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Archive for Sunday, June 23, 2013

Doctor shortage a looming health issue

June 23, 2013

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— Efforts to maintain the availability of a good ol’ country doctor began more than a half-century ago when the University of Kansas chancellor sought to lure new physicians through a new tuition program.

Those techniques are getting more creative as Kansas struggles like much of the nation to keep up with the demand for providers as health care coverage expands. Nationally, an Associated Press review finds doctors are preparing for backlogs, and patients could find it difficult to get quick appointments.

Attempts to address the shortage have taken on increased urgency ahead of the law’s full implementation on Jan. 1.

“The demand for primary care is going to far exceed supply,” said Susan Page, CEO of the Pratt Regional Medical Center in south-central Kansas.

A report by the American Association of Medical Colleges found that as of 2010 there were 2,387 active primary care physicians in Kansas, or 84 doctors for every 100,000 residents. Further, the report found that 26 percent of the physicians were over age 60.

Kansas Gov. Sam Brownback and his fellow GOP legislators have refused a federal offer to pay for expanding Medicaid coverage for low-income and disabled residents. Instead, the state privatized the system, rebranding it as KanCare in 2012 to blunt the growth in costs of providing services to 380,000 residents. Expanding Medicaid would add as many as 240,000 to the KanCare system by some estimates.

However, higher education spending cuts over the next two years could stymie Kansas’ efforts to boost the number of new providers to keep up with existing demands.

The Kansas Board of Regents approved tuition increases on Wednesday for the coming year to offset the reductions. Without state support for the Kansas University medical school, many students could get priced out of the market, said Regent Dan Lykins, of Topeka. Estimates are the cuts could cost the state 30 students in training.

“These are all students — a good chance — who would have stayed in Kansas. We’re not going to have them now,” Lykins said.

Lt. Gov. Jeff Colyer, a plastic surgeon, said the health care law wasn’t the target of a 2011 initiative to lure residents to rural Kansas, but it has become an effective tool.

The changes target income tax breaks for counties that lost 10 percent of their population over the last decade. In 2012, further changes eliminating income taxes for certain businesses, including limited liability companies which include medical practices, helped sweeten the pot.

Shannon Cotsoradis, president and CEO of Kansas Action for Children, said such tax breaks are “stop-gap” methods at best to address shortages.

“You recycle providers in rural areas until they move on after a few years,” she said. “It’s not a sustainable solution, and it doesn’t provide stability for these residents.”

Cotsoradis said keeping young doctors in rural Kansas will be continue to be a problem with the lure of more lucrative practices and quality of life in urban areas.

The Pratt hospital, which serves patients as much as two hours away, is undergoing a $31 million expansion and renovation. Page said most patients are able to see a provider within 24 to 48 hours of seeking care, but that may be a physician’s assistant or nurse practitioner instead of a doctor.

“All of us are going to be focusing on the health of the population and keeping people well and out of the hospital,” Page said. “It’s a totally different change of thought. It’s scary. It kind of feels like you have one foot in the boat and one on the dock.”

Colyer said health care was a “dynamic process,” and no one solution will suffice.

“I think this helps us get down the road significantly. I’m sure that we will have to do more things as this comes along,” he said.

Comments

gr 9 months, 3 weeks ago

Here's a solution:

For the students: raise tuition, prohibit parking.

For the doctors: increase costs, reduce reimbursement, require more paperwork, tell them which patients they must and must not see.

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Number_1_Grandma 9 months, 3 weeks ago

Good. We need to 'weed out' the bad apples anyway. Get back to when doctors wanted to help people instead of getting rich. Quit pushing pills and try to actually fix the problem.

Remember when doctors made house calls....

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Centerville 9 months, 3 weeks ago

There are some interesting developments in the medical industry: concierge clinics for one, and individual doctors who only take payment at the time of service. This gets everyone out of the the insurance hassle and the government snafu. Plus, costs are lower. Worth your time, money and health to get involved with these. Medicare for all is not the answer. Has anyone seen the low end estimates for Medicare Part B premiums, deductibles and co-pays next year? It's being drug down the drain, too, thanks in part to those charlatans at the AARP.

