US Healthcare System Division of Healthcare Division of Healthcare Primary Physician Care Included Defining Primary Care Includes Infuences Specialty Physican Care Typically Primary Care to Specialty Imcludes First Contact Care Portal to Healthcare System Follows Primary Care Includes Development of Medical Technology Defining Specialty Care Inclludes Includes Includes Focuses on the person as a whole 31.3% Average Med Shool Grads Factors Leading to Med School Grad Choice Influences Includes Centers on disease or organ systems 68.7% Average Med School Grads Includes Factors Leading to Med School Grad Choice Includes Incudes Icludes Includes Includes Includes Less School Debt Includes Prestige Lifestyle none factor Medium Pay $257,726 Demographics of the General Population Medium Pay $425,136 More funding/fancier equipment Prestige Life style Higher Reimbursements HCM520: Quality & Performance in Healthcare HCM520: WEEK 3 Paper Week 3 Paper: Leadership & Quality Improvement Initiatives Choose a current article from the following website about hospital leadership and a quality improvement initiative: https://www.beckershospitalreview.com/hospital-management-administration.html?%C2%A0 Instructions: Write an essay that summarizes the article by including the following: • • • • • • • • • • • Introduction Level of management (CEO, physician, nurse, etc.) implementing initiative What is the challenge/issue/problem? What are the goals of the quality improvement initiative? What statistical tools were used to measure quality improvement? What were the results of the improvement initiative? Could management have handled this better? In other words, should adjustments or changes have been made for better outcomes? If so, what? What is the impact of results on the organization? Patient outcomes? As a healthcare leader, what are three key take-a-ways from the article that really stood out to you? Why? Conclude with a commentary regarding how positive leadership can be applied in the workplace to improve healthcare quality goals. Conclusion Submission Requirements: Your paper should meet the following requirements: • • • Be 3 – 4 pages in length, not including the cover or reference pages. Provide full APA citations for articles selected along with associated in-text citations. Utilize headings to organize the content in your work. Week 2: Discussion Post ~ 300-500 words. The Manager’s Role In this discussion, you are to think of an instance in which you had or observed an experience of excellent healthcare quality. You may have had this experience as a customer, patient, provider, or employee. • • • • • Describe the factors that made this experience excellent and how you felt as a result. Include a description of the management’s influence on your experience. Do the same for a situation in which you experienced poor quality. What is the role of leadership pertaining to quality? What is your leadership style and how can you use it to improve quality? Page 1 HCM520: Quality & Performance in Healthcare References for Paper / Discussion Post: Agency for Healthcare Research and Quality. (2019, September 7). Leadership role in improving safety Links to an external site.. PSNet. https://psnet.ahrq.gov/primer/leadership-role-improvingsafety American College of Healthcare Executives. (2020). ACHE healthcare executive 2020 competencies assessment tool. https://www.ache.org/-/media/ache/career-resourcecenter/competencies_booklet.pdf Andersen, L. B., Bjørnholt, B., Bro, L. L., & Holm-Petersen, C. (2018). Achieving high quality through transformational leadership: A qualitative multilevel analysis of transformational leadership and perceived professional quality Links to an external site.. Public Personnel Management, 47(1), 51– 72. https://doi.org/10.1177/0091026017747270 Borkowski, N. & Meese, K.A. (2021). Organizational behavior in health care. Jones and Bartlett Learning. Burns, M. J. (1978). Leadership. Harper & Row. Gandolfi, F., & Stone, S. (2018). Leadership, leadership styles, and servant leadership Links to an external site.. Journal of Management Research (09725814), 18(4), 261–269. Kenney, C. (2019). Purpose and character: The ultimate differentiators of a legacy leader. Links to an external site.American Journal of Health Promotion, 33(7), 1087– 1090. https://doi.org/10.1177/0890117119866957d Spath, Patrice L. (2022). Applying quality management in healthcare: a systems approach (5th ed.). Health Administration Press. **THIS IS OUR TEXTBOOK** Transactional Leadership Theories. (n.d.). Leadership-central. http://www.leadershipcentral.com/transactional-leadership-theories.html#axzz4vsLkYTse Ward, S. (2018, August 22). Leadership definition. The Balance Small Business. https://www.thebalance.com/leadership-definition-2948275 Zellman, M. (2019, March 4). The advantages of transformational leadership style. Chron. https://smallbusiness.chron.com/advantages-transformational-leadership-style-18809.html Page 2 HCM520: Quality & Performance in Healthcare ***Helpful Resources from this week’s readings for Paper***: The Role of Leadership in Managing and Implementing Quality Initiatives This module focuses on the role of leadership in managing and implementing quality initiatives throughout healthcare organizations. In this module, you will explore and analyze different styles, theories, and traits of leadership to develop your thoughts on what type of leadership is necessary to provide quality healthcare. Learning Outcomes 1. Connect the impact of leadership to promoting and managing quality initiatives. 