The wisdom of depending on International Medical School Graduates (IMGs) to fill gaps in physician supply, while US medical schools hold class size constant, is questionable. In addition, the aging of the physician workforce, the decreasing hours worked by both physicians in practice and physicians in residency, and a 20 percent reduction in the effort of the increasing proportion of female physicians, will result in a significant decrease in the “effective” supply of physicians. Should the gap be filled by a major substitution of nurse practitioners, physician assistants, chiropractors, acupuncturists, and others, or are there alternatives?
There is considerable evidence that many of the new medical technologies are used inappropriately, to generate income. What patient protections against inappropriate diagnostic and other procedures should be considered?
Hilda Smith, who had osteoporosis, sustained a hip fracture because of a fall in her home. After 5 nights in an acute care hospital, she is admitted to a SNF where she spends 16 days for rehabilitation, nursing care, and assistance with ADLs. The patient is then discharged to her own home where a physical therapist from a home health agency comes in to train her to use a walker and build strength. After being at home for 25 days, Mrs. Smith develops deep venous thrombosis (blood clot in a vein) in her thigh (related to her fall) and is […]