Artykuły w czasopismach: „Medical workforce shortages”

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Babcock, Jessica M., Blake D. Babcock i Marshall Z. Schwartz. "Maintaining a Sufficient and Quality Physician Workforce: The Role of For-profit Medical Schools". Health Services Insights 6 (styczeń 2013): HSI.S10462. http://dx.doi.org/10.4137/hsi.s10462.

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Currently, in the United States there is a significant physician workforce shortage. This problem is likely to persist as there is no quick solution. The nature of this shortage is complex and involves factors such as an absolute physician shortage, as well as physician shortages in primary care and certain specialty care areas. In addition, there is a misdistribution of physicians to medically underserved areas and populations. The medical education system trains medical school graduates that eventually feed the physician workforce. However, several factors are in place which ultimately limits the effectiveness of this system in providing an appropriate workforce to meet the population demands. For-profit medical schools have been in existence in and around the continental US for many years and some authors have suggested that they may be a major contributor to the physician workforce shortage. There is currently one for-profit medical school in the US, however the majority exist in the Caribbean. The enrollment in and number of these schools have grown to partially meet the ever-growing demand for an increase in medical school graduates and they continue to provide a large number of graduates who return to the US for postgraduate medical training and, ultimately, increase the physician workforce. The question is whether this source will benefit the workforce quality and quantity needs of our growing and aging population.

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Haslam, Michael B., Anita Flynn i Karen Connor. "Access courses and their contribution to the widening participation agenda in the UK". British Journal of Mental Health Nursing 11, nr 1 (2.02.2022): 1–5. http://dx.doi.org/10.12968/bjmh.2021.0030.

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Reasons for mental health nursing shortages in the UK are many and complex. The COVID-19 pandemic has highlighted the need to fill vacant posts, while at the same time negatively impacting on the UK's international recruitment strategy. Whereas international recruitment is essential to reduce workforce shortages, it offers only a short-term solution and potentially leaves lower-income countries with increased nursing shortages themselves. This article considers that a long-term domestic approach to recruitment is needed to reduce future workforce deficits. It is argued that benefits of access courses are increased if delivered by the university directly, as a familiarity with systems, the campus and supportive networks are promoted, and the potential for targeted support is increased. Further research is needed to establish the benefits, but access courses delivered this way may provide a more sustainable solution to nursing workforce shortages in the UK and beyond.

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Jayarathne, Y. G. Shamalee Wasana, Riitta Partanen i Jules Bennet. "Objective Simulated Bush Engagement Experience (OSBEE): A novel approach to promote rural clinical workforce." Asia Pacific Scholar 6, nr 2 (4.05.2021): 94–96. http://dx.doi.org/10.29060/taps.2021-6-2/cs2449.

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The mal-distributed Australian medical workforce continues to result in rural medical workforce shortages. In an attempt to increase rural medical workforce, the Australian Government has invested in the Rural Health Multidisciplinary Training (RHMT) program, involving 21 medical schools (RHMT program, 2020). This funding requires participating universities to ensure at least 25% of domestic students attend a year-long rural placement during their clinical years and 50% of domestic students experience a short-term rural clinical placement for at least four weeks.

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Regmi, Kiran, i Kapil Amgain. "Needs, Challenges, and Opportunities in Establishing and Maintaining Medical Education in Karnali Academy of Health Sciences (KAHS)". Journal of Karnali Academy of Health Sciences 2, nr 2 (6.08.2019): 79–80. http://dx.doi.org/10.3126/jkahs.v2i2.25165.

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The constitution of Nepal (2015), article 35 (Right relating to health) stated that every citizen shall have the right to free basic health services from the State, and no one shall be deprived of emergency health services. According to the World Bank report (collection of development indicators compiled from various official sources, 2016), Nepal has 81% rural and remote populations. Health service delivery is a complex reality for the rural and remote populations and faces enormous challenges. One of them is insufficient and uneven distribution of health workforce. The World Health Report concluded that "the severity of the health workforce crisis is in some of the world's poorest countries, of which 6 are in South East Asia out of 57 countries having critical shortages of health workforce."1Even after 13 years situation has not much improved. Nepal faces a critical shortage of trained health workforce, especially in rural and remote areas. Health workforce recruitment and retention in rural and remote areas is a difficult task challenged by the preferences and migration of health workforce to urban areas in country, or even abroad for better life and professional development.2 One of the most effective strategies for health workforce recruitment and retention for rural and remote areas could be that of establishing and maintaining Medical Education in rural and remote areas decentralized from urban academic medical centers.

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Koczwara, Bogda, Michael B. Barton, Euan T. Walpole, Peter Grimison, Prunella L. Blinman, Sally Crossing i Kay Francis. "Workforce shortages in medical oncology: a looming threat to quality cancer care". Medical Journal of Australia 196, nr 1 (styczeń 2012): 32–33. http://dx.doi.org/10.5694/mja11.10356.

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Uppal, BS, Nishant, i Suhas Gondi, BA. "Addressing the EMS workforce shortage: How medical students can help bridge the gap". Journal of Emergency Management 17, nr 5 (1.09.2019): 380–84. http://dx.doi.org/10.5055/jem.2019.0436.

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The authors propose that, through innovative and mutually beneficial partnerships between medical schools and local Emergency Medical Services (EMS) agencies, medical students can help mitigate EMS shortages in areas across the country. These partnerships, which we have seen very early signs of in some places, would create channels by which medical students get their emergency medical technician certifications in the summer before matriculating and volunteer with the agency’s ambulance service, either as an extracurricular clinical experience (which are very popular among medical students) or as a way to fulfill clinical or service requirements or earn elective credit. In the attached piece, the authors (1) establish, using data, that a key factor contributing to current and impending EMS shortages is a lack of certified personnel, and (2) propose why and how medical students could provide a novel source of additional volunteers for understaffed public ambulance services, explore some of the benefits and limitations of this proposal, and provide a road-map for how to form partnerships between medical schools and local EMS agencies.

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Galbraith, Robert M., i Stephen G. Clyman. "Emerging Trends in the U.S. Physician Workforce: Implications for Licensure and Professional Standards". Journal of Medical Regulation 91, nr 1 (1.03.2005): 14–20. http://dx.doi.org/10.30770/2572-1852-91.1.14.

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ABSTRACT During the past quarter century, demand for physicians has dramatically increased, yet the supply of trained allopathic United States medical graduates (USMG) has become fixed. Expansion of funded residency positions has allowed large-scale absorption of international medical graduates (IMG), but there is now growing competition for IMG from other Anglophone countries with developing shortages. Substantive expansion of allopathic USMG enrollment will have to overcome hard fiscal and political realities and an uncertain pool of additional qualified applicants. Although the numbers of osteopathic physicians and non-physician clinicians (NPC) have increased briskly over the last decade, particularly in primary care, their ability to address shortages of specialists appears limited. This conjunction of events could result in serious shortages of physicians, particularly of specialists and in areas that are traditionally victims of maldistribution. Although many corrective actions are theoretically possible, most are impractical, and increasing enrollment of allopathic USMG may be the most feasible immediate approach. There could also be important ripple effects on professional standards, procedures for licensure and the introduction of several important new initiatives in assessment relevant to licensure and certification.

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Coleman, Mathew, i Denese Playford. "Time to end the drought in the bush". Australasian Psychiatry 27, nr 4 (10.06.2019): 366–68. http://dx.doi.org/10.1177/1039856219852296.

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Objective: This paper outlines the current psychiatry workforce shortages experienced by rural and remote communities in Australia and argues that postgraduate training in psychiatry may play a role in rectifying these healthcare access inequities. Conclusion: Funding for postgraduate medical specialist training in Australia is undergoing a shift away from solely metropolitan-centric training schemes, based on substantial evidence over the past two decades in undergraduate medical training. Psychiatry is well placed to lead the development of dedicated postgraduate rural training pathways to enhance recruitment and retention of an urgently required rural and remote psychiatry workforce.

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Gerber, Jonathan P., i Louis I. Landau. "Driving change in rural workforce planning: the Medical Schools Outcomes Database". Australian Journal of Primary Health 16, nr 1 (2010): 36. http://dx.doi.org/10.1071/py09049.

