Please join AMSA

[spaslam]

Fellow Medical Students:

My name is Sunny Aslam and I am heading up our AMSA chapter. Please consider joining AMSA and coming to our first meeting on Wednesday, Jan. 4th, 2005 at 5:30 p.m. in the First Semester Classroom. Students in clinical rotations should consider joining AMSA also; they have even more chances to benefit from the financial services, networking, conferences and more, available from AMSA.

AMSA is the largest independent association of physicians-in-training in the USA. Students from any country can join. With approximately 50,000 members, AMSA is committed to improving medical training as well as advancing the profession of medicine. AMSA focuses on universal healthcare, disparities in medicine, diversity in medicine and transforming the culture of medical education.

Benefits of joining:

Insurance discounts, including health, accident, auto, life, dental, etc.
Discounts on medical equipment, books, PDAs
Travel discounts including hotel, air and rental cars
The New Physician Magazine
Numerous networking and conference opportunities
Chance to do community service with other med students on island
Build relationships and meet people who can help you in the future

For more info on benefits and to sign up online:

www.amsa.org

All this for $65 for 5 years!

Remember to join us on Jan. 4th, 2005, at 5:30 p.m. in the Histo Lab for our first meeting. We’ll be discussing any questions you have and our plans for the upcoming semester, including community service at the Saba Sacred Heart School.

I encourage you to consider running for officer positions. Come with ideas and an open mind. Until then email me with any questions: aslams@myway.com . Good luck!

Sincerely,
Sunny Aslam
Saba AMSA Chapter President

[AUCMD2006]

before you join take a look at their website and see their political agenda:


-universal healthcare. this will limit your earning power a great deal along with many problems for your patients. it takes months to get an appointment in UK, and canada has places with people who haven't been able to find a pcp in three to five years

-favor limiting access to IMG's

i know most of us want something that connects us to the US medical establisment in anyway but amsa is not the answer in my opinion...please look for yourself.

[spaslam]

please produce some evidence for your statements--I have studied these issues for years and disagree with what you say almost completely.

please see pnhp.org for my references, including the latest Harvard study on single payer health care.

if doctors, as the highest paid profession in the USA, think they are underpaid they have issues. that aside, moving to single-payer, would save the system millions if not billions of dollars of wasted money due to the bloated insurance industry and HMO administrative costs.

The Canadien healthcare system is far more efficient and effective, as measured by health care outcomes infant mortality and maternal mortality, etc. And Canadiens, as well as many Americans recognize the advantages of their systems. Please produce a credible source fr your PCP statement. Most Canadiens at our school are thrilled with their healthcare system. And at least Canada recognizes it ahs some problems and is adding med schools and looking at its problems.

There are delays for those who have less medically necessary problems--just as there is in the USA, but only for those with insurance. The rest just wait until they are so sick they use the ER.

No one favors limiting access to IMGs, except the AMA, which says Caribbean school should be shut down. Again, please share your sources.

But I do agree with your assessment to look for yourself. People should always question any claim and consider the facts.

[rdecastro]

please produce some evidence for your statements--I have studied these issues for years and disagree with what you say almost completely.

please see pnhp.org for my references, including the latest Harvard study on single payer health care.

if doctors, as the highest paid profession in the USA, think they are underpaid they have issues. that aside, moving to single-payer, would save the system millions if not billions of dollars of wasted money due to the bloated insurance industry and HMO administrative costs.

The Canadien healthcare system is far more efficient and effective, as measured by health care outcomes infant mortality and maternal mortality, etc. And Canadiens, as well as many Americans recognize the advantages of their systems. Please produce a credible source fr your PCP statement. Most Canadiens at our school are thrilled with their healthcare system. And at least Canada recognizes it ahs some problems and is adding med schools and looking at its problems.

There are delays for those who have less medically necessary problems--just as there is in the USA, but only for those with insurance. The rest just wait until they are so sick they use the ER.

No one favors limiting access to IMGs, except the AMA, which says Caribbean school should be shut down. Again, please share your sources.

But I do agree with your assessment to look for yourself. People should always question any claim and consider the facts.

If the Canadian system is so great, why are there tour buses full of Canadians going across the border every business day for imaging and diagnostic studies? Why are there more CT scanners in one small (125K population) city in Minnesota than in all of Canada (33M)?

