Let's create a patient shortage instead of a clinician shortage

Dr. Cassandra would have you believe that we are running out of doctors because they are fed up with the system

Here is yet another example. Harry Severance, MD, adjunct assistant professor at Durham, N.C.-based Duke University School of Medicine, joined Becker's to discuss five major issues he predicts will change the physician workforce by 2030.?

By 2032, the average U.S. hospital occupancy will rise from 75% to 85%, according to University of California Los Angeles researchers.?

In the decade before the COVID-19 pandemic, the national occupancy average was about 64%. Post-pandemic, the average is 75%, which the report characterized as "dangerously close to a bed shortage." At that level, hospitals are increasingly buffeted by "daily bed turnover, seasonal fluctuations in hospitalizations and unexpected surges," according to a news release.?

The bigger problem is how do we run out of patients? In other words, how do we decrease the demand for care?

The solutions are based on changing patient behavior, changing clinician behavior and the behavior of organizations that employ them in increasing numbers, and resetting the system that rewards prevention instead of fee for service treatment.

1. Promote Preventive Care

• Public Health Campaigns: Educating the public about healthy lifestyle choices, such as maintaining a balanced diet, exercising regularly, avoiding smoking, and moderating alcohol consumption, can reduce the incidence of chronic diseases like diabetes, hypertension, and heart disease.
• Vaccination Programs: Ensuring widespread access to vaccines helps prevent infectious diseases, reducing the overall burden on healthcare systems.

2. Improve Access to Primary Care

• Primary Care Access: Encouraging individuals to visit primary care providers (PCPs) regularly can help catch health issues early before they escalate into more severe conditions that require expensive treatments.
• Health Check-ups and Screenings: Regular screenings (e.g., for cancer, cholesterol, and blood pressure) help detect diseases early, leading to better outcomes and reducing emergency room visits.

3. Strengthen Mental Health Services

• Mental Health Programs: Providing better access to mental health services can help reduce the demand for emergency healthcare, which often arises from untreated mental health issues. Early intervention through therapy, counseling, and medications can reduce long-term healthcare needs.
• Stress Management: Programs aimed at managing stress can reduce the prevalence of anxiety, depression, and other related health issues that drive people to seek medical care.

4. Focus on Chronic Disease Management

• Chronic Disease Education: Educating patients on managing chronic conditions (e.g., diabetes, asthma, arthritis) effectively can help reduce the frequency of hospitalizations and emergency visits.
• Self-Management Programs: Teaching patients self-care skills, such as blood sugar monitoring, diet control, and medication adherence, can reduce the need for acute care.

5. Implement Telemedicine and Digital Health Tools

• Telemedicine: Encouraging the use of telemedicine services for consultations, follow-ups, and minor health concerns can reduce unnecessary in-person visits, easing the strain on healthcare facilities.
• Health Apps: Using health monitoring apps for tracking symptoms, medications, and overall health can empower individuals to manage their health independently.

6. Promote Health Education

• Educational Programs: Ensuring that the population understands when it is appropriate to seek healthcare services and when to try self-care can reduce unnecessary visits to clinics or emergency rooms.
• Health Literacy: Improving overall health literacy can help people make more informed decisions about their health and healthcare, avoiding overutilization of healthcare services.

7. Reduce Socioeconomic Barriers

• Access to Affordable Care: Lowering the cost of healthcare services and medications can prevent people from delaying care, which can lead to more serious conditions requiring urgent care.
• Social Determinants of Health: Addressing factors such as poverty, poor housing, and inadequate education can prevent the onset of many diseases, reducing the need for healthcare services.

8. Encourage Healthy Work Environments

• Workplace Wellness Programs: Encouraging employers to offer wellness programs, such as fitness classes, health screenings, and mental health support, can reduce illness-related absenteeism and improve employees' overall health.
• Flexible Working Hours: Allowing employees to have a better work-life balance can help reduce stress and chronic conditions that require medical attention.

9. Optimize Healthcare Systems

• Efficient Resource Allocation: Ensuring that resources are directed to the most effective interventions (e.g., preventive care, early diagnosis) rather than reactive or emergency care helps lower the overall demand.
• Reduce Redundant Tests: Encouraging evidence-based guidelines and care protocols can help reduce unnecessary testing and procedures, thus easing the strain on healthcare systems.

