Medium Healthcare Consulting’s Post

Healthcare jobs grew at the fastest rate in 30 years last year, according to research from nonprofit consultancy Altarum According to the report, ambulatory care and hospital jobs accounted for 3.9% of sector employment. However, nursing and residential care employment still lags behind pre-pandemic levels. #HospitalJobs #HealthcareJobs

Summary 1. Primary care needs 350 billion in spending, not 250 billion 2. All primary care sources continue to fall to less and less primary care delivered per FM, IM, PD, NP, and PA graduate. 3. Massive increases in NP PA and DO graduates have not helped PC as each doubling is accompanied by half the primary care retention. 4. The Standard Primary Care Estimates indicate that massive increases in annual graduates would be needed to reach sufficient primary care but of course without 350 billion distributed equitably (not the case now), there is no chance for sufficient primary care. Sufficient primary care continues to elude most of the US population with half enough seen in 2621 counties lowest in health care workforce and across the basic health access specialties. Each year costs of delivery go up and new costs are added. Revenue is flat and lines of better revenue have been in decline for 40 years. The financial design defeats the workforce needed for integration and coordination as well as the quality and numbers of delivery team members required. Dominant RN contributions have fallen steadily for 40 years with lesser trained and less experienced team members replacing them. The finances and the environments continue to compromise the primary care that can be delivered by any and all sources. Departure from primary care is guided by RBRVS. The most flexible IM NP and PA sources have lost the most in primary care retention. Better finances guide better salaries, benefits, and practice environments. Primary care has moved to a temp job for many while awaiting an RBRVS favored career. Most lines of revenue and highest payments and best health plans also shape career choices and locations. The Standard Primary Care Year is the estimate made at the time of graduation of all possible primary care delivery for a source over their career. It is the product of average years in a career times the retention in primary care times the activity in primary care practice times a volume adjuster which continues to decline with decreasing productivity, changing practice environments, and fewer/lesser delivery team members. Internal medicine was dominant in primary care before 1985 due to 60% retention and few NP and PA annual grads, but has had the most options away from primary care and grads continue to take those options. NP and PA were also over 65% in primary care but greater independence and acceptance plus the RBRVS/payer devaluation of basic health access continues to shape lower retention. The primary care retention is so low that all training interventions are defeated - new types (FM NP PA and future new types) and massive expansions of annual graduates (6% more a year for decades for NP PA DO) It takes more graduates to result in the same primary care as a 1975 FM grad primarily due to primary care retention declines. In the second graphic in the comments, the numbers of graduates needed, is more than can be achieved.

This message is for you, hospital systems with a medical group employing physicians and other providers. Large hospital systems and AMCs especially come to mind. I'll keep it simple. I write from experience as a hands-on lay healthcare leadership MBA 'suit' that was always physically present even during the pandemic. If clinicians are expected to be physically present to care for patients, so should the Medical Group Executive Director (ED) to care for the physicians and their care teams. What do I mean by "care for the physicians and their care teams?" The ED role ensures a solid infrastructure and foundation for safe care delivery. The ED role advocates and develops business plans for presentation up the chain of command to provide appropriate support. Why am I singling out the ED of medical groups? Physicians and others continue to reach out and share stories of the growing chasm between leadership and care teams. They report NEVER seeing the ED in the clinical areas and only HEAR from them with email mandates, virtual meetings, and KPI updates. Where is their medical group ED that they speak to me, a virtual stranger? Because of prolonged vacancies, physicians have been denied PTO, 'accepted' more calls, and received no additional compensation. However, physicians report that EDs appear to enjoy their allocated PTO. The pandemic has been over for a long time, and these are not WFH roles; they are far from it. If a 'leader' can't handle the truth, see, and feel the strife of the frontline care teams, then these ED roles are not for them. As hospital systems consolidate physician department leadership between hospitals, with Chiefs and Chairs required to reapply for their jobs, Executive Directors and other roles will likely follow suit. I'm told many of the EDs are glorified and ineffective Practice Managers who are highly compensated. Practice managers show up and walk the talk and are often underpaid while the ED sits pretty - in some far-off place: an office, home, or on the Vineyard. May those who understand the value of being physically present consistently to engage physicians and their teams make the cut. It is physicians and care teams providing patient care. They are the priority, not the ED who is MIA. Even though I was one of them, I never adopted their management style and viewed them as unnecessary overhead bloat. Healthcare with a Heart employs leadership physically present to engage care teams. ❤️ #engagement #relationships #waste #healthcareonlinkedin #sme #accountability #bandwidth #adminbloat #cleanhouse #physicianadvocacy