2. Interpret the changing leadership role for providers. 3. Compare and contrast several leadership styles and assess their effectiveness in healthcare. 4. Classify those involved in managing change initiatives. Defining leadership is an elusive undertaking. Multiple theories on leadership styles, skills, and traits strive to define components of effective leaders. It is likely you have encountered a variety of leaders in your work environments, each with particular styles, skills, and traits. Based on your experiences, how would you define effective leadership? Have you found effective leaders to be inspiring and motivating? Do the effective leaders you have encountered possess one specific leadership style? Take a moment to think of your definition of leadership. Now that you have a definition, identify a healthcare leader that fits your leadership definition. Keep this individual in mind to use as a comparison for our work in this module. The healthcare arena is not selective of any one style or theory of leadership. As you move through this module and learn more about the role of leadership in managing and implementing quality initiatives, you will also have the opportunity to begin to analyze your strengths and weaknesses in a leadership role. 1. What is Quality in Leadership? While leadership and its study have existed since the beginning of history, paradoxically, we cannot define the concept precisely. Ward (2018) defined leadership as “the art of motivating a group of people to act towards achieving a common goal” (para. 1). Do you see the leadership role in healthcare in the 21st century challenged with complexities? Do you feel multiple driving forces impact leadership decisions, thus creating extraordinary challenges? The financial climate alone can change the landscape of the whole organization. We must be cognizant of how this can affect leaders in a healthcare environment. Leaders must maintain a clear purpose with realistic goals. Organizations can Page 3 HCM520: Quality & Performance in Healthcare face difficulties when they are already financially challenged, and unrealistic goals are set for subordinates. Leaders can lose their followers rapidly when the goals are not achievable. To get an inside look at what leadership is and what it entails, view the following video segment from Alex Haslam. Haslam defines leadership, explains why it is needed, and discusses the limitations of a traditional leadership approach (See video) https://youtu.be/p4OvjOVkacY In the fast-paced environment of healthcare, having the ability to motivate and guide improvement is a major component of leadership. In fact, according to Spath (2022) “Leaders must nurture a culture of continuous improvement, high reliability, and accountability” (p. 80) and “…must constantly look for ways to make things better” (p. 74). Additionally, to achieve effectiveness, leaders must combine their knowledge of management and quality to understand and improve the organization (Spath, 2022). The readings for this module provide a comprehensive approach to identifying leadership theories, styles, and roles, as well as how leadership is involved in change processes. 2. Leadership in the 21st Century: The Opportunity to Transform Environments Many theories in leadership, though developed in other fields, can and will be applied to the healthcare environment. They are quite individual, depending on each leader’s ability, knowledge, and experience. Transformational, servant, situational, and transactional are just a few of the leadership theories/styles you may encounter within your career. The entire process of improvement can be viewed in many dimensions. How do we link the leader to a transformational process or any other leadership theory? Can the organizational mission, vision, and values affect the style leaders adopt? Borkowski and Meese (2021) support the transformational leadership role and see it as vital to an organization’s success. They state, “Because of regulatory changes, financial pressures, and evolving care delivery models, health care organizations will be transformed in many ways in the years to come” (p. 209). Leaders must increase their transformational skills because they will experience increasing demands to demonstrate high performance and quality outcomes while reducing cost in the midst of decreasing revenues (Borkowski & Meese, 2021). Given this endorsement for using a transformational leadership approach, what about the other prominent leadership styles? Can a transactional or charismatic leader provide what is necessary for the organization? Most leadership theories started in other fields, but they have been transferred and translated into the healthcare industry. How do we make sure that the theories and styles we select are appropriate within current healthcare organizations? Page 4 