10. Foster a Healthy Environment

• Urban Design: Creating environments that encourage physical activity (e.g., pedestrian-friendly streets, parks, and recreational areas) can help prevent obesity and related health conditions.
• Pollution Control: Addressing environmental factors that contribute to respiratory and cardiovascular diseases can reduce healthcare demand in the long term.

A push to ban sugary drinks, candy and more from the U.S. program that helps low-income families pay for nutritious food has been tried before — but it may soon get a boost from new Trump administration officials.

Robert F. Kennedy Jr., the newly confirmed health and human services secretary, and Brooke Rollins, the new agriculture secretary, have both signaled that they favor stripping such treats from SNAP, the Supplemental Nutrition Assistance Program.

Kennedy has been most vocal, calling for the government to stop allowing the nearly $113 billion program that serves about 42 million Americans to use benefits to pay for “soda or processed foods.”

“The one place that I would say that we need to really change policy is the SNAP program and food stamps and in school lunches,” Kennedy told Fox News host Laura Ingraham last week. “There, the federal government in many cases is paying for it. And we shouldn't be subsidizing people to eat poison.”

Here's why it is so hard to kill fee for service medicine.

In this issue, Baker and colleagues describe how important outcomes of care such as health status and hospitalization are linked to literacy.2 Even after adjusting for confounding sociodemographic variables, they found that patients with low literacy skills had poorer health, higher rates of hospitalization, and incurred higher health care costs than patients with adequate literacy.

America’s children have continued to lose ground on reading skills in the wake of the COVID-19 pandemic and have made little improvement in math, according to the latest results of an exam known as the nation’s report card.

The findings are yet another setback for U.S. schools and reflect the myriad challenges that have upended education, from pandemic school closures to a youth mental health crisis and high rates of chronic absenteeism. The national exam results also show growing inequality: While the highest-performing students have started to regain lost ground, lower-performing students are falling further behind.

Here are some strategies from behavioral economists of how to nudge people do what's in their interest.

Most of these interventions fall into several categories that are different but are part and parcel of the path to change including education, experience, engagement and enabling change.

Education attempts to provide doctors and patients with the knowledge, skills, abilities, and competencies they need to practice their art or, in the case of patients, understand their disease or symptoms or their insurance details such as copays, deductibles and other out of pocket costs for care. Teaching data literacy to medical professionals and and patients is a major challenge.

Experience attempts to meet or exceed doctor or patient expectations about value factors such as convenience, timely access, availability, wait times, low cost, service, speed, the physical and cultural environment or working environment. Here's how to screw up the experience survey.

There’s a lot of talk in organizations about bringing business and experience concepts together. And with good reason — companies that can master this trick can command up to a 16 percent price premium over their competition. But the design of business experience is often done poorly, without real purpose or for show. And just as often, business-driven companies acquire creative agencies —?and then proceed to keep operating in silos. The truth is, both consultants (whose livelihood depends on finding solutions) and creatives (whose realm is creating experiences) want to solve problems. They both want to be a part of something bigger and leave things much better than they found them.

Here's how to piss off your patients

Engagement describes the level of commitment a given doctor, patient or employee has to others or their organization in making themselves, others or their organization better. It is based on trust. Here is what happens when you violate that trust. It describes how much discretionary effort someone is willing to give to go the extra mile. Most of us don’t find purpose at work. Just 34% of the U.S. workforce reports being actively involved, enthusiastic and committed to their jobs, according to a 2018 Gallup poll.

Digital engagement is different than employee engagement and patient engagement and is measured in different ways.

Enabling behavior change describes nudging, providing rewards, helping to monitor and modify helpful or harmful triggers or help those who are unwilling or unable to change. Contemporary digital marketing techniques are used to convert those in the funnel who are prospects to leads to eventual customers. Some are trying to make sick care into a game.

Technology, free tuition to medical school, building more medical schools and manpower substitutes won't fill the gaps as long as long as we don't control the demand for care particularly as we feel the force of the silver tsunami and send grunts to the trenches with blanks in their guns.

We need to stop treating the symptoms instead of the disease.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack