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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
Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.
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.
In Surgeons and the Scope, James R. Zetka Jr. describes the impact of the video laparoscope on the work lives of contemporary surgeons. The video laparoscope allows surgeons to peer into the inner abdomen with a miniaturized camera, thereby enabling them to perform complex operations without large incisions through small ports punched into the abdominal wall. This technological innovation revolutionized surgery as we know it. Zetka blends rich interview and archival data into a compelling account of an important technological development. He shows how the new laparoscopic technology challenged surgeons to rethink their approaches to surgery, to relearn basic hand-eye coordination, to master complex machinery, and to shift from individualistic to team-based work strategies. Zetka then explains how and why general surgeons embraced this disruptive technology by examining the breakdown of the division of labor between general surgeons and gastroenterologists in response to the unintended and unanticipated outcomes of the scope technology. In Surgeons and the Scope, Zetka weaves cultural, structural, and political economic developments into a sophisticated account of technological change. By viewing the advent of laparoscopic surgery within the context of the history, culture, and ideology of medicine, Zetka provides a deeper understanding of the politics of technology, particularly its effects on job skills, occupations, and worker control.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
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.
We all witness, in advertising and on supermarket shelves, the fierce competition for our food dollars. In this engrossing exposé, Marion Nestle goes behind the scenes to reveal how the competition really works and how it affects our health. The abundance of food in the United States--enough calories to meet the needs of every man, woman, and child twice over--has a downside. Our over-efficient food industry must do everything possible to persuade people to eat more--more food, more often, and in larger portions--no matter what it does to waistlines or well-being. Like manufacturing cigarettes or building weapons, making food is big business. Food companies in 2000 generated nearly $900 billion in sales. They have stakeholders to please, shareholders to satisfy, and government regulations to deal with. It is nevertheless shocking to learn precisely how food companies lobby officials, co-opt experts, and expand sales by marketing to children, members of minority groups, and people in developing countries. We learn that the food industry plays politics as well as or better than other industries, not least because so much of its activity takes place outside the public view. Editor of the 1988 Surgeon General's Report on Nutrition and Health, Nestle is uniquely qualified to lead us through the maze of food industry interests and influences. She vividly illustrates food politics in action: watered-down government dietary advice, schools pushing soft drinks, diet supplements promoted as if they were First Amendment rights. When it comes to the mass production and consumption of food, strategic decisions are driven by economics--not science, not common sense, and certainly not health. No wonder most of us are thoroughly confused about what to eat to stay healthy. An accessible and balanced account, Food Politics will forever change the way we respond to food industry marketing practices. By explaining how much the food industry influences government nutrition policies and how cleverly it links its interests to those of nutrition experts, this path-breaking book helps us understand more clearly than ever before what we eat and why.