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The Medical Schools Outcomes Database (MSOD) is an ongoing longitudinal tracking project of medical students from all medical schools in Australia and New Zealand. It was established in 2005 to track the career trajectories of medical students and will directly help develop models of workforce flow, particularly with respect to rural and remote shortages. This paper briefly outlines the MSOD project and reports on key methodological factors in tracking medical students. Finally, the potential impact of the MSOD on understanding changes in rural practice intentions is illustrated using data from the 2005 pilot cohort (n = 112). Rural placements were associated with a shift towards rural practice intentions, while those who intended to practice rurally at both the start and end of medical school tended to be older and interested in a generalist career. Continuing work will track these and future students as they progress through the workforce, as well as exploring issues such as the career trajectories of international fee-paying students, workforce succession planning, and the evaluation of medical education initiatives.

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Flores, Debra, Asher George i Morgan House. "Rural health workforce development - a qualitative study of themes related to provider shortages in West Texas". Southwest Respiratory and Critical Care Chronicles 10, nr 44 (22.07.2022): 35–39. http://dx.doi.org/10.12746/swrccc.v10i44.1057.

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Introduction: Healthcare administrators struggle to recruit healthcare providers for rural communities. Multiple hospital closures throughout the United States reflect a direct outcome of the healthcare professional shortages in rural communities. Medical facility administrators continue to scramble for ideas to recruit healthcare providers. This research was driven by the need to identify effective strategies to recruit healthcare providers to rural communities. Methods: To address this gap in rural health care, four centers associated with the West Texas Area Health Education Center (AHEC) program office set out to host focus groups at regional symposiums over six months in the form of panel discussions. Each center recruited three panels consisting of hospital administrators, practicing healthcare providers, and healthcare provider students, including medical, nurse practitioner, and physician assistant students. Results: The themes that emerged revolve around advantages, disadvantages, suggestions and requests, and overall strategies regarding recruitment and retention of rural providers. These findings included better pay and benefits for providers, small town lifestyles, limited preceptorships, and increased funding for medical education in rural areas. Conclusion: Given the aftermath of the COVID-19 pandemic, these findings support the public health significance of the need for effective recruitment strategies to address the shortage of rural providers in West Texas and beyond.

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Kardonsky, Kimberly, David V. Evans, Jay Erickson i Amanda Kost. "Impact of a Targeted Rural and Underserved Track on Medical Student Match Into Family Medicine and Other Needed Workforce Specialties". Family Medicine 53, nr 2 (3.02.2021): 111–17. http://dx.doi.org/10.22454/fammed.2021.351484.

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Background and Objectives: There is a shortage of physicians in rural communities in the United States. More than other types of primary care physicians, family physicians are the foundation for care in rural areas.1 There are also critical shortages of other specialties such as general surgery, pediatrics, internal medicine, and psychiatry in rural America.2-7 This study assessed student participation in the University of Washington School of Medicine’s (UWSOM) Targeted Rural Underserved Track (TRUST) program as a predictor for family medicine (FM) and needed workforce specialty residency match. Methods: The study group was 156 medical students from 2009-2014; 102 were accepted to the TRUST program compared to a control group of 54 who were not accepted into the TRUST program but did matriculate to UWSOM. Student characteristics for the two groups were compared using t tests. Logistic regression analysis determined whether acceptance in TRUST predicted the outcomes measures of FM residency match or residency match into a needed rural physician workforce specialty; t tests compared match rates to family medicine for TRUST applicants and graduates, UWSOM graduates, and US allopathic seniors. Results: TRUST program graduates had the same FM residency match rate and match rate in needed workforce specialties as the control group. The FM match rate for TRUST graduates was 29.1% compared to UWSOM at 16.9% and US seniors at 8.7% (P<.001). Conclusions: Although match rates in FM and needed workforce specialties were not different in accepted versus not accepted groups, all TRUST applicants had an FM match rate that approaches 30%, which is higher than the general UWSOM class and the United States. In order to help reach the goal of 25% of medical students matching into FM by 2030, medical schools should consider having a rural program and using rural-focused admissions widely.

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Zagales, Israel, Mitchell Bourne, Mason Sutherland, Anthony Pasarin, Ruth Zagales, Muhammed Awan, Mark McKenney i Adel Elkbuli. "Regional Population-Based Workforce Shortages in General Surgery by Practicing Surgeon and Resident Trainee". American Surgeon 87, nr 6 (czerwiec 2021): 855–63. http://dx.doi.org/10.1177/00031348211029870.

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Background The physician shortage in the United States (US) continues to become more apparent. We aimed to evaluate the relationship between the US physician distribution from 2012-2019 by specialty at the state/regional level relative to the corresponding population growth. Methods US matched residents and practicing physicians from 2012-2019 were extracted from the National Resident Matching Program and Association of American Medical College databases, respectively. Residents and practicing physicians were divided by geographic regions (West, Midwest, South, Northeast), states, and specialties (anesthesiology, emergency medicine, family medicine, general surgery (GS), internal medicine, obstetrics/gynecology and pediatrics). Results Entering residents and physicians increased across 7 specialties from 2012-2019 with the exception of GS, which showed .2% decrease in practicing physicians. GS experienced decreases in entering residents in all US regions except the South. All specialties showed a decrease in the people-per-physician (PPP) except GS and pediatrics, which had a 4.1% and 71.3% increase, respectively. EM showed the largest growth overall, both in entering residents and overall workforce. Conclusion GS experienced slow growth of residents, decreases in practicing physicians and workforce overall, and an increase in PPP from 2012-2019. Our findings suggest that current population growth rate is exceeding the rate of physicians entering the field of GS and highlights the need for interventions to promote the recruitment of GS residents and retainment of attending physicians, particularly for rural areas. Future research to measure surgeon distribution in relation to patient outcomes and the efficacy of recent policy to address shortages can help define additional interventions to address physician shortages moving forward.

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Rasschaert, Freya, Mit Philips, Luc Van Leemput, Yibeltal Assefa, Erik Schouten i Wim Van Damme. "Tackling Health Workforce Shortages During Antiretroviral Treatment Scale-up—Experiences From Ethiopia and Malawi". JAIDS Journal of Acquired Immune Deficiency Syndromes 57 (sierpień 2011): S109—S112. http://dx.doi.org/10.1097/qai.0b013e31821f9b69.

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Schneider, Philip J., Craig A. Pedersen, Michael C. Ganio i Douglas J. Scheckelhoff. "ASHP national survey of pharmacy practice in hospital settings: Workforce—2018". American Journal of Health-System Pharmacy 76, nr 15 (18.07.2019): 1127–41. http://dx.doi.org/10.1093/ajhp/zxz102.

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Abstract Purpose Results of the 2018 ASHP national survey of pharmacy practice in hospital settings pertaining to the pharmacy workforce are presented. Methods Pharmacy directors at 4,897 general and children’s medical–surgical hospitals in the United States were surveyed using a mixed-mode method of contact by mail and email. Survey completion was online. IMS Health supplied data on hospital characteristics; the survey sample was drawn from the IMS hospital database. Results The survey response rate was 16.6%. The results indicate that inpatient staffing has increased for both pharmacists and pharmacy technicians. More than half of the respondents reported shortages of pharmacy managers, experienced technicians, and experienced pharmacy technicians with sterile compounding experience. More than half of the respondents reported an excess of entry-level frontline pharmacists. The perceived shortage of pharmacists is in decline, while the perceived shortage of pharmacy technicians, especially those with years of experience, is increasing. Pharmacists commonly chair multidisciplinary committees within health systems, and pharmacy leaders often report directly to the chief executive officer or chief operating officer; they are often responsible for reporting quality information associated with medication use to the health system’s board. The use of a pharmacist credentialing and privileging process beyond licensure has increased over the past 4 years. Attention is being devoted to stress in the work place and addressing burnout among healthcare professionals, including pharmacists. Conclusion The profession is fostering a workforce that is appropriate in composition, sufficient in number, and has the competence to improve the value and safety of medication use.

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Porta, Carolyn M., Erin M. Mann, Rohina Amiri, Melissa D. Avery, Sheba Azim, Janice M. Conway-Klaassen, Parvin Golzareh i in. "Higher Education Institution Partnership to Strengthen the Health Care Workforce in Afghanistan". International Journal of Higher Education 9, nr 2 (7.01.2020): 95. http://dx.doi.org/10.5430/ijhe.v9n2p95.

