Kule nxalenye yochungechunge lwe-Prioritizing Equity, funda ngokungalingani kwembali nokwangoku kwimfundo yezonyango, ingqesho, kunye namathuba obunkokeli.
Uthotho lweevidiyo zePrioritizing Equity luhlola indlela ubulungisa kwinkathalelo yezempilo obuyibumba ngayo inkathalo ngexesha lobhubhane we-COVID-19.
Umgangatho wokhathalelo awumiselwanga yindlela olunikezelwa ngayo, ngoko ke iinkonzo ze-telehealth kufuneka zigcinwe kwimigangatho efanayo neyokhathalelo lomntu.
KwiNgqungquthela yeChangeMed®️ ka-2023, uBrian George, MD, MS, ufumene iMbasa yokuKhawulezisa iChange in Medical Education Award ka-2023. Ukuze ufunde okungakumbi.
Ukwazisa isayensi yeenkqubo zempilo kwizikolo zonyango kuthetha ukufumana ikhaya layo kuqala. Funda okungakumbi kubafundisi bezonyango abaye bakwenza oko.
Uhlaziyo lwe-AMA lugubungela uluhlu lwezihloko zezempilo ezichaphazela ubomi boogqirha kunye nezigulane. Fumanisa indlela yokufumana imfihlo yenkqubo yokuhlala ephumelelayo.
Uhlaziyo lwe-AMA lugubungela uluhlu lwezihloko zezempilo ezichaphazela ubomi boogqirha kunye nezigulane. Fumanisa indlela yokufumana imfihlo yenkqubo yokuhlala ephumelelayo.
Ikhefu lokuhlawula imali mboleko yabafundi liphelile. Fumanisa ukuba oku kuthetha ukuthini koogqirha kunye neziphi iindlela abanazo.
Umfundi wezonyango okanye umhlali angayenza njani intetho entle yepowusta? Ezi ngcebiso zine zisiqalo esihle.
I-AMA ukuya kwi-CMS: Thatha amanyathelo akhawulezileyo ukuqinisekisa ukuba oogqirha abafumani uhlengahlengiso lwentlawulo ye-MIPS ngo-2024 ngokusekelwe ekusebenzeni kwe-MIPS ka-2022 kunye nolunye ulwazi oluchongiweyo kuhlaziyo lwamva nje olukhuthaza uhlengahlengiso lwentlawulo ye-Medicare.
Funda indlela i-CCB ecebisa ngayo utshintsho kuMgaqo-siseko we-AMA kunye neMithetho yeDolophu kwaye inceda ekuhlaziyeni imithetho, imigaqo kunye neenkqubo kwiindawo ezahlukeneyo ze-AMA.
Fumana iinkcukacha kunye nolwazi lokubhalisa iintlanganiso kunye nemicimbi yeCandelo looGqirha abancinci (YPS).
Fumana i-ajenda, amaxwebhu kunye nolwazi olongezelelweyo lweNtlanganiso ye-YPS yowama-2023 Midterm ngomhla we-10 kweyeNkanga kwiGaylord National Resort and Convention Center eNational Harbor, eMaryland.
INgqungquthela yoNcedo lwaBafundi bezonyango yaseMelika yoMbutho wezoNyango waseMelika ka-2024 (i-MAC) iya kubanjwa nge-7-8 kaMatshi, ngo-2024.
Izinto Ezibalulekileyo ZeSepsis: I-webinar yokugqibela kwi-webinar yeCenters for Disease Control and Prevention (CDC) ixoxa ngempembelelo yemfundo ngesepsis ekuqeshweni kwabasebenzi bezempilo. Bhalisa.
Uhlaziyo lwe-AMA lugubungela uluhlu lwezihloko zezempilo ezichaphazela ubomi boogqirha, abahlali, abafundi bezonyango kunye nezigulane. Phulaphula kwiingcali zonyango, ukusuka kwiinkokeli zezonyango zabucala kunye neenkqubo zempilo ukuya kwizazinzulu kunye namagosa ezempilo yoluntu, malunga ne-COVID-19, imfundo yezonyango, ukuthethelela, ukudinwa, izitofu zokugonya nokunye.
