Majority of Doctors Concerned About Quality of Care

Many health professionals are concerned about the quality of healthcare moving forward. Thomson Reuters and HCPLexus conducted the 2011 National Physicians Survey at the end of 2010, which yielded some troublesome findings.

According to the survey, 65 percent of the nearly 3,000 doctors surveyed believe that the quality of healthcare during the next five years will deteriorate.

Fifty-seven percent of physicians say that the Affordable Care Act will have a negative impact on patients and 78 percent say that the act will have a negative impact on them, according to the survey.

A more recent survey conducted by the Physicians Foundation in December of 2011 indicates that feelings haven’t changed in the past year. The Physicians Foundation polled physicians 40 years and younger, who are mostly pessimistic about the future of America’s healthcare system.

When it comes to the Affordable Care Act, 49 percent in the Physicians Foundation survey believe the impact on their practice will be negative, and more than half (57 percent) are pessimistic about the future of the U.S. healthcare system.

Respondents were able to provide free-response reasons for their pessimism. One such answer got to the heart of the problem:

“I do not feel optimistic because of all the increased regulatory burdens on physicians. There will be an increased shortage of physicians to provide primary care and decreased access to care.”

The Main Concern: Will Supply Meet Demand?

Doctors are concerned that the sudden influx of patients will be too great for the current number of healthcare professionals.

“Questions have been raised as to whether there will be a sufficient supply of physicians and other health professionals to serve the nation, especially in light of concerns that the nation was facing potentially significant shortages even before health care reform,” reads a report from the Association of American Medical Colleges.

Taking into account the final Affordable Care Act provisions, the AAMC “project[s] an overall shortage of 91,500 and 130,600 active patient care physicians in 2020 and 2025 respectively, and a primary care shortage of 45,400 and 65,800 physicians in 2020 and 2025.”

If the demand is too great, the result will be overworked physicians that don’t have enough time to properly treat every patient – a decrease in the quality of care for everybody.

“The message [doctors have] taken from healthcare reform appears to be ‘do more with less.’ Doctors are telling us they feel disenfranchised and overburdened,” said David Shrier, CEO of HCPLexus.

Will there be enough physicians to accommodate the influx of patients? Only time will tell, but from where doctors are sitting, they’re not expecting good results – for themselves or their patients.

Proof of the unfair treatment of women lies in the cost of premiums. Before the ACA, a healthy 22-year-old woman could be charged premiums 150 percent higher than a 22-year-old man.

After a quick recap of how women benefit from the Affordable Care Act, we’ll explore how many people have been positively affected and take a look at one woman’s personal story.

Health Reform Benefits For Women

In a nutshell, the Affordable Care Act made health care affordable for women, put a stop to insurance companies discriminating based on gender, allowed for more preventative care, and provides insurance security for women should they lose their jobs, move, or become sick.

More specifically, this is how health care reform affects women. The ACA: 

• Eliminates all lifetime limits on much insurance companies cover
• Bans insurance companies from dropping women from coverage when they get sick
• Prohibits insurance companies from denying women coverage because of a preexisting condition, excluding coverage of that preexisting condition, or charging more because of health status or gender
• Ensures coverage of prevention and basic health services, including maternity benefits
• Requires coverage of basic pediatric services under all new plans, including oral and vision needs, starting in 2014

By the Numbers

Even though not everything is in full effect from the passage of the ACA, it’s already made an impact.

• Approximately 20.4 million women with private health insurance have received preventative health care services like mammograms and pap smears at no additional cost in the last 18 months.
• An additional 2.5 million young adults ages 18 to 25 have gained health coverage since September 2010 as their moms breath sighs of relief. Previously, young adults were dropped from their parents’ insurance plans when they turned 18 or were no longer a full-time student leaving many without care.
• More than 3.8 million people in Texas with private health insurance received preventive service coverage with no cost sharing.

For a complete timeline of the Affordable Care Act’s rollout, visit the White House website.

One Mother’s Story

Vanessa Mishkit, a nurse in Tampa, bore a son 23 years ago. David was born with birth defects, making him developmentally delayed, legally blind, and near deaf.

After his birth Vanessa received letters from the insurance company, stating they he had met his lifetime limit of coverage at one million dollars and that he would no longer be eligible for continued coverage. Because he had a pre-existing condition, it was difficult to find insurance.

Vanessa is relieved that companies will no longer be able to discriminate because of any pre-existing conditions starting in 2014.