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Despite ongoing insecurity, Afghanistan has demonstrated improvement in health outcomes. Reasons for this success include a strategic public-private health service delivery model and investment in Afghan health care workforce development. Afghan universities have the primary responsibility for ensuring that an adequate health care workforce is available to private and public health care delivery settings. Most entry-level health care providers working in Afghanistan are educated within the country. However, university constraints, including faculty shortages and limited access to professional development, have affected both the flow of the health care workforce pipeline and the skill levels and competencies of those who do enter the workforce. Aware of these constraints and workforce needs, the administration at Kabul University of Medical Sciences (KUMS), working in collaboration with the Ministry of Higher Education, prioritized investment in strengthening technical and academic capabilities within four faculties (anesthesiology, dentistry, medical laboratory technology, and midwifery). KUMS partnered with the University of Minnesota in 2017 with United States Agency for International Development support through the University Support and Workforce Development Program. Together they established a unique training-of-trainers (TOT) faculty development program to improve faculty knowledge and skills specific to their technical expertise, as well as knowledge and skills in instructional design and research methods. In this article, we describe the successes and challenges associated with partnership development, implementation, and sustainability.

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Glasgow, Nicholas, i Lucio Naccarella. "Guest Editorial: Getting Evidence into Policy - Stimulating Debate and Building the Evidence Base". Australian Journal of Primary Health 13, nr 2 (2007): 7. http://dx.doi.org/10.1071/py07016.

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In this special edition of the Journal, we have brought together papers with the aim of contributing to primary health care reform in Australia. The papers will stimulate further debate and increase the evidence base through which policies can be informed. Does primary health care in Australia need reform? Are there fundamental problems with the health system demanding a reform response? The challenges confronting Australia's health care system over the next decade are real and well documented (Productivity Commission, 2005; Australian Medical Workforce Advisory Committee [AMWAC], 2005). They include the ageing population and longer life expectancies, the increasing prevalence of chronic illness and co-morbidity, heightened consumer expectations, advances in health technologies and shortages in the health workforce.

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Harris, Mary, i Paul H. Gavel. "Factors influencing decisions about the state in which doctors plan to practise: additional results from the 2002 Australian Medical Workforce Advisory Committee national survey". Australian Health Review 29, nr 3 (2005): 278. http://dx.doi.org/10.1071/ah050278.

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As a result of growing doctor shortages, postgraduate doctor recruitment and retention within Australian states and territories has become an issue of concern. Australia?s policy of national self-sufficiency in health workforce supply implies that state medical schools will, at a minimum, enrol a sufficient number of locally born students to meet future medical workforce requirements. This article focuses on factors influencing the state or territory in which doctors plan to practise medicine, identified through a national survey. Independent variables of interest were birth place, medical school and vocational training location because of their importance to medical workforce policy. The study found that the career location plans of Australianborn and overseas-born doctors in vocational training were similar and that 5% of doctors planned to work overseas. Of Australian-born doctors who planned to work in Australia, 88% graduated from a medical school in the state in which they were born, while 78% and 65%, respectively, were undertaking vocational training in, and proposed to work in, the state in which they were born. The study concludes that trainee-doctor decisions about the state or territory in which they will practise medicine when they are fully qualified are more complex than location of birth.

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Garcia, Edna, Iman Kundu, Melissa Kelly i Ryan Soles. "The American Society for Clinical Pathology’s 2018 Vacancy Survey of Medical Laboratories in the United States". American Journal of Clinical Pathology 152, nr 2 (28.05.2019): 155–68. http://dx.doi.org/10.1093/ajcp/aqz046.

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ABSTRACT Objectives To determine the extent and distribution of workforce shortages within the nation’s medical laboratories. Methods The survey was conducted through collaboration between the American Society for Clinical Pathology’s Institute of Science, Technology, and Policy in Washington, DC, and the Evaluation, Measurement, and Assessment Department and Board of Certification in Chicago, IL. Data were collected via an internet survey distributed to individuals who were able to report on staffing and certifications for their laboratories. Results Results show increased vacancy rates for laboratory positions across all departments surveyed. The overall retirement rates are at its lowest, suggesting that the field has already experienced loss of personnel with a vast amount of experience. Conclusions Focus on retention of qualified and certified laboratory professionals would be crucial factors in addressing the needs of the laboratory workforce. The field also needs to intensify its efforts on recruiting the next generation of laboratory personnel.

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Corrado, Ann Marie. "The ethical concerns of physician recruitment from Africa to the global North". University of Western Ontario Medical Journal 86, nr 2 (3.12.2017): 30–31. http://dx.doi.org/10.5206/uwomj.v86i2.2003.

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For decades, medical recruitment agencies have tried to deal with physician shortages in rural and remote areas of developed countries by recruiting physicians from areas of scarce health human resources in the global South. In South Africa alone, one-third to one-half of medical school graduates migrate to the global North every year, with the majority settling down in Canada, the United States, and the United Kingdom.1 This review paper aims to bring attention to the unethical practice of physician recruitment from Africa to the global North. In particular, it will explore how physician recruitment negatively impacts the donor countries’ economies, compromises the quality of care they can give their citizens, and provides only a short term solution to the recipient country. It is critical that this practice is prohibited and that countries in the global North look for sustainable solutions within their own borders to solve workforce shortages.

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Lambe, Paul J., Thomas C. E. Gale, Tristan Price i Martin J. Roberts. "Sociodemographic and educational characteristics of doctors applying for psychiatry training in the UK: secondary analysis of data from the UK Medical Education Database project". BJPsych Bulletin 43, nr 6 (10.05.2019): 264–70. http://dx.doi.org/10.1192/bjb.2019.33.

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Aims and methodWorkforce shortages in psychiatry are common worldwide. The international literature provides insights into factors influencing decisions to train in psychiatry but is predominately survey based. This national cohort study aimed to identify the characteristics of doctors who were most likely to apply to psychiatry training programmes. The sample comprised doctors who entered UK medical schools in 2007/8 and who made first-time specialty training applications in 2015. The association between application to psychiatry and doctors' sociodemographic and educational characteristics was examined using multivariable logistic regression.ResultsThose most likely to apply were White, privately educated older doctors with below average performance at medical school.Clinical implicationsTo reduce workforce shortages, psychiatry must make itself more attractive to all doctors, especially those from underrepresented groups such as state-educated Black and minority ethnic individuals. Otherwise, national policies to widen participation in the study of medicine by such groups may exacerbate the current recruitment crisis.

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Young, Aaron, Humayun J. Chaudhry, Xiaomei Pei, Katie Halbesleben, Donald H. Polk i Michael Dugan. "A Census of Actively Licensed Physicians in the United States, 2014". Journal of Medical Regulation 101, nr 2 (1.06.2015): 7–22. http://dx.doi.org/10.30770/2572-1852-101.2.7.

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Marked changes have occurred in health care delivery in the United States with the implementation of the Affordable Care Act (ACA), including the advancement of integrated health systems, the introduction of patient centered medical homes and the creation of accountable care organizations. With millions of Americans newly insured, never has there been a more pressing need for accurate physician workforce information and planning. Opinions vary about the nature and degree of anticipated physician shortages, and health care workforce determinations are fraught with variables and uncertainties that are challenging to address definitively. Identifying accurate information about the nation's currently licensed physician workforce, however, is an important starting point. This article reviews data received in 2014 by the Federation of State Medical Boards from the nation's state medical and osteopathic boards about the current supply of actively licensed physicians in the United States and the District of Columbia. Our census data demonstrates the total population of licensed physicians (916,264) has increased by 4% since 2012, and the nation, on average, added 12,168 more licensed physicians annually than it lost. The average physician is now older (by a year), predominantly male (but increasingly female at entry level) and increasingly a graduate of a medical school in the Caribbean. Meanwhile, the percentage of physicians with a single state medical license has remained constant at 79%.

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Kurti, Linda, Susan Rudland, Rebecca Wilkinson, Dawn DeWitt i Catherine Zhang. "Physician's assistants: a workforce solution for Australia?" Australian Journal of Primary Health 17, nr 1 (2011): 23. http://dx.doi.org/10.1071/py10055.

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Significant medical workforce shortages, particularly in rural and remote locations, have prompted a range of responses in Australia at both state and Commonwealth levels. One such response was a pilot project to test the suitability of the Physician Assistant (PA) role in the Australian context. Five US-trained and accredited PAs were employed by Queensland Health and deployed in urban, rural and remote settings across Queensland. A concurrent mixed-method evaluation was conducted by Urbis, an independent research firm. The evaluation found that the PAs provided quality, safe clinical care under the supervision of local medical officers. The majority of nurses and doctors who worked with the PAs believed that the PAs made a positive contribution to the health care team by increasing capacity to meet patient needs; reducing on-call requirements for doctors; liaising with other clinical team members; streamlining procedures for efficient patient throughput; and providing continuity during periods of doctor changeover. The Pilot demonstrated that a delegated PA role can provide safe, quality health care by augmenting an established healthcare team. The PA role has the potential to benefit the community by increasing the capacity of the health care system, and to improve recruitment and retention by providing an additional professional pathway. The small size of the Pilot limits the ability to generalise regarding the future efficacy of the PA role in Australia. Further research is required to test training and deployment of PAs in a wider range of Australian clinical settings, including general practice and rural health clinics.

