-- Andis Robeznieks' story on the American Medical Association criticizing a "doctor of nursing practice" program in California (ModernPhysician.com, Oct. 14) drew much reaction. Some came from physicians who fear other professionals might appropriate the title "doctor" and some from nurses who think the doctors are overwrought.
First of all, you'll find few fields in which people are so jealous of their degrees, certificates and titles. Some clinicians and executives have so many initials after their signatures that it looks as if someone spilled the contents of a Scrabble set.
But the underlying concern is that other practitioners might encroach on physicians' lucrative turf. As noted repeatedly, U.S. healthcare is the most expensive among developed nations. A large part of the cost--21%--is attributable to physician/clinical services, according to government figures. American physician fees and incomes are the highest in the world.
Of course, physicians, even though they make treatment decisions that affect a range of care, hardly deserve all the blame. Hospital care accounts for 31% of spending, 10% from pharmaceuticals and everything from administrative costs to other care makes up the balance. So as the political establishment looks for ways to slash spending, especially after the ill-conceived deficit-reduction deal, all healthcare professionals, no matter what their titles, have something in common--a target on their backs.
-- Meanwhile, the U.S. Preventive Services Task Force this month recommended that men no longer routinely receive the PSA prostate screening test. The task force, which two years ago recommended that women in their 40s no longer get routine mammograms, drew another round of pushback.
The panel, composed of doctors and public health experts, said the prostate-specific antigen test does not save lives in total and often leads to more tests and a cascade of treatments and nasty side effects. Those can include pain, infection, impotence and incontinence.
Many physician groups had already started reducing PSA screening, but some clinicians and laymen still cling to the test. There was resistance from some doctors, notable prostate cancer survivors and at least one advocacy group supported by companies that profit from testing. And then there were the cries of rationing from the usual political quarters--including at least one presidential candidate--even though the task force does not consider costs in its recommendations.
This episode, like the mammogram debate before it, illustrates much of what's wrong with U.S. healthcare. The industry has too many incentives to push lucrative procedures, and the public has been taught to believe that more tests and more treatments are always better.
-- And so we are left with another paradox of American healthcare: Many people are expensively overtreated, often to their detriment, while others can't afford to get basic services that could improve or save their lives.
In Los Angeles last week, nearly 5,000 people signed up at the Los Angeles Sports Arena for a free medical clinic. The Los Angeles Times reported that those in line included the unemployed and uninsured while some had jobs but their employers didn't provide health coverage. Some were on California's Medicaid program, which doesn't include dental work. Some were illegal immigrants who qualify only for emergency care.
This clinic, organized by the not-for-profit L.A.-based CareNow, was staffed by volunteer physicians, dentists and other professionals.
No matter what their degrees, they have earned the best titles--healer and good Samaritan.
Source Citation
"Who are you calling 'doctor'? Title squabbles, overtesting and the best examples of professionalism." Modern Healthcare 24 Oct. 2011: 0023. Nursing and Allied Health Collection. Web. 13 Feb. 2012.
Document URL
http://go.galegroup.com/ps/i.do?id=GALE%7CA270912962&v=2.1&u=22054_acld&it=r&p=PPNU&sw=w
Gale Document Number: GALE|A270912962
-- Andis Robeznieks' story on the American Medical Association criticizing a "doctor of nursing practice" program in California (ModernPhysician.com, Oct. 14) drew much reaction. Some came from physicians who fear other professionals might appropriate the title "doctor" and some from nurses who think the doctors are overwrought.
First of all, you'll find few fields in which people are so jealous of their degrees, certificates and titles. Some clinicians and executives have so many initials after their signatures that it looks as if someone spilled the contents of a Scrabble set.
But the underlying concern is that other practitioners might encroach on physicians' lucrative turf. As noted repeatedly, U.S. healthcare is the most expensive among developed nations. A large part of the cost--21%--is attributable to physician/clinical services, according to government figures. American physician fees and incomes are the highest in the world.
Of course, physicians, even though they make treatment decisions that affect a range of care, hardly deserve all the blame. Hospital care accounts for 31% of spending, 10% from pharmaceuticals and everything from administrative costs to other care makes up the balance. So as the political establishment looks for ways to slash spending, especially after the ill-conceived deficit-reduction deal, all healthcare professionals, no matter what their titles, have something in common--a target on their backs.
-- Meanwhile, the U.S. Preventive Services Task Force this month recommended that men no longer routinely receive the PSA prostate screening test. The task force, which two years ago recommended that women in their 40s no longer get routine mammograms, drew another round of pushback.
The panel, composed of doctors and public health experts, said the prostate-specific antigen test does not save lives in total and often leads to more tests and a cascade of treatments and nasty side effects. Those can include pain, infection, impotence and incontinence.
Many physician groups had already started reducing PSA screening, but some clinicians and laymen still cling to the test. There was resistance from some doctors, notable prostate cancer survivors and at least one advocacy group supported by companies that profit from testing. And then there were the cries of rationing from the usual political quarters--including at least one presidential candidate--even though the task force does not consider costs in its recommendations.
This episode, like the mammogram debate before it, illustrates much of what's wrong with U.S. healthcare. The industry has too many incentives to push lucrative procedures, and the public has been taught to believe that more tests and more treatments are always better.
-- And so we are left with another paradox of American healthcare: Many people are expensively overtreated, often to their detriment, while others can't afford to get basic services that could improve or save their lives.
In Los Angeles last week, nearly 5,000 people signed up at the Los Angeles Sports Arena for a free medical clinic. The Los Angeles Times reported that those in line included the unemployed and uninsured while some had jobs but their employers didn't provide health coverage. Some were on California's Medicaid program, which doesn't include dental work. Some were illegal immigrants who qualify only for emergency care.
This clinic, organized by the not-for-profit L.A.-based CareNow, was staffed by volunteer physicians, dentists and other professionals.
No matter what their degrees, they have earned the best titles--healer and good Samaritan.
Source Citation
"Who are you calling 'doctor'? Title squabbles, overtesting and the best examples of professionalism." Modern Healthcare 24 Oct. 2011: 0023. Nursing and Allied Health Collection. Web. 13 Feb. 2012.
Document URL
http://go.galegroup.com/ps/i.do?id=GALE%7CA270912962&v=2.1&u=22054_acld&it=r&p=PPNU&sw=w
Gale Document Number: GALE|A270912962
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