Where are all the psychitrists?

Seeing the devastation of New Orleans certainly had a sobering affect on me. I had thought after two years things would be back to normal, but boarded-up and gutted houses was what I had been warned about.

What I didn't expect to see was a lack of mental health professionals. If ever there was a supply of people needing help, it is in post-Katrina New Orleans. Read more here including Dr. Kevin Stephens' comment that "we have a lot of post-traumatic stress. We have a lot of depression. We have a lot of suicides. We have a lot of challenges in terms of mental health. And, in fact, a lot of people self-medicate by using alcohol and other drugs."

The professionals we visited certainly validated this over and over again.

In talking with one nurse at the PACE Center, she told of how people just needed to talk--to tell their story, and what they had experienced.

Learning to listen. Taking time to listen. Maybe if all of us did a better job of listening to the needs and concerns of others around us, we might help them through the difficulties they are facing.

Eye Doctors alive and well

Ophthalmologists spent the first 20 minutes of their annual meeting in New Orleans talking about politics—not eyes. Powerpoint slides outlined the group's lobbying efforts to stop the 10.1 percent fee cut in medicare legislation pending before the United States Senate.

Who can blame them though? These physicians went to college and medical school and did residencies and fellowships--all to have the federal government threaten yet another cut to services they provide for older Americans in particular: cataract surgery, AMD treatment, and Glaucoma.

They quickly moved on to the latest procedures, drugs, and experiments that will prevent blindness, and help Americans be able to see better and longer: something they would rather be doing than lobbying the US Congress.

Dentists are in the health workforce too

Dental, or oral health, is often overlooked. Would it surprise you to know that tooth decay is the single most common chronic childhood disease; five times more common than asthma. Untreated tooth decay has been associated with eating, learning and speech problems and diminished self-esteem in children, a Kansas website reported Saturday.

The Mercy Clinic has a "dental day" every Friday for those who qualify. I was pleasantly surprised to see that Dentists in the Athens area have been more responsive than doctors at giving their time to the Mercy Clinic. With dental work like "fillings" and "root canals" being very expensive these days, this is a wonderful service to provide.

The American Dental Association has a ton of reports on the state of the dental workforce in America. See more at www.ada.org

Dental insurance policies are usually not a great deal, and most people do not have them. Therefore, we often wait to go to the dentist when there is problem. When is the last time you had your teeth cleaned? Maybe you should make that appointment this week.

Health Care Down Under

"There is a workforce crisis, not only affecting emergency specialists but also surgeons, psychiatrists, rural doctors, nurses and other health workers. We need to know that there is a workforce plan. At present there is none because politicians don't know what sort of health service to provide," said Dr. Tony Joseph, an Australian physician on Friday.

Government-run health care is ultimately politician-run health care, and bringing this to the US is not going to solve all of our problems. We need to look carefully at what is happening in Australia, Canada and Europe before we assume that this is best for America. All of us in this great country need to work and advocate for the health and welfare of our fellow man. Our class speakers and articles continue to show us the great need out there. Saying healthcare is a "right" and then tasking the government with delivering it is one solution, but maybe not the best.

Maybe the next 8350 class can take a trip to Canada or Italy and see first hand if government run health care is all it is cracked up to be.

In other health workforce news, women doctors are on the rise in Canada. From 2002 to 2006, females in the workforce increased 13 percent compared to only one percent for males. Wow, this sounds like Public Relations here in the US. Women are taking over.

Read more about what is happening in Canada here. In fact, the study referenced shows that women in Canada make up over 48 percent of physicians under the age of 40.

Note to females in class--no hidden message here.

Everything is bigger in Texas

Last week as I debuted my safety-net clinic feature story, I cited a study in Dallas, Texas comparing two geographical areas and how the safety-net clinic there is decreasing costs, stays in the hospital, and numbers of visits.

What I did not say, but have found out since, is that there is an aggressive legislative agenda in the Texas Legislature to move more of the state's uninsured into some kind of health coverage. Read more here.

One positive result is that 3100 new healthcare jobs were created in the workforce in Texas last month alone. Read more in the Star-Telegram. While the article doesn't attribute the legislation with creating the jobs, there are many lawmakers and policy leaders who are obviously working hard to bring effective solutions to the table. This is in contrast to some states who have put a lot of the "eggs" in the SCHIP basket, and now find themselves in a crisis.

Yes, this is a plug for states-rights and limited government (federal) and a reminder that local governments are most effective at serving the needs of their people. States are required to balance their budgets, but the Federal Government is not. Finding "state" solutions within current state budgets is good for the state, and good for the country.

I write this blog from Washington DC, having ridden the metro with thousands of federal employees over the last few days. The Federal Government is huge and costly and bureaucratic--and those or look to it to be their mother or nanny best realize that this task is best left to states.

My cowboy hat is off to the great state of Texas for their innovative health care solutions.

Would you hit your doctor?

I went in for a check-up the other day, and declined a rectum prostrate exam. I told my doc I would await the PSA test results. But I never would have dreamed of hitting him.

Not so in Scotland. Their health workforce is getting assaulted--literally--at a rate of six incidents per day across Edinburgh and The Lothians. Last year in the same region there were 2335 incidents of physical abuse, attempted assault, or verbal abuse of staff. That was up 136 from the year before. This kind of report is not good for recruiting. Read more here.

Friends, welcome to the world of socialized med--uh, universal health care. When anyone can walk in and demand care, every doctor's office will need an armed security guard.

Here is how a blogger responded:
"These figures will be even higher over the next period. The problem is that there are too many undesirables at loose in society. Don't mock, but the problem will become so great and grave that mandatory sterilization and culling of anti-social individuals will become a reality. It's not prisons we need, it's cages."

There is no easy answer for the problems we face in our culture. Universal Health Care, I fear, will shift too much of our economy under government control.

Mental Health Care and Lab Techs

Last week, our AJC guest reporter told us horror story after horror story of abuse in mental hospitals. It was really gut wrenching. Not only do we need more of a psychiatric workforce, but we need to take better care of them in order to increase their longevity. These people may have the toughest job on the planet.

This month in Psychiatric Services (58:1324-1329, Oct 2007), Dr. Edward S. Casper discusses his study with 94 mental health practitioners who were participating in continuing education. One group of them did the standard continuing education, but the other group did continuing education that applied principles of the theory of planned behavior. Guess what? The group using the theory applied what they learned in the class by a 74% versus 42% ratio. The content of the class is not important for this blog, but suffice it to say that we need to be giving mental health practitioners effective tools that can make their job easier and more productive. Lives are at stake. (You'll have to use Galileo to find the article.)

I had my semi-annual "blood drawing" the other day at the health center. I am on Lipitor and have to do that. Did you know that lab workers are an important part of our health workforce? Don't feel bad if you do not as there are a lot of folks who don't think about it. That is why a bunch of laboratory associations are coming together for an initiative called "labs are vital." "Lab Worker contributions save lives, reduce morbidity, and help control the cost of care," said the VP of the American Society for Clinical Pathology."

So the next time you get that "stick" in your arm, thank the lab tech for what they do.