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Smith, Marie A. "Primary Care Teams and Pharmacist Staffing Ratios: Is There a Magic Number?" Annals of Pharmacotherapy 52, nr 3 (11.10.2017): 290–94. http://dx.doi.org/10.1177/1060028017735119.

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Primary care physician (PCP) shortages are predicted for 2025, and many workforce models have recommended the expanded integration of nurse practitioners and physician assistants. However, there has been little consideration of incorporating clinical pharmacists on primary care teams to address the growing number of patient visits that involve medication optimization and management. This article summarizes various estimates of pharmacist staffing ratios based on number of PCPs, patient panel size, or annual patient encounters. Finally, some steps are offered to address the practice- and policy-based implications of expanding primary care pharmacist activities at the local and state levels.

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Arora, Sanjeev, Cleo Ryals, Jorge A. Rodriguez, Emily Byers i Elizabeth Clewett. "Leveraging Digital Technology to Reduce Cancer Care Inequities". American Society of Clinical Oncology Educational Book, nr 42 (kwiecień 2022): 1–8. http://dx.doi.org/10.1200/edbk_350151.

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The rise of digital technologies such as telehealth, mobile apps, electronic medical records, and telementoring for rural primary care providers could provide opportunities for improving equity in cancer care delivery and outcomes. Benefitting from new technologies requires access to broadband internet, appropriate devices (smartphones, computers, etc.) along with basic digital literacy skills to use the devices. When these requirements are not met, the likelihood of widening existing inequities in access to care increases. This article introduces opportunities for improving cancer care using health informatics systems for engaging patients and flagging bias and existing videoconferencing technology to build workforce capacity. Policy recommendations for expanding evidence-based interventions are also highlighted, with the aim of mitigating the effects of workforce shortages and reducing persistent inequities in access to and quality of care.

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Manjunath, M., Mallikarjun K. Biradar i Suresh Lankeshwar. "A study to assess future academic career and service plan of house surgeons". International Journal Of Community Medicine And Public Health 5, nr 12 (24.11.2018): 5381. http://dx.doi.org/10.18203/2394-6040.ijcmph20184821.

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Background: No healthcare without a workforce has been a universal truth. However, shortages and misdistribution of the qualified healthcare workforce have become global concerns affecting nearly all countries, especially less-developed countries.Methods: Cross sectional study done on house surgeons in AIMS, BG Nagar, Mandya district, involving 178 house surgeons. Simple proportions were used to analysis the data.Results: Out of 178 house surgeons, 177 (99.4%) had plan for future academic career and service. 158 (88.7%) had plan for PG course and 19 (10.6%) planned for general practice, 80 (94%) planning to do super specialization and 84 (47.1%) plan to teach in medical colleges. Majority of house surgeons 161 (91.4%) have expressed to work in urban area and 17 (9.5%) in primary health centre in rural areas.Conclusions: Almost all the house surgeons have planned well in advance about their future academic and career plan.

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Wani, Rajvi Jayant, Shinobu Watanabe-Galloway, Hyo Jung Tak, Li-Wu Chen, Nizar Wehbi i Fernando Wilson. "Utilisation of emergency departments of behavioural disorders and supply of workforce in Nebraska". Evidence Based Mental Health 23, nr 2 (6.01.2020): 57–66. http://dx.doi.org/10.1136/ebmental-2019-300125.

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BackgroundEmergency departments (EDs) have become entry points for treating behavioural health (BH) conditions, thereby rendering the evaluation of their utilisation necessary.ObjectivesThis study estimated behavioural-related hospital-based ED visits and outcomes of leaving against medical advice as well as the incurred charges within the primarily rural State of Nebraska. Also, the study correlated behavioural workforce distribution and location of EDs with ED utilisation.MethodsNebraska State Emergency Department Database provided information on utilisation of services, charges, diagnoses and demographic. Health Professional Tracking Services survey provided the distribution of EDs and BH workforce by region. To examine the effect of patient characteristics on discharge against medical advice, multivariable logistic regression modelling was used.FindingsUS$96.4 million were ED charges for 52 035 visits for BH disorders over 3 years. Of these, 35% and 50% were between 25 and 44-years old and privately insured, respectively. The uninsured (OR:1.53, p=0.0047) and 45–64 years old (OR:2.31, p<0.001) had higher odds of leaving against medical advice. The findings from this study identified ED outcomes among high-risk cohort.ConclusionsThere were high ED rates among the limited number EDs facilities in rural Nebraska. Rural regions of Nebraska faced workforce shortages and had high numbers of ED visits at relatively few accessible EDs.Clinical implicationsCustomised rural-centric public health programmes, which are based in clinical settings, can encourage patients to adhere to ED-treatment. Also, increasing the availability of BH workforce (either via telehealth or part-time presence) in rural areas can alleviate the problem and reduce ED revisits.

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Jones, Judith A., John S. Humphreys i Beth Wilson. "Do health and medical workforce shortages explain the lower rate of rural consumers' complaints to Victoria's Health Services Commissioner?" Australian Journal of Rural Health 13, nr 6 (grudzień 2005): 353–58. http://dx.doi.org/10.1111/j.1440-1584.2005.00737.x.

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Alamri, Yassar, Khalid Alsahli i Danus Ravindran. "Trends and applicant characteristics in New Zealand: Radiation oncology versus radiology". Focus on Health Professional Education: A Multi-Professional Journal 21, nr 2 (31.07.2020): 55–60. http://dx.doi.org/10.11157/fohpe.v21i2.295.

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Introduction: Previous research has projected future shortages in radiation oncologistsin Australia. Anecdotal evidence also suggests a similar pattern in New Zealand, howevershortages in the radiology workforce have not been forecast to date. The present study aimed to examine the trends in applications for radiation oncology and radiology positions in New Zealand.Methods: Data were collected on vocational training applicants and senior medical officer (SMO, consultant) positions from 2009 to 2016. Data were obtained from publicly-available data on the New Zealand Ministry of Health and Royal Australian and New Zealand College of Radiologists (RANZCR) websites.Results: Compared with radiation oncology, applications to radiology significantly outnumbered the available positions—a trend that escalated between 2009 and 2016. In addition, the radiation oncology SMO workforce in New Zealand attracted progressively fewer local graduates (i.e., more international medical graduates) compared with radiology over the period studied.Conclusions: This is the first study to shed light on trends in applications to the two specialties overseen by RANZCR in New Zealand. Future efforts should focus on attracting more trainees to radiation oncology and addressing factors underlying the apparent discrepancies between the two specialties, as well as the mental health and wellbeing of trainees.

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Quamruzzaman, Amm. "Exploring the Impact of Medical Brain Drain on Child Health in 188 Countries over 2000–2015". Societies 10, nr 4 (24.09.2020): 73. http://dx.doi.org/10.3390/soc10040073.

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Medical brain drain has been a policy concern in recent years when many countries are struggling with health workforce shortages. Some suggest that wealthy countries only exacerbate this problem by recruiting internationally trained health professionals. Little research has considered the impact of medical brain drain on child health in the sending society, and the few empirical analyses that exist find no conclusive evidence. To fill this gap, I test the underlying mechanisms through which medical brain drain may affect child health in scores of countries. I use a panel dataset covering 188 countries over the period 2000–2015. The findings from fixed-effects regression models suggest that medical brain drain negatively affects child health and that there is a curvilinear relationship between the two. The effects on child health are stronger in countries approximately in the middle of the medical brain drain scale, and weaker on both ends. The implications of the findings for policy and future research are highlighted.

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Riedy, Christine A., Kiet A. Ly, Vickie Ybarra i Peter Milgrom. "An FQHC Research Network in Oral Health: Enhancing the Workforce and Reducing Disparities". Public Health Reports 122, nr 5 (wrzesień 2007): 592–601. http://dx.doi.org/10.1177/003335490712200506.

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Federally Qualified Health Centers (FQHCs) contribute greatly to reducing health disparities by providing care to underserved communities. Yet these safety-net clinics face chronic manpower shortages and turnover. Practice-Based Research Networks aid in translating medical science from bench to clinical practice. These networks have been used to understand and improve health-care delivery and reduce disparities. Initiatives to strengthen lagging translational research in dentistry have begun, but there is no FQHC research network that addresses oral health. This article reviews the potential for, and outlines a model of, an Oral Health FQHC Research Network. It characterizes the needs for an FQHC research network, describes a successful FQHC research-oriented program, and outlines an Oral Health FQHC Research Network conceptual model. It argues that strengthening FQHCs through involvement of their dental staff in clinical research may enhance their jobs, draw staff closer to the community, and strengthen their ability to reduce health disparities.

