Medicine
You cannot fix primary primary care providers and delivery, teaching and teachers, or nurses and nursing without fixing the student or patient and the various situations and relationships involved.
Note also that research studies about "quality" also fail to include sufficient controls for the numerous barriers facing 30 - 50% of Americans in education, health, and other societal outcomes. This results in too much blame placed on teachers, nurses, doctors, and others on the front lines - especially where they are most needed where there is least support and where patients, students, and citizens have been most left behind by national design.
In other words, when you see a difference in an innovation or reorganization, this is usually because a higher status better situation population was compared to another population just enough lower to matter statistically. Not surprisingly the aberrant methods used to measure, evaluate, and pay end up reducing support and revenue where care or education is most needed (Pay for Performance, Readmission Penalties, Teacher Pay Schemes)
It is interesting that nurses have unionized with the teachers union, and hospitalists have also turned to unionization when they felt that they were being marginalized along with their patients. 36 Local Doctors Decide to Unionize More coalitions of front line infrastructure along with half of Americans left behind are a requirement for any real progress in a nation.
Links
This Cover Was a Sucker Punch to All Teachers
36 Local Doctors Decide to Unionize
Other Works
Improving Health Care is Not Likely for 2600 Counties
Basic Health Access Web Basic Health Access Blog World of Rural Medical Education
- Lost Belief In Science Or In Scientific Expertise?
It is a time when we should be more scientific, but we seem to have more nonsense than sense both inside and outside of science. National Geographic published "Why Do Reasonable People Doubt Science." I would indicate that there are scientific leaders,...
- Still Failure After All These Years
The following is a 2004 prediction specific to the year 2014 made by US Health Experts as captured by US News and World Report: In 10 years, the increasing use of online medical resources will yield substantial improvement in many of the pervasive problems...
- Acting Upon Discrimination In Health Spending
Spending Designs Discriminate Designs for spending send less to counties in most need of care that have populations with multiple dimensions of "left behind." This can be tracked by measuring distributions of Medicare dollars or by measuring workforce...
- The Government Control Card Still Plays Well
The Politifact Lie of the Year in 2010 was awarded to the term "Government Takeover." Government Takeover or Government Control in various forms emerged from Republicans, health insurance association consultants, and certain media outlets. A brief attempt...
- Will Small Health Make The News Long Enough To Matter?
It is about time that Small Health Care received some attention as the small hospitals and small practices, but will this continue. Off and on over past decades, primary care has received much attention, but the attention has not resulted in changes in...
Medicine
Rotten Apples, Rotten Support, or Rotten Media?
America's teachers reached the cover of Time Magazine recently, but not in a favorable light. The response of teachers is recorded:
- America’s teachers are not rotten apples, as Time’s cover suggests, that need to be smashed by Silicon Valley millionaires with no experience in education…. Yes, there is a real problem facing America’s teaching profession, but it has nothing to do with tenure. The problem is in recruiting, retaining, and supporting our teachers, especially at the hardest to staff schools. Randi Weingarten American Federation of Teachers
The blame game has been most popular, but Rotten Apple branding is often a distraction from the real situations and relationships crippling education, the teacher-student relationship, and the learning of the child.
The same basic defensive statement can be made regarding any number of basic serving professionals that are under fire, facing declining support, increasing responsibility, increasing complexity, more regulation, and declining appreciation:
- America’s primary care clinicians are not rotten apples, and their essential services cannot be provided by hardware, software, integration, reorganization, or innovative payment change. The problem is in recruiting, retaining, and supporting our primary care clinicians, especially in the counties with lowest concentrations of clinicians where most Americans await care.
- America’s nurses are not rotten apples. The problem is in recruiting, retaining, and supporting our nurses.
- Continue with Public Health, Public Servants, Mental Health, and all on the front lines.
Outcomes in health, education, economics, and other societal components are about cumulative impacts beginning with child well-being and early education. The numerous life events that demonstrate support for a person, or lack thereof, help to shape individual and societal outcomes.
The real rotten apple goes to those who fail, as a nation, to provide the best possible first 8 years of life for a better child, student, employee, patient, and citizen – essential components of a better nation.
You cannot fix primary primary care providers and delivery, teaching and teachers, or nurses and nursing without fixing the student or patient and the various situations and relationships involved.
Note also that research studies about "quality" also fail to include sufficient controls for the numerous barriers facing 30 - 50% of Americans in education, health, and other societal outcomes. This results in too much blame placed on teachers, nurses, doctors, and others on the front lines - especially where they are most needed where there is least support and where patients, students, and citizens have been most left behind by national design.
In other words, when you see a difference in an innovation or reorganization, this is usually because a higher status better situation population was compared to another population just enough lower to matter statistically. Not surprisingly the aberrant methods used to measure, evaluate, and pay end up reducing support and revenue where care or education is most needed (Pay for Performance, Readmission Penalties, Teacher Pay Schemes)
It is interesting that nurses have unionized with the teachers union, and hospitalists have also turned to unionization when they felt that they were being marginalized along with their patients. 36 Local Doctors Decide to Unionize More coalitions of front line infrastructure along with half of Americans left behind are a requirement for any real progress in a nation.
Links
This Cover Was a Sucker Punch to All Teachers
36 Local Doctors Decide to Unionize
Other Works
Improving Health Care is Not Likely for 2600 Counties
Open Season Upon Small Health Care
Continue on to Open Season on Small Health By Big Media
Summary of Small Health Complexities
How To Resolve Health Access for 40 States Behind By Design
Preventing Rural Workforce By Design
Starting to Solve Societal Inequities - Support for a SMART Start from the Very Beginning of Life
Perverse Health Payment Dividing US - More for Fewer and Less for More, and Penalties for Those Caring for Those Most in Need
Global Fails Local But Local Focus Succeeds Globally
Domino Decline By Design - as ERs Close, Those Nearby Face Challenges, as Small or Rural Hospitals Close or Practices Where Needed...
Declines in Health Care Delivery Despite Increases in Health Spending - If We Keep Accelerating Non-Delivery Costs, We Can Continue to Remain Behind Health Care Demand
Best of Basic Health Access
Blogs indicate that primary care can be recovered and should be recovered.
Robert C. Bowman, M.D. [email protected]
Basic Health Access Web Basic Health Access Blog World of Rural Medical Education
Dr. Bowman is the North American Co-Editor of Rural and Remote Health. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association and the long term chair
- Lost Belief In Science Or In Scientific Expertise?
It is a time when we should be more scientific, but we seem to have more nonsense than sense both inside and outside of science. National Geographic published "Why Do Reasonable People Doubt Science." I would indicate that there are scientific leaders,...
- Still Failure After All These Years
The following is a 2004 prediction specific to the year 2014 made by US Health Experts as captured by US News and World Report: In 10 years, the increasing use of online medical resources will yield substantial improvement in many of the pervasive problems...
- Acting Upon Discrimination In Health Spending
Spending Designs Discriminate Designs for spending send less to counties in most need of care that have populations with multiple dimensions of "left behind." This can be tracked by measuring distributions of Medicare dollars or by measuring workforce...
- The Government Control Card Still Plays Well
The Politifact Lie of the Year in 2010 was awarded to the term "Government Takeover." Government Takeover or Government Control in various forms emerged from Republicans, health insurance association consultants, and certain media outlets. A brief attempt...
- Will Small Health Make The News Long Enough To Matter?
It is about time that Small Health Care received some attention as the small hospitals and small practices, but will this continue. Off and on over past decades, primary care has received much attention, but the attention has not resulted in changes in...