TheAffordable Healthcare Act
TheAffordable Healthcare Act
Thehealth care sector is very crucial to the society and economy sinceits one of the determinants of the Gross Domestic Product of anycountry. However, the industry is facing challenges as the number ofprimary care physicians and nurses decreases by the day. In 2005,approximately 100 000 nurses and 300,000 physicians provided primarymedical care in the United States, but still the sector faces agrowing crisis of shortage (Shiver & Cantiello, 2015). The sizeand impact of the current shortage of registered nurses are welldocumented since 1998, which marked the beginning of nurses andphysicians shortage that prevails up to date. It is currentlyestimated at 9,000 primary care physicians, and the resultingunderstaffed hospital positions were estimated at 126,000(Shiver &Cantiello, 2015). The shortage arose due to various factors includinga stressful work environment, rising demand, little growth inregistered nurses’ wages, and demographic changes in the registerednurses workforce that decreased the supply of working nurses.Besides, fewer medical students choose to major in primary care,older primary care physicians are retiring early, and others areleaving the job to open up their private practices (Shiver &Cantiello, 2015). Consequently, the shortage has negativeimplications for the patients’ health due to overcrowding in healthcenters, increased the cost of healthcare, deteriorating the qualityof services, as well as affecting the nurses and physician’scollaboration. However, the problem can be solved by short-termsolutions such as increased wages, allowing nurses practitioners tooffer medical services while implementing long-term solutions such asincreasing the graduating physicians and nurses and integrating theupcoming technological developments into the medical sector.
Implicationsof the shortage
Astudy conducted by IHS Inc. at the request of the Association ofAmerican Medical Colleges projected a severe shortfall in primarycare in the United States. The shortage will range between 12,500 and31,500 physicians by the year 2025, which is notwithstanding thephysicians supply being expected to increase modestly between 2013and 2025 (Shiver & Cantiello, 2015). The health care’s capacityto meet demands varies by geographical location, and patients’primary care varies by socioeconomic indicators and type ofinsurance thus, the effects of these shortages are diverse.
First,the cost of health care services has risen, and it is expected toportray the same trend until a balance can be attained. The highdemand for primary care and its small supply has resulted in anincreased number of nurses leaving for non-nursing jobs. Moreover,the stressful work environment no longer motivates the personnel tocontinue offering their services, which is affecting the cost theservices. The nurses and primary care physician shortage hasincreased the workload on the available professionals. Currently, theUnited States has 210,000 primary care physicians in active duty andrequires an additional 52,000 by 2025(Shiver & Cantiello, 2015).A primary care physicians or a nurse practitioner, who should becaring for only about 500 to 1000 individuals are burdened currentlywith more than 2,500 patients in a year. Consequently, the healthcenters have been experiencing delayed responses of nurses andprimary care physicians to calls alerting them to emergencies.Whether the delays are intentional or because of a tight workschedule, they only worsen a patient’s situation and could evenresult in death. Additionally, the shortage results in overcrowdingespecially in emergency departments (Shiver & Cantiello, 2015).Although provisional improvement of the problem occurred, the issueof emergency department overcrowding has now resurfaced and threatensto become worse. The overcrowding has multiple effects, includingplacing the patient at risk for poor outcome, prolonged pain, andsuffering of some patients.
Thenagain, the tight work schedule created by nurses and primary carephysician shortages reduces the time for collaboration among teams(Shiver & Cantiello, 2015). The delivery of care for hospitalizedpatients is complex and requires coordinated efforts by many healthprofessionals. Physicians, advanced- practice nurses, registerednurses, and other allied health professionals each providesindividualized medical services, which is essential to the patient’soverall health. On the other hand, hospital administrators developstrategic plans, build, manage, continually improve facilities,systems of care, and oversee resource allocations. However, severalsurveys have reported an increased wait time for surgery and testsdue to the increased workload, which has significantly affectedcollaboration among the health care professionals. More complaintsfrom the public affirm that getting a mere appointment with primarycare physician has become quite difficult. Besides, most primary carephysicians are unwilling to attend to the uninsured patients. Thus,it has reduced the quality of patient care, regarding available bedspaces, early detection of complications, and nurses’ time forpatients considerably (Shiver & Cantiello, 2015).
Accordingto statistics, the total physician demand is projected to grow by86,700 to 133,200, which is 11-17 percent, with population growth andaging accounting for 14 percent of growth. Therefore, it is crucialto implement a solution that will resolve the issue before itdeteriorates even further. Accordingly, the shortage issue of nursesand primary care physicians requires both short and long-termsolution to help mitigate the effects successfully (Smith,Hoyt-Hudson & Fitzpatrick, 2011).
Oneof the short-term solutions is to increase wages of primary carephysicians and nurses, which would motivate the current workforce aswell as new recruits. Besides, the nurses and primary care physicianslack the higher level of prestige in the community and high salarycompared to the medical specialist. Thus, it only aggravatesdisinterest in primary care sector by the medical students. However,the situation can change if the nurses and physicians can be given anopportunity to excel as much as their specialists colleagues do(Smith, Hoyt-Hudson & Fitzpatrick, 2011).
