Primary Care Policy

Primary Care Policy
Healthcare spending in the United States is higher than that found in many comparable high income countries, while health outcomes within the U.S.
have not kept up with these expenses. In 2008, as the national and global economy plummeted and the United States' GDP subsequently declined,
spending in healthcare still continued to grow and reached $2.5 trillion in 2009 (Shi 2014). Between 2010 and 2019, it is predicted that healthcare
spending will grow at a rate of 6.1% annually, accounting for $4.5 trillion in 2019 and 19.3% of the GDP (Shi 2014). As our spending continues to
go unchecked, a larger proportion of our GDP is displaced and there is less money to put towards other areas of investment. With the passage of the
Affordable Care Act... Show more content on Helpwriting.net ...
The intention of these policies was to increase the number of residents heading into the primary care workforce so as to help control healthcare
expenses in the future and alleviate the primary care shortage. However, the funding and implementation of these investments is vulnerable and has not
been completely successful. Specifically, the ACA pushed policy that would increase the percentage ofphysician trainees practicing primary care by
increasing subsidies allocated to graduate medical education (GME) programs per resident in primary care curriculums, while decreasing the per
resident amount for all other resident trainees (Schwartz 2012). Furthermore, the ACA paid bonuses to hospitals who had graduating residents who
practiced primary care post–training, expanded loan repayment for residents that practice primary care, increased salaries of primary care residents,
and raised the number of GME resident positions by 3,000 for 5 years beginning in July 2011, with 80% of these new slots being provided for those
who were taking part in primary care training programs (Schwartz 2012). Additionally, the ACA set in place a 10% Medicare bonus for primary care
services for 5 years, beginning in January 2011 (Schwartz 2012). The ACA also encouraged physician training in community–based patient care centers
that provide primary care residency programs, it approved a new grant program to educate primary care providers about care coordination, chronic
disease management, and preventive medicine, as well as creating a program on management of medication in an effort to improve treatment and control
costs regarding chronic conditions and prescription medications (Heisler
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Electronic Consultation Essay
Typically a patient visits with their primary care provider first when we have a health–related concern. Although our primary care provider or PCP is a
qualified professional, the patient and primary physician can have greater access to resources and knowledge through telemedicine. Specifically the
electronic consultation or e–consultation with a specialist. I believe that a higher quality of care can be delivered to the patient when a specialist is
involved. The patient benefits because the primary care provider is the normal medical professional they see during their clinic visits and have formed
a comfort level within that continuity of care. The primary care provider cannot be expected to have a significant amount of knowledge on every...
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Information consultation requests such as laboratory results, digital images, and the health record can be included in the consultation request. The
consultation request is assigned to an appropriate specialist based on availability and specialty who then has one week to respond to the primary care
provider. Ensuring that data privacy requirements are met before going live is a valid concern that need to be addressed when implementing an
e–consultation service. Medical facilities, primary care providers and specialists located in Eastern Ontario used their experience to develop a 10 step
process to outline the successful implementation of e–consultation. 1)Identifying your partners: E–Consultation requires support from primary care
providers, specialists, regional support to provide infrastructure and human service support and a technology partner to facilitate system development,
maintenance, and technical support. 2)Choosing your platform: With many diverse styles of computer systems found with a health care facility finding
an application that can integrate across multiple healthcare organizations is

Becoming A Primary Care Physician
My goal is to serve communities in need by becoming a primary care physician. Key facets are helping others however possible, sharing knowledge to
empower others, researching new methods or treatments. Each of these appeals to me individually, but compassion is what ties them together and
drives me to overcome the challenges of this road. There is no vocation that is more important and meaningful than becoming a physician, and none that
could bring more joy.
Back when I was not sure, I aimed to find out more about what healthcare means for people today by volunteering. It was through this at the Orlando
Regional Medical Center that I began to understand. I witnessed firsthand the kindness and empathy medicine requires of its practitioners. Consoling
and guiding patients were my primary responsibilities, along with restocking supplies, helping transfer patients, and guiding visitors to their loved ones.
I learned to work with people recovering from surgery, terminal patients, and many others only wanting company; I listened to them, wished them a
happy birthday, or simply sat with them while they told me about their lives, their struggles, or how they met their spouses. A human connection was
essential.
Over time, I began connecting many of the patients, visitors and staff at the hospital. It became clear that caring does not always mean diagnosing,
prescribing, and waiting. One night there was a woman in the emergency room with two policemen standing outside her door. Her

Advanced Practice Nursing : Development, Challenges, And...
Advanced Practice Nursing: Development, Challenges, and Trends
Abbey T. Gunderson
Florida Gulf Coast University
Advanced Practice Nursing: Development, Challenges, and Trends
There is an increased need for primary care providers in the United States, as insurance coverage is expanding and the population is aging. The
Association of American Medical Colleges projects a shortage of 130,000 physicians by 2025 (Iglehart, 2014). Therefore, the emerging role of the
Advanced Practice Nurse (APN) is necessary to combat this shortage to increase the access to primary care. However, APNs are facing numerous
barriers in the health care system, including scope of practice limitations, physician discrepancies, and policy payment obstacles. APNs must strive to
overcome these barriers and increase awareness of their role in the United States' health care transformation.
Historical Development Nurse practitioners have been providing healthcare in the United States since the 1960s. The first Nurse Practitioner
program was founded by Dr. Loretta Ford and Dr. Henry Silver in 1965 at the University of Colorado (American Association of Nurse Practitioners,
2016). The role of the APN was developed during a shortage of primary care physicians, similar to what we are experiencing today. In the 1960s, there
was a high demand for primary care in the underserved population. Today, nurse practitioners are widely known for their impeccable, compassionate
care throughout the entire population.

