June 15, 2022

It's not just about leaving a sponge behind

They're called "never events," the medical errors we hope never occur, like operating on the wrong patient or leaving a sponge behind after surgery. Nevertheless, they do happen about 4,000 times a year. But they're not really what you should be worrying about.

HHS has just released a study verifying that one fourth of Medicare patients are harmed while being hospitalized. Those medical errors are called "hospital acquired conditions" and almost half are preventable. Falls, infections, misdiagnoses, faulty medicating. All result in patients who now have a medical ailment they didn't have when they were admitted. Many do not survive to be discharged or are permanently impaired. 

Please consider how you can be a more engaged--and safe--patient. Then start making self-advocacy a priority in your own health care journey. 

June 10, 2022

The part of Obamacare that got left behind

It's been 12 years since the passage of The Affordable Care Act (Obamacare). It's  important to note that a crucial element of that key legislation was the creation of The National Healthcare Workforce Commission, mandated to provide for a sufficient number of health care workers in the future. The statutory intent is to collect data on our present workforce, project needs based on our aging and chronically ill population and make effective preparations so that health care is accessible to all Americans, now and in the coming decades.

Over a decade later, as we face a crisis of worker shortages in health care, the National Healthcare Workforce Commission has yet to hold its first meeting. Why? Because Congress has repeatedly passed on the opportunity--and its obligation--to appropriate a meager $3 million for the Commission to do its work. Pathetic.

May 15, 2022

The health care worker shortage: The first wave of a perfect storm

As we hear stories and experience the health care worker shortages first-hand, it begs the question, "Why now?"

If you listen to Jo's interview with Jeff Angelo of WHO Radio's "Need to Know," you'll learn how this crisis of access is just a hint of what's to come:

April 30, 2022

Well, we've certainly identified the problem . . .

 Another story featuring Iowa's failure to effectively protect its most vulnerable, the youngest and oldest among us. 

Des Moines Register: Nurse fired for reporting resident abuse

But not to worry. The State Long-Term Care Ombudsman office (those in charge of making sure there are "eyes on the ground" at Iowa's care facilities) assure us they have recruited 52 volunteers to oversee 55,751 beds. 

We are beginning to see what our policy makers' and stakeholders' "failure to plan" really looks like. It's not good.

April 14, 2022

Children, patients and the elderly. Who speaks for them?

There's an interesting op-ed in today's Des Moines Register. Substitute the word "patient" or "elderly person" for every "child" and you will find the message equally relevant. 

Des Moines Register op-ed by E. J. Wallace

Gosh. Convening another "task force" wasn't the solution to a systemic problem? Almost hard to believe. As for passing legislative "solutions" that fly in the face of common sense and the will of constituents, nothing new to see here.

Child care, elder care and health care access are all in crisis mode. That's largely due to the demographic realities of a shifting dependency ratio and our leaders' unwillingness to acknowledge and prepare for what was entirely predictable.

As the Iowans most directly affected--parents, patients and advocates--we must be the change. Leaders' epic failures to act in a timely and competent manner leaves us little choice. The time to pursue innovative and cooperative answers for these life-altering dilemmas is now.

March 10, 2022

Name calling is not a planning strategy

We all see them. There are Now HIring! signs at every type of business: service, retail, education, law enforcement, yada, yada, yada. It would be wrong headed to expect the health care industry to be an exception. It is not.

Job openings in the "Health Care and Social Assistance" sector have grown 810,000 since the pre-pandemic standard of February 2020. They now total 1,944,000. Nurses and direct care workers find themselves in the unusual position (for them) of being in a sellers' market. The reaction of policy makers and stakeholders? To label them and the staffing agencies they are turning to as "greedy" and this predictable supply/demand phenomenon as "price gouging." 

That will not address the issues of health care access now stemming from mass retirements and burnout. It just will not.

March 3, 2022

COVID-19 is receding. Why isn't the health care worker shortage?

