There has been a rising supply of nurse practitioners and physician’s assistants for office-based physicians. Many office-based physicians are creating specific job descriptions to land the candidates they desire. NPs and PAs are becoming more specialized, making them desirable to single specialty, multi-specialty groups and primary care practices alike. Looking for physician extenders in general seems to have been much less of a challenge for practices this past year. Assisted recruitments were down dramatically in 2002 compared to the previous years, according to an annual report by Allied Consulting, Inc., a professional recruitment firm affiliated with the recruitment firm Merritt, Hawkins and Associates. Salary ranges for nurse practitioners and PAs appear to be rising. Even with higher salary ranges, however, these professionals still appear to be a major asset to practices. Nurse practitioners and physician’s assistants may be able to generate revenue at a pace close to that of a physician at a considerably lower salary. They also can receive Medicare reimbursement at 100% of the physician fee schedule if they bill under the physician’s provider number, or at 85% if they bill independently.

The number of PhD Degrees awarded in science and engineering has fallen off since the mid-1990s, with only the life sciences holding their own. From the perspective of long-term global competitiveness, the data reveals a potential cause for concern: only 59% of science and engineering PhDs granted by U.S. universities went to American citizens (see Table 3).

Circulatory system disorders account for 12% of social security disability payments.

As Healthcare costs and building projects increased throughout the United States, many are looking at other countries to see what they are doing for provision of healthcare services. The following table shows some interesting statistics relevant to the European community.

Once derided as potentially offering second-class medicine, the Veterans Health System has made some significant advances in recent years. It has developed a model program for computerized tracking of patient care designed to lower cost and reduce medical errors. At a time of rising health costs, the VA’s per patient spending is coming down: from $5,019 in 2001 to $4,928 in 2002. Medicare is going in the opposite direction: from $6,214 in 2001 to $6,604 in 2002. The number of Veterans enrolled in the Department of Veterans Affairs (DVA), healthcare system has been rising.  The numbers of Veterans visiting VA facilities for outpatient treatments is rising, reflecting greater demands for care, increased emphasis on non-hospital care, and growth in the number of clinics. At the same time inpatient care is declining.

Off pump, beating-heart coronary artery bypass graft surgery continues to have major impact on cardiovascular surgical practice. While considerable debate exists concerning the efficacy of the technique and skepticism expressed by some; the tide has been turning in favor of off-pump bypass surgery.  Off-pump bypass appears to be much more appealing to “the customer”.  In a consumer-driven environment, patients appear to be asking for this type of surgery on a more frequent basis. The Table below shows a recent study by Solucient performed in 2003 looking at the prevalence of off-pump surgery.  

Many people think that American consumers use the Internet as the prime source for healthcare information. However, a recently reported study would suggest that only 38% of adults, or 72 million people have sought healthcare information in the previous year from a source other than their doctor (see table). In contrast, 60% of American adults fail to seek any health information, suggesting significant challenges still exist in educating consumers. Only one in six consumers turn to the Internet for health information (16%) or 30 million adults. In contrast, nearly one in four adults relied on books or magazines for information (23% or 44 million adults), and another 20%, or 37 million adults turn to friends or relatives. Only a small segment of consumers is quite active in pursuing health information: about one in five adults use multiple sources to obtain health information.

1. Web based learning solutions have proliferated in healthcare over the past few years. According to recent reviews, there are apparently more than 11,000 CME courses offered online for a total of more than 20,000 credit hours. Online education exists in a variety of prices and formats. Eighty percent of the 20,000 CME hours cost less than $15 per credit hour. Interestingly, online CME still represents only 5% of the total CME views continuing medical education (CME).
   
   
2. Americans are living longer and becoming more health conscious, while at the same time becoming more chronically ill, according to the National Center for Health Statistics. Overall, U.S. life expectancy in 2001 was 77.2 years, an increase of nearly four months from 2000. People also were spending more on healthcare. The percentage of children classified as “overweight” increased from seven percent in the late 1970s, to 15% in the late 1990s. A similar increase was also seen in adolescents. The most significant trend is the rise in diabetes, which in 2002 afflicted 6.5% of adults.

With over twenty-five years of clinical and business experience, we have worked with physician practices, hospitals, health systems, academic medical centers and healthcare businesses in 48 states.  With focus on strategy, new business development and performance improvement, we specialize in integrating the business and clinical aspects of healthcare.Some of our current projects include:

1. Development of Heart Centers/Heart Hospitals, Enhancement of Cardiac Service Lines and Vascular Centers, Development of Strategic Alliances and new marketing plans for Heart & Vascular Programs
   
   
2. Strategy and market development for hospitals, health systems, clinical groups, and other healthcare businesses
   
   
3. Group practice management enhancements and clinical practice assessments
   
   
4. Facilitation and leadership programs/educational forums for healthcare industry executives, trustees, directors and clinicians
   
   
5. Business enhancement strategies for emerging healthcare companies and healthcare related businesses
   
   
6. Executive and career counseling for physicians and healthcare executives