And the limitation on earning is quite obvious - with controls on prices, the earnings are limited to the number of hours a physician can work, and the reimbursements that the government is willing to offer. Just like in Canada.

[wolfvgang22]

I'm not going to comment one way or the other on whether socialized medicine is better than what we have in the US, because I just don't know.

What I did think was funny was a news story I saw on TV the other day, where US citizens were going over to Canada and getting flu shots at Canadian clinics. The nurses were even walking out into the parking lot and giving US citizens shots as they sat in their cars! And it was cold outside! :lol:

And then their is the whole issue about prescription drug costs in the US for patients vs. costs in countries like Canada where the government has cost controls in place for prescription medications. I'm sure you know that the pharmaceutical companies are retaliating against Canadian pharmacies that sell prescription medications to US citizens by not allowing those pharmacies to buy prescription drugs anymore. :(

I don't know if the US system is better than the Canadian system, but we could sure use flu shots and cheaper drugs somehow.

[spaslam]

again, I would say please cite a source for these claims on Canada. the pnhp.org web site shows clearly according to real sources that few Canadiens come to the USA for healthcare. where are these buses exactly? are they passing the busloads of Americans on their way to Canada to get cheap drugs or vaccine shots? typical corporate media lies and distortions--just like WMD in Iraq, etc.

imaging is a real issue. my canadien friends say if it's an emergency they get their patients in for imaging. the other less medically necessary cases (no patient believes they are less medically necessary, of course) have to wait, that is true. but Canada has put huge amounts of money into the system, responding to these concerns. unlike in the USA, where Bill Frist gets up at the GOP convention and talks about the wonders Bush has done for American healthcare, clearly one of the worst systems in the developed world--except for the ultrawealthy.

I beg people to start to look beyond corporate media reporting which rarely ever challenges norms.

Did anyone ever think to ask that maybe we have wasted to many imaging machines in the USA? could we use less imaging and give more people insurance?

Do HMOs and Insurance companies limit doctors earnings in the USA? of course they do. there are certainly many ways to pay doctors and no good ones. but there are no salary caps in Canada anymore. it's fee for service--the more you work the more you get paid.

we spend 2x as much per person in the USA as Canada does--and they cover everyone. the sooner we get rid of the HMO/Insurance industry the better off we'll all be.

[rdecastro]

again, I would say please cite a source for these claims on Canada. the pnhp.org web site shows clearly according to real sources that few Canadiens come to the USA for healthcare. where are these buses exactly? are they passing the busloads of Americans on their way to Canada to get cheap drugs or vaccine shots? typical corporate media lies and distortions--just like WMD in Iraq, etc.

imaging is a real issue. my canadien friends say if it's an emergency they get their patients in for imaging. the other less medically necessary cases (no patient believes they are less medically necessary, of course) have to wait, that is true. but Canada has put huge amounts of money into the system, responding to these concerns. unlike in the USA, where Bill Frist gets up at the GOP convention and talks about the wonders Bush has done for American healthcare, clearly one of the worst systems in the developed world--except for the ultrawealthy.

I beg people to start to look beyond corporate media reporting which rarely ever challenges norms.

Did anyone ever think to ask that maybe we have wasted to many imaging machines in the USA? could we use less imaging and give more people insurance?

Do HMOs and Insurance companies limit doctors earnings in the USA? of course they do. there are certainly many ways to pay doctors and no good ones. but there are no salary caps in Canada anymore. it's fee for service--the more you work the more you get paid.

we spend 2x as much per person in the USA as Canada does--and they cover everyone. the sooner we get rid of the HMO/Insurance industry the better off we'll all be.

Here's a start:

http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id=658

No, HMO and insurance companies don't limit a physicians income - the physician can opt out of the program. Nor are they capped, as was a FP physician I saw last year, in Kingston, Ontario on vacation. She told me that her income was limited by the province to about $80K cdn/year, and thats why she limited her patient base - no point in her incurring more work and liability for no increase in income. She was more than happy to bill me CDN40 for a quick visit and a script for a Z-pack. Since I am happily not a subject of Canada I had the option of actually getting a physician in Canada.

