By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 08/04/2012
I always learn a lot while watching the Olympics. During the parade of nations, I'm routinely educated about the existence of at least two countries that have, until then, escaped my awareness. I often discover that an otherwise ordinary capacity of the human body has been associated with some type of ball to create a new Olympic sport. And with each Olympics, I am freshly reminded that I am months or years behind in my personal fitness program.
But late last month, I was thoroughly stunned to learn from the 2012 Opening Ceremonies in London that real doctors can actually dance! The spectacle of British physicians and nurses kicking up their heels swept me off my feet. And it provided reassuring proof that medical office parties need not always be flat-footed events.
Watching an octogenarian Queen parachute into the stadium was unremarkable compared to witnessing happy doctors performing the Lindy Hop, keeping time and rhythm, having fun, receiving cheers from an appreciative public. In contrast, on this side of the pond, doctors are more likely to be doing the hobble, dancing as fast as they can, trying to work a somewhat cheerless crowd.
In the tradition of Olympics host countries, the Brits set out in the Opening Ceremony to showcase their unique history and culture. Homage was paid to the industrial revolution, the Beatles, the World Wide Web, multiculturalism, Mary Poppins, and, yes, the "NHS" -- the country's health care system.
The National Health Service is Britain's taxpayer funded, government-run health care system (akin to our country's Medicare program) that since 1948 has provided free medical care to citizens of all ages (not akin to Medicare). Alongside the likes of celebrities and other cherished British institutions, the NHS was upheld and celebrated before an estimated international viewing audience of 1 billion people. A brilliant display of lights spelled out "N-H-S," applause erupted within the stadium, and hundreds of British health care professionals -- including actual doctors and nurses -- jubilantly danced.
It's hard to imagine a comparable celebration of health care within the United States. Public discontent runs high, and the most formidable obstacle is that we lack an actual system to celebrate. Instead, we'd have to round up dozens of operational fragments and competing insurance providers, hoping to coax them into step with one other, if only for an hour under the klieg lights. A disturbingly large area of the stage would remain vacant to represent 50 million uninsured Americans.
Additionally, we'd have to find hundreds of happy, dancing U.S. doctors and nurses to jazz up the festivities. That challenge is dually formidable -- because of prevalent job dissatisfaction rates, and actual numeric shortages of health care providers. For example, according to the Association of American Medical Colleges, in 2015 the U.S. will have about 63,000 fewer doctors than it needs. And a recent Health Affairs report projects our nursing shortage to increase to 260,000 registered nurses by 2025.
Finally, we'd have to somehow find a stadium that was small enough to accommodate the cheering section of U.S. health care consumers.
It's a good bet that the overwhelming majority of red-blooded uninsured Americans would die for an opportunity to obtain health care from the dancing doctors and nurses of the NHS. Indeed, according to Harvard Medical School, more than 45,000 of those Americans die each year merely because they lack health insurance.
Meanwhile, in the U.S. we also face a troubling shortage of doctors and nurses that is projected to increase through 2025. The escalating health care requirements of an aging population will further stress those shortages, as will the planned expansion of health insurance to 30 million more Americans in 2014 as provided by our country's new health care law.
The point is, that if we are serious about addressing those workforce shortages and don't expect new recruiting to keep pace, we must also address issues of job satisfaction and retention among currently employed nurses and doctors. And for doctors in private practice, haggling with insurance companies for payment ranks high on the job dissatisfaction list. It's costly in morale and in dollar signs -- $80,000 per year, according to a 2011 study in Heath Affairs.
This costly demoralization also plays out in doctors' unwillingness to provide care to patients with Medicaid insurance -- the federal-and-state jointly-funded health insurance program for the poor. In addition to struggling with the haggling factor, physicians must deal with Medicaid reimbursement rates that are unjustifiably low: about $18 for an office visit. The Center for Studying Health System Change reports that only 42 percent of primary care physicians currently accept new Medicaid patients.
And therein lies the greatest obstacle to realizing the goal of expanding insurance coverage for most Americans under the new health care law: it heavily relies on further expansion through the already strained Medicaid insurance program.
On a final note, we must take notice that the next generation of American physicians is dancing to a new beat that shuns soul-stomping haggles with third-party health care insurers. Increasingly, they are choosing salaried positions over fee-for-service jobs, and opting to work in group over solo practices -- similar to an NHS practice setting.
In the end, our hopes to address our doctor shortage in quest of expanding health care coverage to most Americans will require us to look beyond the medical profession. It will require us to look at health care funding sources with a keen eye toward improving physician morale and retention, eliminating wasteful administrative costs on slow and wretched dances with insurance providers, and keeping tempo with the next generation of health care providers. In other words, for the sake of our own health, we may be seeking a system that looks a lot like the NHS.
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Kate Scannell is a Bay Area physician and the author most recently of "Flood Stage."