Kwi-AMA News yanamhlanje, owayesakuba nguMongameli we-AMA uGerald Harmon, MD, ujoyina ingxoxo yokunqongophala kwabasebenzi bezonyango kunye nexabiso loogqirha abadala. UDkt. Harmon wabelana ngeengcinga zakhe ngendima yakhe entsha njengomphathi wexeshana weSikolo sezonyango seYunivesithi yaseSouth Carolina eColumbia, umsebenzi wakhe njengosekela mongameli wemicimbi yezonyango kwiTidelands Health ePawleys Island, eSouth Carolina, kunye noko kufunekayo ukuze uhambe kwicandelo lezonyango. njengogqirha. Iingcebiso malunga nendlela yokuhlala usebenza. Oogqirha abangaphezu kweminyaka engama-65 ubudala. Umsingathi: Igosa eliyiNtloko lamava le-AMA uTodd Unger.
Emva kokulwela oogqirha ngexesha lobhubhane, i-American Medical Association ithatha umngeni wayo olandelayo ongaqhelekanga: ukuqinisekisa kwakhona ukuzibophelela kwesizwe koogqirha.
Unger: Molo kwaye wamkelekile kwividiyo ye-AMA ehlaziyiweyo kunye ne-podcast. Namhlanje sithetha ngokunqongophala kwabasebenzi kunye nokubaluleka koogqirha abadala ekusombululeni le ngxaki. Le ngxaki ixoxwa apha nguGqr. Gerald Harmon, umphathi wexeshana weSikolo sezonyango seYunivesithi yaseSouth Carolina eColumbia, eSouth Carolina, kunye nomongameli wangaphambili we-AMA, okanye ngamazwi akhe, “umongameli we-AMA obuyiselweyo.” NdinguTodd Unger, iGosa eliyiNtloko lamava e-AMA eChicago. Gqr. Harmon, ndiyavuya ukukwazi. Unjani?
UDkt. Harmon: Todd, ngumbuzo onomdla lowo. Ukongeza kwindima yam njengoSihlalo we-AMA Recovery, ndifumene indima entsha. Kule nyanga nje, ndiqale indima entsha kumsebenzi wam njengoSosayensi oyiNtloko yeNkqubo yezeMpilo kunye neDean yexeshana yeSikolo sezonyango kwiYunivesithi yaseSouth Carolina eColumbia, eSouth Carolina.
UDkt. Harmon: Kaloku, ziindaba ezinkulu ezo. Ibilutshintsho olungalindelekanga lomsebenzi kum. Umntu othile undixelele ngeziqinisekiso zakhe kunye nezinto azilindeleyo. Ndivakalelwa kukuba kum oku kukulingana okudalwe ezulwini, ukuba akukuko ukulingana okudalwe ezulwini, ubuncinane phakathi kweenkwenkwezi.
Unger: Ewe, ndiqinisekile ukuba xa bejonga i-resume yakho, bachukumisekile zezinye zezinto ozifezileyo. Ubungugqirha wosapho osebenzayo kangangeminyaka engama-35, uNcedisi woGqirha Jikelele we-United States Air Force, uGqirha Jikelele we-National Guard, kwaye, ewe, kutshanje, unguMongameli we-AMA. Oko akuyonxalenye yemfazwe. Ngokuqinisekileyo ufumene ilungelo lokuthatha umhlala-phantsi, kodwa uqala isahluko esitsha ngokupheleleyo. Yintoni ebangela oku?