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lucky_guy 9 months, 3 weeks ago

IGWT's response says it all. All this crack medical information on Fox news and Huckabee, that is all you got? Concierge medicine can be had in Lawrence and it is cheaper than the Wichita doc. I would think twice about it though, just ask Michael Jackson about his experience with this, oh, wait, you can't.

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In_God_we_trust 9 months, 3 weeks ago

I saw on Fox News, "Huckabee", they had three doctors on that are not working with "Obamacare". The Dr. in Wichita, KS charged a monthly fee (the oldest pay the most, (20 yr. old range is the least expensive). The highest (65 years old and older) rate per month was $100/mo. This bought you health care with no record sharing with the government. The amount you pay for coverage counts toward "Obamacare" amount paid for coverage. Hopefully more Dr.'s in this area will provide this type of health care that does not require insurance.

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irtnog2001 9 months, 3 weeks ago

The doctor of the future will be a computer connected to your cell phone. Especially if you live in western kansas.

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Nikonman 9 months, 3 weeks ago

Programs to lure Doctors to rural parts of the state have been tried before and even financed by local organizations, not the state or federal government. As far as I know, none of the programs worked. The Doctors left for areas more flush with money after a year or two. Breaking a contract wasn't a problem for them if they had one. After all, they could easily make up the difference in California , Eastern Kansas, Pacific Northwest, you name it. If there's no big bucks to be made, they won't locate there.

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Currahee 9 months, 3 weeks ago

The problem actually comes around to the insurance system. There are increasing amounts of doctors nationwide who are opting not to take insurance because insurance is dictating what they can do and can't do. Procedures require approval from the insurance and sometimes insurance will require cheaper substitutes before approving expensive procedures and medication. Not taking insurance has let doctors provide better quality of service at the same cost because they don't need administrative personnel to process insurance paperwork.

This problem with insurance also extends to medicare, which has not increased or cut back costs. This hits primary care physicians the most, and a lot have resorted to becoming bankrupt because they keep feeling the squeeze from insurance providers. This will become a problem in the coming decades because you may start to see some physicians not take people on medicare (some even are not now) and the ones who will take these people will find themselves overburdened and unable to provide good service.

Will the ACA force insurers to pay more? Maybe, because it mandates that 80% of premiums be directed towards healthcare and 20% for administrative overhead and profit. But I don't think insurers couldn't increase prices to keep a healthy profit.

I'm not saying get rid of insurance and have people pay out of pocket (although it seems it is much, much cheaper for some procedures. e.g. a CT scan cost a person $5k with insurance, only to find out it was only $250 if they paid cash) or that insurance is great. There obviously is a problem if it's starting to become a nuisance in preventing people getting the care they need.

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Cait McKnelly 9 months, 3 weeks ago

Why the heck would ANY educated person want to live/work in Kansas? Especially when you have the legislature telling you how to do your job right down to putting lies in your mouth and forcing you to tell them?

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akt2 9 months, 3 weeks ago

Hospitalists actually streamline InPatient care for the primary care physicians as well. The primary care doctors don't have to make rounds but can still be in communication with the hospitalists. They follow up with their primary care physicians after hospitalization. How would a primary care physician even have time to round anymore with a waiting room full of patients at the office.

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vernonvernon877 9 months, 3 weeks ago

my buddy's step-aunt makes $69/hr on the laptop. She has been out of a job for 6 months but last month her check was $14441 just working on the laptop for a few hours. Read more on this web site... b­u­z­z­9­0.c­ℴ­m

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yourworstnightmare 9 months, 3 weeks ago

Western Kansas can rely on faith healing, just as they rely on faith for everything else including politics and voting.

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Pheps 9 months, 3 weeks ago

Eat healthy and hope for the best. The good old days of healthcare are long gone. There will soon be no incentive to care for people. Government programs do that to systems.

The poor may get more aspirins and bandages from someone that may give a concerned smile, but that's about it. In my humble opinion.