Primary Care Personal Statement
I want to empower my patients to take control over their health; the best way for me to accomplish that is to remain in direct and prolonged contact
with the same patients over time as their primary care physician. My own life and my teaching experience equip me with the tools and passion to care
for patients over a lifetime through primary care.
My parents, both remarried, each struggle to find quality primary care providers in their communities; my mother is Mexican–American and my father
lives in rural Appalachia. Having lived with each parent at different times in my life, I have experienced these difficulties in accessing affordable care
firsthand. These hardships fuel my dedication to bring quality medical services as a primary care ... Show more content on Helpwriting.net ...
Having grown up without access to affordable healthcare, I am dedicated to returning to underserved communities like my own to help others as a
primary care physician. Raised in a dual–culture life, coming from both the Hispanic and Appalachian communities, I understand how difficult it can
be to find affordable quality healthcare. I recognize that my future patients may similarly hesitate to visit a physician due to reasons including language
barriers, finances, immigration status, lack of coverage, and lack of geographic access. I will use the skills I gained as an educator, as well as my
personal hardships, to find creative ways to dismantle these complex structural barriers for marginalized populations. The longer I am in the
educational and medical systems, the more I understand why so few are able to make this same commitment to primary care. I am sincerely,
personally, and deeply devoted to this area of practice, and that is why I am asking for you to support my pursuit of these

What Are The Various Approaches To Overcoming The Shortage...
The major protocol of this paper is to find out the various approaches to overcoming the shortage of primary care physicians in the US. There are
different reasons why this has happened, yet one thing's for sure: With the increasingly old population, the issue is just going to deteriorate. After all, it
might appear to be peculiar at the first look when you consider that such many individuals apply to medical school to become doctors and that the
quantity of medical graduates is at an unequaled high. So why the lack? (Rosenblat & Hart, 2000). One of the primary reasons is that during the most
recent few decades, American medical undergrads have naturally been attracted to significantly more lucrative specialty fortes, including radiology,...
On the other hand, that some type of monetary instigation upgrades the repayment for country administrations, at that point doctors will probably
situate in these territories. Given the substances of the present framework, future endeavors should focus on enhancing the fit amongst need and
administrations, upgraded coordination–and lessened duplication–of administrations, given the better distinguishing proof of undergrads to at last serve
in the NHSC and state programs, and enhanced viability and productivity of administratively supported health care administrations (Rosenblat & Hart,
2000).
Reforms in payment to diminish the salary gap between essential care and other specialties is past the control of any medical school. Different ways to
deal with alleviation in the primary care doctor deficit is to incorporate making essential care conveyance more proficient and expanding the number of
medical school graduates who pick this field. Effectiveness is imperative, however, Compelling doctors to see more patients in shorter visits debases
crafted by essential care and improves stress. More significant measures of proficiency think about access, understanding fulfillment, and wellbeing
results. At the point when these more important measures are joined with group based care and other working environment changes, both proficiency
and work fulfillment may enhance (Kernan, 2015).

Advanced Care Planning And Advance Directive Completion
Template Initial Steps for an Evidence–Based Project Project Title: Advanced Care Planning and Advance Directive Completion in the Primary Care
SettingStudent Name: Christina M. Young 1. Introduction: (25 to 50 words) Advanced care planning is critical element in the therapeutic alliance
between healthcare team and patient in providing adequate patient–centered care, with the patient a more willing collaborator. This process provides
patient, family, and caregiver with realistic expectations about result of treatment and prudent preparation for possible outcomes. Effective advance
care planning has been shown to increase satisfaction with care, lower moral distress, lead to healthier bereavement after death, provide timely... Show
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4. Background and Significance: (50 to 100 words) The Federal Patient Self–Determination Act (PSDA) of 1991 first brought attention to the
importance of advance directives (GAPNA, n.d.). Although regulatory bodies continue to promote advance directives, little has been done to encourage
and enforce this initiative, highlighting the need for directed efforts to improve AD completion rates. The overall prevalence of completed advance
directives in the United has been estimated that 5–15% (Tung & North, 2009). This indicates a need for programs to educate and empower patients and
providers to ensure that dialogue about advanced care planning is initiated early on, and that advance directives are completed. Studies have shown that
patients prefer that their primary care doctor initiate such planning while they are in good health and that such planning should occur earlier than it did
in terms of age, natural history of disease, and patient–physician relationship. The barriers to advance care planning that have been identified include
availability of trained staff, organizational commitment and policy to support advance care planning, and understanding/support of providers
(Ramsaroop, Reid, & Adelman, 2007). 5. PICOt

Essay On Primary Care Physicians
In the state of Florida there is a shortage of primary care physicians, and it's expected that within 10 years half of the current primary care physicians
who are practicing in this state will be reaching retirement age, possibly worsening the current shortage (Florida Association of Nurse Practitioners,
2017). The United States Census Bureau (2016) showed that there was an estimate of 20,612, 439 people living within the Florida in 2016, and there
were only 15,226 active primary care physicians workforce in 2016, meaning that there is less than one primary care physician per 1350 people
(Florida Department of Health, 2016). Therefore, the current shortage of primary care providers, is only expected to get worst in the next ten years, the
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One Florida legislation restriction that greatly affects advance practice nursing is that all APRN's are required to practice medical tasks of diagnosis,
treatments, and follow protocols under the direct supervision of a Florida licensed doctor of osteopathy, medical doctor, or dentist, and there is a limit
in the number of APRN's these doctors can supervise at a time (Buppert, 2007). A second barrier is that Florida legislation restricts the ability of
APRN's of signing important documents related to patient care, such as death certificates, "Do Not Resuscitate (DNR)" orders, and Baker Acts (Florida
Association of Nurse Practitioners, 2017).
Research data shows that states who have taken the initiative to remove barriers from APRN practice seen an increase in primary care access, and a
reduction of medical costs (Florida Association of Nurse Practitioners, 2017). In 2010 the Institute of Medicine (IOM), recommended that in order for
ARNP's to achieve quality output, efficiency, and uniformity of performance, barriers for nurses should be removed, and in 2012 the American
Academy of Family Physicians published an article stating there is a need for more primary care providers, and promoting that primary care should be
a team effort by physicians and APRN's, and that both should practice at the full extent of their training, education, and medical skills (Montoya, 2013).

