The Healthcare sector has been continuously transforming to meet the needs of the people. The government, being the primary institution that should attend to the health and medical needs of the people should be proactive in planning and legislating laws to answer the growing demand. University-affiliated hospitals are at the forefront in the provision of medical care since physicians get their training and skills from them.
The institution with a school of medicine (and other allied health courses) and a primary teaching hospital is referred to as an academic health center (Hanft, 1982). Various centers share the facilities, equipment, and research to maintain optimum quality service and training of the health care professionals, which are always affected by the availability of funding (Hanft, 1982). Since the 1930s, the government funneled its financial support on biomedical research and particular health care needs (e.g. communicable diseases, veterans) (Hanft, 1982). Laws were passed beginning the 1930s (e.g. creation of the National Institutes of Health) and small grants were given to researchers and schools.
The federal government did not prioritize giving financial support to the centers since that time. For instance, only six medical schools (out of 71) offering four-year degrees receive assistance from the government in 1941. The medical schools spending grew from 11 percent in 1949 to 29 percent in 1969 over the government support. The grants given to research had led to “research-oriented faculty” in medical schools for about two decades. This has also caused more specialized disciplines. There was a growing demand for health care between 1950 and 1960 spurred by the introduction of health insurance (Hanft, 1982, p. 71).
Public and private studies already urged the government to provide support to medical education, but this is strongly opposed by the “organized medicine” that only relaxed its position during the early part of 1960 (Hanft, 1982, p. 71). Several laws were enacted thereafter that include the Health Professionals Education Assistance Act (1963, provided grants for teaching facilities construction), Medicare (1965), Medicaid (1965), etc.
While federal aid has aided in the development of more specialized fields in health care, hospitals at present are promoting cross-training of staff so that they will be capable of performing various tasks (or multi-tasking). This resulted in fewer but capable staff who could render more than one type of health care service.
An empirical study conducted over one year in a small welfare clinic revealed that maximizing the performance of the nursing personnel revealed that the waiting time of the patients is greatly reduced. This indicates an improvement in the quality of care (Meel, 2003).
The growing disparity in the distribution of physicians in rural and urban areas has caught the attention of the government. Thus, Congress commissioned the Council on Graduate Medical Education or COGME in 1986 to undertake a thorough evaluation of the situation (U.S. Department of Health and Human Services, 1998). COGME submitted a series of reports to several government institutions (e.g. Secretary of the Department of Health and Human Services, Senate Committee on Labor and Human Resources, and the House Committee on Commerce) that includes the assessments and recommendations.
It has been noted that there is much concentration of health care professionals and specialized services in the urban facilities while numerous inner-city and rural areas experience a dearth in this aspect (USDH, 1998). It is quite an ambiguous reality that while there is an oversupply in one area, there is also a deficiency in another. Rural and inner-city cannot attract more professionals and specialists. The study found out that specialists are more inclined to render service in the urban areas while physicians who prefer to serve as family doctors and provide primary care tend to work in the “underserved areas” (USDH, 1998, p. xiii).
The government and educational institutions remedied this scenario by attracting more students who would prefer to serve as primary care doctors, especially when federal funding and incentive are allocated for the program. Through the National Health Service Corps, the Community Health Center Program, and specific Medicare and Medicaid incentives, more physicians sought to render service in areas that they would not choose in the first place.
References
Hanft, R.S. (1982). The Impact of Changes in Federal Policy on Academic Health Centers. Health Affairs, 1(3), 68 – 82. Web.
Meel, B.L. (2003). Adequacy and efficiency of nursing staff in a child-welfare-clinic at Umtata General Hospital, South Africa. African Health Sciences, 3(3), 127 – 130. Web.
U.S. Department of Health and Human Services. (1998). Physician Distribution and Health Care Challenges in Rural and Inner-City Areas. Council on Graduate Medical Education Tenth Report. Public Health Service. Health Resources and Services Administration. Web.