HCM520: Quality & Performance in Healthcare Image Caption: Arrows pointing to transformational leadership: leveraging your emotional intelligence, building strategic relationships, leading through change, translating strategy into action, developing employee capability. Page 5 HCM520: Quality & Performance in Healthcare 3. Leadership Styles in Promoting and Managing Quality We have addressed the fact that many theories and styles of leadership are utilized in our healthcare arenas. The specific leadership styles examined in our course include transformational, transactional, and servant. These styles of leadership are the most well-known and embody a contemporary approach, addressing what is occurring in our healthcare systems, what customers need and want, and how the team will deliver the optimal quality service they are striving for. However, other styles may also be used in the field. 5 Different Types of Leadership Styles: https://smallbusiness.chron.com/5-different-types-leadership-styles-17584.html Level 5 Leadership: https://www.mindtools.com/atqwpnm/level-5-leadership Sir MacGregor Burns introduced the concepts of transformational and transactional leadership in 1978. He viewed the follower as having input into the process, becoming reciprocal. Eventually, he proposed the possibility of leaders and followers working together. What is the act of transforming leadership? The act of transforming leadership, according to Burns (1978), raises the level of the followers’ morality of conduct and ethical aspirations to lead to active engagement. Click through the following activity to learn more. Transformational leadership attempts and succeeds in raising colleagues, subordinates, followers, clients, or constituencies to a greater awareness of the issues of consequence. According to Zellman (2018), a benefit of the transformational leadership style is that managers have the adeptness to retain employees. This retention can be a major incentive for healthcare organizations, given the need for highly qualified and dedicated workers. Transactional leadership, in comparison, is based off of performance and reward and consists of task accomplishment and the maintenance of a good leader/subordinate relationship (Borkowski & Meese, 2021). What is deemed valuable may be different for each transactional leader and their organization, but the principle remains the same. This style of leadership often relies on a system of rewards and punishments. Some criticisms of this style are that not every employee may be personally motivated by the rewards being offered; additionally, transactional leadership does not take social values into account (Leadership-central.com, n.d.). Servant leadership was first developed in the 1970s. It “focuses on serving the highest needs of other people in an effort to help others to achieve their goals” (Borkowski & Meese, 2021, p. 213, as cited in Greenleaf, 1969). This style of leadership requires that the leader makes a personal investment in his or her employees; the leader must value the contributions of the team and encourage each person to grow in their abilities and interests. If you are interested, you can learn more about the Ten Principles of Servant Leadership. 10 Principles f Servant Leadership (and Why It’s Our Favorite Style): https://www.teamgantt.com/blog/servant-leadership Page 6 HCM520: Quality & Performance in Healthcare The styles, theories, and thoughts of leadership you have learned about in this module vary greatly in defining leadership. Have you been involved with any of the types of leadership that were discussed in this module? In summary, the leadership theories/styles presented here have been and will continue to be used in the healthcare setting. Now that we have explored leadership and leadership styles ask yourself: Are you a leader or a follower? If you are a follower, what will engage you to follow the leader? If you are the leader, what is your philosophical approach to leadership? What leadership theory might you subscribe to in the leader role? Healthcare Leaders While all leaders have specific characteristics that define them as transformational, transactional, or servant leaders, healthcare leaders also require additional skills and knowledge to be effective in the constantly evolving healthcare environment. Review the healthcare leadership assessment tool.by the American College of Healthcare Executives (ACHE) to see what is expected of leaders in the three stages of career development: novice, competent, and expert. https://www.ache.org/-/media/ache/career-resource-center/competencies_booklet.pdf Page 7 HCM500: The U.S. Healthcare System HCM500: WEEK 3 Paper Week 3 Paper: Health Services Professionals & Medical Technology: Imbalance in Care Submit a paper that examines the Medicare Trust Fund and its projected solvency. Some key questions to consider: Create a concept map that represents the relationship and factors creating the imbalance/maldistribution between primary and specialty physician care in the United States healthcare system. Please include a brief 1–2-page summary of your diagram to explain its contents; this can be viewed as what you would say in a in a presentation