The Effect Of Patient Centered Medical Home Essay
Researchers conducted an observational study to assess the effect of Patient–Centered Medical Home (PCMH) implementation on patient satisfaction,
quality of care, staff burnout, and emergency department use. Information was gathered from 913 Veterans Health Administration (VHA)
hospital–based and community–based clinics through the use of several surveys. Composite scores were then arranged into eight core domains of
Patient Aligned Care Team (PACT)
–the VHA's version of a PCMH model. Researchers then developed a PACT Implementation Progress Index (Pi2)
tool which was used identify the effectiveness of PACT implementation at each participating clinic. Clinics were awarded a scored between–8 and 8.
Those with scores between 5 and 8 were said to have effectively implemented their programs. Researchers ultimately found that clinics with higher Pi2
scores had less reported staff burnout, better overall patient satisfaction, improved patient outcomes and lower rates of hospital admissions. This was a
very large scale study that provided important insight about the outcomes associated with effective implementation of PCMH–like model. However,
generalization of the findings is limited because the study only assessed clinics within the VHA system. Other limitations included the presence of
personal biases in self–reports, and low survey response rates. Nevertheless, the study supports that effective implementation of PCMH has positive
implications on patient satisfaction, quality

The Affordable Care Act Of The United States
Health care reform is referring to the changes in health care policies. This reform is driven by the high cost of health care and the right to health
care. Health care is focusing on exploring and applying the Affordable Care Act. The Affordable Care Act addresses delivery issues within the current
health care system and is working to improve them. Research is important in the Affordable Care Act in order to help individuals make informed
health care decisions. Health care reform can affect the nursing practices at the bedside, influence advanced primary care nurses and their bill of
service, and move nursing towards a new direction with the new health care system in the United States. Nursing Practice Nurses have the knowledge,
skill,... Show more content on Helpwriting.net ...
The main problem of this idea is knowing exactly how much one should appropriately pay nurses for their services. This kind of change could be
very good for some of the middle and higher registered nurses, but it could negatively impact others at the same time. There are direct and indirect
implications of the Affordable Care Act for nursing. Those that are directly related to requirements of nursing and those that will affect nurses
through provisions and newfound opportunities that will come up. The largest indirect impact on nurses is the concern regarding the number of
primary care physicians available to care for all of the new individuals who will be able to afford health care. Many advanced primary registered
nurses are being called to step up and help out with the large number of new patients. The United States Bureau of Labor Statistics predicts that
demand for nurses will result in 3.5 million nursing jobs by 2020. Nurses with strong skills will be in high demand in the labor market as new job
opportunities will arise (health reform affect demand). Advanced Practice Nurses One state, Massachusetts, enacted the legislation guaranteeing
universal health coverage, this overwhelmed the state's primary care physicians by a wave of newly insured patients. This resulted in advanced
practice nurses because they

Gatekeepers' Pros and Cons Essay
A gatekeeper is a primary care provider who acts as an agent for patients. They coordinate medical care so that patient receives appropriate services
and also provide referrals to specialists. Typically, primary care physicians include family practitioner, generalist physician and pediatrician. Ideally,
gatekeepers are much like family doctors, they focus on the health of the person as a whole instead of a single organ. They help emphasize prevention
care and establish appropriate health screening based on the patient. On the hand, there are concerns that the system of gatekeeping makes urgent care
inconvenient. The pros and cons surrounding the system of gatekeeping really question its effectiveness. On the other hand, no system is... Show more
content on Helpwriting.net ...
Having a primary care provider not only gives you a personal health care organizer but it also reduces your health care cost. According to a
research at the University of Missouri, 90 percent of patient's medical needs can be met by primary care providers in an outpatient setting. Going
to a specialist with an issue that you might be uncertain of can be expensive. First of all, the specialist might not have your medical record. The
specialist may have no idea about your past medical history, physical examination report and social and family report. This increases your chance
of doing screenings that you've done in the past which results in unnecessary cost. Instead of blindly going to a specialist, your PCP can make
initial diagnoses and decide whether he/she can take care of you at their office or need to refer you to a specialist. PCPs also obtains most of your
medical record, they are aware of your circumstances and can help you prevent an illness before it happens. According to doctor McDoniel from Palos
Medical Group, "The time, money and amount of medicine needed to treat high blood pressure are a lot less than it is to treat a heart attack." Having
an organized health care plan can eliminate unnecessary costs and increase preventive treatments. Ideally, primary care providers are supposed to look
out for your best interest and arrange all your health care needs. In reality, you might be unsatisfied with your PCP, and want to

The Primary Care Physician Shortage
As the primary care physician shortage continues to rise along with the healthcare costs many states are looking for a solution to the crisis. Some
states have already passed laws that have removed the limitations of a nurse practitioner's ability to practice. Pennsylvania is currently not one of
these states but that may soon change if the Senate Bill 1063 is passed (Larson, 2014). The Senate Bill 1063 is a bill that was introduced into
legislation on April 16, 2013 by Senator Patricia Vance. The outline and history of the bill can be found on the Pennsylvania General Assembly
website. The original memo was posted by Senator Vance at 12:48 PM and directed to all of the Senate Members. The subject was titled "Memo #18
– Modernization of the Professional Nursing Law." The Senate Bill 1063 was later referred to the Consumer Protection and Professional Licensure on
July 19, 2013. There have been no further actions listed in the history of the bill (Pennsylvania General Assembly, 2014). The following link that is
provided will take you to the site of this legislation. http://www.legis.state.pa.us/cfdocs/billinfo
/billinfo.cfm?syear=2013&sind=0&body=S&type=B&BN=1063 This legislation was introduced in hopes of reconsidering the law by allowing
independent practice of the advanced practice registered nurse (APRN) in the state of Pennsylvania. Pennsylvania law currently states that an APRN
must work under the direct supervision of a physician (Fairman, Rowe, Hassmiller, & Shalala,

Ensuring Access For Primary Care For Women And Children Act
Introduction
H.R. 2253– Ensuring Access to Primary Care for Women and Children Act was introduced to the house May 5, 2015 (Congress, 2015). The Bill
Sponsor is Rep. Castor , Kathy who is a member of the House Committee on Energy and Commerce, and member of The House Committee on
Energy and Commerce: Subcommittee on Health and was cosponsored by Rep. Speier, Jackie on May 12, 2015 and Rep. Kirkpatrick, Ann on July 7,
2015. The Bill was referred to the House– Energy and Commerce and House Committee on Energy and Commerce: Subcommittee on Health which
will consider it before sending it to the House floor for consideration (Congress, 2015). As of 9/19/2015 no amendment information for H.R. 2253–
Ensuring Access to Primary Care for Women and Children Act has been received (Congress, 2015).
Environmental
Even though Medicaid is a health insurance program for low income individuals, having coverage does not guarantee access to a physician and many
of these patients are going without needed care (American College of Physicians, 2015). In the past Medicaid has been known to pay well below what
private insurance and Medicare pays for primary care services and is one of the top reasons many providers do not participate in Medicaid (American
College of Physicians, 2015). "In 47 other states Medicare pays up to 67% less than Medicare for the same primary care services" (American College
of Nurse–Midwives, 2015). A study published in the New England Journal of Medicine states that