Rural Clinicians 𝗚𝗲𝘁 𝗜𝘁. At Ontario Medical Clinic, we 𝗴𝗲𝘁 𝗶𝘁- if you don’t “grow your own,” there is no future for #rural #healthcare. That’s why we’ve been committed to #training the next generation of #GPs since 1996, as part of our responsibility to future-proof healthcare in our region. We 𝗴𝗲𝘁 that training in a busy clinic isn’t always easy. When you’re balancing patient care and learning at the same time, it can feel overwhelming. That’s why we’ve created an environment where our #registrars don’t hesitate to ask what they think are “stupid questions”- and there are many of those in #Fellowship training! My consult room is a revolving door, with three registrars at various stages of their training at the moment, all learning, all trying to 𝗴𝗲𝘁 𝗶𝘁. This year, we have an Australian College of Rural and Remote Medicine (ACRRM) registrar, & ACRRM 𝗴𝗲𝘁𝘀 𝗶𝘁 too. They understand that rural healthcare can’t be an afterthought. You can’t take a metro model and try to make it fit in rural areas- it just doesn’t work. Healthcare can be just clinical if that’s all you want it to be. But it is more- and it should be more. Most of us get into healthcare to help people, to make a difference in the lives of the patients in front of us. But over time, some of us realize that there’s more to it. The system has gaps, inequities, and challenges that need addressing. Our newest GP registrar has already figured this out- he 𝗴𝗲𝘁𝘀 𝗶𝘁. Ryan isn’t just focused on clinical care- he grew up locally and has come back to serve the community he calls home. Rural communities are home to doctors like Ryan, and they 𝗴𝗲𝘁 𝗶𝘁 on a deeper level. They understand the unique needs of rural health because this is their world. Ryan 𝗴𝗲𝘁𝘀 𝗶𝘁. He’s driven by a passion to close the rural health gap and improve the career path for rural GPs. He’s committed to making a lasting difference, not just for his patients, but for the wider community, particularly in addressing the needs of #prioritypopulations. When I first met him, I just knew he was someone special- an emerging leader who shows that true leadership comes about organically when you really 𝗴𝗲𝘁 𝗶𝘁. We’re so lucky to have him back in #Mildura. Because he 𝗴𝗲𝘁𝘀 that our patients are more than just their clinical issues, and our communities are more than just their health (or illness). There’s so much more to the care we provide in rural general practice, and it’s this deeper understanding that allows us to truly make a difference. You have to 𝗴𝗲𝘁 𝗶𝘁. As for Dr. Ryan Sheridan- watch this space, 𝘁𝗵𝗶𝘀 𝗴𝘂𝘆 𝗴𝗲𝘁𝘀 𝗶𝘁, and he’s going places. Rural Doctors Association of Australia Rural Doctors Foundation Rural Doctors Association of Victoria National Rural Health Alliance Dr Dan Wilson Dr Marian Dover #GPRegistrar #RuralHealth #GeneralPractice #MultidisciplinaryCare #HealthEquity #MilduraGP #DestinationRural

Day 22 🏆✨ Why are Achievements, awards, recognitions, acknowledgements important for any hospital? 🏥 🔍 Achievements, awards, recognitions, and acknowledgements are crucial for any hospital as they serve as a testament to the quality of care and service provided. Here's why they are so important: 1️⃣ Validation of Quality: Accreditations such as National Accreditation Board for Hospitals & Healthcare (NABH) , National Accreditation Board For Testing and Calibration Laboratories (#NABL) , and Joint Commission (JCI) are a symbol of excellence in healthcare. These accreditations demonstrate that the hospital has met stringent standards and guidelines, ensuring high-quality care for patients. 2️⃣ Trust and Credibility: Achievements and awards enhance the hospital's reputation and build trust among patients, visitors, and stakeholders. They instil confidence in the hospital's abilities and showcase its commitment to providing top-notch healthcare services. 3️⃣ Attracting Top Talent: Hospitals that are recognized for their achievements are more likely to attract skilled professionals who are looking to work in a reputable and successful institution. This can help improve the overall quality of care and services provided. 4️⃣ Competitive Advantage: By showcasing achievements and awards, hospitals can differentiate themselves from competitors and attract more patients. This can lead to an increase in patient volume and revenue for the hospital. 5️⃣ Continuous Improvement: Achievements and awards push hospitals to strive for excellence and continuously improve their services. They serve as a motivator for staff to maintain high standards and provide the best possible care to patients. In conclusion, achievements, awards, recognitions, and acknowledgements are not just a way to celebrate success, but they also play a vital role in demonstrating a hospital's commitment to quality care and excellence in healthcare. 🌟 #HealthcareExcellence #QualityCare #HospitalAccreditations #NABH #NABL #JCI #PatientCare #HealthcareServices #MedicalExcellence #TrustandCredibility #HealthcareProfessionals #ContinuousImprovement 🏥🥼🏆 #HealthcareIndustry #HealthTech #MedicalDevices #Telemedicine #PatientCare #HealthcareIT #nursing #HealthcareProfessionals #HospitalManagement #HealthcareJobs #HealthAndWellness #MedicalResearch #Nursing #PatientExperience #HealthcareLeadership #Pharmacy #ElderCare #MentalHealthAwareness #SurgicalTech #HealthcareMarketing #HealthcareConsulting #CareerDevelopment #PersonalBranding #ProfessionalNetworking #RemoteWork #DigitalMarketing #LeadershipDevelopment #DiversityandInclusion #WorkLifeBalance #Entrepreneurship #AIandTechnology #FutureofWork #FinancialWellness #CreativityandInnovation #HealthandWellness #Sustainability #WomeninBusiness #SocialMediaMarketing #JobSearch #ProfessionalGrowth #PersonalFinance #TechIndustry #FinanceIndustry #HealthcareIndustry #MarketingIndustry

