I just returned from New York City where I had the privilege of delivering the commencement keynote to the 2006 graduating class of the New York College of Podiatric Medicine. While there, the college honored me with an honorary Doctorate of Humane Letters degree. I guess that means from now on, you'll have to call me doctor, doctor or perhaps just D² :) College officials told me this year's graduating class was the smallest ever. Just 58 newly minted podiatrists will join the ranks this year, down from as many as 100 in past years. The outlook is slightly better for the next few years now that jobs in high-tech or investment banking have lost some of their luster. None-the-less, officials say it is getting harder and harder to attract the best and brightest into medicine.That point was driven home when I came across a recent article in the Boston Globe predicting a dire shortage of medical professionals at the very time we'll need them most. The article states that one-third of America's post-residency trained physician work force is older than 55 and likely to retire about the time baby boomers really start hitting our healthcare system. That is a very scary thought. Hospitals are already seeing severe shortages in certain medical specialties like general surgery, pediatric surgery, and interventional radiology. And patients are well aware of how hard it is in many communities to find a primary care doctor to care for them.Young people have been turning away from careers in medicine, and who could blame them? Although physicians still make a good living, its no gravy train. The education is long, arduous and expensive. Factor in the cost of training, lost wages, long hours, high stress, and the ever-present threat of lawsuits and its no wonder other professions look more appealing. Did my own kid choose a career in medicine? Nope. She works for Google .We can fret about the need for electronic medical records and better information technology in healthcare, but what if there's no one to use it once we get it? Or perhaps, because doctors will have better tools to do their work and more time to focus on patients instead of paperwork, medicine will become more appealing once again as a career choice. I certainly hope so, because I'm one of those aging boomers about to hit the system.What do you think? Let us know.Bill Crounse, MD Healthcare Industry Director Microsoft Healthcare and Life Sciences
What the politicans dont know will hurt us all:
As a medical administrator of a one practioner clinic, with a second EMR/PMS with billing installed and operational, I feel strongly the medical software industry is finally responding with a few top quality products. But this comes after providers have already paid for EMR's that have come and gone, have had to absorb uneccesary costs and losses of failed products, while software newbies try to make the new EMR industry the old dot com, (ie., get rich quick with a great idea, undercaptialized, but get in and get out- and mind you some of these are produced "by doctors for doctors"). While the capitalist system (quality supply eventually will win out) it is inevitable that eventually better products are produced. Nevertheless, the cost of the losses to go electronic are crippling the practioner small and large alike. Not to mention to try to find competent, experienced medical tech support, much less someone who can "customize" your product. Most resellers of EMR etc are taking their "lion" share by adding to the software cost, training dollars, customizing and tech support dollars (which on the average are $200 an hour and over). No wonder installation to implementation is at least a $20,000 proposition per provider for the most basic product and without hardware included. This is a tremendous cost incurred solely by the provider. And because of the current PPO/HMO insurance reimbursement system providers CANNOT pass that cost on to the insurance company nor to consumers. WE eat it. No matter what is charged for an office visit under a PPO contract you will only be reimbursed a set fee. The rising cost of healthcare then is being passed on to the uninsured- cash paying patient. This has created a vicious cycle. The providers then increase their patient load, decrease quality time with each patient and reach burn out (burn out from both patient's and the business practice itself) well before they should and before the student loans are paid. The advise of most healthcare providers, certainly on the primary, general care and internal medicine level is do not let your children grow up to be doctors.
The only answer is a well studied, well fashioned healthcare reform that addresses all areas of the industry from provider issues, to adminstrator issues, insurance and patient popluation issues. If any current reform only focuses on one of these, the failure of the entire system will be monumental and fast.