Friday, November 18, 2005

Preparing Our Medical Frontline For the Future

This article at Eureka Alert caught my attention.  It makes some good points.  However, it was written in Australia.  To address the same issue fully in the United States, one would have to pay attention not just to medical training, but also to reimbursement.
Preparing our medical frontline for the future

The medical workforce of the future will not be prepared for the challenges of tomorrow's disease burden unless drastic changes are made to introduce flexible work patterns and multidisciplinary teamwork, according to a health policy expert.

The Director of the Menzies Centre for Public Health Policy and Practice at ANU, Mr Robert Wells, told the International Workforce Conference tomorrow's doctors and nurses will be faced with patients who will be older, more likely to suffer from a chronic condition and informed by the Internet.

"It's going to be a much more complex health picture in the future and the workforce shortage is unlikely to improve considering the lower birth rate numbers since the 1970s - we're not likely to have enough doctors to replace the ones we have.

"There needs to be urgent change in models of training so our workforce is ready for the challenges. Training needs to enable better team working, multidisciplinary approaches to care and more emphasis on primary care training."

Workforce numbers continue to highlight the need for changes in training and working, Mr Wells said. [...]

The main points here are that, as the average age of the population increases, the average complexity of medical cases will increase.  This will increase demand for health care professionals, and will require that the practitioners be well-versed in interdisciplinary teamwork.  Those are good points.  In a nation with a national health care plan, that is as far as it goes.  In the (rather perverse) system we have in the USA, though, it would not be sufficient to  increase the supply of health care practitioners and to make sure that they can work in teams.

The way health care reimbursement works in the USA, doctors do not get paid for sitting and thinking about their patients; nor do they get paid for conferring with nurses, informally checking with colleagues, etc.  In other words, they do not get paid for teamwork.  Teamwork is good, but it takes a lot of time.  Therefore, unless the reimbursement system is changed, care for the elderly (or any patient with complex problems) will only get worse over time.