Additionally,another solution would be to allow the nurses practitioners toprovide health care services rather than offering just a supportservice to the doctors. About 90 percent of nurse practitioners arewell prepared for primary care delivery (Smith, Hoyt-Hudson &Fitzpatrick, 2011). Thus, effective integration of these nurses intothe health care system could potentially decrease the expectedshortage in primary care providers. The solution will prove viablesince it takes less time to train new nurse practitioners compared tothe time taken to train physicians. Furthermore, nurse practitionersserve a wider scope of community settings and provide care for thevulnerable populations such as the uninsured patients (Smith,Hoyt-Hudson & Fitzpatrick, 2011).
Alogical long-term solution would be to recruit new physicians. Thenumber of primary care physicians joining the health care sectorcontinues to decrease with shortages estimated to reach as high as40,000 over the next decade (Smith, Hoyt-Hudson & Fitzpatrick,2011). The approach to recruit students is required for the long-termbasis since the shortage predictions show a worsening condition inthe future. The solution is viable considering that many efforts arealready in progress to recruit high school students into the healthcare fields. Besides, funding efforts to help attract students toenter the healthcare field through generous scholarships and loanrepayment systems should also help to ease the situation. Thesefinancial awards should be designed to encourage more students topursue degrees and employment within the healthcare sector(Smith, Hoyt-Hudson & Fitzpatrick, 2011).
Onthe other hand, technology has become essential in every part of thesociety, and the healthcare industry should integrate it to simplifythe workload. Hence, this requires environmental changes in theinformation technology infrastructure, the infrastructure thatsupports the development and integration of new clinical knowledgeand technologies, payment policies, and preparation of the healthcare workforce (Smith, Hoyt-Hudson & Fitzpatrick, 2011).Incorporating the comprehensive health information systems ande-health to the majority of medical settings in the United Stateswill ensure efficiency gains, which will help the health careprofessionals to meet the demand of about 8 to 15 percent morepatients than would with the traditional methods(Smith, Hoyt-Hudson &Fitzpatrick, 2011). For example, Kaiser Permanente studied theintroduction of a comprehensive electronic health record system inHawaii, including a multi-purpose patient interface, or portal. Itavailed preliminary evidence on the potential effects of informationtechnology on physician workforce needs. Patients had access to theirlab results, e-prescribing, and e-mail to providers, among otherfunctions. The organization reported a twenty-five percent reductionin office visits from 2004 to 2007(Smith, Hoyt-Hudson &Fitzpatrick, 2011). Effective use of patient registries have beenimplemented in many settings to issue reminders for preventive care,offer the necessary follow-up, and provide feedback to the providerpractice on patients’ compliance and service use. Sharing ofclinical and other information among all members of the care team,ranging from patient-carried medical records to automated patientrecords can also improve primary care (Smith, Hoyt-Hudson &Fitzpatrick, 2011).
Moreover,the industry can also use product planning to find the best way toallocate staff, equipment, and other resources to meet the needs ofcustomers, as well as reduce the costs (Smith, Hoyt-Hudson &Fitzpatrick, 2011). Application of the principle depends on adetailed understanding of work processes, specifically, theidentification of repetitive patterns of work. Although the needs ofpatients vary from day to day, all clinical practices have a naturalrhythm defined by a period, which makes it easy to apply productplanning strategies. The use of a repetitive master schedule couldmake the best use of resources in meeting patient needs (Smith,Hoyt-Hudson & Fitzpatrick, 2011).
Inconclusion, statistics shows that the demand for nurses andphysicians are expected to rise primarily due to population increaseand aging as well as greater access to health insurance. Current andprojected figures are shocking, and there is no doubt that somethingneeds to be done to resolve the problem. However, it is wrong andunfair to assume that the current workforce is not working hardenough. Despite the increasing shortage, the existing professionalsare doing an excellent job. The key focus to realize better serviceprovision and equilibrium of the demand and supply of primary carephysicians and nurses should be the need to redesign how primary careare delivered. The new approaches should involve changing systems ofcare will, rather than stressing the current system of care. Thestrategies described above, if efficiently implemented, should helprealize a significant reduction in the primary care physicians andnurse shortage. The scarcity of nurses and physicians are expected toworsen in the future as more nurses retire. The past solutions suchas relocation coverage, sign on bonuses, or new payment packages willhave temporary effects because they simply relocate the availablenurses instead of increasing it. These solutions are already gainingin popularity. Nonetheless, the solutions to create a lastingimprovement to the nurses’ shortage will require a more radicalapproach than past solutions and must address the long-term issues.Once the short and long-term solutions are implemented, they shouldcontribute to reducing the number of projected shortages of nursesand primary care physicians.
Shiver,J. M., & Cantiello, J. (2015). ManagingIntegrated Health Systems.Burlington, Massachusetts: Jones & Bartlett Learning.
Smith,B. H., Hoyt-Hudson, P., & Fitzpatrick, J. J. (2011). ProblemSolving for Better Health: A Global Perspective.New York: Springer Pub. Co.