UP Ibalon Bicol: American Medical Association

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Death & cost of terminal care are still taboo among many patients

8/25/2009 | Posted by mesiamd | Edit Post

The provision of reimbursing time given by physicians to counsel patients on end-of-life issues elicited unease and horror among many Americans. Sen. Sarah Palin spoke against it in terms of “death panels” and others thought the measure was a step towards euthanasia. Such fear is expected. The Obama administration debunked these fears as myths.

The public has been reluctant to talk about advance directives, health proxies, and power of attorneys as “rationing” loomed. If money becomes too tight in the healthcare budget, control on who gets the services may be inevitable in USA.

Not representing the majority of US licensed physicians, the American Medical Association (AMA) believes compensating MDs to discuss options of a terminal patient is OK. It saves on expenses while clarifying voluntarily issues about the death process. Upon request however, free advice on life and the dying has been available in medical care since time immemorial. Why then does the government want to shell in additional money for counseling when it is part of healthcare all along? Obviously, money has something to do with it.

“Studies have shown that the 5% of Medicare patients who die each year account for 30% of Medicare's costs, with 78% of last-year-of-life expenses occurring in the month before death. A March 9 Archives of Internal Medicine study of 603 dying cancer patients at seven hospitals, oncology clinics and hospices found that care for patients who had end-of-life discussions with their physicians cost $1,295, compared with $2,780 for patients who did not have such talks.

Anthony L. Back, MD, professor of oncology at the University of Washington School of Medicine and an oncologist at the Fred Hutchinson Cancer Center,said “encouraging physicians to have extended counseling sessions with their patients through the Medicare system could help patients get the care they want at the end of their lives while saving the health system money.”---AMA News. (08/24/09, O’ Reilly KB)

The counseling supported by AMA may remove barriers and misconceptions in tackling death, but there are practically no rules on what and how the doctor will share his advice. Physicians are inadequately trained on dispensing end-of-life advices. There is a possibility that patients and their relatives may be pressured in their decisions. =0=

RELATED BLOGS: AARP loses 60,000 members in July-August 2009 Posted by mesiamd at 8/18/2009; Sen. Sarah Palin stirs the healthcare debate with her warning of the “death panel” Posted by mesiamd at 8/15/2009

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Labels: AMA, American Medical Association, death panels, euthanasia, life, life and death issues, Medicare, rationing, terminal illness, Totie Mesia

Filipino doctors in USA, 2nd to India among IMGs

3/23/2009 | Posted by mesiamd | Edit Post

We are quick to assert that among the international medical graduates (IMGs) in the United States, Filipinos are 2nd to doctors from India as the most represented ethnic group in the profession. This is a very good record for our country who has distinguished itself as one of the most prolific doctor suppliers of America. About ¼ of doctors in USA are IMGs.

Top Ten Countries of Medical Education for IMG Physicians

2007
India------------------------------------ 19.99%----------------------47,581
Philippines------------------------------8.7%-------------------------20,861
Mexico----------------------------------5.8%-------------------------13,929
Pakistan---------------------------------4.8%-------------------------11,330
Dominican Republic------------------3.3%--------------------------7,892
Russia----------------------------------2.5%------------------------- 6,039
Grenada---------------------------------2.4%--------------------------5,708
Egypt------------------------------------2.2%--------------------------5,202
Korea------------------------------------2,1%--------------------------4,982
Italy--------------------------------------2.1%--------------------------4,741
Source: American Medical Association (AMA) Masterfile 2007

2008
India-------------------------------------21%--------------------------41,247
Philippines------------------------------ 9%---------------------------21,081
Mexico---------------------------------- 6%---------------------------13,980
Pakistan----------------------------------5%---------------------------11,901
Dominican Republic-------------------3.7%---------------------------8,618
Russia------------------------------------2.7%---------------------------6,293
Grenada----------------------------------2.7%---------------------------6,299
Egypt-------------------------------------2.2%---------------------------5,301
Korea-------------------------------------2.1%---------------------------5,031
China-------------------------------------2.1%---------------------------5,087
Source: American Medical Association (AMA) Masterfile 2008

The 2008 American Medical Association (AMA) IMG record shows the Filipino doctors rank second to India in number----9% and 21% respectively of the total number of foreign medics who train in the United States. That’s a total of 21,081 Filipinos vs. 41,247 Indians. Because of the sharp difference (double) in numbers between the two groups, Filipino physicians in USA looks scarcer compared to the Indians.

The current distribution of Filipino doctors will probably stay for a while since the boom of the nursing profession in the Philippines has lured more doctors to come to USA as nurses. Former Sec of Health Dr. Jaime Galvez Tan confirmed this trend when he revealed in 2007, "My latest study, there are 9,000 doctors who have become nurses. Six thousand of them (6,000) have left the Philippines mainly for the U.S. to work as nurses." Majority of these MD-nurses come from government hospitals, keeping the pool of United States Medical Licensure Examination (USMLE) takers and residency seekers from new graduates relatively intact.

A coincident fall of medical student enrollment, as much as 40% in some schools, has caused the lack of physicians in the Philippines, but not so much in USA since it remains to be a favored job destination of Filipino health professionals for more than 50 years. What is astounding is even if Filipino IMGs are second to the Indians, their number is small---less than half of the latter.(Photo Credit: Jandentonchua) =0=

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Labels: American Medical Association, Filipino doctors, Filipinos, IMG, India, International Medical Graduate, Medicine, Physicians, Totie Mesia, USMLE

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Death & cost of terminal care are still taboo among many patients

Filipino doctors in USA, 2nd to India among IMGs

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