BTW, there are reports in the literature of diagnostic imaging studies in Canada taking more than three months - and finally physicians telling the patients to go across the border. Last summer I needed an MRI of my neck, that was on a monday afternoon, 10 AM the next morning I was having the study done - less than 18 hours, not 90+ days.

Your comment about too many, and wasteful machines is ignorant, immature and specious to boot. When a resource is artificially limited (as health care in Canada is, by the government) the natural result is shortages. The government has no particular interest in seeing that any one person has what they need, they limit the cost to everyone. The result is the situation in canada where even though health care is "free", 30% of the citizens have no primary care physician (the Fraiser study). So, they have to go to the ED for primary care - except, there are fewer beds and diagnostic equipment available than in the US.

The US system has problems, but making it the Canadian system will make it far, far worse.

And if you have any studies that refute that, show them.

[scoobz1981]

My dad lives in ontario... his MRI took 6 months before he got it...

Val

[sprvs]

One of my friend gave birth to a dead baby in Florida because she didnot have medical insurance and could not effort $5K in advance payment. Physicans refused her to take as a patient because she could not pay this amount in advance. She had to see a midwife (who is not a doctor) every few months. Even a year after the delivery, she could not find out why her baby was born dead. My friend was just one of 44.961 million people in USA who did not have medical insurance in 2003 and this number is one and a half times the total population of Canada.

http://www.census.gov/prod/2004pubs/p60-226.pdf (page 15)

I am not saying Canada's health care system is better than ours or we need to socialize medicine but something definitely needs to be done to fix it here.

[spaslam]

http://www.cbc.ca/news/background/fraserinstitute/

Fraser is a common 'privatize everything, abolism minimum wage, flatten taxes' group, familiar to Americans.

again check pnhp.org for the studies and data on outcomes, the true measure of healthcare, not who got an MRI that was owned by the local doc so he could make a bunch of cash.

do physicians ever really opt out of insurance companies and HMOs? no note in reality, they are essentially the only game in town.

we ration health care in the USA; to those with insurance, all the rest can go to the ER. and the waits are still long. of course there are exceptions--if you are wealthy or have good insurance. but getting imaging doesn't necessairly mean anything.

and imaging is not all medicine--just look at the data on infant and maternal mortality, life expectancy, etc. certainly no system is perfect, but the solution is too get rid of HMOs and insurance companies and to start out with a new system and make changes as you go. the problem in Canada is not the system; it's the funding. the problem in the USA is a system that serves a small group of the population well and leaves the rest of the public in limbo.

[jgilbert63]

Caveat Emptor !!!!!!!!!!!!!!!!!

Here's a sample of what I found on the AMSA website:

http://www.amsa.org/hp/stateinits.cfm (AMSA and Universal Care)

http://www.amsa.org/news/pr/03/0320.cfm (AMSA and Universal Care)

http://www.amsa.org/news/focus/0704news.cfm (Scroll down for the Op-Ed: Its Time for an International Vote)

http://www.amsa.org/about/ppp/constitution.pdf#page=16&zoom=120,40,50 (Check out Page 3, Section 1, Para A, on who is eligible for FULL membership and see Page 5, Section 2, Para D1 on IMG office restrictions)

http://www.amsa.org/intl/ecfmg.cfm (See Question 9 - AAMC's touting of the AAIMG and advocating the use of the AAIMG website for evaluating Caribbean schools)

[rdecastro]

One of my friend gave birth to a dead baby in Florida because she didnot have medical insurance and could not effort $5K in advance payment. Physicans refused her to take as a patient because she could not pay this amount in advance. She had to see a midwife (who is not a doctor) every few months. Even a year after the delivery, she could not find out why her baby was born dead. My friend was just one of 44.961 million people in USA who did not have medical insurance in 2003 and this number is one and a half times the total population of Canada.

http://www.census.gov/prod/2004pubs/p60-226.pdf (page 15)

I am not saying Canada's health care system is better than ours or we need to socialize medicine but something definitely needs to be done to fix it here.


That 44 mil number includes a lot of people who either are young and healthy (and don't need insurance) or are wealthy enough to pay for it themselves, or choose not to spend their own money (through employee benefit plans or directly) on health insurance. It's a shame about your friend, but the lack of health insurance may well not have had any bearing on the stillbirth - Nurse-Midwives are a well understood mid-level practicioner, and because of EMTALA had a problem been identified, care would have been available at a hospital (as it is for ANYONE in the US with a medical emergency, regardless of ability to pay).