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Post 2 – From “The New Agreements in Healthcare”   Over the Labor Day weekend, I reread my second book I published in 2006, "The New Agreements in Healthcare--healing a healthcare system on life support" This book points out the systematic nature the then big problems in healthcare. It also offers a case study of a loving, systemic approach (the New Agreements Work) to turn around a troubled hospital and grow/heal staff in the process. It's been almost 20 years since we first began implementing this work--which has become more elegant--morphing to be called #3DHealthcare or #LovingWorkflows--in healthcare. In reading what I wrote, which now seem prophetic, we see healthcare making the same mistakes it was 20 years ago, resulting in a steady decline to today when it's broken beyond repair and, to survive, must be transformed, especially in care delivery. I'm going to create a series of posts with excerpts from this book showing healthcare it can be done. See how staff we trained not only turned the hospital around but healed themselves in the process: What People Are Saying about NEW AGREEMENTS Healthcare (20 years ago) Our work with David Dibble and New Agreements Healthcare is helping us to understand that systems, not people, are most often the reason for errors and inefficiency. And if we are to have our people help us solve our problems and prevent errors, we must create an environment where fear is replaced with love and growth. . . . I am convinced that we are becoming a significantly better organization, one that can serve as a model for what healthcare can be and what organizations can become. —John Rossfeld, CEO, Gila Regional Medical Center The New Agreements creates a framework for a holistic approach to the operations of an organization. We all know intuitively that it is a combination of the people and the systems that affect how well an organization operates. New Agreements Healthcare embraces the development of the people while setting them up to be successful through optimization of the systems in which they must work. —Sue Nieboer, RN, MPA, VP Operations, Gerber Memorial Health Systems Implementation of the New Agreements over the past 18 months has greatly improved our organization through expediting change, growing people and improving systems. . . . My clinical nursing departments are walking away from the darkness of despair and frustration and into the sunrise of happiness in the workplace. —Cathy Woodard, RN, CNO, Gila Regional Medical Center David brings the concepts of the New Agreements and the Four Agreements together in one forum. He demonstrates that we can make a difference in the lives of those we serve, as well as have a positive effect on the bottom line. I wish all leaders would have the opportunity to take this training! —Michelle Goldbach, RNC, MHA, Nurse Manager, San Diego Hospice #LovingSystemsThinking #SystemsBasedLeadership #SystemsBasedManagement #ALovingOrganization

Hospitals and Hierarchies Like many folks of my age and stage in life, I have once more been hanging out a lot at a hospital in my role as a caregiver. The health crisis has been managed, my mind wanders and I start observing how people interact with each other. I perceive what incredibly hierarchical entities hospitals are (ref Cameron and Quinn Hierarchy/ Control culture). Nurse's eyes open wide on top of her face mask, her eyebrows shooting up into her hygiene cap, when I suggest she call a senior doctor and ask when he will be coming by. There is a tight reporting structure and very many layers of command. Each person knows their own job, a small piece of the health service delivery puzzle. Every role is clearly defined and they have all done this countless times. When the next patient walks in the door - rinse and repeat! The place is a well-oiled machine. There is stability, predictability, and very little individual discretion is allowed. If I have to bring a pillow in with me to the waiting room, I need to go to the administrative offices and take permission from a senior security officer (this level of control just boggled my mind, jaded as I am by a more egalitarian and independent lens). The advantage is consistent delivery of healthcare despite the skewed ratio of healthcare staff to patients. They rely on processes because otherwise it would be chaotic. They limit discretion in the interests of patient and staff safety. Overall it works. The biggest challenge I see in this model of functioning is about having a patient-first approach rather than a treatment-first one. Frequent shift changes, different doctors coming and going means they are all relying on information charts rather than first-hand knowledge of the individual. They are primarily using what they know of the disease to do their job rather than what they understand about the patient. To be fair, most of the staff are already aware of this gap and cheerfully try their best to bridge it. But perhaps there are things that can be done systemically as well. E.g. enabling more cross team learning opportunities, or patient connect programs that shed more light on the journey beyond the hospital experience. They could have more generalists being the primary admitting doctor rather than just specialists who focus on their own silos. They could also take on community volunteers to provide humane, non-expert support for patients. What are other things that hospitals and other hierarchies can do to stay relevant in this changing world? Any best practices you are aware of? Do share in the comments! #workculture #hierarchy #hospital #controlculture #competingvalues

The healthcare sector in the United States is facing critical challenges. Without effective solutions, the next 15 years could impact millions of lives, both in the US and globally. This insightful article by Duquesne University School of Nursing offers a comprehensive overview of the root causes, potential effects, and actionable steps to tackle these pressing issues in the healthcare industry. The Shortage of Healthcare Workers in the USA Read full article here: https://lnkd.in/euscRHXc What do you think is the most critical issue facing the healthcare industry today? Share your thoughts below! #TheShiredotCoUSA #JobOpportunities #Careers #StaffingSolutions