Medicine
- Perverse Health Payment Dividing Us
Numerous examples exist of perverse payment designs that pay less or that are more likely to penalize hospitals and practices in counties where lower to lowest concentrations of clinicians are found.The same service by an outpatient hospital compared...
- Flexible Fails And Permanent Primary Care Prevented
The United States has a health policy construct that actually prevents recovery of primary care. Primary care revenue support is insufficient to keep up with the increasing cost of delivering primary care. New types of costs burden primary care practices...
- Fifty Years Of Failed Primary Care Workforce Innovation
For fifty years nurse practitioners and physician assistants have been promoted as primary care solutions, but the primary care result has been negated by a movement from 65% primary care to over 65% non-primary care. The promises of the past have not...
- Rural Primary Care: Stark Realities
All primary care sources have declined in primary care per graduate and in rural primary care delivery per graduate. The rural Standard Primary Care Year contributions over the class years illustrate the declines in rural primary care delivery. The Standard...
- Generic Expansions Are Not Smart
Medical and medical education associations want generic expansions of graduate medical education positions. Billions taken from health care diverted to medical education will not address primary care deficits SMARTly. Generic expansion fails for...
Medicine
To Be SMART or Not to Have Health Access
Many new proposals attempt to be seen as solutions for basic health access. Even more fail to be solutions. Few will remain objective in the next 20 years of desperation in primary care workforce. Those eager to meet their own agendas will continue to wave the primary care banner even with less than one-third of graduates delivering primary care workforce. Readers should understand that what is being promoted as a primary care solution is typically generic, not specific.
This blog will focus on solutions that have worked and that will work. This blog will help eliminate solutions that will not work or cannot work.
What works in primary care is SMART focus upon primary care - Specific, Measurable, Achievable, Realistic, and Timely. What does not work is less spending upon primary care, less spending in locations in need of primary care, flexible sources of primary care that fail to remain in primary care, and claims of primary care that are not measurable or achievable or common sense.
Designs that work:
- spend more upon primary care,
- spend more in locations in need of primary care,
- spend most specifically on primary care service delivery, and
- spend training funds on types of workforce that are most likely to serve in health access for 100% of their career delivering the most primary care per graduate.
These are designs that work for an entire nation when applied to an entire nation. When these designs are not compromised by spending elsewhere not primary care, nations can count on primary care staff, nurses, and professionals that remain in primary care, that continue to gain primary care experience, and that deliver the best primary care for the least spending.
SMART works when the focus is specific for primary care. SMART principles also work for rural health with specific rural focus.
- Perverse Health Payment Dividing Us
Numerous examples exist of perverse payment designs that pay less or that are more likely to penalize hospitals and practices in counties where lower to lowest concentrations of clinicians are found.The same service by an outpatient hospital compared...
- Flexible Fails And Permanent Primary Care Prevented
The United States has a health policy construct that actually prevents recovery of primary care. Primary care revenue support is insufficient to keep up with the increasing cost of delivering primary care. New types of costs burden primary care practices...
- Fifty Years Of Failed Primary Care Workforce Innovation
For fifty years nurse practitioners and physician assistants have been promoted as primary care solutions, but the primary care result has been negated by a movement from 65% primary care to over 65% non-primary care. The promises of the past have not...
- Rural Primary Care: Stark Realities
All primary care sources have declined in primary care per graduate and in rural primary care delivery per graduate. The rural Standard Primary Care Year contributions over the class years illustrate the declines in rural primary care delivery. The Standard...
- Generic Expansions Are Not Smart
Medical and medical education associations want generic expansions of graduate medical education positions. Billions taken from health care diverted to medical education will not address primary care deficits SMARTly. Generic expansion fails for...