Things are changing quickly, at first it was little things like you are now a primary care provider instead of a GP or Family Physician. Today I read that we are now First Level Providers , or Second Level Providers instead of a specialist. What's in a name....? Everything. Nomenclature often defines the culture, and new vocabulary and abbreviations change the way we think, write and do.
I am now lumped in with "Vision Care Providers"....which seems to lump me in with Opticians, and Optometrists. One thing I was always challenged with is the relative lack of sophistication and/or knowledge as to the difference between and O.D. (Optometrist) and M.D. (Ophthalmologist). In recent years Optometrists become certified in therapeutics for treatment of some eye conditions. The threshold for medical treatment has been lowered substantially.
Health Reform iinvolves both quantity and quality of health care. During the most recent decades there are many who argue that quantity does not equate with quality of care. Measuring quality is challenging at to where to look. Recent ideas include better outcomes (ostensibly measured by the number of reductions in readmission after hospitalization within the first 30 days of discharge. That metric however encompasses a small measure of health delivery.
The outpatient, or ambulatory service setting presents the majority of health expense and visits, save for long term care of the aged population.
The affordable care act will markedly increase outpatient services for states who have opted-in for medicaid expansion. This will be covered in an upcoming edition.