The United States has yet to design a health care system that works for more than a majority of Americans. The weakest link is clearly basic health access. The Principles of Health Access and the Process toward Health Access Solutions can be found at www.basichealthaccess.org. States, provinces, and nations that implement these principles have efficient and effective health care infrastructure that has worked in the past, works now, and will continue to work in the future.
The Health Access Medical School: The Only Solution for Health Access at the Current Time leaner, 100% primary care for decades of primary care per graduate, required to remain instate for practice, delivering most needed health access during training, and only 20 - 25 graduates per year to meet the workforce needs of 600,000 people such as in Alaska. Why pay 10 - 14 million a year to get less than half the needed basic health access.
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Recent contacts include New Mexico, Mississippi, and Arizona, colleagues in Japan and Australia, and continued advice regarding the early path to admissions involving education, college health advisors, medical students, and admissions committees. The Physician Workforce Studies web page is the main collection for new works. Searching on Google for Physician Workforce will turn up this site as a top choice. About the Site and Author These studies involve complete data sets across the nation, not selected high performing subgroups targeted for health policy promotion. One of the major points throughout is the need for specific work in individual states and individual state professional schools to help understand the distribution of professionals, and access to education, economics, jobs, income, and health that they provide.
Primary Care Past, Present, and Future Using the Most Important Criteria for Primary Care - Actually Remaining in Primary Care and Delivering Primary Care Make the comparison between 15,000 more flexible forms with 5000 more IM, 5000 more NP, and 5000 more PA graduates as compared to 5000 more family medicine residency graduates. Flexible training forms fail to address massive and growing primary care deficits while the family medicine intervention moves the nation toward most needed health access. Graphics illustrate the changes.
Summary - Why 5000 More Family Medicine Graduates Is the Remaining Solution for Recovery of Basic Health Access in the United States Maximal primary care, maximal distribution to all populations in need, maximal retention in primary care, 6 - 10 times more primary care per graduate, and far less decline in primary care contributions compared to other primary care forms are all logical, common sense reasons to increase family medicine residency graduates to 8000 per year by 2020.
Missing Persons: Eliminations of Primary Care in the 1980s and 2000s Compare the graphics demonstrating production of primary care to identify the decades with decreased production and retention of primary care. Also remember the insufficient health access production extending for decades prior to the 1970s. Then consider the deficits being built now, for the next decade, and potentially beyond.
Why Nurse Practitioners Are Not Primary Care Shortage Solutions Fewest years in a career (27 not 35), lowest volume of primary care delivered, lowest % remaining active, low primary care retention (and getting lower), and movement steadily away from the family practice broad generalist mode in pratice (not just training) that is the only mode associated with most needed health access makes nurse practitioners poor choices for primary care and basic health access and much better choices for the hospital and specialty careers that they are more and more likely to pursue. Benefits are seen for NP (salaries, support, benefits) as well as employer (lowest cost of workforce and higher revenue generation) for maximal cost to productivity ratios.
The works more specific to state decisions regarding health professions include:
Consistent Family Physician Distributions - each class year, consistent distribution for years and years and years to rural, to underserved to isolated and more
Primary Care Workforce Years - short comparing IM, PD, PA, NP, IMG 1 family physician supplies 0.85 FTE or nearly 26 primary care years out of a 30 year career. Takes 2 - 5 graduates of other primary care types to generate this level of primary care workforce.
Distributional Research Series - medical school type, Visa programs, comparative studies of the best forms of distribution, and more
Same State Birth To Practice Tables - which programs retain graduates instate
Managed Care Comparison Table - Managed Care and Choice of FP - Medical school graduates of 1995 - 1997 had the best choice of family medicine and the best physician distribution in the nation's history. Those born in urban areas, those born instate, and younger students were the most likely to have increased choice of FP.
Clearly some states have more difficult challenges regarding the delivery of health care. When populations are sparse, the resources necessary to delivery top notch health care become more difficult to access. The states noted in this table face difficult challenges and any state with neglected inner city populations is inundated with health care costs, prison costs, social costs, and the general inefficiencies resulting when children lag behind by age 8.
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Physician Workforce Studies