UGqr. Harmon: Ndicinga ukuba bendiqonda ukuba ndisenalo ithuba lokwabelana ngamava am obomi nabanye. Igama elithi “ugqirha” livela kwisiLatini kwaye lithetha “ukuthwala okanye ukufundisa.” Ndivakalelwa kukuba ndisenako ukufundisa, ukwabelana ngamava am obomi, kunye nokubonelela ngemfundo kunye nesikhokelo (ukuba asikuko ulwalathiso) kwisizukulwana soogqirha abaqeqeshwayo kwanabo basebenza koogqirha. Ngoko ke bekukuhle kakhulu ukuba ndinganyaniseki ukuthatha indima yomncedisi wophando ngelixa ndigcina amandla am okufundisa eklinikhi. Ngoko ke bendingenakukwazi ukulilahla eli thuba.
UDkt. Harmon: Kaloku, indima yokuba ngumfundisi yinto endingazange ndiyibone ngaphambili. Ndandinguprofesa wekholeji kwaye ndifundisa iiklasi (ndifundisa ngokoqobo) ndingumntu endaweni yokunika amanqaku novavanyo olubhaliweyo kubafundi, abahlali, kunye nabanye oochwephesha bezempilo (abahlengikazi, iingcali ze-radiology, iingcali ze-sonographer, abancedisi boogqirha). Uninzi lweminyaka yam engama-35-40 yokusebenza, ndandingutitshala, ndingumfundisi osebenzayo. Ngoko ke le ndima ayiyonto intsha.
Ukuthandwa kwezemfundo akunakuthathelwa ngqalelo. Ndifunda – andisebenzisi lo mzekeliso ngepayipi yomlilo, kodwa ngeebhakethi zebhakethi. Ndicela abantu bandifundise ulwazi olunye ngexesha. Ngoko ke elinye isebe lizisa ibhakethi yalo, elinye isebe lizisa ibhakethi yalo, umphathi uzisa ibhakethi yalo. Emva koko ndathabatha ibhakethi endaweni yokuzaliswa yipayipi yomlilo ndize nditshone. Ukuze ndikwazi ukulawula amanqaku edatha kancinci. Siza kuzama enye ibhakethi kwiveki ezayo.
Unger: Gqirha Harmon, la magama ovula ngawo isahluko esitsha apha anomdla. Kwangaxeshanye, siyazi ukuba oogqirha abaninzi bakhetha ukuthatha umhlala-phantsi kwangethuba okanye ukukhawulezisa ngenxa yobhubhane. Ngaba ukhe wakubona okanye weva oku kusenzeka phakathi koogxa bakho?
UGqr. Harmon: Ndiyibonile iveki ephelileyo, Todd, ewe. Sinedatha ephakathi kobhubhane, mhlawumbi uphando lwedatha lwe-AMA luka-2021-2022, olubonisa ukuba ama-20%, okanye omnye koogqirha abahlanu, bathi baza kuthatha umhlala-phantsi. Baza kuthatha umhlala-phantsi kwiinyanga ezingama-24 ezizayo. Oku sikubona phakathi kwabanye oogqirha bezempilo, ingakumbi abahlengikazi. Ama-40% abahlengikazi (ababini kwabahlanu) bathi ndiza kuyishiya indima yam yokuba ngumongikazi kwisithuba seminyaka emibini ezayo.
Ngoko ke ewe, njengoko benditshilo, ndiyibonile le veki iphelileyo. Bendinogqirha okwinqanaba eliphakathi owabhengeza umhlala-phantsi wakhe. Ungugqirha wotyando, uneminyaka engama-60 ubudala. Uthe: Ndiyayeka ukusebenza. Le ntsholongwane indifundise ukuthatha izinto nzulu ngaphezu komsebenzi wam. Ndikwimeko entle yezemali. Kwicala lasekhaya, kufuneka achithe ixesha elingakumbi nosapho lwakhe. Ngoko ke wagqiba ekubeni athathe umhlala-phantsi ngokupheleleyo.