And I'm not saying that the system in the US is perfect either - it's not. But, there is not a single example existing of a socialized medicine system in the world that doesn't have equally bad (albeit different) or worse problems. Starting with Canada.

And, among the other reasons why infant mortality rates (which the loony left likes to hold up as a health-care indicator) are low in the US is because we in the US count any birth as a live birth (many countries have higher standards than that, some including the infant living for at least a week) and we will try and resucitate infants that would be considered stillborn in most other countries. Today in the news theres a story about a premie (26 WGA) who weighed 8.6 ozs at birth - thats well under the typical 500 g weight considered "viable" in most of the rest of the civilized world.

[spaslam]

Socialized medicine is when doctors are employees of the government. In Canada, the healthcare system is publicly funded and PRIVATELY delivered. They have one billing system, which is much simpler than the huge bureaucracy for the hundreds, if not thousands of different forms, deductibles, policies, etc. in the USA.

Some of the best healthcare is delivered like it is in Canada: Medicare and Medicaid are the two largest health insurers in the USA, both government programs. If only more docs accepted Medicaid. Medicare recipients and the VA system get some of the best marks on quality values and from their patients.

We need to take what works with the Canadien system and stop paying corporate execs to cut costs to doc and deny claims from patients.

[teratos]

One of my friend gave birth to a dead baby in Florida because she didnot have medical insurance and could not effort $5K in advance payment. Physicans refused her to take as a patient because she could not pay this amount in advance. She had to see a midwife (who is not a doctor) every few months. Even a year after the delivery, she could not find out why her baby was born dead. My friend was just one of 44.961 million people in USA who did not have medical insurance in 2003 and this number is one and a half times the total population of Canada.

http://www.census.gov/prod/2004pubs/p60-226.pdf (page 15)

I am not saying Canada's health care system is better than ours or we need to socialize medicine but something definitely needs to be done to fix it here.

I'm sorry, but there is no excuse for that. Try WIC (http://www.fns.usda.gov/wic/aboutwic/mission.htm), try Catholic hospitals. There are vast resources available for those without insurance. Especially if you are pregnant. I think the care in most is very good.

The US health system is the best in the world. The thing that makes the infant mortality rate etc. high compared to many first world countries is that we have a large "third world" component to our population. Lots of drug abuse etc. Our education system is really suffering, and there is a lot of ignorance. Many people just don't take care of themselves.

I don't think our healthcare system is just for the "haves" either. I see a fair number of people who have no insurance. drug reps are usually happy to provide samples of drugs people need, if you ask (it isn't hard). Many labs will bill at a reduced rate for people without insurance. Sure there is some expense for people, but nothing they can't afford. I find is fascinating that some people without insurance can't pay $15 per month for their meds, but pay $4/pack for cigarettes. It is about personal responsibility, and some people just don't accept that.

I love practice in the US system. I sent a guy off for a lower extremity doppler to rule out DVT, had my answer in 1 hour. Great. The problem with misuse of testing IMHO, is lawyers. We order a lot of CYA tests. Canada and the UK just can't compare. The only efficiency we should worry about in medicine is getting the right tests done quickly. G[/url]

[AUCMD2006]

i don't have time to list all the sites of canadian doctors limiting work hours for no extra pay, about citizens without a pcp for years etc. but i'l try when i get home but i have to answer the part about florida:

"One of my friend gave birth to a dead baby in Florida because she didnot have medical insurance and could not effort $5K in advance payment"

sorry for her loss and this will sound harsh but maybe she doesn't know because the doctors don't know. many stillbirths can't be anwered by l;abs or autopsies. for pts its hard going to the doctor and not getting a direct answer i know. my mom fainted two months ago went to ER etc. and called me really upset because they ran tests on her and couldn't find anything worng so she called her second year med student son who knows about as much medicine as a ER janitor to diagnose her.....

