The blog of Freedom and Individual Rights in Medicine (FIRM)
Like workers in any public service, doctors always say that morale has never been lower. But this time many are threatening to vote with their feet and practise overseas. Normally the General Medical Council, which regulates the profession, gets 20-25 requests a day for certificates of professional status, which make it easier to work abroad. From September 16th-18th it received a staggering 1,644 requests.
NHS staff in England will stage a strike on Monday in protest at a third year without a pay rise – their first over pay in more than three decades. More than 450,000 people, from cleaners and porters to ambulance drivers and occupational therapists, will be involved in a four-hour walkout.
Beauty-obsessed Venezuelans face a scarcity of brand-name breast implants, and women are so desperate that they and their doctors are turning to devices that are the wrong size or made in China, with less rigorous quality standards.As Dr. Megan Edison quipped online, "The problem with socialism is that eventually you run out of other people's breast implants."
Venezuelans once had easy access to implants approved by the US Food and Drug Administration. But doctors say they are now all but impossible to find because restrictive currency controls have deprived local businesses of the cash to import foreign goods. It may not be the gravest shortfall facing the socialist South American country, but surgeons say the issue cuts to the psyche of the image-conscious Venezuelan woman...
Is it fair to ask a patient to pay $6 for emergency medical care? Or are patients entitled to free medical care whenever they need it? That's the question Australian government officials are currently grappling with.As the Australian health care unfolds, there are two lessons for Americans -- one political and one philosophical.
“Making physicians into secretaries is not a winning proposition,” said Dr. Christine Sinsky, a primary care physician at Medical Associates Clinic and Health Plans, in Dubuque, Iowa, who also researches physician dissatisfaction.Dr. Sinsky, who was an author of the article in Health Affairs, has visited more than 50 primary care practices over the past five years, in the course of studying ways to stem high rates of physician burnout. She has found that physicians who use scribes are more satisfied with their work and choice of careers.The inconsistency isn’t lost on health care experts. In most industries, automation leads to increased efficiency, even employee layoffs. In health care, it seems, the computer has created the need for an extra human in the exam room...
The number of doctors who opted out of Medicare last year, while a small proportion of the nation's health professionals, nearly tripled from three years earlier, according to the Centers for Medicare and Medicaid Services, the government agency that administers the program. Other doctors are limiting the number of Medicare patients they treat even if they don't formally opt out of the system.NPR: "Canvassers For Health Coverage Find Few Takers In Boca Raton" (7/29/2013)
Using pre-fabricated buildings, stripping out air-conditioning and even training visitors to help with post-operative care, the group believes it can cut the cost of heart surgery to an astonishing 800 dollars.
Niklas Hedberg, head of the new drugs on the TLV, believes that there is an unfortunate wording, but that the work complies with legislation stipulating that they must weigh each consequence of a drug subsidy.
-For us it is a very complex issue, the starting point is that society's resources for drugs is limited and we are commissioned to be those that prioritize the allocation between different patient groups. Since the legislation has made clear that we must weigh up different principles, and we will take account of drugs in a society holistically, says Niklas Hedberg.
Would you expect that retirees actually costs if they survive?
-What is unfortunate is that you can get the picture that it just is a matter of age, it only concerns pensioners. But I think your question is good and it is also very complex. Should we take into account that a patient can start working or not? It is then output effect comes into play.Consumption effect is always when you extend the life of a treat.
Are pensioners lives worth less?
-Everyone's health is valued as much, but the calculation model allows perched on top gives the socio-economic perspective, an added benefit of the treatments that allow the patient group can start working again.In effect, those who are deemed more productive to society will be given higher priority in the national health system than those who are considered a net drain.
Right now, such conditions would be nearly unthinkable here in the US. For now.The report, which examined conditions at Stafford Hospital in Staffordshire over a 50-month period between 2005 and 2009, cites example after example of horrific treatment: patients left unbathed and lying in their own urine and excrement; patients left so thirsty that they drank water from vases; patients denied medication, pain relief and food by callous and overworked staff members; patients who contracted infections due to filthy conditions; and patients sent home to die after being given the wrong diagnoses.“This is the story of the appalling and unnecessary suffering of hundreds of people,” Robert Francis, the lawyer appointed by the government to lead the inquiry, said at a news conference.
During an hour-long presentation to the Guardian, St Göran's chief executive, Britta Wallgren, says the 310-bed hospital, serving 430,000 people, outperforms state-owned rivals inside and outside the country.One patient who opposed the private sector used it nonetheless:
She says emergency patients see a doctor within half an hour, compared with A&E waits of up to four hours in the NHS. "We took an A&E department that dealt with 35,000 patients a year and now treats 75,000," Wallgren says. "As admissions grow and we have an increasingly elderly population so must our performance improve."
Capio stresses that St G̦ran has low levels of hospital-acquired infections, and patient surveys record high levels of public satisfaction. It has also produced year-on-year productivity gains Рsomething the state cannot match. Thomas Berglund, Capio's president, says the "profit motive works in healthcare" and companies run on "capitalism, not altruism".
"I am one of those Swedes who do not agree that private hospitals should exist," says Christina Rigert, 62, who used to work as an administrator in the hospital but resigned "on principle" when it was privatised a decade ago.Note that she attacked it, even while benefiting from it.
Now back as a patient after gastric band surgery, she says: "The experience was very good. I had no complaints. There's less waiting than other hospitals. I still do not think there should be private hospitals in Sweden but it's happening."
The new analysis from consulting firm Oliver Wyman released Monday says the growth of accountable care organizations, or ACOs, has reached up to 25 million to 31 million patients, growing beyond the 2.4 million patients in the government's voluntarily program for seniors covered by the Medicare health insurance program for the elderly to patients in private and employer-sponsored health plans.If patients don't like their ACO, there's always this alternative: "Medical tourism booms in Costa Rica".