of your diagram. Your paper should be well-written and meet the following requirements: • • • Brief introduction Concept Map discussing imbalance / maldistribution between primary and specialty physician care in the US healthcare system. Conclusion Your paper should be well-written and meet the following requirements: • • 1-2 pages in length, • Be sure to discuss and reference concepts taken from the assigned textbook reading and relevant research. Include a minimum of at least 2 credible, academic references from peer-reviewed articles beyond the text or other course materials. (Not more than 5 years old) Week 3: Discussion Post – 300 words. Discuss the role of one specific healthcare professional (Recommend Pharmacist: Pharm D.), other than your own role. You may select any career in the healthcare field with the exception of registered nurse or physician as the idea is to become more familiar with the range of professions in the industry, especially those that are less commonly understood by the general public. In your summary, include a description of the role, required education, work setting, expected income, and future demand. What limitations do these professionals have? Discuss how this healthcare professional contributes to the organization’s success and patient outcomes. The initial post must be substantive (250-300 words); use peer-reviewed, academic sources to support your statements with logic and argument; and cite all sources referenced Page 1 HCM500: The U.S. Healthcare System References for Paper & Discussion: Agency for Healthcare Research and Quality. (2017). National healthcare quality and disparities report: Chartbook on rural health care. https://www.ahrq.gov/sites/default/files/wysiwyg/research/ findings/nhqrdr/chartbooks/qdr-ruralhealthchartbook-update.pdf American Medical Association. (n.d.). Requirements for becoming a physician. http://www.amaassn.org/ama/pub/education-careers/becoming-physician.page Health Resources and Services Administration. (n.d.). Shortage designation: Health professional shortage areas & medically underserved areas/populations. http://www.hrsa.gov/shortage/ Kane, L. (2020). Medscape physician compensation report 2020. https://www.medscape.com/slideshow/2020-compensation-overview-6012684#1 Moore, N., & Constantinescu, A. E. (2019). Impact of technology on quality and customer experience Links to an external site.. Journal for Quality & Participation, 42(1), 22–24. Redford, L. J. (2019). Building the rural healthcare workforce: Challenges–and strategies–in the current economy Links to an external site.. Generations, 43(2), 71–75. Shi, L., & Singh, D. A (2019). Delivering healthcare in America: A systems approach (7th ed.). Jones and Bartlett Publishers. **THIS IS OUR TEXTBOOK** Stiffler, S. (2014, September 4). Rural doctor shortage worsens as newly insured Washington residents seek care. The Seattle Times. http://kaiserhealthnews.org/news/rural-doctor-shortage-worsens-asnewly-insured-washington-residents-seek-care/ Tarassoli, S. P. (2019). Artificial intelligence, regenerative surgery, robotics? What is realistic for the future of surgery? Links to an external site. Annals of Medicine and Surgery, 41, 53–55. Page 2 HCM500: The U.S. Healthcare System ***Helpful Resources from this week’s readings for Paper***: Learning Outcomes 1. Examine the distribution of providers, services, and products in the healthcare continuum. 2. Identify various workforce roles that contribute to healthcare services. 3. Contrast the roles and the impact of professional healthcare organizations on the healthcare industry. 4. Describe how technology impacts healthcare delivery. 1. How Much Money Do Physicians Really Make? Before examining data about physician income, it is important to remember that physicians work long and hard to become doctors, and many work just as hard once they enter the profession. Few physicians work a standard forty-hour work week; most work sixty or more hours per week. Historically, physicians were paid for their efforts based on the nature of the work they performed. For example, they would bill the patient or the insurance company for providing services such as a physical examination in the office or hospital setting, or for performing procedures or surgeries. In general, they were not paid based on how many hours they worked. There are still sole practitioners who own their practices, which are often located in rural areas. These doctors may have one or two physician partners, and generally have a small office staff. Before these doctors take any money home, they first pay for things like office rent, utilities, business and malpractice insurance, staff salaries and benefits, and so on. These physicians practice medicine and run their own businesses. Today, however, many physicians are employed by medical groups and are often paid a salary, usually based on productivity, and occasionally modified by clinical quality and patient satisfaction outcomes. These medical groups generally hire administrative professionals to manage the business, allowing the physicians to concentrate on clinical practice. A medical group receives its revenue in the same way a sole practitioner does: by