also having done the apps and every other paperwork for florida medicaid i can tell you that all a woman needs to get "emergency medicaid" and WIC is a positive pregnancy test. then she goes in for the interview and the laws are very liberal for pregant women. i had women who had full time jobs, were lower middle class, etc covered no problem, i also had 14 year old girls living alone, women living with thier parents covered. no provider that i worked with (there were around 300 GYN's in dade, broward, palm beachm, that i referred to so that is probably a good sample) asks for payment upfront unless its a private clinic. i also have two friends opted out of medicare medicaid, and hmo's so there are some that do it. the only thing medicaid did not cover back then was the epidural

on top of what these women get for free they also get WIC for the first 12 months of the kids life, they get automatically applied for other aid inculding food stamps as well to see if they qualify. on top of that they can have the baby circumsized for free while they are admitted. on top of that she can get a tubal for free. on top of that she gets the six week visit covered. so unless the florida medicaid changed there is a vital piece of info missing from that story. regardless it will not change the outcome nor will it change the fact that florida and illinois (the two that i know) have very liberal acceptance into their pregnant programs and into WIC.

england also has a "single payer system", however you want to label it it is universal healthcare b/c its under govt control so call it whatever you want. they have the public and private clinics. the public clinics take the same as canada to get in and to tests. the private clinics are much quicker.

both systems are flawed but patients are our first priority, not some pseudo diagnostician ego that says "i am so cool, i can diagnose this without a machine"(saying with snooty accent) nor a shotgun CYA approach that is mindless. a combination of the two is logical, we should examine first send a test to confirm and be able to have results in a day or so. right now for a patient's sake i would rather have access and results quickly

[spaslam]

VA Hospitals Beat National Average in Overall Quality of Care
By Will Boggs, MD
http://www.medscape.com/viewarticle/496454

NEW YORK (Reuters Health) Dec 21 - Veterans Health Administration hospitals score better than national averages in overall quality of care, chronic disease care, and preventive care, according to a report in the December 21st Annals of Internal Medicine.

"This study showed that in major areas of care, the VA did better than the country's general health care system at providing recommended care," Dr. Steven M. Asch from West Los Angeles Veterans Affairs Medical Center, Los Angeles, California told Reuters Health. "In fact, there was no area in which the VA did worse than the general health care delivery system."

Dr. Asch and colleagues compared the overall quality of care delivered in the VHA system and in the United States, as well as the quality of acute, chronic, and preventive care across 26 conditions.

VHA patients overall were more likely than patients in the national sample to receive the recommended care for their condition (67% versus 51%, respectively), the authors report.

Performance was better in the VHA than in the national sample for chronic care (72% versus 59%, respectively) and preventive care (64% versus 44%), but not for acute care (53% versus 55%), the report indicates.

Differences were even more substantial in the areas targeted by the VHA for improved quality, the researchers note.

"We found that what gets measured gets done," Dr. Asch explained. "In other words, the VA advantage over the rest of the country was greatest for care covered by the VA quality tracking system."

The study findings persisted after adjustments for age, number of acute and chronic conditions, number of outpatient visits, and when the comparison included only processes supported by randomized, controlled trials.

"These findings are so important because they show us that it is possible to improve the care that patients receive," Dr. Asch said. "We also found that there was a spillover effect, so that important parts of care that were not part of the VA quality tracking system, but were closely related, still got done more often. This is a strong argument for the continued spread of quality measurement systems throughout the healthcare system."

"Physicians were central to the development of the indicators of quality that we used," Dr. Asch added. "Participation of physicians in these sorts of efforts ensures that they will be as clinically relevant as possible and thus help our patients the most."

Ann Intern Med 2004;141:938-945.

[rdecastro]

If you're going to post the exact same thing twice (and you've done it at least twice now) try posting to different threads.

And, if you want to discuss the far left liberal, anti-physician stands of AMSA and why people shouldn't join without a complete understanding of what they're getting into, lets do it.

In the mean time, you're droning here. Next step is trolling.

[scoobz1981]

Zzzzzzzzz.... Zzzzzzzz.... Zzzzzzz.... <sigh>.....

is that a big enough hint?




Val

[AUCMD2006]

visit a va hospital, enough said

[dksamp]

Hello,
I can tell you as a practicing physician, that the scenario you described is EXTREMELY UNUSUAL, and VERY UNLIKELY given the way Florida is.

Some FACTS...