Ndinomnye umntu endisebenza naye olungileyo kunyango lweentsapho. Enyanisweni, umfazi wakhe weza kum kwiinyanga ezimbalwa ezidlulileyo wathi, “Uyazi, olu bhubhane lubeke uxinzelelo olukhulu kusapho lwethu.” Ndicele uGqr. X, umyeni wakhe, kunye nomnye endisebenza naye emsebenzini ukuba banciphise umthamo. Kuba uchitha ixesha elingakumbi eofisini. Akufika ekhaya, wahlala ekhompyutheni wenza wonke umsebenzi wekhompyutha awayengenalo ixesha lawo. Wayexakekile ebona inani elikhulu lezigulana. Ngoko ke uyayeka. Wayephantsi koxinzelelo losapho lwakhe. Unabantwana abahlanu.
Konke oku kubangela uxinzelelo olukhulu koogqirha abaninzi abadala, kodwa abo bakwiminyaka ephakathi emsebenzini, abaneminyaka engama-50 nangaphezulu, basengozini enkulu yoxinzelelo, njengezizukulwana zethu eziselula.
Unger: Ubuncinane oku kuyayenza ibe nzima imeko yokunqongophala koogqirha esisele siyibona. Enyanisweni, uphando olwenziwe yi-Association of American Medical Colleges luqikelela ukuba ukunqongophala koogqirha kuya kufikelela kwi-124,000 ngo-2034, nto leyo equka indibaniselwano yezinto esisandula ukuthetha ngazo, inani labantu abalupheleyo kunye nabasebenzi boogqirha abalupheleyo.
Njengogqirha wangaphambili wezonyango losapho okhonza uluntu oluninzi lwasemaphandleni, uthini uluvo lwakho ngale nto?
UGqr. Harmon: Todd, uchanekile. Ukunqongophala koogqirha kuya kusiba mandundu ngokukhawuleza, okanye ubuncinane ngokwe-logarithmic, kungekuphela nje ngokudibanisa nokuthabatha. Oogqirha bayaluphala. Sithetha ngento yokuba kwiminyaka elishumi ezayo, izigulane e-US ziya kuba neminyaka engama-65 ubudala nangaphezulu, kwaye ama-34% azo ngoku aya kufuna unyango. Kwiminyaka elishumi ezayo, ama-42% ukuya kuma-45% abantu baya kufuna unyango. Bafuna unyango olungakumbi. Ukhankanye ukunqongophala koogqirha. Ezi zigulane zikhulileyo zifuna unyango oluphezulu, kwaye uninzi lwazo luhlala kwiindawo zasemaphandleni ezinabantu abambalwa.
Ngoko ke njengoko oogqirha bekhula, ukuthatha umhlala-phantsi akushiyi ngasemva uninzi loogqirha nabasebenzi bezempilo abafuna ukuya kwiindawo zasemaphandleni, abafuna ukuya kwiindawo ezisele zingafumani nkonzo ingako. Ngoko ke, imeko kwiindawo zasemaphandleni iya kuba mandundu ngakumbi. Kungathi izigulane ezikuloo ndawo ziyaluphala kwaye inani labantu abakwiindawo zasemaphandleni alikhuli. Asikuboni ukwanda kwenani labasebenzi bezempilo abafudukela kwezi ndawo zasemaphandleni.
Ngoko ke kufuneka size netekhnoloji entsha, iingcamango ezintsha, unyango olukhawulezileyo, ukhathalelo olusekelwe kwiqela ukunceda ukuhlangabezana neemfuno zasemaphandleni aseMelika angenazo iinkonzo ezaneleyo.
Unger: Inani labantu liyakhula okanye liyaguga, kwaye noogqirha nabo bayaguga. Oku kudala umsantsa omkhulu. Ungajonga nje idatha engacacanga ukuba loo msantsa ubonakala njani?
