Recruiting for primary care

Article Abstract:

Economic incentives rather than federal regulations or curriculum reforms may be more likely to increase the number of medical students who choose primary care as a career. Fifty percent of all doctors should be primary care physicians, but in the US, only 20% will be, according to projections. Some educators believe that curriculum reform will encourage more students to choose primary care. However, some reforms have been in place for decades while student specialization increased. It may be unrealistic to increase general practitioners' salaries, but it is certainly feasible to redistribute physicians's salaries so that primary care physicians are paid more and specialists are paid less. Placing primary care physicians in charge of a patient's health care could reduce costs because primary care physicians order fewer tests and procedures.

Compensation and benefits, Family medicine, Training, Career choice, Physicians (General practice), General practitioners

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Social, institutional, and economic barriers to the exercise of patients' rights

Article Abstract:

Many outside factors undermine patient rights, such as available choices of treatment and access to information about recommended medical care. Contrary to the principle of autonomy, patients may not be informed about their doctor's HIV infection or drug abuse. Many people eliminate choices by receiving delayed care, often due to a lack of health insurance coverage. Managed care interferes with the standard patient-physician relationship by introducing business ethics to medicine. Limiting medical care for economic reasons translates into few or no choices for the patient. Physicians, procedures, referrals, laboratory tests, and diagnostic tests are no longer freely available elements of medical care. Patients and physicians are both subject to controls undermining the right of informed consent in the quest of reducing health care costs.

Health aspects, Management, Medical economics, Column, Ethical aspects, Health maintenance organizations, Informed consent (Medical law), Informed consent, Patient advocacy

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Quality and equity in dialysis and renal transplantation

Article Abstract:

The federal government must ensure that all dialysis patients receive adequate care whether they are treated at a for-profit dialysis center or a non-profit center. Medicare pays for much of the dialysis care received by people with end-stage kidney disease. A 1999 study found that mortality rates were 20% in patients treated at for-profit dialysis centers compared to non-profit centers. Patients at for-profit centers were less likely to be placed on a waiting list for a kidney transplant. Many centers have cut costs because the Medicare reimbursement for dialysis has decreased since 1973.

Care and treatment, Editorial, Hemodialysis patients, Hemodialysis facilities, Dialysis facilities

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