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Williams, K., C. Selwyn, C. Elkins, S. Young, K. Pancione, M. Baker i Y. Getch. "An integrated addictions nursing subspecialty to expand the opioid use disorder and substance use disorder workforce". European Psychiatry 64, S1 (kwiecień 2021): S570. http://dx.doi.org/10.1192/j.eurpsy.2021.1521.

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IntroductionIn the U.S. approximately11.4 million misused prescription pain relievers; 2.1 million had an OUD in 2017. The Addictions Nursing Subspecialty was created to address this epidemic by expanding a workforce trained in OUD/SUD screening, treatment, and prevention. A curriculum was developed that included integrated/telehealth health care settings in medical and mental health provider shortage areas during their last nine months of training. Courses were developed and taught by aninterprofessional team of university faculty and informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery. Courses were also offered as electives for nursing, clinical-counseling, social work, and other health science disciplines emphasizing an interdisciplinary approach to healthcare.ObjectivesExpand the OUD/SUD trained workforce in areas with high OUD/SUD mortality rates and high mental health provider shortages emphasizing team-based integrated care and telehealth settings.MethodsProgram curriculum was informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery using integrated care. Competencies included: Core Competencies for Integrated Behavioral Health and Primary Care that have been set forth by the Center for Integrated Health Solutions, telehealth competencies outlined in the recommended competencies by the National Organization of Nurse Practitioner Faculties (NONPF), and Core Competencies for Addictions Medicine by the American Board of Addictions Medicine.ResultsApproximately 11 students enrolled in courses received additions integrated/telehealth health care settings. Students responded positively to evaluations regarding timely feedback, unique approach (i.e. intrative content, short videos and discussions).ConclusionsThe Addictions Nursing subspecialty will continue to be offered allowing enrollment for nurses twice a year.

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Cawley, James F., i Roderick S. Hooker. "Determinants of the physician assistant/associate concept in global health systems". International Journal of Healthcare 4, nr 1 (3.04.2018): 50. http://dx.doi.org/10.5430/ijh.v4n1p50.

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Introduction: A global shortage of doctors has led to strategies to improve access to care. The physician assistant/associate (PA) was established in North America and Africa in the 1960s in response to medical shortages. PA activity was cataloged to understand what determines their utilization in a country’s health system.Methods: A mixed-method study design began with searching the available literature regarding the development of PAs worldwide. Key words included “physician assistants”, “non-physicians”, “physician associates”, and “advanced practice providers”. Additional data was through an online search of reports; personal communications with researchers, policymakers, government officials, and practitioners in each country; visits by the authors to a number of the countries; and a review of official documents. In each country interviews included educators, policymakers and government officials who had direct involvement with the introduction of the PA concept, and clinically active PAs. Domain analyses were based on stratification of differences among countries: global region, income, physician to population ratio, attitudes of medical professionals, and practice/regulatory authority. Countries were segmented into two categories: well resourced and less well resourced.Results: The history and status of the PA concept into the health systems of 15 states were reviewed. The determinants for the successful incorporation of PAs include prevailing medical needs, a shortage of physicians or an aging physician workforce; support and sponsorship by physician organizations and government agencies; the ability to mobilize and establish a legal and regulatory framework to accommodate PAs; and evidence that their introduction is acceptable to patients, physicians, and other health professionals.Discussion: The introduction of PAs into health systems occurs because their education is less expensive and time intensive than physicians. In addition, graduates are more likely to occupy roles where there is scarcity of doctors such as in rural and underserved areas. In most instances, a physician-dependent role permits their introduction into health systems in a non-threatening manner to doctors and their practices. The utilization of PAs, particularly in primary healthcare roles, increases access to services, is cost-beneficial, and shows a physician-equivalent quality of care.Conclusion: The PA has been a remarkable health workforce policy development that has spread among countries’ health systems and is likely to continue.

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Gray, Katherine, Kristian Krogh, David Newsome, Victoria Smith, Donald Lancaster i Debra Nestel. "TelePresence in Rural Medical Education: A Mixed Methods Evaluation". Journal of Biomedical Education 2014 (10.02.2014): 1–8. http://dx.doi.org/10.1155/2014/823639.

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In response to rural health workforce shortages, universities and training providers offer rural and remote clinical placements. This has led to development of educational methods to counter the barriers of distance. In this emerging field, recent improvements in technology have provided solutions including the use of sophisticated videoconferencing systems such as the Cisco TelePresence model CTS-500. This paper evaluates the use of TelePresence in diverse medical education activities using a mixed methods design—questionnaires n=60, individual interviews n=33, and observed practice of activities n=22. TelePresence was found to be beneficial to learning and teaching and superior to other systems participants had used. In particular, the audiovisual quality, resulting intimacy, convenience, and ease of use facilitated teaching and learning, while the fixed camera and poorly arranged physical environment were found to be limitations. The system is best suited for small group activities. Clinical skills-based activities are viable. It is recommended that technical support be available during setup and use and a picture-in-picture mode be included and improved integration of office suite software to provide a joint workspace for display of presentations, images, editing or annotation of documents, and file sharing.

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Okumu, B. A., L. M. Catherine, K. Estie i T. Marc. "Demographics of Kenyan dentists under the predevolved system of government; a dental workforce study". African Journal of Oral Health 9, nr 1 (11.11.2019): 5–13. http://dx.doi.org/10.4314/ajoh.v9i1.2.

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Objective: The main aim of this study was to analyse the dental workforce in Kenya prior to the decentralization of health workforce management to county governments in 2013.Methods: This was a cross-sectional study of Kenyan dentists who were practising as at 2013. Demographic data was obtained from the Kenya Medical Practitioners and Dentists' Board and the Ministry of Health annual retention registers. These data were integrated and analysed in Microsoft Excel 2016. All tests for significance were set at 95% confidence level (p ≤0.05).Results: Most of the dentists studied were male (55.6%) and more than half (54.5%) were below the age of 40 years (M=39.8, SD=11.9). A majority (79.3%) were general practitioners and approximately half (50.8%) were involved in private practice. Whereas, 76% had received local undergraduate training, many specialists (51.2%) held foreign degrees.Conclusion: There is urgent need for Kenya to develop strategies that will increase and retain the number of dentists and specialists. It remains to be seen whether the creation of a decentralised system of government will address existing shortages as well as the age, gender and speciality imbalances affecting the dental workforce.Keywords: Kenya, dentists, dental specialists, demographics, pre-devolution

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Rosenberger, Kelly D., Heidi Olson, Martin MacDowell i Valerie Gruss. "Using IPEC pedagogy to transform the future rural advanced practice nursing workforce". Journal of Nursing Education and Practice 11, nr 10 (26.05.2021): 1. http://dx.doi.org/10.5430/jnep.v11n10p1.

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Objective: The number of primary care providers has not kept pace with the increasing number of underserved rural populations placing unprecedented demands on the healthcare system and the gap is expected to widen with shortages projected to increase across the United States. Given the urgent need to grow and expand the number of trained diverse primary care providers in rural communities, an innovative sustainable program was implemented to recruit and train diverse rural advanced practice nurses. Building on the successful rural medical and rural pharmacy educational programs at the UIC Health Sciences Campus in Rockford, a rural nursing program with interprofessional curriculum was designed and refined to enable nursing students along with two other professions to develop appreciation, insight, and knowledge of rural healthcare and health disparities in a variety of rural settings as part of an interprofessional team.Methods: A mixed-methods program evaluation approach utilized both quantitative and qualitative data to evaluate program satisfaction and inform ongoing program refinement.Results: Students indicated positive responses to this interprofessional course of study. Continued development and refinement of the curriculum is planned to train the future rural healthcare workforce.Conclusions: Students from three health sciences colleges benefitted from the IPEC program with confirmed satisfaction in interprofessional rural education and collaborative practice. The addition of a rural nursing program merits continuation with modification and expansion to prepare the future rural interprofessional healthcare workforce.

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Freed, Gary L., Erin Turbitt i Amy Allen. "Public or private care: where do specialists spend their time?" Australian Health Review 41, nr 5 (2017): 541. http://dx.doi.org/10.1071/ah15228.

