Saturday, July 20, 2013
Changes in primary care
Timely access regulation, physician shortage & increase new clients:
The demand of healthcare services in primary care has been expanding. 32 million people will be eligible for health care by 2019. Starting 2014 the health exchange program will be effective that will drastically increase the demand in primary care services. However, primary care physicians shortage is not getting better. 52,000 primary care providers are needed by 2025.
OC will be a feasible and cost effective solution to have RN to see the new clients. A 1998 study showed that OC decreased new client no show rate from 45% to 18%.
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I think those numbers and the increasingly shrinking nursing pool are representative of a true crisis in health care. We want everyone to receive good care but we simply do not have enough providers. I see this in rural America all the time. One area has one primary care physician for 4 small rural towns. A challenge for sure!
ReplyDeleteJenanne,
ReplyDeleteYes, physician shortage is not going to be better. We have an open position since 1/1/2013. We interviewed the residents before they graduated. You know what? Still we could not compete with private sector or HMO like Kaiser that has better benefit or work environment. We are waiting for next year's graduating residents. That is why we use RNs to do OC.
I can certainly see the challenge here. As value-based purchasing begins to affect more people including physicians the challenge may increase. Are you all having in plans to address this like hiring NP's?
DeletePenny
Penny,
DeleteRight on target! SFDPH has been hiring more NPs to see clients. However, the access still cannot meet the demand. That is the reason my health center started OC back in 2007 and maintain ZERO new client wait list. Thus, OC will be implemented in all health centers and eventually most of the new clients except those with urgent needs will be seen at OC. Thus, OC replaces the first provider visit that increase provider access. The plan is to have RNs work on top of the RN license to see not only the new clients at OC but also clients with good control of their medical conditions using the standardize procedures.
Nurse Run Clinics are the way of the future. There is a huge increase in demand that calls for more healthcare providers. Patients are living longer and have more complex diseases that require more attention. I think the push for these clinics is important to our society especially in rural areas where healthcare clinics are scarce.
ReplyDeleteI think that it would be great to see more nurse run clinics in large cities to reduce the amount of patients inundating emergency rooms for primary care visits.
DeleteI agree with you. Nurses have great value and will be able to utilize their education to a greater extent.
DeleteMayra and Kelly,
ReplyDeleteI agree that nurse run clinics are the way to provide health care in the primary care settings. People are living longer and the primary care physician shortage is not getting any better. My dream is to spread nurse run clinics starting with new client orientation clinic then progress to chronic disease management clinics. Nurses will be recognized as important members in reaching the triple aim.