Copyright, 2012 Kate Scannell
First Published in Print: 08/04/2012
I always learn a lot while watching the Olympics. During the parade of nations, I'm routinely educated about the existence of at least two countries that have, until then, escaped my awareness. I often discover that an otherwise ordinary capacity of the human body has been associated with some type of ball to create a new Olympic sport. And with each Olympics, I am freshly reminded that I am months or years behind in my personal fitness program.
But late last month, I was thoroughly stunned to learn from the 2012 Opening Ceremonies in London that real doctors can actually dance! The spectacle of British physicians and nurses kicking up their heels swept me off my feet. And it provided reassuring proof that medical office parties need not always be flat-footed events.
Watching an octogenarian Queen parachute into the stadium was unremarkable compared to witnessing happy doctors performing the Lindy Hop, keeping time and rhythm, having fun, receiving cheers from an appreciative public. In contrast, on this side of the pond, doctors are more likely to be doing the hobble, dancing as fast as they can, trying to work a somewhat cheerless crowd.
In the tradition of Olympics host countries, the Brits set out in the Opening Ceremony to showcase their unique history and culture. Homage was paid to the industrial revolution, the Beatles, the World Wide Web, multiculturalism, Mary Poppins, and, yes, the "NHS" -- the country's health care system.
The National Health Service is Britain's taxpayer funded, government-run health care system (akin to our country's Medicare program) that since 1948 has provided free medical care to citizens of all ages (not akin to Medicare). Alongside the likes of celebrities and other cherished British institutions, the NHS was upheld and celebrated before an estimated international viewing audience of 1 billion people. A brilliant display of lights spelled out "N-H-S," applause erupted within the stadium, and hundreds of British health care professionals -- including actual doctors and nurses -- jubilantly danced.
It's hard to imagine a comparable celebration of health care within the United States. Public discontent runs high, and the most formidable obstacle is that we lack an actual system to celebrate. Instead, we'd have to round up dozens of operational fragments and competing insurance providers, hoping to coax them into step with one other, if only for an hour under the klieg lights. A disturbingly large area of the stage would remain vacant to represent 50 million uninsured Americans.
Additionally, we'd have to find hundreds of happy, dancing U.S. doctors and nurses to jazz up the festivities. That challenge is dually formidable -- because of prevalent job dissatisfaction rates, and actual numeric shortages of health care providers. For example, according to the Association of American Medical Colleges, in 2015 the U.S. will have about 63,000 fewer doctors than it needs. And a recent Health Affairs report projects our nursing shortage to increase to 260,000 registered nurses by 2025.
Finally, we'd have to somehow find a stadium that was small enough to accommodate the cheering section of U.S. health care consumers.
It's a good bet that the overwhelming majority of red-blooded uninsured Americans would die for an opportunity to obtain health care from the dancing doctors and nurses of the NHS. Indeed, according to Harvard Medical School, more than 45,000 of those Americans die each year merely because they lack health insurance.
Meanwhile, in the U.S. we also face a troubling shortage of doctors and nurses that is projected to increase through 2025. The escalating health care requirements of an aging population will further stress those shortages, as will the planned expansion of health insurance to 30 million more Americans in 2014 as provided by our country's new health care law.
The point is, that if we are serious about addressing those workforce shortages and don't expect new recruiting to keep pace, we must also address issues of job satisfaction and retention among currently employed nurses and doctors. And for doctors in private practice, haggling with insurance companies for payment ranks high on the job dissatisfaction list. It's costly in morale and in dollar signs -- $80,000 per year, according to a 2011 study in Heath Affairs.
This costly demoralization also plays out in doctors' unwillingness to provide care to patients with Medicaid insurance -- the federal-and-state jointly-funded health insurance program for the poor. In addition to struggling with the haggling factor, physicians must deal with Medicaid reimbursement rates that are unjustifiably low: about $18 for an office visit. The Center for Studying Health System Change reports that only 42 percent of primary care physicians currently accept new Medicaid patients.
And therein lies the greatest obstacle to realizing the goal of expanding insurance coverage for most Americans under the new health care law: it heavily relies on further expansion through the already strained Medicaid insurance program.
On a final note, we must take notice that the next generation of American physicians is dancing to a new beat that shuns soul-stomping haggles with third-party health care insurers. Increasingly, they are choosing salaried positions over fee-for-service jobs, and opting to work in group over solo practices -- similar to an NHS practice setting.
In the end, our hopes to address our doctor shortage in quest of expanding health care coverage to most Americans will require us to look beyond the medical profession. It will require us to look at health care funding sources with a keen eye toward improving physician morale and retention, eliminating wasteful administrative costs on slow and wretched dances with insurance providers, and keeping tempo with the next generation of health care providers. In other words, for the sake of our own health, we may be seeking a system that looks a lot like the NHS.
-----------------------------------------------------------
Kate Scannell is a Bay Area physician and the author most recently of "Flood Stage."
Copyright, 2012 Kate Scannell