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The discussion that a career in medicine is less attractive baffles me. Healthcare careers remain what I see as a stable career choice with guaranteed employment. Change is inevitable; adaptability to change is a must in healthcare. Advances with research, equipment, and the increasing age of patients demand that we improve and change for the better.
Why are doctors so unhappy? According to (Cassatly & Bergguist, 2011), the arrival of managed care in the 1990s is the blame for some. Doctors for years have been in control of the care they give their patients, the management of what is needed for their patients, and the cost of that care. Managed care has taken away that control and put it in the hands of healthcare systems and insurance companies. Managed care has made the relationship more about profit and not providing care; providers are expected to see more patients, thus spending less time with them. The gain is then going to corporations and investors, not care providers. The shortage of doctors has changed care delivery with advanced practice nurse positions. Yet, the patient load expected from a doctor is now increased and limits the relationship between patient and doctor, creating a gap in maintaining quality care. Decreased reimbursement, the rising cost of having a practice, increased expenses for liability insurance are some of the reasons for early retirement. Managed care needs to be part of any healthcare professional working with patients. The need for holistic care is the goal of all healthcare, yet the control of care required should remain with the provider of the care rather than insurance companies whose goal is to not tap into profits.
Cost, quality, and access to healthcare concerns in this country are significant; decades of research, political discussions, and changes in healthcare delivery contribute to healthcare reform. Voluntary health insurance has been the predominant way people offset the cost of healthcare since the 1960s. Government programs like Medicaid and Medicare, introduced in 1965, provided the elderly and low-income people with healthcare. The Affordable Care Act (A.C.A.), introduced in 2010, is an effort to make healthcare available to all. The ban of holding pre-existing conditions, lifetime limits to essential healthcare, and holding insurance companies accountable that premium dollars are to be spent primarily on health care is a solid positive aspect of the A.C.A. The system continues to reward providers for the volume of services delivered over incentives to maintain and improve health status among populations remains a concern with the act (Young & Kroth, (2018).
The question I ask with the A.C.A. is the insurance offered to people affordable to all? I believe the critical concern in this country is the argument on whether or not healthcare is a right for everyone. According to (Schimmel, 2013) the United States is arguably the wealthiest of nations and one of the few countries that do not see healthcare as a right to all. “We the people” of this country need to see everyone as the responsibility of the people to provide primary healthcare. Healthcare is how we prevent and manage disease and injury; why would we want our neighbors not to have access.
Cassatly, M. G., D.M.D., & Bergquist, W. H., Ph.D. (2011). The Broken Covenant in U.S. Healthcare. The Journal of Medical Practice Management: M.P.M., 27(3), 136-9. https://aspenuniversity.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/broken-covenant-u-s-healthcare/docview/916422356/se-2?accountid=34574
Schimmel, N. (2013). The Place of Human Rights in American Efforts to Expand and Universalize Healthcare. Human Rights Review, 14(1), 1-29. http://dx.doi.org/10.1007/s12142-012-0247-x
Young, K. & Kroth, P. (2018). Sultz & Young’s Health Care U.S.A.: Understanding its organization and delivery. Jones and Bartlett Learning.
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