UGqr. Harmon: Masithi isiseko soogqirha bangoku sikhonza izigulane ezingama-280,000. Njengoko inani labantu baseMelika likhula, lingama-34% ngoku kwaye lingama-42% ukuya kuma-45% kwiminyaka elishumi, ngoko ke njengoko ubonile, ndicinga ukuba loo manani amalunga nama-400,000 abantu. Ngoko ke lo ngumsantsa omkhulu. Ukongeza kwisidingo esiqikelelweyo soogqirha abaninzi, uya kufuna oogqirha abaninzi ukuze bakhonze abantu abadala.
Mandikuxelele. Ayingoogqirha kuphela. Lo ngugqirha we-radiology, lo ngumongikazi, ingasathethwa ke indlela abahlengikazi abathatha umhlala-phantsi ngayo. Iinkqubo zethu zezibhedlele kwiindawo zasemaphandleni zaseMelika zixinene kakhulu: akukho bachwephesha baneleyo be-sonographers, ii-radiologists, kunye neengcali zelebhu. Yonke inkqubo yezempilo eMelika sele yoluliwe ngenxa yokunqongophala kwabasebenzi bezempilo bazo zonke iintlobo.
Unger: Ukulungisa okanye ukusombulula ingxaki yokunqongophala koogqirha ngoku ngokucacileyo kufuna isisombululo esibanzi. Kodwa masithethe ngokuthe ngqo. Ucinga ukuba oogqirha abadala bangena njani kwesi sisombululo? Kutheni befanelekile ngokukodwa ekunyamekeleni abantu abadala?
UGqr. Harmon: Oku kunomdla. Ndicinga ukuba akukho mathandabuzo okuba ubuncinane baya kuba novelwano, ukuba abayi kuba novelwano, ngezigulane eziza. Kanye njengokuba sithetha ngabantu baseMelika abaneminyaka engama-65 nangaphezulu abenza ama-42% abantu, olu luhlu lwabantu lubonakala nakubasebenzi boogqirha: ama-42–45% oogqirha nabo baneminyaka engama-65 ubudala. Ngoko ke baya kuba namava afanayo obomi. Baya kukwazi ukuqonda ukuba ngaba kukunciphisa amalungu omzimba, ukuncipha kwengqondo okanye ukwehla kwengqondo, okanye ukungakwazi ukuva nokubona, okanye mhlawumbi nokuba sisifo esisifumanayo njengoko sikhula, isifo sentliziyo. isifo seswekile.
Sithethe ngendlela i-podcast endiyenzileyo ebonise ngayo ukuba malunga nezigidi ezingama-90 zaseMelika zinesifo seswekile, kwaye ama-85 ukuya kuma-90 ekhulwini abo abazi nokuba banesifo seswekile. Ngenxa yoko, abantu abadala baseMelika nabo bathwele umthwalo wezifo ezingapheliyo. Xa singena kuluhlu loogqirha, uya kufumanisa ukuba banovelwano, kodwa banamava obomi. Banezakhono ezahlukeneyo. Bayazi indlela yokwenza uxilongo.
Ngamanye amaxesha ndithanda ukucinga ukuba oogqirha abalingana nam kunye nam banokucinga baze benze uxilongo ngaphandle kobuchwepheshe obuthile. Akunyanzelekanga ukuba sicinge ngento yokuba ukuba lo mntu unengxaki encinci ngesi sixhobo somzimba, andizukuyenza i-MRI okanye i-PET scan okanye naluphi na uvavanyo lwelabhoratri. Ndingabona ukuba olu rhashalala yi-shingles. Oku akusiyo i-contact dermatitis. Kodwa kungenxa yokuba bendibona izigulana iminyaka engama-35 okanye engama-40 kuphela apho ndine-psychological index endincedayo ukusebenzisa oko ndikubiza ngokuba bubukrelekrele bokwenyani bomntu, kungekhona ubukrelekrele bokwenziwa, ekuxilongweni.
Ngoko ke akufuneki ndenze zonke ezi vavanyo. Ndingakwazi ukuxilonga kwangaphambili, ukunyanga nokuqinisekisa abantu abadala.
