the study, said the United States spends twice as much on health care as the others, with the current economic woes putting more people at risk of losing employer-provided health insurance.
"Overall, the United States stands out for chronically ill adults reporting the most negative experiences," Schoen said in a conference call with reporters.
"In short, the U.S. patients are telling us about inefficient, unsafe and often wasteful care. The lack of access, combined with poorly coordinated care, is putting these patients at very high health risk and driving up costs of care."
The U.S. Census Bureau has reported that 15 percent of Americans, 45.7 million people, had no public or private health insurance last year.
The study, published in the journal Health Affairs, was the latest to show the U.S. health care system is performing worse than those in comparable countries. Unlike many rich nations, the United States does not have universal health care.
(Editing by Maggie Fox)
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