"They" keep saying we have delayed surgeries, long waits for care and no hospital beds because of COVID-19. But infection and hospitalization rates are way down, so why are hospitals still paying $220 an hour to contract nurse agencies? Post hoc, ergo propter hoc. "Since event Y followed event X, event X must have caused event Y". Maybe sometimes, but not in this case.

Health care worker shortages were destined to occur, ever since the 1960s. Demography is destiny and health care utilization has risen dramatically due to our aging population and America's epidemic of chronic illness--not to mention all the Baby Boomer health care professionals now retiring.

Are people starting to see the light? Wall Street Journal - March 3, 2022

February 22, 2022

What IS the next step?

A Facebook friend asked what we can do to address the problem of health care worker shortages and Iowa's "brain drain." I wish I had a smart and credible answer for her. Instead, I admitted that I am very frustrated with the refusal of Iowa's leaders to listen to the facts and acknowledge reality. Their proposals for "solutions" are not only poorly thought out, they will most likely serve to exacerbate existing obstacles to health care access for Iowans.

I am struggling with how to proceed, but I have a feeling I will be going straight to the people with the most at stake and most willing to forge ahead: the health care consumers and those they advocate for.

Stay tuned. I will be back soon with a plan. Wish me luck. 

February 8, 2022

Stiff competition for physicians across the United States

Iowa is ranked 23rd for private practice physicians' conditions, i.e., compensation, providers per 100,000 in population, regulatory environment, etc.

Becker's ASC Review - Feb. 8, 2022

That certainly doesn't help in recruiting doctors, nurses and administrators. 

February 1, 2022

What the heck is "the supply chain"? And why should you care?

We thought all we would ever need to know about economics was supply, demand and price. Now we understand how the TP shortage of 2020 and the delayed holiday giving of 2021 are related. But what does the supply chain have to do with health care access?

Jo's article in Healthcare Business Today

January 24, 2022

There's something missing from Iowa's list of legislative priorities

I was disappointed (again) to find that Iowa's legislators and policy leaders are dissing the stability of our health care workforce as a legislative priority in 2022. I got the chance to voice my concern in the Des Moines Register today:

Jo's op-ed in the Des Moines Register of January 24, 2022

January 15, 2022

EPIC FAIL #18 - Our love/hate relationship with EHRs

The major push for Electronic Health Records began with the Health Information Technology for Economic and Clinical Health Act (HITECH), part of the American Recovery and Reinvestment Act of 2009.

Converting to computerized records promised to cut red tape, reduce treatment/medication errors, enable data sharing and save billions of health care dollars. Have they fulfilled their promises?


January 11, 2022

For Iowans, the health care shortage will not go away with Covid-19

By 2030, there will be an additional 135,000 Iowans aged 65 and older. 135,000 more than are here today, and we're already ranked 17th in the nation for our proportion of seniors.

It's time for Iowa's policy makers, bureaucrats and health care stakeholders to start planning for this inevitable perfect storm of health care.

Des Moines Register 1-11-2022

January 8, 2022

What's the most important issue concerning the vaccine mandate?

All eyes are now on the U.S. Supreme Court, as we await their decisions on allowing vaccine mandates for employers and health care providers who accept Medicare and Medicaid reimbursement. While others focus on how this shiny object may impact health care access, I ask the question: "What about the health care worker shortages already evident throughout the system?

The Great Health Care Resignation of 2021 and Beyond began long before any of us had ever heard the term "pandemic." One-third to one-half of today's health care workers will reach retirement age by the end of this decade, just as utilization by aging and chronically ill patients dramatically rises. Along with professional burnout, those inevitable factors make for a very predictable crisis in health care access. How a vaccine mandate will exacerbate this medical emergency remains to be seen.

Once the legal arguments are settled, I hope our policy makers and health care stakeholders will begin to take a serious look at the health care worker shortages that will not go away with the eradication of Covid-19.