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ravenjayhawk 9 months, 3 weeks ago

The problem is with the KU med school staff.. Take a look at how many non Kansans are admitted. Many top KU students are not accepted or wait listed. Most KU med students are somewhat encouraged to become hospitalists,which help nothing but the hospitals. All KU med needs to do is find out who wants to actually practice on their own in Ks and teach them. Most instructors themselves know little of actual private practice as they have stayed in the Ed system most if not all of their careers

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9 months, 3 weeks ago

It's interesting that posters above blame in large part the current and past presidents without taking into consideration several factors over which they've had little to no control. Two of them are:

The litigious nature of our society - the desire to get something for nothing. A sky-rocketing increase in malpractice cases over almost any condition. Granted, some are legitimate, malfeasance, misdiagnosis, gross incompetence to name a few of a small list, but most are the result of ambulance chasers luring people in with the thought of a quick buck. This results in the cost of malpractice insurance going through the roof (read that as money to insurance companies). I know of several specialists who pulled in their shingle because they could no longer afford the malpractice insurance. They had not been sued, but the actuaries said their specialty had a high propensity of being sued. This happened with obstetricians in Lawrence over 25 years ago; they stopped taking new obstetrics patients and took no more after their existing patients gave birth. The insurance companies, lawyers and something for nothing attitude drove that pat of the train.

The increasing cost of education and resulting student loan debt. It's bad enough for someone not pursuing a medical degree, but it's worse for someone going to medical school or getting a specialty. Many go to large cities because that's where the money is; they can charge more, pay their student loans and afford the malpractice insurance. The days of a new doctor hanging his or her shingle in a small town are almost gone.

You'll note that neither of the above as well as a multitude of other reasons point to any federal governmental policy or presidential administration. If programs were funded that were designed to bring physicians to small town Kansas as some promised at the state level during campaigns, them maybe we wouldn't be in the fix that we are now. We, as a society, did this to ourselves.

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irtnog2001 9 months, 3 weeks ago

Some states have both MD and DO programs in their state college systems (michigan and oklahoma are two I can think of). I believe more DO's actually stick around and practice in rural areas. How about starting a DO program at wsu or ksu?

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Alceste 9 months, 3 weeks ago

Pratt? A "think tank" "city"? Alceste does not think so, having almost first hand data given the Alceste 5 generations of Kansasness started in that quagmire of a town.....dead ever since the railroad left it in the dust....to dry up and go away. Didn't go away....this fact is true.....but to look to Pratt, Kansas USA for ANY kind of useful data is idiotic. It is the Pratt, Kansas types of the state of Kansas who persist and insist in putting rubes into office which dominate the ignorance of the Kansas legislature. Let the folks west of 59 eat cake. They're the one's who control the bulk of the "democratic process" in Kansas anyway....

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MacHeath 9 months, 3 weeks ago

You know, this is all a Illuminati plot. An Illuminati plot to turn the US medical system into a single-payer system.

The Illuminati know that Obamacare won't work. They worked to get Romney to think the whole plan up, and had McCain run on it.

When Obama won, they just switched players, and now we call it "Obamacare". Well, some of us with short memories do.

After Romneycare...I mean Obamacare fails, everyone will be in such a frenzy, that a move to a single-payer will be lauded by the public at large, if noticed at all. There is no way we could return to the old system, as Medical and insurance lobbies will have lost their power and become redundant.

So, thats it, folks. Might as well enjoy the ride! In 15 years or so we will have good single-payer medical, and folks won't remember what the fuss was about.

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Richard Heckler 9 months, 3 weeks ago

The answer is Expanded Medicare Single Payer Insurance for All of us. This would create an estimated 2.4 million jobs while reducing the cost of medical insurance substantially. Everyone would be insured thus eliminating a great big headache.

Let's Compare: Single-Payer (HR 676 and S 703) Expanded Medicare for All Vs. Proposed Healthcare “Private insurance with Public Option” http://www.healthcare-now.org/docs/spreport.pdf ( very interesting findings)

http://www.pnhp.org/facts/single-payer-resources Physicians for a National Health Program

IMPROVED Medicare Single Payer Insurance for ALL would cover every person for all necessary medical care 24/7 to include:

Wellness /prescription drugs / hospital / surgical / outpatient services / primary and preventive care / emergency services / dental / mental health / home health / physical therapy / rehabilitation (including for substance abuse) / vision care / hearing services including hearing aids / chiropractic / medical equipment / palliative care / long term care

No deductibles / No Co-pays

Congress has nothing better to offer. All they and their parrots have is nonsense rhetoric.