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Objectives The aim of the present study was to provide data to help clarify the public–private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation’s needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and private sectors. In aggregate, 48% of specialists work across both sectors, 33% work only in public practice and 19% work only in private practice. What does this paper add? Because of the potential for significant variability across specialties, these consolidated figures may be problematic in assessing the public and private allocation of the physician workforce. Herein we provide the first speciality-specific data on the public–private mix of practice in Australia. Among the most important findings from the present study is that, for many specialists in Australia, a large majority of time is spent providing care to patients in the private sector. For the surgical specialties studied, on average less than 30% of clinical time is spent in the public sector. What are the implications for practitioners? Public policies that are designed to ensure an adequate medical workforce will need to take into account the division of time providing care in the public vs. the private sector. Public perceptions of shortages in the public sector may increase the availability of public sector positions.

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Byrne, John-Paul, Jennifer Creese, Anne Matthews, Aoife M. McDermott, Richard W. Costello i Niamh Humphries. "‘…the way it was staffed during COVID is the way it should be staffed in real life…’: a qualitative study of the impact of COVID-19 on the working conditions of junior hospital doctors". BMJ Open 11, nr 8 (sierpień 2021): e050358. http://dx.doi.org/10.1136/bmjopen-2021-050358.

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ObjectivesCOVID-19 has prompted the reconfiguration of hospital services and medical workforces in countries across the world, bringing significant transformations to the work environments of hospital doctors. Before the pandemic, the working conditions of hospital doctors in Ireland were characterised by understaffing, overload, long hours and work–life conflict. As working conditions can affect staff well-being, workforce retention and patient outcomes, the objective of this study was to analyse how the pandemic and health system response impacted junior hospital doctors’ working conditions during the first wave of COVID-19 in Ireland.Methods and analysisUsing a qualitative study design, the article draws on semi-structured interviews with 30 junior hospital doctors. Informed by an abductive approach that draws iteratively on existing literature and empirical data to explain unexpected observations, data were analysed using inductive and deductive coding techniques to identify the key themes reflecting the experiences of working in Irish hospitals during the first wave of COVID-19. We use the Consolidated Criteria for Reporting Qualitative Research to present this research.ResultsOur analysis generated three themes which demonstrate how COVID-19 prompted changes in medical staffing which in turn enhanced interviewees’ work environments. First, interviewees felt there were more doctors staffing the hospital wards during the first wave of the pandemic. Second, this had positive implications for a range of factors important to their experience of work, including the ability to take sick leave, workplace relationships, collective workplace morale, access to senior clinical support and the speed of clinical decision-making. Third, interviewees noted how it took a pandemic for these improvements to occur and cautioned against a return to pre-pandemic medical staffing levels, which had negatively impacted their working conditions and well-being.ConclusionsInterviewees’ experience of the first wave of COVID-19 illustrates how enhanced levels of medical staffing can improve junior hospital doctors’ working conditions. Given the pervasive impact of staffing on the quality of interviewees’ work experience, perhaps it is time to consider medical staffing standards as a vital job resource for hospital doctors and a key policy lever to enhance medical workforce retention. In a global context of sustained COVID-19 demands, pressures from delayed care and international health worker shortages, understanding frontline experiences and identifying strategies to improve them are vital to the development of more sustainable work practices and to improve doctor retention.

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Xu, Hui, Sufang Huang, Chun Qiu, Shangkun Liu, Juan Deng, Bo Jiao, Xi Tan i in. "Monitoring and Management of Home-Quarantined Patients With COVID-19 Using a WeChat-Based Telemedicine System: Retrospective Cohort Study". Journal of Medical Internet Research 22, nr 7 (2.07.2020): e19514. http://dx.doi.org/10.2196/19514.

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Background Most patients with coronavirus disease (COVID-19) who show mild symptoms are sent home by physicians to recover. However, the condition of some of these patients becomes severe or critical as the disease progresses. Objective The aim of this study was to evaluate a telemedicine model that was developed to address the challenges of treating patients with progressive COVID-19 who are home-quarantined and shortages in the medical workforce. Methods A telemedicine system was developed to continuously monitor the progression of home-quarantined patients with COVID-19. The system was built based on a popular social media smartphone app called WeChat; the app was used to establish two-way communication between a multidisciplinary team consisting of 7 medical workers and 188 home-quarantined individuals (including 74 confirmed patients with COVID-19). The system helped patients self-assess their conditions and update the multidisciplinary team through a telemedicine form stored on a cloud service, based on which the multidisciplinary team made treatment decisions. We evaluated this telemedicine system via a single-center retrospective study conducted at Tongji Hospital in Wuhan, China, in January 2020. Results Among 188 individuals using the telemedicine system, 114 (60.6%) were not infected with COVID-19 and were dismissed. Of the 74 confirmed patients with COVID-19, 26 (35%) recovered during the study period and voluntarily stopped using the system. The remaining 48/76 confirmed patients with COVID-19 (63%) used the system until the end of the study, including 6 patients whose conditions progressed to severe or critical. These 6 patients were admitted to hospital and were stabilized (one received extracorporeal membrane oxygenation support for 17 days). All 74 patients with COVID-19 eventually recovered. Through a comparison of the monitored symptoms between hospitalized and nonhospitalized patients, we found prolonged persistence and deterioration of fever, dyspnea, lack of strength, and muscle soreness to be diagnostic of need for hospitalization. Conclusions By continuously monitoring the changes in several key symptoms, the telemedicine system reduces the risks of delayed hospitalization due to disease progression for patients with COVID-19 quarantined at home. The system uses a set of scales for quarantine management assessment that enables patients to self-assess their conditions. The results are useful for medical staff to identify disease progression and, hence, make appropriate and timely treatment decisions. The system requires few staff to manage a large cohort of patients. In addition, the system can solicit help from recovered but self-quarantined medical workers to alleviate shortages in the medical workforce and free healthy medical workers to fight COVID-19 on the front line. Thus, it optimizes the usage of local medical resources and prevents cross-infections among medical workers and patients.

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Gibbons, Aidan, i Bosu Seo. "Predicting Future Physician Output for British Columbia, Canada". Research in Health Science 4, nr 1 (25.02.2019): 15. http://dx.doi.org/10.22158/rhs.v4n1p15.

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<p><em>This study looks at data since 2002 and estimates a prediction for the health care output by physicians for British Columbia. The measure used to capture this output is full time equivalence (FTE), developed by the Canadian Institute for Health Information to capture an aggregate level of output by physicians through the value of their billings. The paper uses past data to estimate future physician numbers for the province based on Canadian medical school graduates, interprovincial migration, as well as estimates for the number of physicians leaving the workforce and the number of foreign educated physicians entering the province every year. Taking this prediction for future number of physicians, along with data on the age and gender distribution of doctors, BC population estimates, and previous FTE data, a regression model is developed to predict the level of FTE in BC for 2018 to 2020. This research ultimately predicts a steady, but modest rise in FTE for BC in the next few years. However, whether this growth will continue beyond 2020 is unclear, and a rise alone does not necessarily mean that it will better address future demand as BC is currently experiencing a shortage in physician services, and the demand for health care is expected to rise with the increasing proportion of seniors to working age individuals in the province. This paper suggests that changes should be put in place to increase the number of seats available in Canadian medical schools to address the shortage of physicians in the long term, and that BC will have to increase the number of foreign educated doctors in order to address shortages in the short term.</em></p>

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Hernandez, Raquel G. "What’s new in graduate medical education?" Cardiology in the Young 26, nr 8 (grudzień 2016): 1459–64. http://dx.doi.org/10.1017/s1047951116002444.

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AbstractThe development of new graduate medical education programmes provides both opportunities and challenges. Efforts to address physician workforce shortages as well as a realisation that curricula need to be updated to adjust to our rapidly changing healthcare environment have resulted in more educators considering the “how to” and “what’s new” of programme development. Understanding the Next Accreditation System, an accreditation system introduced by the Accreditation Council of Graduate Medical Education in 2012, is critical to the success of new as well as existing residency and fellowship programmes. Although many educators are aware of the general rational for the Next Accreditation System, an in-depth understanding of the meaning of Next Accreditation System is necessary from an experiential and theoretical perspective to be able to successfully launch new programmes and moves towards accreditation. A new paediatric categorical residency programme and a new paediatric surgical programme were developed at our institution immediately following the implementation of Next Accreditation System. We provide a series of insights and perspectives based on our experience relative to what priorities we saw outlined from both the programmatic and the institutional perspective to have our graduate medical education programmes reviewed for accreditation. During this discussion, the following objectives are outlined: to overview the Next Accreditation System as a framework and priorities, to discuss the opportunities and challenges that may exist in developing new programmes, and to discuss future directions in the evaluation of trainees and assessment of training competency. Although challenges are outlined, we hope to relay the continued excitement and opportunities that exist relative to enhancing training curricula for future graduate medical education programme builders.