billing the insurance company and/or the patient for services provided. Medscape, a subsidiary of the website WebMD, conducts an annual survey of physician compensation and publishes a report based on the responses. The Medscape’s 2020 Compensation Report examined data from over 20,000 doctors in 29 specialties. Some highlights are provided in the image below (Kane, 2020): Page 3 HCM500: The U.S. Healthcare System See source below for excellent graphs: (Source: https://www.medscape.com/slideshow/2020-compensation-overview-6012684#1) Page 4 HCM500: The U.S. Healthcare System 2. What it Takes to Become a Physician: Education & Training Physicians play a central role in the delivery of healthcare services; they analyze and interpret data and information provided via numerous sources, such as the patient, laboratory tests, imaging studies, etc. Using this information, they offer a diagnosis and then prescribe a plan of treatment that is implemented by various members of the healthcare team, including nurses, pharmacists, respiratory care practitioners, physical and occupational therapists, and so on. In the United States, the process to become licensed as a physician is quite lengthy and involves undergraduate education, medical school, and graduate medical education (i.e., residency and fellowship). Click below to explore the general route to becoming a physician. • • • • The first step involves earning a bachelor’s degree, which typically takes 4 years. Next comes medical school, which generally takes an additional 4 years. Advance medical training, known as residency, follows, for an average of 3 to 4 more years (although some specialties take longer). Becoming a physician takes an average of 11 to 12 years of education beyond high school! In reality, the education process never ends for a physician. States, hospital medical staff, and professional organizations typically require physicians to earn continuing medical education (CME) credits to renew their licenses, memberships, and certifications. This ensures that a physician’s knowledge and skills remain current. 3. Where Physicians Work: Urban Surplus and Rural Shortage The term maldistribution is used to refer to the surplus or shortage of physicians in terms of either the number (geographic maldistribution) and/or the type of physicians (specialty maldistribution) necessary to maintain the health status of a defined population. The Agency for Healthcare Research and Quality (2017) estimated that 19.3% of the U.S. population lives in rural areas; however, only 9% of physicians practice in these areas. The U.S. Health Resources and Services Administration (HRSA) uses shortage designation criteria that it developed to decide whether or not a geographic area or population group is a Health Professional Shortage Area (HPSA). For example, primary care HPSAs are based on a physician-to-population ratio of 1 provider for every 3,500 residents; that is, when there are 3,500 or more people per primary care physician, that area can be designated as a primary care HPSA. As of June 19, 2014, there were 6,100 designated primary care HPSAs. HRSA calculates that approximately 8,200 additional primary care physicians are needed to address this shortage (HRSA, n.d.). Why such a shortage in rural areas? Physicians often leave rural areas for personal or family reasons; for example, the desire to raise a family in a suburban area. Some leave for professional reasons; for example, they might move to areas where they will see more patients and have better access to a broader professional network. Finally, many leave for financial reasons. Page 5 HCM500: The U.S. Healthcare System A 2014 report in The Seattle Times, produced in partnership with Kaiser Health News, noted several additional reasons for the shortage of doctors in rural areas: • Reason 1: The percentage of doctors practicing primary care is about 34%; the rest are specialists who are less likely to practice in rural areas (Stiffler, 2014). • Reason 2: Rural healthcare providers tend to work long hours and are often on call (Stiffler, 2014). • Reason 3: Most residencies are through teaching hospitals in big cities, and research has shown that the location of this training often has a strong impact on where a doctor will practice later (Stiffler, 2014). One solution to addressing physician maldistribution, whether specialty or geographic, is the use of nonphysician providers. One of these is the nurse midwife, who functions in many of the same ways as an OB/GYN. 4. Will Robots Replace Surgeons? The science fiction of the 1950s has become the reality of the twenty-first century. Medical technology, such as pharmaceuticals, biologics, computers, and other machines, have evolved at a rapid pace. Technology has, in many cases, improved safety, reduced hospital length of stay, and reduced patient recovery time. It is also a key driver in the increasing cost of healthcare. The term “robotic surgery” is used to refer to procedures performed using very small tools attached to a robotic arm. A physician controls the robotic arm with a computer. Because incisions are often smaller and there is greater precision, there are some key advantages to robotic