Foreign-Trained Docs as Good as US Physicians: Study -> 去美國執業嗎? 這是一篇政治正確的文章!
國外訓練的醫師不會比較差，even better!
麻姐不會比較差，even better!
MBA的想法，供應鍊要cost down, 就用成本低的來取代
不是第一線的醫師通常會覺得沒錯
但是對一個first line doc而言
對地方的鄉土民情不瞭解，
通常就會做一大堆無謂的檢查
waste a lot of medical cost
然後，even a wrong diagnosis coming out
無謂的檢查是有風險的，to patient/ to doc / to NHB
黃達天也說過一樣的話，這是政治正確的
both governments wanna to cut medical costs
不同的是，our government 已經砍到骨頭了
WASHINGTON (Reuters) Aug 03 - Physicians trained in other countries provide care just as good as U.S. doctors, according to a report to be released today.
And a second report found that nurse anesthetists can safely provide care without doctors supervising them.
Both reports, scheduled for publication in Health Affairs, suggest ways to help provide care to more Americans at potentially lower cost, just as healthcare reform promises to extend health coverage to millions who do not have it.
"Despite a rigorous U.S. certification process for international graduates, the quality of care provided by doctors educated abroad has been an ongoing concern," said John Norcini, president of the Foundation for Advancement of International Medical Education and Research, who led the study.
Norcini's team analyzed 244,153 hospitalizations of patients with congestive heart failure or acute heart attack in Pennsylvania who were treated by either a U.S.-trained or foreign-trained doctor.
Patients of foreign-born international medical graduates had the lowest death rates. Patients of U.S. citizens who attended medical school in other countries had the highest death rates. U.S.-born and trained doctors fell in the middle.
"These findings bring attention to foreign-trained doctors and the valuable role they have played in responding to the nation's physician shortage," Norcini said.
"It is reassuring to know that patients of these doctors receive the same quality of care that they would receive from a physician trained in the United States."
He said 25% of all doctors practicing in the United States are educated abroad.
The study also found that experience did not always mean the best care. The longer it had been since a doctor left medical school, the worse the rate of death and complications requiring patients to stay in the hospital longer.
"Ongoing training programs and periodic reassessment of doctors' knowledge and skills can help maintain the level of physician competence needed to deliver high quality health care," Norcini said.
The second study looked at the care provided by nurse anesthetists.
"Nurse anesthetists get essentially the same training in anesthesia as anesthesiologists. So in this case, a nurse is just about a perfect substitute for the doctor," Jerry Cromwell, a health economist at the Research Triangle Institute in North Carolina who led one study, said in a statement.
"Eliminating physician supervision will not only allow nurses to do what they are trained and highly qualified to do, but it will encourage hospitals and surgeons to use a more cost-effective mix of anesthetists."
Cromwell and colleague Brian Dulisse analyzed 481,440 hospitalizations covered by Medicare. While more nurse anesthetists cared for patients during surgery between 1999 and 2005, there was no increase in poor outcomes.
SOURCE: Abstract
Health Affairs 2010.
麻姐不會比較差，even better!
MBA的想法，供應鍊要cost down, 就用成本低的來取代
不是第一線的醫師通常會覺得沒錯
但是對一個first line doc而言
對地方的鄉土民情不瞭解，
通常就會做一大堆無謂的檢查
waste a lot of medical cost
然後，even a wrong diagnosis coming out
無謂的檢查是有風險的，to patient/ to doc / to NHB
黃達天也說過一樣的話，這是政治正確的
both governments wanna to cut medical costs
不同的是，our government 已經砍到骨頭了
WASHINGTON (Reuters) Aug 03 - Physicians trained in other countries provide care just as good as U.S. doctors, according to a report to be released today.
And a second report found that nurse anesthetists can safely provide care without doctors supervising them.
Both reports, scheduled for publication in Health Affairs, suggest ways to help provide care to more Americans at potentially lower cost, just as healthcare reform promises to extend health coverage to millions who do not have it.
"Despite a rigorous U.S. certification process for international graduates, the quality of care provided by doctors educated abroad has been an ongoing concern," said John Norcini, president of the Foundation for Advancement of International Medical Education and Research, who led the study.
Norcini's team analyzed 244,153 hospitalizations of patients with congestive heart failure or acute heart attack in Pennsylvania who were treated by either a U.S.-trained or foreign-trained doctor.
Patients of foreign-born international medical graduates had the lowest death rates. Patients of U.S. citizens who attended medical school in other countries had the highest death rates. U.S.-born and trained doctors fell in the middle.
"These findings bring attention to foreign-trained doctors and the valuable role they have played in responding to the nation's physician shortage," Norcini said.
"It is reassuring to know that patients of these doctors receive the same quality of care that they would receive from a physician trained in the United States."
He said 25% of all doctors practicing in the United States are educated abroad.
The study also found that experience did not always mean the best care. The longer it had been since a doctor left medical school, the worse the rate of death and complications requiring patients to stay in the hospital longer.
"Ongoing training programs and periodic reassessment of doctors' knowledge and skills can help maintain the level of physician competence needed to deliver high quality health care," Norcini said.
The second study looked at the care provided by nurse anesthetists.
"Nurse anesthetists get essentially the same training in anesthesia as anesthesiologists. So in this case, a nurse is just about a perfect substitute for the doctor," Jerry Cromwell, a health economist at the Research Triangle Institute in North Carolina who led one study, said in a statement.
"Eliminating physician supervision will not only allow nurses to do what they are trained and highly qualified to do, but it will encourage hospitals and surgeons to use a more cost-effective mix of anesthetists."
Cromwell and colleague Brian Dulisse analyzed 481,440 hospitalizations covered by Medicare. While more nurse anesthetists cared for patients during surgery between 1999 and 2005, there was no increase in poor outcomes.
SOURCE: Abstract
Health Affairs 2010.
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