“There are thousands and thousands of families” that experience similar things, she said. “They can’t advocate for themselves at this time because they’re caught up in day-to-day survival.”

To hear her story, watch the video below.

Next week we’ll explore cons to healthcare reform with Will Healthcare Reform Negatively Affect the Quality of Care?

The Good About Health Reform

Health reform’s positive effects include a variety of new provisions, particularly benefitting women. Among them, the ACA:

• Eliminates all lifetime limits on much insurance companies cover
• Prohibits insurance companies from denying women coverage because of a preexisting condition, excluding coverage of that preexisting condition, or charging more because of health status or gender
• Ensures coverage of prevention and basic health services, including maternity benefits

Since its inception, health reform has allowed approximately 20.4 million women with private health insurance to received preventative health care services like mammograms and pap smears at no additional cost.

The Bad About Health Reform

But with the major overhaul to the healthcare industry, there are some concerns, particularly from those providing the care.

According to the 2011 National Physicians Survey, 65 percent of the nearly 3,000 doctors surveyed believe that the quality of healthcare during the next five years will deteriorate. A more recent survey conducted by the Physicians Foundation in December of 2011 indicates that feelings haven’t changed in the past year.

The main concern deals with supply and demand. “I do not feel optimistic because of all the increased regulatory burdens on physicians,” one professional wrote in a response. “There will be an increased shortage of physicians to provide primary care and decreased access to care.”

Coming Up

In the coming weeks, we’ll explore each side in more depth, first with How the Affordable Care Act Has Affected Women After Two Years that will be followed by Will Healthcare Reform Negatively Affect the Quality of Care?

Most HPV infections in young females are benign and don’t have long-term significance. 70% are gone in a single year and 90% eradicating within two years. But when infection persists—in 5% to 10% of infected women—there is the high risk of developing the cervical precancer, which can progress to invasive cervical cancer. This process can takes as long as 15–20 years though, providing many opportunities for detection and treatment of the pre-cancerous condition, often with high cure rates. HPV infection is a cause of nearly all cases of cervical cancer. However, most infections with HPV do not cause disease. Signs and symptoms may take weeks, months, and perhaps years to appear, with some symptoms never actually appearing.

Factors that may increase the risk of cervical cancer in women with HPV infection include smoking and multiple pregnancies. Having numerous sexual partners is also a risk factor for HPV. Using a condom may provide only limited protection.

Two HPV vaccines are currently on the market in the US: Gardasil and Cervarix. Both vaccines protect against two of the most common high risk HPV types (HPV-16 and HPV-18) These two types are the cause of most cervix and genital cancers. Public health officials in Australia, Canada, Europe, and the United States recommend vaccination of young women and girls as young as 9 years of age to prevent cervical cancer and genital warts. The vaccine will have the most impact if given before any sexually activity has occurred.

Worldwide, HPV is the most common sexually transmitted infection in adults.

For example, more than 80% of American women will have contracted at least one strain of HPV by age fifty. There are an estimated 470,000 new cases of cervical cancer that result in 233,000 deaths per year globally. In the United States, most of the approximately 11,000 cervical cancers found annually occur in women who have never had a Pap smear, or not had one in the previous five years.

The vaccine is not recommended for pregnant women, as there has been limited research looking at safety for them and their unborn babies. As of now, studies do suggest that the vaccine won’t cause health problems for pregnant women or their developing child. If a woman finds out she is pregnant after she’s started getting the vaccine series, she should wait until her pregnancy is over before finishing the series.
It is not yet known if the current vaccine is effective in boys or men, however vaccinating males could possibly have health benefits by preventing genital warts and rare cancers, such as penile and anal cancer. It is also possible that vaccinating males will have indirect health benefits for females. Studies are currently underway to see out if the vaccine works to prevent HPV infection in males. When more information is available, an HPV vaccine may be licensed and recommended for boys and men as well.

The Da Vinci system and robotic surgical procedures have had a profound impact on both the Dallas medical community and its patients. Prior to the introduction of non-invasive, robotic surgical techniques, procedures such as hysterectomies required patients to recover from 10-12 inch long incisions which significantly limited physical abilities for a period of 6-8 weeks. The Da Vinci procedure, requiring four small, hole-like incisions, has reduced recovery times to 1-2 weeks, with patients generally returning to work and family activities during the recovery period.

Beyond minimizing scarring and increasing recovery times, robotic surgery has had a positive impact on the North Texas economy.

