Doctors, nurses and urgent care centers address increasing demand

The (Lynchburg, Va.) News and Advance reports on doctor shortages in Virginia: "Attracting more physicians to the area, and keeping them, is a challenge that has become more urgent. So much so that Centra is in the midst of creating a formal Physician Recruiting Office, where staff will work to convince physicians to consider coming to Lynchburg for their residency or to practice. The need is expected to grow locally and nationwide. Studies released last month predict a significant shortage of doctors across the country over the next 15 years. At the same time, Virginia has a more difficult time retaining new doctors than many other states, with only about a third of graduates from the state's medical schools choosing to stay in the commonwealth, according to a study from the state's Healthcare Workforce Data Center. That ranks Virginia 30th out of 45 states in the percentage of physicians remaining in state after medical school" (Trent, 10/25).

The Wall Street Journal: "New Jersey health officials may let specialized nurses sedate patients in hospitals without a doctor present, an idea that has angered many physicians statewide. Current rules require nurse anesthetists to work under direct supervision of an anesthesiologist. Now the state health department is proposing to let the nurses work unassisted, provided there's a plan to reach a doctor if necessary. Professional medical associations argue that nurse anesthetists—who are registered nurses with graduate degrees—don't have enough training to know how to handle every emergency when a patient is sedated. Amending the state rules, they say, would invite complications and put patients at risk. … About 30 states let nurses with specialized training in anesthetics work without physician supervision and 17 have some supervision requirement, either in hospital, nursing or medical licensing laws or regulations, said Christopher Bettin, spokesman for the American Association of Nurse Anesthetists" (Sataline, 10/23).

MSNBC reports on the rise of urgent care clinics amid increasing demand on primary care physicians and emergency rooms. MSNBC describes urgent care as "the health care equivalent fast food" and examines quality issues around the care (Costello, 10/24).

Crain's Detroit Business: "Detroit Medical Center has formed its first ever physician-hospital organization and has applied for the physician group incentive program with Blue Cross Blue Shield of Michigan. More than 500 doctors, including private physicians on the DMC medical staff and about 75 physicians employed by DMC, paid a $250 annual fee to join the new DMC PHO, said Steven Grant, M.D., its executive director and DMC's executive vice president of physician partnerships. … The DMC PHO, which is a joint venture between DMC and participating physicians, is designed to engage in business ventures and quality improvement efforts" (Greene, 10/24).