Wednesday, August 17, 2022

Staffing again: The Next Level

One factor driving call volume is that doctors' offices are overworked as well.

Members call because they need to change their primary care provider when the assigned one can't get them in until November. Maybe they got a referral to a specialist, but the specialist can't get them in.

I can't say that the only issue is a doctor shortage. When COVID first hit, many non-emergency surgeries were postponed, partly for safety and partly because hospitals were full. There could be some residual backlog from that. Once a backlog starts it is hard to get out.

However, we have also lost doctors and nurses to COVID. Some have died, some may now be disabled, and some are just burnt out.

I believe I made it pretty clear in the last post that I support universal health care. That doesn't need to be Medicare for all (there are ways in which Medicaid for all might be better), but there should be something.

However, we could probably change that structure far faster than we can change the amount of health care providers out there, and we will need more. 

I referred in an earlier post to the two months required for training for my job, but also then the time and experience required before you become adept. That affects the ability to make change.

What if the training takes eight years? (Depending on how you count it.)

What if that training is becoming more and more financially inaccessible?

Astronomical debt may increase stress in a way that contributes to burnout, but that's assuming someone still takes it on. How many people who would make great doctors are just deciding that it's out of reach?

The current system has its flaws; there can be some really good arguments for a training process that requires less sleep deprivation and substance abuse and the complete takeover of one's life. Changes that make the process better for the learners won't necessarily get them through faster.

Even Navy corpsman training takes fourteen weeks.

There are things we can do. 

College used to be a lot more affordable, and we should get back to that. It still takes time.

You have probably seen nurse practitioners and physician assistants doing more. That can be helpful.

We might be able to do a crash course, where lots of people take something similar to the corpsman training, and then work in association with medical doctors. Locating candidates, setting up training, and arranging places for them to practice also requires work.

Infrastructure isn't just roads and power lines. 

There is a lot that goes into a functioning society, but the giant first step is deciding priorities.

Do we want people to be well? When you're sick, do you want to be able to get care? When your mother falls, do you want her to have wait a few hours to be treated? 

For people you don't know, can you believe that they should also be able to receive medical care?

If not, is your sense of well-being wrapped up in other people not having their needs met in demonstration of the fact that you are worth more?

And just in case I have not spelled out enough complications, there is one more thing driving calls.

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