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FastEddy 9 months, 3 weeks ago

It's no secret that Kansas has struggled to for many years to keep up with the demand for Doctors. Obamacare (many have referred to this as a "trainwreck") and associated costs will hit us fully in the wallet next year. Brownback's decision to not participate in the coming train wreck may look like a good decison in the not so distant future. Funding for KU, although very important, will not be the main driver of a shortage of Doctors in Kansas. The availability of Doctors will be in short supply nationwide.

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Richard Heckler 9 months, 3 weeks ago

Does Obamacare really say those things?

Considering both Brownback and BUSHCO eliminated a ton of jobs on their watch how will those formerly employed pay for medical care? Where is the new employment Brownback promised as a result of wreckanomics?

Who exactly are these people who refuse to work?

I say some are not aware of how many job applicants show up to be interviewed for a position or how many job applications come in online for one position. The numbers are staggering.

A new store on the Plaza must have had 100 or more show up as the line outside the store was quite long.

We might ask why USA corporations receive tax incentives for opening up factories and retail outlets in other countries?

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toe 9 months, 3 weeks ago

Doctors. Who needs them? They are just tools of the government.

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skinny 9 months, 3 weeks ago

Would you go to school for ten years only to have the Federal Government tell you that you had to treat the low income and those who refuse to work for free? NOT!

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rlsd 9 months, 3 weeks ago

Here is a thought, Obamacare is not going to work.........duh.........our Gov had nothing to do with that and they are all just not reading it to find out what is in it.....

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Richard Heckler 9 months, 3 weeks ago

One of the big problems is so many family care doctors became "specialists" because the insurance industry would pay more to specialists.

How often does one need a specialist or an MRI for that matter? More often than not patients need neither.

That says to me more specialists will revert back to Family practice. It will be a long long long time before a doctors wage of any sort have them in line for food stamps.

Not only that healthy people seldom rush to the doctor's office. We have learned over the years that the human body can heal itself without shoving pharmaceuticals in our mouth. We don't know that pharmaceuticals cure anything.......only remove symptoms.

AS I see it there should not be a massive surge to the doctor's office UNLESS consumers receive a massive dose of commercials scaring them to the doctor's office. I would suggest strongly that medical commercials be removed from the airways for they interfere with patient care and they add bundles to the cost of health care.

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Slowponder 9 months, 3 weeks ago

Sammie has an alternative to primary care: prayer. And if you're not getting well, then you are not praying enough.

The lack of primary medical care is a serious issue for Kansans. The visionless leadership in Topeka exacerbates the problem.

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Richard Heckler 9 months, 3 weeks ago

Now letters produced by a Freedom of Information Act request reveal that many of these same anti-Obamacare Republicans have solicited grants from the very program they claim to despise. This is evidence not merely of shameless hypocrisy but of the fact that the ACA bestows tangible benefits that even Congress’s most extreme right-wing ideologues are hard-pressed to deny to their constituents.

As I reported here last September, Congressman Paul Ryan, who as Mitt Romney’s running mate in 2012 called for its repeal, sent a letter requesting ACA money for health clinics in his district two years earlier. The Nation has obtained documents revealing that at least twenty other Obamacare-bashing GOP lawmakers have similarly pleaded for ACA funds on behalf of constituents. Among them are Kristi Noem, a Republican lawmaker from South Dakota likely to run for the Senate next year, as well as Ohio Senator Rob Portman, who has been touted as a potential GOP presidential candidate in 2016.

http://www.thenation.com/article/174669/revealed-letters-republicans-seeking-obamacare-money#axzz2W9Q3zls0

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Richard Heckler 9 months, 3 weeks ago

"Kansas Gov. Sam Brownback and his fellow GOP legislators have refused a federal offer to pay for expanding Medicaid coverage for low-income and disabled residents. Instead, the state privatized the system, rebranding it as KanCare in 2012 to blunt the growth in costs of providing services to 380,000 residents. Expanding Medicaid would add as many as 240,000 to the KanCare system by some estimates."

Not fiscal responsible. So much of the money was coming from OUR federal tax dollars which is one way to bring our tax dollars home.

Instead Kansas republicans decided to give OUR tax dollars to the private insurance industry which is irresponsible. The private insurance industry must pay CEO's, shareholders and contribute to political campaigns out of the same dollar source paying for healthcare. DO YOU WANT your tax dollars spent this way?

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LeBo 9 months, 3 weeks ago

Such an advanced nation that we only can care for the wealthy!

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