The Future of the Nursing Workforce in the United States: Data, Trends and Implications provides a timely, comprehensive, and integrated body of data supported by rich discussion of the forces shaping the nursing workforce in the US. Using plain, jargon free language, the book identifies and describes the key changes in the current nursing workforce and provide insights about what is likely to develop in the future. The Future of the Nursing Workforce offers an in-depth discussion of specific policy options to help employers, educators, and policymakers design and implement actions aimed at strengthening the current and future RN workforce. The only book of its kind, this renowned author team presents extensive data, exhibits and tables on the nurse labor market, how the composition of the workforce is evolving, changes occurring in the work environment where nurses practice their profession, and on the publics opinion of the nursing profession.
This book contains five chapters based on papers that were prepared for the Cornell University Medical College Second Conference on Health Policy held in New York City on February 27-28, 1986, plus an introductory chapter and a summary of the discussion written by me as chairman and editor. The title, From Physician Shortage to Patient Shortage: The Uncertain Future of Medical Practice, underscores two of the major changes that are operating to reshape the U.S. health care sector.
Author: Institute of Medicine (U.S.). Committee on Enhancing the Practice of Occupational and Environmental Medicine. Subcommittee on Physician Shortage
Enormous changes are occurring in the organization and financing of the U.S. health care systemâ€"rapid changes that are being driven by market forces rather than by government initiatives. Although it is difficult to predict what they system will look like once it begins to stabilize, the changes will affect all components of the health care workforce, and the numbers and types of health care professionals that will be needed in the futureâ€"as well as the roles they will fillâ€"will surely be much different than they were in the past. Despite numerous studies in the past 15 years showing that we might have more doctors than we need, the number of physicians in residency training continues to grow. At the same time, there is evidence that the demand for physician services will decrease as a result of growth of managed care. All of this is evidence that the demand for physician services will decrease as a result of growth of managed care. All of this is taking place at a time when, coincident with the result of failure of comprehensive health care reform, there is no coordinated and widely accepted physician workforce policy in the United States. The present study examines the following three questions: (1) Is there a physician policy in the United States? (2) If there a surplus, what is its likely impact on the cost, quality, and access to health care and on the efficient use of human resources? (3) What realistic steps can be taken to deal with a physician surplus? December
This Atlas builds on the analyses presented in the 2006 edition. As before, the focus is on Medicare beneficiaries who had severe chronic illnesses and were in their last two years of life. This edition both updates the earlier analyses to encompass more recent data (through 2005) and expands the scope to include all sectors of care covered by the Medicare program. This Atlas also proposes new ways of thinking about how to achieve better care coordination and reduce the overuse of acute care hospital services. It offers concrete recommendations on the ways different stakeholders can use the new data - from choosing the right provider to reforming the U.S. health care system.
Integrating Behavioral Health into the Medical Home: A Rapid Implementation Guide offers up- to-the-minute guidance on how to integrate behavioral health (BH) into primary care in a manner which is legal, profitable, clinically effective, time-efficient, and reflective of best practices.
At 6:30 A.M. a head nurse reviews room assignments and the day''s challenges ahead: twenty-nine patients, most of them seriously ill, and four nurses to care for them. That means a barely manageable and potentially risky patient-nurse ratio of seven to one, with one nurse taking eight patients. Unfortunately, this dismal scenario is played out again and again in hospitals across the country.This in-depth, behind-the-scene''s account of a healthcare system under stress and the declining quality of medical treatment in America should serve as a wakeup call to the public. Faye Satterly, a Registered Nurse with over two decades of experience, spells out the alarming statistics: The average nurse today is forty-five years old and anticipating retirement. Only 12 percent of nurses are under age thirty. At the same time, nursing schools report decreasing enrollments and fewer graduates. The result is that the nurses who are on the front lines of healthcare are feeling overwhelmed and leaving the field for less stressful opportunities outside hospital settings.Compounding the looming crisis is the fact that just as nurses are becoming scarce, the need for them is becoming ever greater. Over the next decade, aging baby boomers will swell the ranks of the over-fifty-five population, a group that experiences higher healthcare needs than those in their thirties and forties.There are answers, the author insists, but they will require an honest public debate about our choices and expectations. What are we willing to do and how much are we willing to pay for safe, effective delivery of healthcare?This fascinating and disturbing account by a veteran nurse with extensive experience is a compelling call for action to counter the nursing shortage and ensure that "caring" regains its premium status in healthcare.
