The Patient Protection and Affordable Care Act, signed into law in 2010 and upheld by the U.S. Supreme Court last year, is expected to provide health care coverage to as many as 32 million Americans by 2019. As demand for health care expands, the need for accurate data about the current and future physician workforce will remain paramount. This census of actively licensed physicians in the United States and the District of Columbia represents data received from state medical boards in 2012 by the Federation of State Medical Boards. It demonstrates that the total population of licensed physicians (878,194) has expanded by 3% since 2010, is slightly older, has more women, and includes a substantive increase in physicians who graduated from a medical school in the Caribbean. As state medical boards begin to collect a Minimum Data Set about practicing physicians and their practice patterns in the years ahead, this information will inform decisions by policymakers, regulators and health care market participants to better align health care demand with supply.
The outcomes and costs of 6 different methods of motivating therapists to meet service delivery goals at a community mental health center for children and adolescents were evaluated over a 5-year period. The costs and cost-savings benefits of each motivational method were compared with each other and with two baselines. Four incentive interventions generated more cost savings than they required in monetary outlays. Most cost-beneficial were bonuses paid to therapists for each hour of service they delivered over their monthly goals and bonus plans that rewarded therapists for exceeding their goals while also rewarding staff if total department goals were exceeded. The most cost-beneficial system saved $25,542 over 6 months that would have been paid to compensate for therapy hours not delivered, for an incentive investment of $9,726 over the 6 months. This yielded a net benefit of $15,816, or $31,632 annually.
Fulfilling a statutory responsibility to protect the public within their jurisdictions, state medical boards have been working with the Federation of State Medical Boards (FSMB) and collaborating organizations to thoughtfully explore pathways and procedures by which Maintenance of Licensure (MOL) may be implemented for physicians in the years ahead. As a better understanding emerges of the types of continuing medical education (CME) and continuous professional development (CPD) activities physicians already engage in, and the resources that may be necessary for state boards to meaningfully implement MOL, questions have sometimes arisen about the value of these activities in contributing to quality health care and improved patient outcomes. Though MOL has not yet been formally implemented, there is a growing body of compelling evidence and rationale for the educational activities that could meet a state board's requirements for MOL. This article summarizes the recent literature on the subject, including CME and CPD, and recent policy statements of organizations and thought leaders from the house of medicine.
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