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Mohamed, Alanood Elnaeem, Yasir Ahmed Mohammed Elhadi, Nora Alnaeem Mohammed, Aniekan Ekpenyong i Don Eliseo Lucero-Prisno. "Exploring Challenges to COVID-19 Vaccination in the Darfur Region of Sudan". American Journal of Tropical Medicine and Hygiene 106, nr 1 (5.01.2022): 17–20. http://dx.doi.org/10.4269/ajtmh.21-0782.

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ABSTRACT. The current COVID-19 pandemic has affected the ability of health systems to provide essential services globally. The Darfur region, located in the western part of Sudan, has been largely devastated by the war that began in 2003 and has been drawing considerable attention from the international community. The war, which erupted as a result of environmental, political, and economic factors, has led to tragic outcomes. Collapsing health-care infrastructures, health workforce shortages, lack of storage facilities for medicines and medical products, and inadequate access to health services are some of the effects of the war. After Sudan received the AstraZeneca COVID-19 vaccine through the COVID-19 Vaccines Global Access facility, significant challenges have been implicated in the delivery, storage, and use of the vaccine in the Darfur region. Lack of vaccine storage and transportation facilities, vaccination hesitancy, inequity in the distribution to health facilities, and shortage of health-care professionals resulting from insecurity and instability have added an extra layer of burden on local authorities and their ability to manage COVID-19 vaccinations in the region adequately. Addressing the impact of COVID-19 requires an effectively managed vaccination program. In the face of current challenges in Darfur, ensuring a fully vaccinated population might remain far-fetched and improbable if meaningful efforts are not put in place by all stakeholders and actors to address some of the challenges identified.

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Meehan-Andrews, Terri, Judith Jones i John Humphreys. "How do we Canvass Rural Consumer Viewpoints for Health Care Planning and Quality Assurance? Methodological Considerations for Data Collection". Australian Journal of Primary Health 12, nr 3 (2006): 72. http://dx.doi.org/10.1071/py06048.

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Consumer input is vitally important when planning health care services and monitoring health system performance. Australia's rural residents suffer poorer health status and health outcomes than do metropolitan residents; this, along with medical and health workforce shortages, makes this planning and monitoring especially relevant. In rural and remote regions people are geographically dispersed across diverse communities, often making it difficult to access and recruit consumers. This paper provides a framework to address the major issues associated with how best to canvass representative rural consumer views relating to health care services and quality assurance. The review provides a critical appraisal of the advantages and disadvantages of the main methodologies employed in rural health studies. Many of the problems associated with gaining representative rural consumer perspectives in relation to health can be overcome by planning the research process, adopting the appropriate survey tool and engaging potential participants.

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Hinkel, J. M., J. L. Vandergrift, S. J. Perkel, M. B. Waldinger MHSA, W. Levy PA-C i F. M. Stewart. "The impact of midlevel providers on productivity in outpatient oncology clinics at National Comprehensive Cancer Network (NCCN) institutions". Journal of Clinical Oncology 27, nr 15_suppl (20.05.2009): 6628. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.6628.

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6628 Background: An ASCO workforce study has predicted an oncologist shortage by 2020. Increased reliance on mid-level providers (PA/NPs) has been proposed to ameliorate the physician shortage. However, no methods currently exist to assess the impact of PA/NPs as physician extenders in an oncology setting. Obtaining productivity data is challenging due to variations in PA/NP utilization and billing. NCCN developed a survey to evaluate the use of PA/NPs in cancer centers and to pilot test PA/NP productivity metrics in outpatient oncology clinics. Methods: An online survey instrument was developed in consultation with oncologists, executive administrators, and PA/NP leaders at NCCN institutions. It included questions on work characteristics, allocation of time and labor, and productivity. PA/NP outpatient clinic productivity was measured as the average number of new and follow-up patients seen per half-day clinic (patients per clinic, PPC). A convenience sample was obtained through 15 NCCN institutions that distributed the survey through their own internal PA/NP e-mail lists. Results: A total of 206 PA/NPs completed the survey. A greater proportion of respondents were NPs (54%) than PAs (46%). Most responding PA/NPs listed their primary specialty as medical oncology (MO, 34%), followed by hematologic malignancies/BMT (HM/BMT, 28%) and surgical oncology (SO, 23%). The highest reported productivity was observed for SO specialists (mean = 8.7 PPC, SD = 3.5), followed by MO (mean = 7.6, SD = 4.3), and HM/BMT (mean = 6.1, SD = 2.8). Within the SO and HM/BMT specialties, little difference was observed between NP and PA productivity. Among MO specialists, NPs reported seeing more follow-up patients per clinic (mean = 7.2, SD = 4.3) than PAs (mean = 5.5, SD = 2.7, p = 0.04). In most cases, productivity was unrelated to seniority. However, more experienced HM/BMT NPs were more productive with new patients (rs = 0.46, p = 0.03). Conclusions: Mid-level providers have a measurable impact on productivity in outpatient oncology clinics. Refining productivity metrics for PAs/NPs will help inform workforce projections and staffing decisions for oncology practices/specialists and cancer centers, especially in the face of future physician shortages. No significant financial relationships to disclose.

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Tan, Amy C. W., Lynne M. Emmerton i H. Laetitia Hattingh. "Prescribing and medication-initiation roles based on the perspectives of rural healthcare providers in a study community in Queensland". Australian Health Review 37, nr 2 (2013): 172. http://dx.doi.org/10.1071/ah12190.

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Objective. There are recognised health service inequities in rural communities, including the timely provision of medications, often due to shortages of qualified prescribers. The present paper explores the insights of rural healthcare providers into the prescribing and medication-initiation roles of health professionals for their rural community. Methods. Forty-nine healthcare providers (medical practitioners, pharmacists, nurses, occupational therapists, a dentist and an optometrist) from four neighbouring towns in a rural health service district in Queensland participated in face-to-face semistructured interviews. The interviews explored medication supply and management issues in the community, including the roles of health professionals to address these issues. The interviews, averaging 45 min in duration, were recorded, transcribed and qualitatively analysed for general trends and unique responses. Results. Participants recognised the potential for dentists, optometrists and nurse practitioners to reduce the prescribing workload of rural medical practitioners, and there was some support for a ‘continued dispensing’ model for pharmacists. Medication-initiation orders by endorsed registered nurses were also valued in providing timely medical treatment in rural hospitals. Conclusions. Rural communities have unique needs that require consideration of multidisciplinary support to assist medical practitioners in coping with prescription demands for timely medical treatment. What is known about the topic? Extension of prescribing rights to non-medical prescribers has been a topic of considerable debate in Australia for some decades. Several extended-prescribing or medication-initiation roles were established to supplement and support the medical workforce, particularly in rural areas, where health service inequalities and inefficiencies in prescribing and provision of medications are recognised. To date, workforce dynamics and legislative boundaries have restricted the eventual number of rurally located non-medical prescribers. What does this paper add? Little research has been conducted to investigate or evaluate the application of prescribing or medication-initiation roles in rural settings from a multidisciplinary approach. This paper provides the perspectives of rural healthcare providers on the prescribing and medication-initiation roles across health professions. Key findings from this rural-engagement exercise are considered valuable for policymakers and health service planners in optimisation of the prescribing or medication-initiation models. The qualitative methods also added richness and depth to the discussion about these roles. What are the implications for practitioners? According to the literature review and other media, extended prescribing roles are not universally accepted. However, some of the roles are being developed and implemented. Hence, it is important for health practitioners to embrace the roles and optimise their application. Specifically in rural settings, it is also important to recognise the value of multidisciplinary support and collaboration within the limited health workforce.

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Smith, Erica Mitchell, Angela Keniston, Christine Cara Welles, Nemanja Vukovic, Lauren McBeth, Ben Harnke i Marisha Burden. "Inpatient clinician workload: a scoping review protocol to understand the definition, measurement and impact of non-procedural clinician workloads". BMJ Open 12, nr 12 (grudzień 2022): e062878. http://dx.doi.org/10.1136/bmjopen-2022-062878.