Calming fears, alleviating suffering, enhancing and saving lives -- this is what motivates doctors virtually every single day. When the structure and culture in which physicians work are well aligned, being a doctor is a most rewarding job. But something has gone wrong in the physician world, and it is urgent that we fix it. Fundamental flaws in the US health care system make it more difficult and less rewarding than ever to be a doctor. The convergence of a complex amalgam of forces prevents primary care and specialty physicians from doing what they most want to do: Put their patients first at every step in the care process every time. Barriers include regulation, bureaucracy, the liability burden, reduced reimbursements, and much more. Physicians must accept the responsibility for guiding our nation toward a better health care delivery system, but the pathway forward -- amidst jarring changes in our health care system -- is not always clear. In The Doctor Crisis, Dr. Jack Cochran, executive director of The Permanente Federation, and author Charles Kenney show how we can improve health care on a grassroots level, regardless of political policy disputes, by improving conditions for physicians and asking them to take on broader accountability; by calling on physicians to be effective leaders as well as excellent clinicians. The authors clarify the necessary steps required to enable physicians to focus on patient care and offer concrete ideas for establishing systems that place patients' needs above all else. Cochran and Kenney make a compelling case that fixing the doctor crisis is a prerequisite to achieving access to quality and affordable health care throughout the United States.
Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare exposes a vast conspiracy of political maneuvering and corporate greed that has led to the replacement of qualified medical professionals by lesser trained practitioners. As corporations seek to save money and government agencies aim to increase constituent access, minimum qualifications for the guardians of our nation’s healthcare continue to decline—with deadly consequences. This is a story that has not yet been told, and one that has dangerous repercussions for all Americans. With the rate of nurse practitioner and physician assistant graduates exceeding that of physician graduates, if you are not already being treated by a non-physician, chances are, you soon will be. While advocates for these professions insist that research shows that they can provide the same care as physicians, patients do not know the whole truth: that there are no credible scientific studies to support the safety and efficacy of non-physicians practicing without physician supervision. Written by two physicians who have witnessed the decline of medical expertise over the last twenty years, this data-driven book interweaves heart-rending true patient stories with hard data, showing how patients have been sacrificed for profit by the substitution of non-physician practitioners. Adding a dimension neglected by modern healthcare critiques such as An American Sickness, this book provides a roadmap for patients to protect themselves from medical harm. WORDS OF PRAISE and REVIEWS Al-Agba and Bernard tell a frightening story that insiders know all too well. As mega corporations push for efficiency and tout consumer focused retail services, American healthcare is being dumbed down to the point of no return. It's a story that many media outlets are missing and one that puts you and your family's health at real risk. --John Irvine, Deductible Media Laced with actual patient cases, the book’s data and patterns of large corporations replacing physicians with non-physician practitioners, despite the vast difference in training is enlightening and astounding. The authors' extensively researched book methodically lays out the problems of our changing medical care landscape and solutions to ensure quality care. --Marilyn M. Singleton, MD, JD A masterful job of bringing to light a rapidly growing issue of what should be great concern to all of us: the proliferation of non-physician practitioners that work predominantly inside algorithms rather than applying years of training, clinical knowledge, and experience. Instead of a patient-first mentality, we are increasingly met with the sad statement of Profits Over Patients, echoed by hospitals and health insurance companies. --John M. Chamberlain, MHA, LFACHE, Board Chairman, Citizen Health A must read for patients attempting to navigate today’s healthcare marketplace. --Brian Wilhelmi MD, JD, FASA
The American Society of Clinical Oncology (ASCO) predicts that by 2020, there will be an 81 percent increase in people living with or surviving cancer, but only a 14 percent increase in the number of practicing oncologists. As a result, there may be too few oncologists to meet the population's need for cancer care. To help address the challenges in overcoming this potential crisis of cancer care, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened the workshop Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century in Washington, DC on October 20 and 21, 2008.
