Healthcare trends: New tech but few family doctors

The health care industry in San Francisco and on the Peninsula is spending money on technology to increase patient safety, even as it worries about shortages in job candidates for essential roles, including primary-care doctors and nurses.

In this, the region reflects industry trends nationwide. According to a 1999 Institute of Medicine survey cited by the National Institutes of Health, 44,000 to 98,000 people die annually in hospitals as a result of errors in care. Meanwhile, primary care doctors are becoming rarer, with only 24 percent of third-year internal medicine residents in 2006 intending to pursue careers in general internal medicine, down from 54 percent in 1998, according to the American College of Physicians.

Key new technologies include electronic medical records such as the system adopted by Catholic Healthcare West’s St. Mary’s Medical Center this year, which eliminate lost paper and bad doctor handwriting that can lead to incorrectly filled prescriptions and missing information.

Another new technology is a barcode system for administering drugs, already in use by Sutter Health’s Mills Peninsula Health Services and recently adopted by the county-run San Mateo Medical Center. Nurses delivering drugs scan a barcode bracelet on their own wrist, then the medication vial, and finally a barcode bracelet on the patient.

The goal is to get the right amount of the right drugs delivered at the right time, San Mateo Medical Center VP Dr. Chester Kunnappilly said.

“Many hospitals are looking at this,” Kunnappilly said. “We are just waiting for a couple pieces of the infrastructure to be ready to go.”

Meanwhile, while some health care organizations have few job vacancies, industry officials throughout San Francisco and the Peninsula are concerned that there are not enough people in some needed professions.

For primary care physicians, a growing pay gap between the prevention-oriented internist and the specialist doctors who order the expensive tests is at fault, according to Mills Peninsula Medical Group CEO Brian Roach and UC San Francisco Chairman of Family and Community Medicine Kevin Grumbach.

The demanding, 24/7 lifestyle of traditional primary care physicians is also an issue,as more doctors choose to work solely in hospitals or as specialists, where they can keep regular hours.

“There’s a pipeline of primary care physicians in the United States and San Francisco that’s been drying up,” Grumbach said.

That pushes more care into the more expensive realm of specialists, driving up health care costs, he said. Grumbach advocates for a system similar to one adopted in North Carolina, where doctors are paid a monthly per-patient stipend for maintaining medical records and focusing on proactive care.

Hospitals are increasingly working with schools and unions to increase the number of people studying nursing and high-paying but rare technical specialties, according to hospital officials and the United Healthcare Workers West union.

Economic engines

A look at changes in the industries that employ the workers of The City and the Peninsula

Monday: Introduction

Tuesday: Hospitality

Today: Health care

Thursday: Finance

Friday: Technology

kwilliamson@examiner.com

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