surgery: less pain and bleeding, reduced risk of infection, reduced length of hospital stay, and faster recovery. Robotic surgery may be used in a number of procedures, including gallbladder removal, heart surgery, hysterectomy, kidney removal and transplant, and the removal of cancerous tissue from delicate areas such as blood vessels, nerves, or organs. Will these robots replace surgeons? While we never fully know what the future holds, it is not likely. For one thing, the current robots are manipulated by a trained surgeon. The surgeon controls the instruments from a console that is usually located in the operating room. Remote robotic surgery is possible, however, and is currently in use at many hospitals. The possible applications for remote surgery are exciting and promising. For example, the expertise of specialized surgeons could be made available to patients anywhere in the world, eliminating the need for patients (and the surgeon) to travel further than their local hospital. Unfortunately, the cost for these systems is high (often exceeding one million dollars), and therefore too expensive for most small hospitals, especially those in rural areas. Recently, though, medical technology has focused more on the individual patient rather than the hospital or other clinical setting. Watch this video on how wearable technology has the potential to improve lives. Page 6 Running head: Imbalance in Care 1 Option #1: Imbalance in Care Audrey Roberts CSU Global University HCM500 The US Healthcare System 4/5/2020 This study source was downloaded by 100000808075316 from CourseHero.com on 11-25-2022 18:17:00 GMT -06:00 https://www.coursehero.com/file/66136009/HCM500-Module3-Critical-Thinking-Roberts-Adoc/ Imbalance in Care 2 Concept Map-Imbalance in Care Five areas of distinction between Primary Care Physicians (PCPs) and Specialty care: Primary care is the entry point into healthcare versus specialty care being the follow-up. PCPs help control costs, allocation of resources, and rates. PCPs provide longitudinal care versus specialty care being episodic. Primary focus on the whole person versus specialty care focuses on a particular disease. PCPs and specialists are trained differently. Reasons for the Imbalance between Primary and Specialty Care Reimbursement Insurance Insurance reimburses reimburses specialists specialists at at aa higher rate higher rate than than primary primary care care.. Most Most insurances insurances reimburse reimburse will will pay pay for for hospital-based hospital-based services services versus versus preventative preventative care. care. Under Under Medicare’s Medicare’s resource-based resource-based relative relative value value scale scale (RBRVS), (RBRVS), PCPs PCPs receive receive lower lower payment payment than than specialists. specialists. Income Specialists Specialists earn earn more more than than PCPs. PCPs. Specialists Specialists earned earned about about 45.6% 45.6% more more than than PCPs. PCPs. In In 2017, 2017, the the top top procedural procedural specialist specialist earned earned $489,000 $489,000 compared compared to to PCP PCP which which earned earned $225,000. $225,000. Medical Technology Increased Increased reliance reliance on on technology technology to to treat treat and and diagnose diagnose diseases. diseases. Specialists Specialists rely rely more more on on medical medical technology technology than than PCPs. PCPs. Hospitals Hospitals with with the the most up-to-date most up-to-date technology technology employ employ specialists. specialists. This study source was downloaded by 100000808075316 from CourseHero.com on 11-25-2022 18:17:00 GMT -06:00 https://www.coursehero.com/file/66136009/HCM500-Module3-Critical-Thinking-Roberts-Adoc/ Marketing in Medical School 47.7% 47.7% of of physicians physicians work work in in the the primary primary care care setting setting and and 52.3% of 52.3% of physicians physicians work work in in specialty specialty area. area. The The number number of of physicians physicians entering entering the the primary primary care care setting setting has has dcreased dcreased with with 21.5 21.5 of of third-year third-year residents residents reporting reporting entering entering the the primary primary care care setting. setting. Appeal Appeal of of speciality speciality benefits benefits versus primary versus primary care care setting. setting. Imbalance in Care 3 Imbalance in Care There are five distinct differences between a primary care physician (PCP) and a specialist physician. Patients first see their PCPs prior to being referred to a specialist. Primary care is viewed as the entry point into the healthcare system. If a specialist is needed, typically a referral will made for follow-up care (Shi, L. & Singh, D., 2019). Thus, since a referral needs to be made by a PCP for a specialist, the PCP helps control costs, allocation of resources, and rates. The third difference is the time spent with a patient. PCPs have a longitudinal relationship with the patient. This means PCPs are with the patient from the start, meaning treatment and diagnosis, and providing follow-up care. PCPs are reposinsible for the continuity of care (Shi, L. & Singh, D., 