This MSN article states that doctor-owned hospitals are on the rise. In California, the opposite is the case. The hospital business is a lousy business in which to be. I would rather open a surgical facility. I had an opportunity to be a part of a group that bought a hospital a few years ago and passed.
In California, real medicine is going into the toilet as doctors realize that the work they have put in to get educated makes practicing fairly unrewarding. Niche markets and gimmicks are replacing the conventional medical landscape. That’s the reason we have so many non-plastic surgeons turning to cosmetic work. The bottom line is that you need to pay doctors enough so they can make a decent living or they will find something else to do.
Sad but true.
With the aging of America, it’s well known that there will be a shortage of registered nurses and nursing assistants to take care of the population. It’s predicted that the shortage of nurses in California will climb to 80,000 by 2015. California has just 653 registered nurses employed per 100,000 people.
One of the problems is a lack of qualified faculty to teach at nursing schools. California was forced to turn away 23,000 qualified applicants from nursing programs during 2008-2009. And this week Humboldt State University announced plans to discontinue the school’s nursing program because of financial concerns and inability to retain nursing faculty. Shortage of nurses and closing nursing programs — now there’s a big disconnect.
Just admit it: Deep in your heart you’ve always wanted to be an emergency medical technician, if at least for a few moments. If you’re located in San Ramon Valley, California, you can now live that dream: The local fire department has released an iPhone app that will alert you of any emergency activity in the area.
The well thought-out application will send out a push notification to users who have indicated that they are proficient in CPR whenever there is a cardiac emergency nearby. In addition, the closest public-access automated external defibrillator (AED) is located by the app. Current response status of dispatched units are shown and incident locations are pinpointed on an interactive map. There’s even a log of recent incidents including a photo gallery. For the old-school ham and scanner lads, it’s possible to listen in on live emergency radio traffic. The app is available for free.
In California, the U.S. district court has ordered that tens of thousands of prisoners be released to reduce overcrowding. The case, Schwarzenegger v. Plata, was argued this past Tuesday and the transcript is online.
This is relevant to a psychiatry blog because one of the arguments used in support of the releases is the contention that overcrowded facilities reduce access to mental health and medical services and that overcrowding causes mental deterioration and breakdown. The APA filed an amicus brief in the case, but the brief isn’t available online yet. (Keep an eye out for it here.)
The challenge with this case is that there is no (or extremely little) actual research to support the link between overcrowding and psychological problems. Correctional systems have spent a lot of time litigating issues — and experts make a fair amount of money working on these cases — without actual data. Read more »
*This blog post was originally published at Shrink Rap*
New Jersey’s state health department is considering a rule that would allow nurse anesthetists to work without a doctor’s supervision, as long as there’s a plan to reach one in case of an emergency. New Jersey would join the 30 states that allow nurse anesthetists to work without direct supervision.
On the other end of the country, a California court upheld the state’s decision to opt out of a Medicare requirement that doctors be present while a nurse anesthetist works in order to be reimbursed. The Centers for Medicare and Medicaid Services have allowed states to opt out of that requirement since 2001.
Since then, there has been no evidence of increased inpatient deaths or complications, researchers reported in the August 2010 issue of Health Affairs. Earlier this month, the Institute of Medicine reported that nurses should have a larger role in medical care, including anesthesiology.
*This blog post was originally published at ACP Internist*
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