The Healthcare Industry of America; An investigative look...
The Healthcare Industry of America: An investigative look at HMO's
It's no secret that Health Maintenance Organizations, known as HMO's, have made healthcare affordable for many Americans, but at what risks?
Most employers offer some type of health care plan that is an HMO. Let's face it, given the choice among insurance coverage through your employer,
in which he pays half the costs, or acquiring private insurance coverage outside your employer, most Americans choose to go with employer–provided
HMO's. Why then, has there been so much controversy with HMO's?
An HMO is an organization whereby the subscriber, or patient, is allowed to choose a medical provider from a list of doctors within a certain medical
group. Each physician ... Show more content on Helpwriting.net ...
This process could take weeks due to cumbersome paperwork and the limited number of specialist per each group or health plan. Again, many doctors
only accept these plans to supplement their practices. It is common for them to stop accepting your HMO after only a few years which leaves the
patient a choice of either paying cash, or changing doctors or insurance companies. One can see why this might be a frustrating process.
Managed care reduces cost by keeping a pool of doctors and specialist to a minimum, and at the same time keeping the volume of patients high. This
often means that a patient may not receive the same amount of attention and care as they should, or were accustomed to. Consumers have long
grumbled that HMO's have done too much too keep health costs down by stinting on patient care.(1).
Healthcare expenditures have more than doubled since 1965. Americans spend over a trillion dollars a year on health care. (2). As of 1996, 110
million Americans were enrolled in HMO's. More than three–fourths of all individuals in HMO's are covered by job–based insurance. More than 13
million Medicaid recipients have been put into managed care plans. Managed care and HMO's have been the subject of many negative stories in the
press and are constantly being charged with endangering the health and lives of their enrollees. As a result, congressional hearing, state, and federal
regulation, and action by the

Essay on Emergency Room Overutilization
Emergency room over utilization is one of the leading causes of today's ever increasing healthcare costs. The majority of the patients seen in
emergency rooms across the nation are Medicaid recipients, for non–emergent reasons. The federal government initiated Medicaid Managed Care
programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the
issues and solved the problem? The answer is 'Yes' and 'No'.
Throughout the early 1980's and 1990's the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing
number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the ... Show more content on Helpwriting.net
...
It was also hoped that the number of uninsured people would dramatically decrease by offering Medicaid managed care coverage to low–income
families and individuals that were not Medicaid eligible. These services and coverage could be delivered through the Medicaid managed care carriers
and be covered by the cost savings.
States have chosen to two forms of Medicaid managed care to better deliver healthcare services besides the traditional fee–for–service Medicaid
programs; primary case management and traditional health maintenance organizations. "In primary care case management, the state Medicaid agency
contracts with a primary gatekeeper entity (e.g., physician, clinic) that coordinates primary and specialty care for Medicaid beneficiaries. For
healthcare maintenance type programs, a State Medicaid agency contracts with an existing healthcare maintenance organization, prepaid health plan, or
other institutional health care provider who, in addition to proving primary care services, assumes insurance risk of providing covered services.
Typically primary case management are paid on a fee–for–service basis plus a monthly case management fee per enrollee, while health maintenance
organization plans are paid a capitation rate and are at full financial risk." (1)
Once implementation of the program began, enrolling and educating the Medicaid population was one of the

Primary Care Physician Essay
With all of the specialists that exist in the medical field, the importance of having a primary care physician is often overlooked. Today, however, they
are still both relevant and important to your health care. The following are four reasons to have a primary doctor.
They offer a comprehensive approach to health care
A primary care physician is a generalist, so they approach your health from a more comprehensive point of view than a specialist does. The latter often
has a narrow area of medicine that they are practicing in. Although they can be an extremely important part of treating a health problem, because they
are focused on a specific problem, they can only address certain issues. Having a single, general practitioner looking at your

Cultural Influences Have Large Scale Impacts On Personal...
Cultural influences have large–scale impacts on personal decisions. You may decide to go out to a social event that you are not particularly interested in
just because you're expected to. In the medical education setting, cultural influences play an active role in decision making. During a medical student's
primary education, they often are forced to rely on mentors and staff to guide them through the grueling process. Many decisions are made, what to
specialize in? Do I go into private practice? With these important decisions at hand, the influence mentors have on students could not be more impactful.
Individuals trust practitioners with their lives, but is community health the determining factor for medical students when deciding the field of medicine
to practice? Should it be? I have decided to conduct my research on why primary care seems to be looked down upon in the medical school culture, and
the impact declining numbers of primary care physicians has on the community. I've also researched the Affordable Care Act's impact on public
health, and how this may increase the demand for primary care doctors even more so. This act is notable due to its political nature, and educating
oneself on the effects of policies could impact political and voting stances. It is interesting to investigate why primary care is discouraged in medical
school even though the field plays a sizable role in public health. For this trend to change, it is necessary to examine the cultural forces

Primary Care Physician
HCA–240 February 1, 2014 Vernon Thacker The Primary Care Physician Dilemma Today, the United States is facing a shortage of about 16,000
primary care physicians and this number will continue to grow by 2025 (Amirault, 2014). Primary care physicians (PCPs) are the doctors who focus
on overall health and offer the treatments and preventive screenings that save lives. A physician shortage is a situation in which there are not enough
providers to treat all patients in need of medical care. The Association of American Medical Colleges (AAMC) has long pointed out that the shortage
of primary care physicians will be a major setback for the American healthcare system advancing (Amirault, 2014). The shortage of primary care
providers presents... Show more content on Helpwriting.net ...
Even though the demand for primary care physicians is increasing, only about twenty percent of medical residents go into primary care (Amirault,
2014). In addition to the challenges of the primary care physician shortage, the shortage will also have a great impact on health care organizations
from a business perspective. The shortage will have a great effect because physicians are revenue makers for healthcare organizations. The care
primary care physicians provide translates into billable services that make up the organization's income. It is reported that the average physician
generates approximately $1.4 million in income for a healthcare organization (Amirault, 2014). Therefore, organizations operating with less primary
care physicians could experience significant revenue loss. For example, if a health care organization is short a single primary care physician it could
mean longer appointment waiting times for patients. This could result in patients choosing a different organization for their medical care and the
health care organization will lose money. The organization will be affected in other ways as well because fewer primary care physicians mean lower
patient satisfaction and quality of care. From a business perspective, the shortage of primary care physicians will

