The Doctors and the Hospital: Part III
By Brandy Nance (Contact)
Originally published 01:12 p.m., May 8, 2008
Updated 01:12 p.m., May 8, 2008
The future of health care in the United States is expected to bring about new models, better technology and more streamlined care.
Challenges
Amy Jordan Wooden, senior director for public affairs at The University of Kansas Medical Center, said the industry is facing many challenges right now and measures are being taken to help alleviate those in the future. The industry now is facing shortages of nurses and far fewer physicians are choosing primary care.
“I feel like we do a lot already to encourage individuals to go into primary care,” Wooden said. “Right now we require a rural track for the medical students. We have a lot of students who want to be (for example) a cardiologist. Then they go spend eight weeks in Goodland with a primary doctor and they fall in love with being a primary care physician.”
Student loan forgiveness programs also are changing the future. There are forgiveness programs for students who choose to be primary care physicians in underserved communities.
“My hope is 10 years from now we will have reversed the trend at least in Kansas in training primary care doctors. ...” Wooden said. “Kansas is the top on training with primary care physicians ... but that doesn’t mean we can rest on our laurels. ...”
In the future, some of the problems centering around the primary care shortage can be relieved with telemedicine, which allows physicians to communicate via satellite.
“It provides a tremendous service to the residents of Kansas,” Wooden said. “When you look at our geography, it’s unrealistic to travel the distance. I can only see an expansion of the program.”
However, Wooden said, the truth of the matter is, the future health care model doesn’t paint the picture of having a primary care physician in every town.
“And we’re kidding ourselves if that’s where we think we’re going to,” she said.
Wooden said the health care model of the future will include a variety of specialties.
“We have a ton of allied professions that are coming into play here,” she said.
The nursing shortage is another hot issue when taking a look into the future, Wooden said. Wooden said many people don’t know that there’s a severe shortage in teachers available to teach new nurses. The University of Kansas is seeking to turn that around by offering the only online doctorate nursing program in the region.
“With many nurses, he or she can’t just pick up and go to school full time,” Wooden said. “The national trend is there are fewer and fewer medical school graduates choosing non-primary care.”
Care model
The health care model is set to change dramatically in the future from where physicians are employed to the incorporation of hospitalist programs around the country.
Many hospital physicians around the country are employed by the hospital. Newman Regional Health has moved closer to that step with the employment of the hospital’s two orthopedic surgeons. Terry Lambert, chief executive officer of Newman Regional Health, said the relationship is going to change between doctors and hospitals.
“A lot of physicians are employed (by hospitals),” Lambert said. “Then everyone is on the same page ... the board (of trustees) is open to the discussion of that option.”
Newman could see a hospitalist program in its future but no decisions have been made either way. The board of trustees recently studied the program, which allows physicians to tear away from the on-call lifestyle. Rather, hospitalists manage patients who are admitted to the hospital and they communicate directly with the primary care physicians. It is estimated that by 2010, there will be 30,000 hospitalists working in the United States.
“It’s something that has grown nationwide for a long time,” Lambert said. “We really didn’t act on it because we had local doctors taking care of the population.”
The hospital decided to look at a hospitalist program at the request of a couple of physicians in Emporia. A hospitalist program also is becoming a recruiting tool around the country. Paula Taylor, assistant administrator of clinical services at Newman, said some of the newer physicians coming out of medical school are looking for a hospitalist program when looking into practicing medicine in a community.
“We don’t live in the model that we knew as kids,” Taylor said.
Many of the newer physicians are not interested in a lifestyle that requires them to be on call. They are wanting time with family.
“It’s a huge difference in the quality of home life,” said Nancy LeClear, Newman director of marketing.
Melissa Parker, a hospitalist in the department of internal medicine and the medical director for the hospitalist group at The University of Kansas school of medicine, said the hospitalist program there is an academic hospitalist program. There are seven full-time hospitalists on the staff with the plan of bumping that up to 11 by this summer.
The primary charge of the hospitalists is to take care of hospitalized patients and also teach the medical students in residence who are in the hospital.
Parker said the reason why hospitalist programs were put in academic centers is because of work hour restrictions of residents. In the private medical world, hospitalists are doing what the primary care physicians either don’t want to do or are unable to do. Hospitalists provide timely care upon admission, care for the patient while he or she is in the hospital and feedback for the physicians.