First, in one of the most challenging economic times in modern history, the thought of taking a 6-8 week medical leave is almost unthinkable for both employees and employers. The fast recovery times associated with robotic procedures have put North Texans back into their daily routines, helping to increase productivity and decrease the economical impact of surgery. Second, the medical community in North Texas has been a pioneer of robotic surgery, attracting patients from both out of state and out of the country. These patients were brought into North Texas as their medical cases were severe enough to require a minimally invasive procedure the was unavailable in their state or country of residence. Beyond impacting their quality of life, this has been positive for the North Texas economy.

Dr. Eisenberg returned to work after the holidays with a full surgical schedule for the months of January and February, during which time he will continue to step up to new surgical challenges using some of most advanced surgical equipment in the healthcare industry today.

#1 – Is The Robotic Procedure Required

Not all procedures require the use of a robot. Any patient considering a procedure that is available through the Da Vinci system should get clarification as to why the robotic procedure is being recommended during both the primary consult and the second opinion. Though a very high percentage of robotic procedures are successful, the process does introduce variables that do not exist in a normal procedure. Therefore, unless there is a specific advantage that the robotic procedure will bring to a patient, the introduction of additional variables should be avoided in any surgical procedure.

#2 – Ask Your Surgeon How Many Robotic Procedures They Have Performed

Robotic surgery is a completely new skill set that is learned much later in a surgeon’s career. There is no substitute for experience. Ask your surgeon very pointed questions as to the number of procedures they have performed and for how long they have been performing these procedures.

#3 – Inquire Into Your Surgeons Experience in a Specific Procedure

There are multiple procedures that can be performed with robotic equipment. A hysterectomy and the removal of uterine fibroids, for example, are two different surgeries. As a patient, you should seek specialization from your healthcare provider. During your consult, ask questions regarding the experience your surgeon has in performing your specific procedure robotically.

Summary

Robotic surgical procedures offer one of the largest medical breakthroughs in the healthcare industry. As a patient, educate yourself on the implementation of robotics in the procedure you require and find a surgeon experienced in your specific procedure.

Hysterectomy Procedure

Hysterectomy surgery requires the removal of a woman’s uterus. There are three types of hysterectomy surgeries that are performed: partial hysterectomy, total hysterectomy and radical hysterectomy. The most common surgery is the total hysterectomy where the uterus and cervix are both removed. The partial is where only the upper part of the uterus is removed. The radical includes the removal of all female reproductive organs including the uterus, fallopian tubes, ovaries and cervix.

Symptoms leading to a Hysterectomy Procedure

A hysterectomy surgery will be performed for a variety of reasons. The main reasons according to the US Department of Health and Human Services are:

• Uterine fibroids
• Uterine prolapse
• Cancer
• Endometriosis
• Persistent bleeding
• Chronic pelvic pain

Hysterectomy Information

Although a hysterectomy may be one of the solutions that a doctor may suggest, it is not always the only solution, except in cancer cases.

Some signs that you are having serious issues usually include abnormal pain and/or excessive bleeding. Please consult a physician if you are experiencing either of these.

Hysterectomy Resources

• Hysterectomy Frequently Asked Questions

Symptoms of Dyspareunia (Painful Sex)

The symptoms of dyspareunia are a decrease in the natural lubrication of the vagina as well as the vagina being less or undialated. These symptoms cause pain in the phallus during penetration making sexual intercourse painful.

Causes of Dyspareunia (Painful Sex)

There are many causes of dyspareunia. A proper physical exam by a medical doctor is the only way to diagnose dyspareunia due to the fact that painful sexual intercourse can be caused by medical and/or psychological reasons. Some of the physical causes of dyspareunia include infections of various parts the vagina including: urinary tract, cervix, and fallopian tubes. Other causes can include surgical scar tissue, ovarian cysts or tumors, STDs, and estrogen deficiencies. There are more causes less frequently seen, thus, it is best to see a doctor to help diagnose them.

Treatment of Dyspareunia (Painful Sex)

Treatment for dyspareunia will depend on the cause of pain during sexual intercourse, but below are some common treatments.

Examination of the pelvis to duplicate the pain experienced during sexual intercourse, allowing the identification of the pain source. Your doctor should explain the cause of the pain so that steps can be taken to lessen and remove the pain over time. Some of these steps often include the removal of the pain source when needed, usage of a lubricant, changes to a couples sexual routine, and decreasing the depth of penetration.

Dyspareunia (Painful Sex) Resources

• Connection Between Dyspareunia and Vaginismus
• Dyspareunia Related Symptoms