The Future Of Nurse Practitioners
Running head: PROFESSIONAL WRITING WILSON N432 The Future of Nurse Practitioners Lakeisha C. Wilson University of Mississippi
Medical Center School of Nursing PROFESSIONAL WRITING WILSON N432 The Future of Nurse Practitioners As the largest group of health
care professionals, nurses hold the key to effective health care system change. Without the nurses and their leadership skills and expertise, we know
that the efforts to address the challenges facing the healthcare system will be in vain. So much of what nurses do directly addresses health care reform
goals concerning better quality care for more people at a lower cost. Throughout the years nurses have made a tremendous effort to reduce the rates of
medical errors,... Show more content on Helpwriting.net ...
NP can perform comprehensive and focused physical assessments, diagnose and treat common acute and chronic illnesses, prescribe medications and
perform minor procedures in the office. NP can also work independently of physicians as allowed by state regulations. While focusing on several key
areas that are critical to the success in transforming to the new healthcare policy, the importance is in ensuring the efficiency in managing care for the
patients. With these changes, the nurse must be prepared to shape and lead the emerging PROFESSIONAL WRITING WILSON N432 environment to
achieve the highest quality outcome for patients and their families. Nurse Practitioners provides highly individualized preventive health care to patients
who cannot receive the proper treatment because of their financial situation. NP focuses on the patient's well–being and the illnesses that affect them
and their family. They make sure that the patients are well educated about their disease process while preparing an individualized care plan which
encourages the patients to become a part of their decision making process in their daily routine care. Although physicians and NP possess a similar
goal of improving patient's outcome, barriers to successful outcomes exist between them. With the expanding role of the NP many physicians have
voiced their opinions regarding patient safety while under the care of a nurse practitioner

Health Policy : Medicaid Expansion Of The Ppaca
Health Policy: Medicaid Expansion of the PPACA:
In the United States, there is an inequitable distribution of power, money, and resources that create health disparities among the different
socioeconomic classes (WHO, 2014). The PPACA was created to affect the social determinants of health through the Expansion ofMedicaid via the
PPACA. An example of health disparities can be seen with life expectancy across the difference levels of social economical levels. In theUnited States,
the upper class individuals live on average 20 years longer than those in the poorer classes (Marmot, 2005).
The federal government has created rules to expand Medicaid that include offering Medicaid medical insurance to all non–Medicare eligible individuals
whom are under the age of 65 with incomes up to 133% of the federal poverty level which is based on the modified adjusted gross income (MAGI)
(KFF, 2013).
Social Problem:
There is expected to be roughly 17 million individuals becoming newly insured through the Medicaid Expansion of the PPACA by 2019 (Carrier,
Yee, & Stark, 2011). The expansion of Medicaid will create a major supply and demand issue within the health care services. Simply put, the demand
for primary care services will exceed the capacity of the current primary care infrastructure. This will only add to health care spending because the
newly insured individuals will not have many options to obtain primary care services and they may be forced to use inappropriate services such

Acute Respiratory Distress Syndrome and Primary Care...
1. A physician is called to the intensive care unit to provide care for a patient who received second– and third–degree burns over 50 percent of his
body due to a chemical fire. The patient is in respiratory distress and is suffering from severe dehydration. The physician provides support for two
hours. Later that day the physician returns and provides an additional hour of critical care support to the patient.
2. A 23–month–old infant with a heart condition presented to the ED. The physician examined the infant and , after reviewing the patient's history of a
heart condition, ordered a transport to a specialty cardiac hospital. This specialty hospital is 150 miles away from the current hospital. The physician
accompanies the patient in ... Show more content on Helpwriting.net ...
The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness,
and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body
systems, which included all required elements. Medical decision making was of moderate complexity. 7. A full–term baby girl was born at a local
community hospital on 07/08, at which time the infant's APGAR scores were 9 and 10 and the normal infant was examined prior to her admission to
the nursery. On the second day of admission (07/09), the normal newborn was discharged home with her mother. Code the discharge.
8. Dr. Williams treated a 9–month–old new female patient in the office for diaper rash. An expanded problem focused history and exam were
performed, and MDM was straightforward. 9. A 72–year–old patient with a history of breast cancer has a suspicious mass in her uterus. A biopsy was
done. The determination was that the patient had a carcinoma in situ of the uterus. The physician who conducted the surgery called a face–to–face
meeting with his fellow surgeons, the patient and the patient's family and discussed the case and the patient's outcome for 30 minutes.
10. Dr. Martin provided 1 hour and 20 minutes of critical care services to Jack Smithton, age 64, who is in the Intensive Care Unit with acute respiratory
distress syndrome

The Importance Of Primary Care Physicians In Mississippi
An issue that concerns me for the state of Mississippi is the lack of primary care physicians and the lack of interest many medical students have in
specializing in a primary care field. Our state has one of the lowest primary care physician to population ratios in the country. Mississippians should
be more concerned about the future of healthcare in the state. In my county, there are only two primary care doctors and there aren't any in my town.
If I want to see a doctor for a walk–in, I have to drive 20 minutes out of my county to the closest doctor. The truth is, a vast majority of our primary
care doctors are over 40 years old and retiring fast with no one to fill their shoes. Many medical school students are opting to specialize in certain

The Affordable Care Act Of The United States Essay
The revised affordable care act was intended to solve the everlasting issue of how health insurance would be delivered and how it would be paid for.
The ACA requires everyone to have insurance. Public insurance was expanded and private insurance rates were subsidized. There are raises in revenue
because of the new taxes surrounding the ACA, and a cut in spending under the nation 's largest insurance plan, which is Medicare. Projecting the
impacts of fundamental reform to the health care system is filled with complicatedness. This brief describes these reforms and, where possible,
documents their initial impact at the ACA's five–year mark. Our report discusses the key results from that prior reform and what they might imply for
the impacts of the ACA. Introduction This report will analyze delivery and payment (financial) models in existence today after the implementation of
the ACA. The purpose of this report is to provide information on at least 5 payment models and different types of models that are implemented in the
healthcare organizations with our choice of health care industry The Health Maintenance Organizations, well–known as HMO, has made healthcare a
reasonably priced for numerous people here in America. What is an HMO? An HMO is an organization where the patient or subscriber is able to
choose a medical provider from a list of doctors in a certain medical group. Every medical doctor has signed an agreement to see patients at a reduced
rate. This kind of