1. If you are pregnant in FL, you DO have access to prenatal care...PERIOD...whether you have insurance or not. What happens is that the uninsured pregnant mom will get access thru the county hospital facility.

Which county in FL did your friend live in????

Once tapped in, the social worker files for medicaid. Now, once she has medicaid, she can go to any OB-GYN medicaid provider. To provide a REAL example, there is a local cafe that me and my clinic frequents. Most of the workers there are recently arrived immigrants from South America. I remember at one point, three of them were pregnant. None of them had insurance, and frankly none of the ladies were even LEGAL with the proper papers. Yet, EVERY single one of them had access to the county hospital's prenatal clinic where they got regular checkups free of charge. No deposit was asked for. They delivered at the county hospital, and their babies qualifiued for medicaid.

I also remember during my training in the midwest, the county bore the responsibility of caring for the pregnant ladies whether they had insurtance or not, whether they were LEGAL or not (as we had many mexican immigrants without papers who got regular prenatal checkups at the county facilities)...I know because MY ATTENDING AND I DID THOSE CHECKUPS FOR THEM!!!!

So IMHO, your friend was not given the proper counseling as to what her options and resources were. If the issue was access to OB-GYN, that is a NATIONAL problem, as many OB's are dropping out of deliveries because of the malpractice crisis. Also, many OB's are refusing to see High-Risk OB cases (i.e. preexisging diseases of the heart, lung, etc). The midwife she saw should have known the information of the community resources and informed her about her options)

By the way, the 44 million figure that gets repeated in the media about the "uninsured" is a GROSSLY INACCURATE figure that is IMPROPERLY CALCULATED...Here is a good link that explains why...

http://aspe.hhs.gov/health/uninchil/chap2.htm

As a private practicioner, I am sick & tired of the endless streams of MISINFORMATION put out in the popular media and the folks that are all too willing to believe it without questioning it further.

Just my $0.02


-Derek

One of my friend gave birth to a dead baby in Florida because she didnot have medical insurance and could not effort $5K in advance payment. Physicans refused her to take as a patient because she could not pay this amount in advance. She had to see a midwife (who is not a doctor) every few months. Even a year after the delivery, she could not find out why her baby was born dead. My friend was just one of 44.961 million people in USA who did not have medical insurance in 2003 and this number is one and a half times the total population of Canada.

http://www.census.gov/prod/2004pubs/p60-226.pdf (page 15)

I am not saying Canada's health care system is better than ours or we need to socialize medicine but something definitely needs to be done to fix it here.

[FLK]

One of my friend gave birth to a dead baby in Florida because she didnot have medical insurance and could not effort $5K in advance payment..

Oh no, please tell me that after demanding people supply data to back up statements, you go and throw out anecdotal reports.

Come on pal.

PS: infant mortality is higher in the USA for many reasons ( most of which have very little to do with the quality of healthcare in America)

Visit any NICU in large southern cities, and you will see million dollar healthcare being dispensed to premature infants, born to illegal aliens.
Does Canada have the illegal alien burden of California, Arizona and Texas?
Take care of several million of these folks, and let's see how well your system looks


They are in high risk categories in America

African American children have higher ( basically double ) infant mortality at all socioeconomic strata compared to whites. ( this is due to lower birthweight primarily )
The United States has a lot of African-American citizens which affects infant mortality relative to other countries

Finally, the vast majority of infant mortality occurs in infants with birthweights less than 1500 grams.
In America ( as opposed to other countries ) these patients are requscitated and cared for.
In cuba , these infants are not resuscitated and do not count as livebirths, and do not affect the infant mortality statistic

The factors that affect infant mortality are far more complex than the just who funds healthcare and how it is dispensed.
To criticize US healthcare with a simple analysis if infant mortality is naive at best.
This is being addressed in a comprehensive fetal and infant mortality review by the surgeon general.




PS: AMSA is a far-left kook fringe group that does not represent the vast majority of American medical students and certainly not the mindset of practicing physicians in America.

