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The Future of the Health Care Workfarce in America: Is it Supercalifragilistic Neurodiagnostic?

ASET annual meeting, August 2013

Fred Lenhoff

on 1 August 2013

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Transcript of The Future of the Health Care Workfarce in America: Is it Supercalifragilistic Neurodiagnostic?

The Future of the Health Care Workfarce [sic](k):
Is it Supercalifragilistic Neurodiagnostic?

Fred Donini-Lenhoff, Health Professions Network (HPN)
August 1, 2013
ASET Annual Meeting
Where I live…
Fred Donini-Lenhoff
Medical Education
Communications Director
American Medical Association
515 N State St
Chicago, IL 60654
312 464-4635
312 464-5830 Fax
“There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don't know. But there are also unknown unknowns. There are things we don't know we don't know.”
- Donald Rumsfeld
Where's the beef?
The "big" picture
Those three little words
22 percent of Americans incorrectly believe that health care reform has been repealed
26 percent aren’t sure
19 percent say, “Can I get fries with that?”
Patient Protection and Affordable Care Act
(cc) image by anemoneprojectors on Flickr
The solution(s)?
Road map
I. The "system"
III. The problems
Challenges in allied health
Educational staffing, resources, clinical sites
Workplace: Recruitment, retention, retraining
Need for accurate, timely, & specific data
Legislative and regulatory issues
Sufficient economic support, funding
Uneven distribution of workforce in rural, urban settings
Inadequate diversity
Safety culture and the medical hierarchy: “Who's right, not what's right.”
Challenges for ND techs
Clinical site shortages
Not enough techs
Maldistribution of techs
Not enough schools
Lack of state licensure
Scope of practice issues (chiropractic and audiologists)
Need more?
Buy-in by HR, hospital management
Practitioners are aging
Lack of respect, recognition, understanding of role
Lack of career pathways—ladders and lattices
Few enticements, rewards for professional development
Gap between education of physicians and ND techs
What's in a name?
The cocktail party test
R.I.P. "Electro"
Sleep techs
Neurology technicians?
Brain/nerve study technicians?
“Who's taking care of your brain?”
Journal of Allied Health, 2008:

Coming together, moving apart: A history of the term “allied health” in education, accreditation, and practice
Bottom line
Together we are stronger
It's all
"Got lemons?" Well...
Collect nationwide data, state by state
Show that quality of personnel has impact on bottom line (and patient safety)
Publish these data
Use the data to support advocacy goals
Jump on the CER bandwagon
Get y'all
some data
Get right
with the feds
Acute care to chronic care?
Hospital-based to ambulatory models?
Patient-centered medical home
Accountable Care Organizations
More care, or more quality?
("The problem is that volume drives revenue; one person's waste is another's income")
Teamwork, cultural competence
From specialization to generalism?
From alphabet soup to standardization?
Put on your futuro-ray spex ($3.99)
Get y'all
some pardners
Get y'all's
"In many ways, the history of allied health mirrors the history of medicine, with its marked trend towards increased specialization and subspecialization, in response to advances in medicine and medical technology. As the allied health professions continue to grow and develop separate identities and greater public awareness, the challenge will be to maintain cohesion and collaboration among the professions. Without a strong, unified voice in the policy arena, all allied health professions—particularly smaller professions with less visibility and lower educational requirements—are at risk of reduced federal/state funding for health care workforce development and education."
Physicians and physician organizations
Health Professions Network
Other allied health groups ("Kum ba ya"?)
Legislators (hey, they're people, too!)

Some faculty members who belittle students still win teaching awards with amazing regularity.

1933 Occupational therapy
1934 Medical technology
1935 Physical therapy
1943 Health information administration
1944 Radiography
1972 The "END"
1994 The real End: CAHEA has left the building!

I am lost
Let’s get directions
Here’s the remote

Yogi Bear
"It's hard to predict anything -- especially the future."
• They can spit
• Don’t like to be touched
• Extremely hardy
• Lifespan of 20 years
• Some people spit at it
• Gets people touchy
• Extremely hard to understand
• Could outlive us all

Alpaca vs. PPACA
• Costs, reimbursements
• Patient safety/quallity
• Hamster health care *
• Workforce shortages *
• Disparities
• Graying of America
• Widening of America
But this I know...
Blue states
red states
Me and Rummy ain’t the only ones who don’t know . . .
II. The workfarce
"Allied health"
(whatever *that* is...)
About 100 (~) allied health professions total
The “hidden” health care workforce
About 60% of US health care workforce
Many fields have shortages
Many require only 1 or 2 years of colleges
Everyone except MDs and nurses?
Everyone except MODVOP fields?
Physical therapy? Occupational therapy?
Home health aides and OJT fields?
Athletic Trainer
Cardiovascular Technologist
Emergency Medical Technician-Paramedic
Medical Assistant
Orthotist and Prosthetist
Polysomnographic Technologist (zzz)
Respiratory Therapist
Surgical Technologist
Michael Wayne Adams (Virginia)
Timothy Wayne Adams (Texas)
Shannon Wayne Agofsky (Texas)
Thomas Wayne Akers (North Carolina)
Matthew Wayne Almand (Florida)
Stephen Wayne Anderson (California)*
Joshua Wayne Andrews (Virginia)
David Wayne Arisman (California)
Dennis Wayne Bagwell (Texas)*
Timothy Wayne Barnett (Alabama)
Michael Wayne Baxter (Maryland)*
Kenneth Wayne Beck (Missouri)
Wayne's World?
Career: 9 to 5 focus
Job: 5 to 9 focus
National public service announcements (work with HPN, HOSA)
Like the Johnson & Johnson Campaign for Nursing's Future
Social media--be funny, be memorable, get viral! ("This is your brain on... ?")
Like medicine, change how you select students (career vs a job)
Quality, safety, accountability, cost effectiveness, excellence
Dirty little secret...
Medicine . . . doesn't . . . matter . . .
"We can't look at health in isolation. It’s not just in the doctor’s office. It's got to be where we live, we work, we play, we pray. If you have a healthy community, you have a healthy individual."
Regina Benjamin, MD
It takes a village. . . and, a barber shop?

Barbers helping shave rates of hypertension.
Barbers used to be surgeons: Today, barbers in the African-American community can help counsel clients about managing blood pressure.
Cedric the Entertainer says it best:
"If we can’t talk straight in a barber shop, where can we talk straight?!”
AMA president Cecil Wilson, MD, speaking at HPN meeting in 2009: 50% of health issues come from lack of personal responsibility
(20% environmental factors, 20% genetics).
Social determinants of health (public health):
Eating well, staying active, not smoking
Access to socioeconomic opportunities
Clean, safe, healthful homes, schools, neighborhoods, workplaces
Cleanliness of our water, food, and air
Our social interactions and relationships
Full transcript