Primary Care Shortage Paper
As defined by the Committee on the Future of Primary Care, "Primary care is the provision of integrated, accessible health care services by clinicians
who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in
the context of family and community." Primary care plays a key role in improving quality of health, containing cost, and overall quality of life. A strong
primary care foundation can be considered as one of the most consistent feature of successful health care system. For the same investment, those
countries that organize their health system around the principles of primary care, produce a higher level of health.
Having a primary care physician ... Show more content on Helpwriting.net ...
Another way of addressing the shortage is to expand the roles and numbers of primary care practitioners (PCNPs) providing primary care services.
However, both these options have pros and cons. Even though the Affordable Care Act provided limited funding and new motivations to increase the
supply of these clinicians, Congress denied to fund many of these provisions. Also, included in the rejected list of provisions, is the expansion of the
PCNP workforce through increased opportunities for interprofessional collaboration and education.

Nurse Managed Health Centers Essay
NURSE MANAGED HEALTH CENTERS AND PATIENT
–CENTERED MEDICAL HOMES COULD MITIGATE EXPECTED PRIMARY CARE
PHYSICIAN SHORTAGE Des Moines University ABSTRACT There has been an enormous focus on the impending increase in baby boomers
approaching the year 2025 and the predicted shortage of primary care providers. This focus has only increased with the implications the Affordable
Care Act has created through its provisions of increased insurance coverage for the uninsured. The numbers that are being predicted as shortfalls of
health care providers may be exaggerated under many estimates or under–represented in others. The authors in, "Nurse Managed Health Centers and
Patient–Centered Medical Homes Could Mitigate... Show more content on Helpwriting.net ...
The financing moreover staffing of long–term will remain a major challenge. (Shi & Singh 2015) This information is intriguing as the long term care
industry looks for alternatives to ensure individuals can stay where they want, as long as they want, with coordinated high–quality care. This level of
care will only occur through good communication, technology, workforce supply, financial provisions and resources, as well as overhauls of
regulations and the entire framework of the long–term care system. This study noted that one of the critical issues is that the scope of practice laws,
workforce supply and level of training as well as payment systems will have to change in order to be able to implement what the results of their
analysis have shown. However, it implies that alternatives are available to mitigate the impending shortages and surpluses in health care delivery.
Major Conclusions The authors came up with three main points that support their overall conclusions. These points included confirming what other
current forecasts have found. There will be large shortages across the nation in primary care physicians but surpluses of physician extenders or nurse
practitioners. (Auerbach, Chen, Friedberg, Reid, Lau, Buerhaus 2013) These results could be skewed based on timing, and new initiatives promoted by
the Affordable Care Act. The second point that this analysis showed is there are marked differences

Primary Care Physician Shortage: Case Study
Martin, Building a healthcare workforce pipeline is vital to offsetting the looming primary care physician shortage. In Tennessee, there are multiple
approaches to addressing that issue. The Tennessee Rural Partnership (TRP), an operating subsidiary of the Tennessee Hospital Association, actively
exposes high school students, medical residents and other healthcare students to rural often; so that they may understand the varied levels of rural that
will help them later make informed decisions about living and practicing in rural community. The TRP "matches clinicians with job opportunities
...[clinicians] committed to working in rural and underserved areas of Tennessee" (TNRP.org, 2016). This is crucial for some communities that are in
dire

Primary Care Physicians Scenarios
Healthcare is an evolving system in the United States; constantly changing as a result of regulations like the Affordable Care Act or because of the
large financial burden healthcare presents to many individuals. The system is moving from a fee–for–service system to one that holds healthcare
organizations accountable for the health outcomes of the individuals it serves. Certainly for the consumer, these changes are beneficial, but for a
healthcare organization, it can be like navigating a mine field, and for a new organization, there are numerous challenges. This paper will discuss the
implications of opening a primary care physicians group in the outer belt of Washington, D.C. The focus will be on office configuration, scheduling...
Typically this insurance is characterized with low monthly costs, but more than likely a high deductible plan that will lead this group to be more
conscious about overall healthcare costs; the opposite of those participating in a rich Medicare benefit plan. In addition, these groups will most likely
be cared for, or making healthcare decisions for at least one individual in the baby boomer cohort; therefore, their need for healthcare goes beyond
their personal needs. Not only are the individual healthcare needs of each generation significantly different, but so too are the ways they participate in
healthcare. According to Berkowitz (2011), the baby boomers take direction from physicians regarding care and medication, whereas, the other
generations tend to ask more questions regarding their care, and may forgo care if they determine the cost is more than their perceived benefit. For the
physicians group, embracing the differences each generation presents will be key to the long term survival of the

Essay about Managed Care
Managed Care
There are so many problems with our society's health care. Everyone wants to find a
solution, but no one has been able to come up with one yet. Many different things have been
tried, but none have put a cease to the exorbitant costs, which most believe to be the main
problem. Out of everything tried, the most recent and popular system is known as managed care.
Managed care is the most common form of health insurance in the United States, and provides
more a cost efficient coverage than paying a fee–for–service charge. However, it is also a very
complicated system. Over the next few pages I am going to try and go over the main parts of the
managed care structure. In the end, I am going to ... Show more content on Helpwriting.net ...
Although the goals have not yet been met, managed care has
continued to grow throughout the past four decades. At the end of 1996, there were over 600
HMO's in operation, enrolling around 65 million members, which is about 1/4 of the population
(Tufts 1998).
Before I get into the different types of managed care organizations, I am going to go over

some cost control methods in managed care. Managed care organizations are different methods
used to control utilization of services. Utilization management requires three things. First, you
have to have an expert evaluation of which services are medically necessary in a given case. This
ensures that unnecessary services are kept to a minimum. Secondly it requires a determination of
how those services can be provided most inexpensively, while maintaining a high level of
quality of care. It also requires a review of the process of care and changes in the patients
condition to revise the course of medical treatment if necessary. The methods that are most
commonly used for utilization monitoring and control are choice restriction, gatekeeping, case
management, utilization reviews, and practice profiling.
The first method I am going to talk about is choice restriction. Traditional health
insurance gave the insured open access to any provider. This led to an over use of services. Most
of the managed care plans have some sort of