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IntroductionClinicians that care for hospitalised patients face unprecedented work conditions with exposure to highly infectious disease, exceedingly high patient numbers, and unpredictable work demands, all of which have resulted in increases in stress and burnout. Preliminary studies suggest that increasing workloads negatively affect inpatient clinician well-being and may negatively affect job performance; yet high workloads may be prioritised secondary to financial drivers or from workforce shortages. Despite this, the correlation between workload and these negative outcomes has not been fully quantified. Additionally, there are no clear measures for inpatient clinician workload and no standards to define ideal workloads. Using the protocol described here, we will perform a scoping review of the literature to generate a comprehensive understanding of how clinician workload of medical patients is currently defined, measured in clinical settings and its impact on the workforce, patients and institutional outcomes.Methods and analysisWe will follow the methodology outlined by Joanna Briggs Institute and Arksey and O’Malley to conduct a comprehensive search of major electronic databases including Ovid Medline (PubMed), Embase (Embase.com), PsycINFO, ProQuest Dissertations and Google Scholar. All relevant published peer-reviewed and dissertaion grey literature will be included. Data will be extracted using a standardised form to capture key article information. Results will be presented in a descriptive narrative format.Ethics and disseminationThis review does not require ethics approval though all included studies will be screened to ensure appropriate approval. The synthesis of this literature will provide a better understanding of the current state of work for inpatient clinicians, associated outcomes, and will identify gaps in the literature. These findings will be used in conjunction with an expert Delphi panel to identify measures of inpatient clinician workload to then guide the development of a novel workforce mobile application to actively track clinician work. We aim to lay the groundwork for future workforce studies to understand the optimal workloads that drive key outcomes for clinicians, patients and institutions.

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Leitch, Sharon, i Susan Dovey. "Review of registration requirements for new part-time doctors in New Zealand, Australia, the United Kingdom, Ireland and Canada". Journal of Primary Health Care 2, nr 4 (2010): 273. http://dx.doi.org/10.1071/hc10273.

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INTRODUCTION: By the time medical students graduate many wish to work part-time while accommodating other lifestyle interests. AIM: To review flexibility of medical registration requirements for provisional registrants in New Zealand, Australia, the United Kingdom, Ireland and Canada. METHODS: Internet-based review of registration bodies of each country, and each state or province in Australia and Canada, supplemented by emails and phone calls seeking clarification of missing or obscure information. RESULTS: Data from 20 regions were examined. Many similarities were found between study countries in their approaches to the registration of new doctors, although there are some regional differences. Most regions (65%) have a provisional registration period of one year. Extending this period was possible in 91% of regions. Part-time options were possible in 75% of regions. All regions required trainees to work in approved practice settings. DISCUSSION: Only the UK provided comprehensive documentation of their requirements in an accessible format and clearly explaining the options for part-time work. Australia appeared to be more flexible than other countries with respect to part- and full-time work requirements. All countries need to examine their registration requirements to introduce more flexibility wherever possible, as a strategy for addressing workforce shortages. KEYWORDS: Family practice; education, medical, graduate; government regulation

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Reddy, Anjani T., Sonia A. Lazreg, Robert L. Phillips, Andrew W. Bazemore i Sean C. Lucan. "Toward Defining and Measuring Social Accountability in Graduate Medical Education: A Stakeholder Study". Journal of Graduate Medical Education 5, nr 3 (1.09.2013): 439–45. http://dx.doi.org/10.4300/jgme-d-12-00274.1.

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Abstract Background Since 1965, Medicare has publically financed graduate medical education (GME) in the United States. Given public financing, various advisory groups have argued that GME should be more socially accountable. Several efforts are underway to develop accountability measures for GME that could be tied to Medicare payments, but it is not clear how to measure or even define social accountability. Objective We explored how GME stakeholders perceive, define, and measure social accountability. Methods Through purposive and snowball sampling, we completed semistructured interviews with 18 GME stakeholders from GME training sites, government agencies, and health care organizations. We analyzed interview field notes and audiorecordings using a flexible, iterative, qualitative group process to identify themes. Results Three themes emerged in regards to defining social accountability: (1) creating a diverse physician workforce to address regional needs and primary care and specialty shortages; (2) ensuring quality in training and care to best serve patients; and (3) providing service to surrounding communities and the general public. All but 1 stakeholder believed GME institutions have a responsibility to be socially accountable. Reported barriers to achieving social accountability included training time constraints, financial limitations, and institutional resistance. Suggestions for measuring social accountability included reviewing graduates' specialties and practice locations, evaluating curricular content, and reviewing program services to surrounding communities. Conclusions Most stakeholders endorsed the concept of social accountability in GME, suggesting definitions and possible measures that could inform policy makers calls for increased accountability despite recognized barriers.

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Hudson, Matthew F., Mark Allen O'Rourke, Dawn W. Blackhurst, Jennifer Caldwell, Regina A. Franco, Rebecca Russ-Sellers i Ronnie Horner. "Clinical work intensity among medical oncologists." Journal of Clinical Oncology 36, nr 30_suppl (20.10.2018): 118. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.118.

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118 Background: Oncology faces workforce shortages and increasing stress. Oncology provider well-being and resilience are mediated by organizational factors through clinical work intensity. Clinical work intensity (CWI) is the level of requisite technical skill, physical and mental effort and clinical judgement necessary, plus care provision-associated stress. Suboptimal clinical work intensity may result from unfavorable practice organizational factors preceding burnout. This pilot study assess CWI experienced by medical oncologists and oncologic advanced practice registered nurses (APRNs)/nurse practitioners as a prelude to a study of provider resilience. Methods: Investigators solicited seventeen medical oncologists-12 physicians and 5 nurse practitioners-from five oncology clinics in the Northwest, Midwest, and Southern regions of the United States Providers reported on level of work intensity associated with 339 patient visits occurring over an 8 week period where for each provider 5 visits were randomly selected from each of 4 randomly selected clinic days. Intensity was measured by the NASA-Task Load Index that assesses 6 dimensions (subscales) with additional questions measuring stress and visit satisfaction. Results: Compared to medical oncologists, APRNs reported a higher work intensity score on average (38.6 vs. 32.9; p < 0.0064), and higher scores on the frustration subscale (36.5 vs. 21.5; p < 0.0001). APRNs also scored higher on stress (27.8 vs. 22.2; p < 0.048), and scored lower on provider-perceived satisfaction with the visit (73.0 vs. 81.1; p < 0.0001). There was no difference between oncologists and nurse practitioners on the other dimensions, including mental, time, and physical demand, and effort. Conclusions: Oncologic APRNs may experience greater work intensity than medical oncologists. Future research will consider whether APRN work intensity scores reflect different or disproportionate challenges owing to scope of practice, workload, or administrative responsibilities, and determine those dimensions of higher work intensity that portend provider burnout. The goal is to identify strategies optimizing work intensity among oncology providers, mitigating provider burnout and enhancing the practice environment.

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Drennan, Vari M., Melania Calestani, Francesca Taylor, Mary Halter i Ros Levenson. "Perceived impact on efficiency and safety of experienced American physician assistants/associates in acute hospital care in England: findings from a multi-site case organisational study". JRSM Open 11, nr 10 (październik 2020): 205427042096957. http://dx.doi.org/10.1177/2054270420969572.

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Summary Objectives To investigate the contribution, efficiency and safety of experienced physician associates included in the staffing of medical/surgical teams in acute hospitals in England, including facilitating and hindering factors. Design Mixed methods longitudinal, multi-site evaluation of a two-year programme employing 27 American physician associates: interviews and documentary analysis. Setting Eight acute hospitals, England. Participants 36 medical directors, consultants, junior doctors, nurses and manager, 198 documents. Results Over time, the experienced physician associates became viewed as a positive asset to medical and surgical teams, even in services where high levels of scepticism were initially expressed. Their positive contribution was described as bringing continuity to the medical/surgical team which benefited patients, consultants, doctors-in-training, nurses and the overall efficiency of the service. This is the first report of the positive impact that, including physician associates in medical/surgical teams, had on achieving safe working hours for doctors in training. Many reported the lack of physician associates regulation with attendant legislated authority to prescribe medicines and order ionising radiation was a hindrance in their deployment and employment. However, by the end of the programme, seven hospitals had published plans to increase the numbers of physician associates employed and host clinical placements for student physician associates. Conclusions The programme demonstrated the types of contributions the experienced physician associates made to patient experience, junior doctor experience and acute care services with medical workforce shortages. The General Medical Council will regulate the profession in the future. Robust quantitative research is now required.

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Kruger, Estie, Irosha Perera i Marc Tennant. "Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia". Australian Journal of Primary Health 16, nr 4 (2010): 291. http://dx.doi.org/10.1071/py10028.

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Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.

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