Unger: Olu lulandelelwano oluhle kakhulu. Ndifuna ukuthetha nawe ngakumbi ngalo mba malunga netekhnoloji. Ulilungu elisebenzayo leCandelo looGqirha abaPhezulu, uvakalisa izimvo kwaye unika iingcebiso kwimiba echaphazela oogqirha abaphezulu. Enye yezinto ezivele kakhulu kutshanje (enyanisweni, bendithetha kakhulu ngobukrelekrele bokwenziwa kwiiveki ezimbalwa ezidlulileyo) ngumbuzo wokuba oogqirha abadala baza kuziqhelanisa njani netekhnoloji entsha. Ziziphi iingcebiso onazo malunga noku? I-AMA inganceda njani?
UDkt. Harmon: Kaloku, undibonile ngaphambili – ndithethe esidlangalaleni kwiintetho nakwiiphaneli – kufuneka samkele obu buchwepheshe butsha. Abuyi kuphela. Oko sikubonayo kubukrelekrele bokwenziwa (i-AMA isebenzisa eli gama kwaye ndivumelana nalo ngakumbi) bubukrelekrele obongeziweyo. Kuba abuyi kuze buyithathe indawo yale khompyutha apha. Sinezakhono ezithile zokugweba nokwenza izigqibo ezingenakukwazi ukuzifunda kwanoomatshini ababalaseleyo.
Kodwa kufuneka siyiqonde kakuhle le teknoloji. Akufuneki siyilibazise inkqubela yakhe. Akufuneki siyilibazise ukuyisebenzisa. Akufuneki siyilibazise eminye imibhalo ye-elektroniki esithetha ngayo ngendlela ethoba isidima. Le yiteknoloji entsha. Ayizukuphela. Oku kuya kuphucula ukunikezelwa kweenkonzo zokhathalelo. Oku kuya kuphucula ukhuseleko, kunciphise iimpazamo, kwaye, ndicinga, kuphucule ukuchaneka kokuxilonga.
Ngoko ke oogqirha kufuneka bayamkele le nto baze bayijonge. Sisixhobo, njengayo nayiphi na enye into. Kufana nokusebenzisa i-stethoscope, usebenzisa amehlo akho, uchukumisa kwaye ujonge abantu. Kukuphucula izakhono zakho, hayi isithintelo.
Unger: UGqr. Harmon, umbuzo wokugqibela. Zeziphi ezinye iindlela oogqirha abagqiba kwelokuba abasakwazi ukunyamekela izigulane abanokuhlala bekhuthele kwimisebenzi yabo? Kutheni kuluncedo koogqirha nabasebenzi ukugcina unxibelelwano oluqinileyo kangaka?
UDkt. Harmon: Todd, wonke umntu uzenzela izigqibo zakhe kwihlabathi lakhe esebenzisa idatha yakhe. Ngoko ke, nangona ugqirha enokuba nemibuzo malunga nobuchule bakhe, ukhuseleko lwakhe, nokuba kusegumbini lotyando okanye kwindawo yokunyanga apho usenza khona uxilongo, awunyanzelekanga ukuba wenze izixhobo okanye utyando. Kukho utshintsho oluqhelekileyo. Sonke kufuneka sikhathazeke ngale nto.
Okokuqala, ukuba ukhathazekile ngokwenene, ukuba uyathandabuza izakhono zakho, zengqondo okanye zomzimba, thetha nomntu osebenza naye. Musa ukuba neentloni. Sinengxaki efanayo nempilo yokuziphatha. Xa ndithetha namaqela oogqirha, ndiyazi ukuba sithetha ngokudinwa ngoogqirha. Sithetha ngeengxaki zomsebenzi kunye nendlela esidimazeke ngayo. Idatha yethu ibonisa ukuba ngaphezulu kwama-40% oogqirha babecinga ngeendlela zabo zomsebenzi—nditsho, elo linani eloyikekayo.
Ixesha lokuthumela: Oktobha-13-2023