Primary Care Physicians
licy Brief
February 28th, 201 Every year, the number of specialized doctors in the United States increases, yet the quality of care decreases and the costs
continue to skyrocket. Are the two correlated? Why is it that a large decrease in the amount of primary care physicians relates to a decrease in quality?
Although the Affordable Care Act of 2014 granted coverage to 20 million more people in the United States, the supply and distribution of primary care
physicians creates yet another health care access barrier for Americans. Disparities within cities and neighborhoods leave some people without
physicians within miles from their home.
This health policy brief calls the much needed attention to the lack of primary care physicians and ... Show more content on Helpwriting.net ...
For some reason, the doctor who knows about a given body part is often seen as superior to the doctor who knows about the patients as a whole. There
is a stigma that if a student decides they want to go into primary care healthcare that they won't have the lifestyle they deserve or that their hard work
through medical school wasn't worth it.
STUDENT DEBT: The cost of medical school education has been exponentially increasing for years. In 2008, 87% of the student would graduated
from medical school had debt. The average debt for student who attended a public school was roughly $145,000 while private school was closer to
$180,000 [5]. There is a huge disparity between the income of specialty and primary care physicians. This is important to consider because each
student is coming out with similar debt, and the smaller primary care income may be discouraging students from choosing that path because they have
so much debt. There may be a few variables to consider here. Students with little to no debt are most likely student who come from a higher
socioeconomic background, thus want to continue that high socioeconomic status so they don't go into primary care [6]. Secondly, students who do
have very high debt, usually lower socioeconomic students, will also chose not to go into primary care because their income

Primary Care Physician (PCP)
Family practice, general practice, internal medicine are all names for one kind of doctor–the primary care physician (PCP). For many people, having a
designated PCP is an insurance requirement, but it just makes sense for everyone to have one. The benefits far outweigh the disadvantages of
seeing your doctor annually. Your primary care doctor is dedicated to prevention of illness. During your annual checkup, your doctor will order
cancer screenings (like mammograms), as well as tests to check your cholesterol and to check for diabetes. If you do need to see a specialist, such as a
cardiologist or endocrinologist, many doctors require your PCP refer you to their office. The doctor will coordinate care all in one place. The specialist

The Shortage Of Physician Primary Care Provider
Prescriptive Authority The shortage of physician primary care provider, has created public awareness bringing about the demand of the advanced
practice registered nurses (APRNs). The APRN has the necessary training to assess, diagnose and treat patients. As the role of APRN begin to expand
the need to prescribe medications becomes very important. According to the American Association of Nurse Practitioners (AANP), APRN practice in
the United States is divided into three groups: full practice, reduced practice, or restricted practice. The scope of practice and prescriptive authority of
the APRN is determined according to state regulations (Gutchell, ldzik, & Lazear, 2014). Report according to Peck (2013), shows that... Show more
However variations occurs in states regulations with regards to prescriptive authority in terms of procedures and requirements that must be met by the
APRN, relationship with a physician if any to prescribe, and the scope of the APRN prescriptive authority to prescribe controlled drug (Joel, 2013,
p.125). In other to understand the variations between states regulations with regards to prescriptive authority, a comparison is made between the state
of Texas and the state of Nevada.
State of Texas Prescriptive Authority According to the Texas board of nursing, the senate bill 406 improved the prescriptive authority for advanced
practice registered nurses (APRNs) in Texas allowing them now prescribe medications in a facility–based practice settings under a protocol and in
other practice settings under a prescriptive authority agreement. In the state of Texas an APRN who has been issued full licensure and a valid
prescription authorization number by the Board of nursing may prescribe non–prescription drugs, dangerous drugs, and devices, including durable
medical equipment. If an APRN wishes to prescribe controlled substances, he or she obtains the authority to order and prescribe certain categories of
controlled substances. Having an advanced pharmacotherapeutics education is a must. APRNs in

The Affordable Care Act
GOAL STATEMENT
The goal of this policy brief is to support Alabama's current decision to continue Medicaid Primary Care Parity, as first enacted by congress in 2010
to all states under section 1202 of the Affordable Care Act (ACA). However, as Alabama is facing budget cuts to its Medicaid services, supporting the
"Ensuring Access to Primary Care for Women and Children Act" will extend federally fundedMedicaid primary care parity without harming the state
budget and negate the consequences of limiting Medicaid enrollee access and benefits. The federal government proposed to pay 100% of Medicaid
services mandated under section 1202, from 2013 to 2014, which has since expired in December 2014. This program requires certain primary care
services to be reimbursed at higher rates equivalent to those rates paid by Medicare for equivalent primary care services. Limited provider
participation, limited Medicaid beneficiary access & decreased enrollment of physicians, physician assistants (PAs) and nurse practitioners (NPs) into
primary care can be improved through this monetary incentive.
SCOPE OF THE PROBLEM
Medicaid has grown exponentially after healthcare was expanded under the Affordable Care Act. However, this did not guarantee an increase in access
to health care services, as many providers do not accept Medicaid beneficiaries, one of many reasons being low reimbursement rates. This discrepancy
in rate reimbursement is further underscored when compared to those

Primary Care And Health Care
Primary care, or day to day care, is expected to rise significantly over the next five years because of the increase in population as well as the aging
of an already staggering population. Also having some to do with the increase in health care is the expansion in health insurance. If the fundamentals
of primary care remain as they are, there is expected to be a shortage of 20,400 primary care physicians by the year 2020. If non–physician practitioners
are integrated into the system, such as in patient–centered medical homes, the stress that will be on the health care system will be somewhat alleviated.
In a study done by the US department of health and human services, national averages in areas where primary care physicians is well above
average their numbers will remain above average, while areas where the number of primary care physicians is well below average will be severely
struggling. Aging population and population growth accounts for 81 percent of the change, while the remainder is taken into account because of the
implementation of the Affordable Care Act. To help with the increase in health care services needed, primary care nurse practitioners is expected to
increase roughly 30 percent, and if primary care nurse practitioners would be integrated into the primary care health setting it could help alleviate up to
6,400 jobs by 2020. The institute of medicine reported that primary care physician shortages are based on the traditional health care delivery model,