2019). Speciality physicians are with the patient briefly, typically for the treatment of one condition. Another different is PCPs treats the patient as a whole versus specialists treat one specific disease or organ (Shi, L. & Singh, D., 2019). Lastly, training between a PCP and specialty physician differs. PCPs are generally trained in an outpatient setting, learning about various illnesses and condition. Specialists are mostly trained within the hospital, learning the latest medical technology (Shi, L. & Singh, D., 2019). Even though PCPs are an important role within the healthcare system, more and more physician are choosing to become specialists. Thus, creating a speciality maldistribution with a surplus of speciality phsyicians and a shortage of primary are physicians (Shi, L. & Singh, D., 2019). There are four reasons for this maldistribution which are: reimbursement rates, physician income, medical technology, and marketing within medical schools. Reasons for Maldistribution One of the reasons for more physicians want to become specialists instead of working within the primary care setting are due to the reimbursement rates from insutance companies. This study source was downloaded by 100000808075316 from CourseHero.com on 11-25-2022 18:17:00 GMT -06:00 https://www.coursehero.com/file/66136009/HCM500-Module3-Critical-Thinking-Roberts-Adoc/ Imbalance in Care 4 Specialists receive a significant higher reimbursement for their services compared to PCPs. The resource-based relative value scale (RBRVS), contributes to PCPs receiving lower payments for services under Medicare (Shi, L., 2012). Under the RBRVS, physicians are paid based on the estimated practice cost and total work effort. Many insurance companies pay more for hospitalbased services utilizing advanced medical technology, but not for routine medical visits or preventive care received in a primary care setting (Shi, L., 2012). Thus, there is a significant income differential between a PCP and a specialisit. In 2017, there was a survey conducted around physician compensation, which resulted in specialists making 45.6% more than PCPs (LaPointe, J., 2017). Salaries in the primary care setting varied, where family medicine physician made around $209,000 to internal medicine physicians making $289,000 per year. However, specialists salaries nearly doubled that of PCPs. Procedural specialist salaries ranged from $410,000 to $489,000 (LaPointe, J., 2017). Thirdly, hospitals attempt to utilize the most up-to-date medical technology to diagnose and treat patients (Shi, L. & Singh, D., 2019). Specialists rely more on medical technology than PCPs. These three reasons contribute significantly to the reasons which medical students chose to focus on becoming a specialist versus entering into the primary care setting. Specialists are marketed as more appealing due to receiving higher reimbursements for their services, a significantly higher income, and get to learn and work with advanced medical technology. Thus only 21.5% of third year medical residents are entering into the primary care setting and currently 47.7% of physician work within the primary care setting and 52.3% work as specialists (Shi, L. & Singh, D., 2019). Conclusion This study source was downloaded by 100000808075316 from CourseHero.com on 11-25-2022 18:17:00 GMT -06:00 https://www.coursehero.com/file/66136009/HCM500-Module3-Critical-Thinking-Roberts-Adoc/ Imbalance in Care 5 More physician are entering into the healthcare setting as specialists and not as PCPs. There are four main contributors to this maldistribution which are: reimbursement rates, income, medical technology, and marketing. Specialists have significant higher salaries, great reimbursement rates for their services, and get to work with the most up-to-date medical technology. These reasons contributes to the appeal of becoming a specialists versus a PCP. Therefore, medical students would rather become a specialist versus becoming a PCP, creating a shortage of PCPs. References: LaPointe, J. (2017). Physician Compensation for Specialists 45.6% more than for PCPs. Retrieved Apil 1, 2020, from https://revcycleintelligence.com/news/physiciancompensation-for-specialists-45.6-more-than-for-pcps This study source was downloaded by 100000808075316 from CourseHero.com on 11-25-2022 18:17:00 GMT -06:00 https://www.coursehero.com/file/66136009/HCM500-Module3-Critical-Thinking-Roberts-Adoc/ Imbalance in Care Shi, L. (2012). The Impact of Primary Care: A Focused Review. Retrieved April 1, 2020, from https://www.hindawi.com/journals/scientifica/2012/432892/ Shi, L., & Singh, D.A. (2019). Delivering Healthcare in America: A Systems Approach. Burlington, MA: Jones & Barlett Learning. This study source was downloaded by 100000808075316 from CourseHero.com on 11-25-2022 18:17:00 GMT -06:00 https://www.coursehero.com/file/66136009/HCM500-Module3-Critical-Thinking-Roberts-Adoc/ Powered by TCPDF (www.tcpdf.org) 6 This study source was downloaded by 100000808075316 from CourseHero.com on 11-25-2022 18:27:35 GMT -06:00 https://www.coursehero.com/file/55284611/Simple-Concept-Map-physicansjpeg/ Powered by TCPDF (www.tcpdf.org)

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