I would suggest students not fund this sick organization just to get a magazine detailing "lesbians in medicine" or whatever pet project they are pushing at the moment

...or plonk down your money to fund queer people of color. It's a free country :cry: http://www.amsa.org/adv/lgbtpm/qpoc.cfm

[heart1st]

I am a nursing student and spent some of my clinical time in a VA hospital. I don't think you can adequately judge the "socialized medicine" aspect of the VA system unless you can find statistics about how much is spent on how many patients. What may not be known is that, at least in the subacute care, if they had room, private patients could be housed if they had the medical insurance to cover it.

What I saw of the VA, compared to the 3 other institutions I've done clinical at--it had, by far, the most up-to-date equipment (computerized medical records; bar-code medications which could be compared with the bar code on the patient's id bracelet; fancy throw-away washcloths for doing bed-baths.) It may be that the VA I did my clinical hours was not typical of other VA hospitals, but I doubt it. I remember years ago how another VA hospital had messenger robots--robots that followed painted lines in the floor and delivered--I'm not sure what. I don't think this comes cheap, and I deeply suspect that the VA spends quite a bit on their patients.

heart




VA Hospitals Beat National Average in Overall Quality of Care
By Will Boggs, MD
http://www.medscape.com/viewarticle/496454

NEW YORK (Reuters Health) Dec 21 - Veterans Health Administration hospitals score better than national averages in overall quality of care, chronic disease care, and preventive care, according to a report in the December 21st Annals of Internal Medicine.

"This study showed that in major areas of care, the VA did better than the country's general health care system at providing recommended care," Dr. Steven M. Asch from West Los Angeles Veterans Affairs Medical Center, Los Angeles, California told Reuters Health. "In fact, there was no area in which the VA did worse than the general health care delivery system."

Dr. Asch and colleagues compared the overall quality of care delivered in the VHA system and in the United States, as well as the quality of acute, chronic, and preventive care across 26 conditions.

VHA patients overall were more likely than patients in the national sample to receive the recommended care for their condition (67% versus 51%, respectively), the authors report.

Performance was better in the VHA than in the national sample for chronic care (72% versus 59%, respectively) and preventive care (64% versus 44%), but not for acute care (53% versus 55%), the report indicates.

Differences were even more substantial in the areas targeted by the VHA for improved quality, the researchers note.

"We found that what gets measured gets done," Dr. Asch explained. "In other words, the VA advantage over the rest of the country was greatest for care covered by the VA quality tracking system."

The study findings persisted after adjustments for age, number of acute and chronic conditions, number of outpatient visits, and when the comparison included only processes supported by randomized, controlled trials.

"These findings are so important because they show us that it is possible to improve the care that patients receive," Dr. Asch said. "We also found that there was a spillover effect, so that important parts of care that were not part of the VA quality tracking system, but were closely related, still got done more often. This is a strong argument for the continued spread of quality measurement systems throughout the healthcare system."

"Physicians were central to the development of the indicators of quality that we used," Dr. Asch added. "Participation of physicians in these sorts of efforts ensures that they will be as clinically relevant as possible and thus help our patients the most."

Ann Intern Med 2004;141:938-945.

[teratos]

Bar codes and robots are all wonderful, but how was the patient care. Maybe it is just our VA but things here move SSSSSSSSSSSSLLLLLLLLLLLLLLLLLOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOWWWWWWWWWWWWWW

[heart1st]

I don't have any metrics, really, to judge it by. The staff, however, seemed happy, and apparently, a number of the graduates of my nursing school have gone to work there after graduation.

heart

[wolfvgang22]

Look everybody, FLK's back! He's alive.....aaaaaaliiiiiiiiiiiiivvvvvveeeeeee
:scared:

[AUCMD2006]

why? maybe could the money spent on develpment, building, implementation of that useless crap be better sepnt on paying the medical staff more, hiriing more staff, more patinet care?

[hapshey_usa]

Umm i'm a member of amsa and all i can say is that the only benefit is the new physician magazine. Oh and yes i get a monthly email and for the past 9 months they have been talking about the limited work hours they fought hard for residents. That is a good thing. Yes you get discounts on insurance and other things but its not really that much of a discount and the insurance provider is some "offbrand" company. I actually signed up for the insurance through amsa. I had to print out my insurance card on my own. I never got any documentation other than what was online. Basically I just threw away 500 bucks on the insurance and then 60 bucks on amsa. I'd say just keep your money and don't waste your money on an organization that really does not care about you, the foreign medical graduate.