Primary Care Physician Assistant: A Case Study
It is the indescribable bond between patients and their health care providers that drives me to pursue a career as primary care physician assistant.
While all health care providers should strive to connect with and relate to their patients, it is the privilege of primary care providers to form close
bonds with their patients that they may treat for the rest of their lives.
I am encouraged by the growth of physician assistants in primary care and strive to one day be a primary care provider myself. With changes in
health care, it is becoming increasingly important for patients to have a primary care provider that they trust and rely on, and a physician assistant is a
viable option for many families. One of the main focuses of the University

Factors Leading For Shortage Of Primary Care Physicians
Navya Motaparthi Midwestern State University HSAD 5013 Outline TITLE: Factors responsible for shortage of primary care physicians A)
Introduction: Shortage of primary care physicians An overview of primary care. A brief description of primary care physicians and their shortage.
Statistical and numerical analysis. Research Question – What are the factors that created the shortage of primary care physicians? Importance – Better
preventative care to the people Conclusion B) History of primary care and primary care physicians C) Ethical issues in shortage of primary care gap
D) Economic issues in primary care gap E) Summary F) Recommendations G) Conclusions Abstract The main objective of this research question is to
analyze the factors that led to the shortage of primary care physicians. The United States did not substantively address the primary care until the 1960s
when two noteworthy reports characterized U.S. primary care. The decline in the number of general practitioners led to the evolution of primary care
physicians in the past during the 1960s. Their role served many

Health Care Market Paper
The Health Care Market The health care market comprises of various aspects which including delivering adequate care, keeping up with the supply
and demand of health care products, cost, and provider reimbursement to list a few. Like any other industry, this is not without risk, one of the key
issues is the loss of revenue which is a constant problem. There are also controversial matters that affect the business such as the advantages and
disadvantages of HMO for the physicians and patients. There are many components of the health care market; nonetheless, the overall objective is the
same which is to deliver care at an affordable cost while meeting the needs of the consumers. The State of Georgia Health Care Delivery The state of
Georgia faces... Show more content on Helpwriting.net ...
Consumers must choose a primary care provider, and some prefer not to have limits on the doctors they can see or may find that the doctor they prefer
is not in–network. Referrals are required to see a specialist that the must get from their primary physician. Due to the cost–saving efforts patients, may
also be denied necessary treatment because of its cost. There are also limitations placed on which labs and hospital they can use for diagnostic testing
and treatment. Healthcare is expensive; consequently, for some consumers, the cost is the determining factor why many prefer HMO plans. On the
other hand, the strict guideline and restrictions is a deterrent for many causing them to choose other methods that allow more

Primary Care Physicians Toward Corporal Punishment Analysis
Parents must gauge the degree of severity of misconduct to fairly judge which punishment to use to teach appropriate behavior and develop respect.
Family and child psychologist, Dr. McCormick stated in the article "Attitudes of Primary Care Physicians Toward Corporal Punishment" in the Journal
of the American Medical Association that "Most family physicians and pediatricians support the use of corporal punishment... and agree that children
should be spanked if they misbehave" (Andero and Stewart 92). Having pediatrician support and advice is important in helping parents set boundaries
and expectations so that children are aware of these prior to wrong–doing and can continue to respect their parent's wishes. Where spanking does
reinforce acceptable

The Mandatory Regulation Of Nurse Practitioners
New York has joined 16 other States and the district of Columbia in the abrogation of the mandatory regulation that required nurse practitioner to
deliver primary care under the supervision of a physician. Dr. Jauhar, explained that the reason behind this law is due to the scarcity in the expanse of
primary care physicians. He argued that Nurse Practitioners are thought to be cost–effective because they are remunerated lesser than medical doctors,
however, that's not the case Mr. Jauhar elaborated that Nurse Practitioner, though an asset tomedicine, aren 't equipped with enough training and clinical
hours to practice self–sufficiently. For example, research from 1999, determined that nurse practitioners ordered more diagnostic test such ... Show more
In his closing remarks, he makes an authoritative and disparaging statement that primary care providers should be doctors and an increment in salary
will attract the best from medical school. This suggest that money is force as to why individuals become physician and patient care is the reason why
individuals enter the field of nursing. Overall, sentences are well structured and is easily understandable to the audience who are not in the healthcare
field.
There is no falsehood that there has a been a shortage in primary care physicians. Petterson, Liaw, Tran, & Bazemore (2015), anticipated a shortage
of over 33,000 primary care physicians by 2035. The American Association of Nurse Practitioners (2012) describes Nurse practitioners as registered
nurses who have innovative knowledge, enhanced clinical training and have completed graduate or doctoral degree from an accredited institution.
Nurse practitioners are contributing tremendously to the field of nursing and health care by providing high quality primary care especially to low
income and minorities nationwide. In reference to Ryan & Rahman (2012), in rural communities, there's a high demand for primary care and a
shortage of primary care providers, however, nurse practitioners are willing to fill the void and provide health care services such in communities even
when physicians are unwilling.

Primary Care And The Patient Protection And Affordable...
Primary Care and the Patient Protection and Affordable Care Act Introduction: The Patient Protection and Affordable Care Act is a comprehensive
health reform bill that was enacted on March 23, 2010. Considering it as a landmark change in health policy, it is anticipated that, "the new law will
have an immense impact on the US health care reform and policy".1 With modern advances in science and technology and their applications, America
is expected to be a pioneer and leading country in the world in disease eradication, increasing longevity and providing a better quality of life for her
citizens.1Unfortunately, the real picture isn't the same. According to the commonwealth fund survey 2014, USA ranked the last and worst amongst 11
other developed countries including UK, France, Australia, Germany, Canada, Sweden, New Zealand, Norway, Netherlands, and Switzerland in terms
of efficiency, equity and outcomes instead of having the world's most expensive health care system.2 So, the imperatives for a change in health care
system were urgent. The new Affordable Care Act (ACA) contains different policies and almost all of them are pertinent to expanding health care
access when needed, shaping insurance and market system, improving quality of care and life, promoting preventive services and extending the health
workforce or reducing the financial burden. One important policy component of the ACA under 'improving quality/health system performance' is
'Primary

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