Technology
Technology in the medical field is growing by leaps and bounds, especially in the area of research. Ossama Tawfik is the professor of pathology, vice-chairman of the department for the school of research for education, and director of anatomic and surgical pathology at the University of Kansas Hospital. Tawfik, who is originally from Cairo, Egypt, said there are many innovations on the horizon.
“I like innovations because I want life to be simpler,” he said. “I want life to be easier and I want to take care of the patients better. I’m always on the lookout to better take care of patients and new research.”
Tawfik spoke about a couple of the new technologies that the medical school is using. One involves the way cancer cells are evaluated. Tawfik said he uses an automated cellular imaging system, one of the few in the country.
“The system accurately analyzes cancerous tissue and helps physicians predict how or if a tumor will spread,” a press release on The University of Kansas Hospital’s Web site stated.
Another technology that Tawfik said is on the horizon is digital or virtual microscopy, which will allow physicians like Tawfik to look at a slide on a computer screen from across the country or across the world. The same goes for surgeries. You would have a brain surgeon assist with a brain surgery in Emporia, Tawfik said, even when the surgeon is in another part of the United States.
“The boundaries have melted away,” he said.
In the future, Tawfik said, he could log onto another hospital’s network, review slides and provide feedback.
“It’s going to be amazing,” he said. “So, I could be hiding in the Bahamas and I could get a phone call and be asked to look at a case ... that’s probably going to be the biggest change in the way we practice pathology in the future.”
Tawfik said gaps in medical care will be filled in the future.
“It’s going to be anybody can do anything in the future,” he said, adding that surgeries will be able to be done via physician assistance over the Internet, reducing the need to transfer a patient to another hospital.
“That will change for sure,” he said.
There are obstacles in implementing new technologies and health care models, Tawfik said, especially with medical personnel who have been in the field for many years.
“They are not buying it because they are scared of new things,” he said. “Because they don’t know how to use it. But eventually they come around. So I think there are always late doctors with some resistance.”
Tawfik said students coming out of medical school now are armed with this knowledge and using a computer comes very naturally.
“I think the younger generations are always going to be our future,” he said.
Comments
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Posted by clueless (anonymous) on May 9, 2008 at 8:01 a.m. (Suggest removal)
I continually hear how understaffed the hospital is. I can now see why, My sister is a patient on 2nd floor,I went to the desk just yesterday (Thurs) to ask the nurse in charge a question.I had to almost fight to get a word in,as she and another nurse were in a heated discussion about yet ANOTHER NURSE.I stood and listened until she even acknowledged I was there.With the nursing shortage,why in the world would you bash the people you work with. Come on girls,GET A CLUE!!
Posted by clueless (anonymous) on May 9, 2008 at 8:13 a.m. (Suggest removal)
A revision to my last comment,the date in which I was talking about was Wed of this wk,not Thursday.
Posted by emporian2008 (anonymous) on May 9, 2008 at 1:25 p.m. (Suggest removal)
I totally agree with you there clueless. I've heard so much from working there. There are so many good nurses there who walk around with a knife stuck in their back constantly because of all the trash talk. So many times it is the lazy ones bashing others because the hard-working ones aren't working fast enough to do their job plus the job of the lazy ones. It's not fair at all there. So many people get dumped on. There were many days I cried while on the job because of all the drama. I'm sorry but no one should have to work in that kind of environment. No one respects anyone there.
Posted by patience (anonymous) on May 9, 2008 at 2:32 p.m. (Suggest removal)
Last month my husband was hospitalized for 15 days. When we first entered his room there were flower petals on the window sill, a sign that it had not been cleaned well. The housekeeping department was not good at all. Very often when I went back up in late afternoon there were gauze wrappers, needle covers, cotton balls on the floor. No one tossed his straw wrappers away etc. The worst was that his bathroom was not cleaned. The nurses were good, although messy. Cleanliness, however, was not a priority.
Posted by clueless (anonymous) on May 10, 2008 at 10:07 a.m. (Suggest removal)
With all the talk about the administration...why is there NOT a zero tolerance for the type of "bashing" that goes on there? Evidentally from emporian2008,I am not the only one who recognizes that there is a "problem" that exists. There was absolutely NO PROFESSIONALISM displayed on Wed at the nurses desk.I saw the other nurses working that day,with the exception of the two at the desk.I was under the impression that nursing was a TEAM effort..?????
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