Workplace Violence Against Nurses and Other Medical Staff is a Growing Problem
You are up at 5 a.m. to begin working the early morning shift at the local community hospital. A half-hour later, nurses and two doctors in the emergency room are confronting a patient with a disease for which they never bargained nor are trained to manage. It is being documented in the scientific literature as an epidemic of violence spreading throughout health-care systems worldwide.
Workers are largely left to fend for themselves. Administrators offer little planning and training to prevent violence against medical staff, and the judicial system, including police departments, are not much more help. Violence in medical facilities is viewed as an occupational hazard. Continue reading
Holistic Medicine Treats the Whole Human
I remember watching a news conference called by physicians in Boston. The hospital won a court order to perform another painful, but hopefully life-extending, unique treatment on a toddler against the objections of his parents. The doctors praised the court’s wisdom in recognizing the value of modern medicine. When asked for a response, the mother replied, “pray.” The doctor shook his head back and rolled his eyes, unable to make a more disdainful and dismissive expression. That is what holistic medicine is not.
Holistic medicine is care through collaboration in a cooperative relationship of family, patient, physicians, and other professionals responsible for improving the physical, mental, and spiritual well-being of the patient. Holistic medicine treats the whole body and not just its parts, employing scientific medicine plus nutrition, herbal treatments, cranial and spinal manipulation, spiritual enhancement therapies, and more. Continue reading
Under the Right Circumstances, Medical Tourism is a Potential Gold Mine
The globalization of business and tourism combined with twenty-first-century health-care self-awareness creates a worldwide medical tourism industry. It is a strategy for economic growth, but it will only succeed if hospitals and countries organize their resources and approach medical tourism like a business enterprise.
More than ten million people a year travel away from home and outside their home countries for medical care, according to the International Medical Travel Journal. They are medical tourists in a fast-growing but higgledy-piggledy global industry. Continue reading
The Global Shortage of Doctors is a Healthcare Crisis in Itself
European, Israeli, and US medical associations predicted more than a decade ago the coming doctor shortage and the health-care global crisis. Recent reports by the OECD, Israeli, and American medical associations suggest their systems are already showing signs of the impact of doctor shortages. The reports document deteriorating quality of care, widening gaps between the rich and poor, growing violence against medical staff, hospital bed shortages, excessive physician burnout fostering early retirement, doctors emigrating, relying on foreign doctors filling positions in higher numbers, draining doctors from developing countries where they are needed to care for their own people, and medical students getting their degrees abroad from schools with lower academic standings.
A 2002 study reported in Health Affairs (21:1) blames the US doctor shortage on constricting entrance requirements to medical school and the slow pace of medical education. Some argue the United States is short 90,000 physicians with the shortfall rising to a doctor shortage of 130,000 by mid-2020. Others believe the shortfall will be less. The argument reminds me of the Cold War rhetoric surrounding the number of nuclear bombs the United States needs in its arsenal. What does it matter when a nation achieves critical mass? I want to be examined and treated when I need a doctor and do not care if the country is short 100,000 doctors or 50,000. My care is going to be delayed because we are short that one doctor I need to see me. Continue reading
Artificial Intelligence is Reshaping Medicine
Stephen Hawking says, “Intelligence is the ability to adapt to change.”
In the life cycle of the digital age, mankind is now able to sublimate microchips and processors turning mega data into creative intelligent behavior. Machines, computers, and software are the intelligent agents. They assess the environment and determine actions for successful outcomes. The handsel contributions of artificial intelligence (AI) to medicine are on the path to repair the body, unlock forefended secrets in the manipulation of human biology, and improve health care.
AI gained traction with the invention of the programmable digital electronic computer. AI’s importance and wider use in many fields are propelled by more powerful computers and sophisticated software. The emphasis on applying AI to specific problem solving, the collaboration of scientists and information technologists across academic and research specialties, and their commitments to mathematics and tough scientific standards are delineated in the classic textbook Artificial Intelligence: A Modern Approach by S. J. Russell and P. Norvig (third edition, 2009). Continue reading
Incentivizing People to Lead Healthy Lives is Common Sense
I read an article in the New York Times advocating the practice of rewarding people with financial incentives for eating healthy. My first reaction was to cringe, but then the article triggered a question, “Don’t we pay people to do all kinds of activities?” We do, so why not incentivize people to cut sugar and reduce chances for diabetes? Reduce red meat intake and lower cholesterol. Eat more fresh vegetables and fruits and less fast foods, and challenge the trend to obesity.
American corporations and government offer financial incentives for all kinds of behavior. Insurance companies offer lower premiums to safe drivers. My overseas private health carrier pays me not to use them to cover hospital expenses when I can get the bills paid through the government health insurance. Americans can deduct charitable donations from their income, thus saving on income taxes. They can also deduct medical insurance premiums in many cases from income and save on taxes. Corporations enjoy a myriad of tax deductions to improve their competitiveness in world trade battles. Companies reward laid-off workers or those they fire with severance packages to go quietly, not sue, reveal proprietary secrets, or bad-mouth the management. Continue reading
Battles are raging in almost every US state and other advanced nations to legalize marijuana possession for personal medical use. The legal possession of marijuana for recreational use is not yet a dispositive case but not too long away. Once laws are passed opening the doors of pot dispensaries, communities better prepare for changes in their medical, cultural, social, workplace, and safety environments. They will need apolitical outsourcing help in designing impact studies and plans. It is a good bet that legalized marijuana is coming to your neighborhood.
The seismic cultural shift results from changes in social mores. The liquor lobby and older generation is seemingly the bulwark against pot legalization for any reason. They are moribund being replaced by leaders and professionals likely to have used pot in high school and college along with experimenting with many other drugs. They and their children are inured to marijuana because illegal pot is easy to buy, and it is everywhere. A competitor in retail sales once asked me if we demand employee drug testing. I emphatically responded no, or we will not have any young employees. Continue reading
Digital Medicine Offers Us a Bright Future
The fundamentals of health-care management are changing with the advent of digital medicine. Computers, mobile devices, and wearables are capturing information on patient conditions, transmitting them to patients and doctors, and storing data for baseline comparisons. Digital medicine is creating new medical knowledge and public health pathways.
Outsourcing companies have an opportunity to tap this wealth of information. Digital medicine might become the most powerful aggregation of data in the history of mankind. Continue reading
The American hospital, and for that matter hospitals in most advanced countries, is changing rapidly. It is increasingly difficult to predict what hospitals will be like in the rest of the 21st century. They need to take a lesson from how retail businesses build customer loyalty and brand themselves to build similar loyalties.
Business plans and marketing strategies need to change if hospitals are to remain solvent and relevant to their communities. Revenue sources paying for heads in beds are changing. The more people pay as they go, the more free choice they have deciding where to shop for their medical care. Self-payers are increasing, but so are service demands, with the advent of the Affordable Care Act and changes in workplace health-insurance programs. Continue reading
Poet, artist, and songwriter Shel Silverstein wrote a collection of poems, Where the Sidewalk Ends (copyright, 1974). It’s a book for dreamers, “A hope-er, a pray-er, a magic bean buyer…,” personifying those wanting to build an inclusive US health-care system.
Obamacare is not a fix of a broken system. It is more akin to rearranging the deck chairs on the Titanic. The health-care system is a mess, but it is time to get Obamacare to work after the June ruling by the US Supreme Court that ensures longevity. Continue reading