User login
We are living through an era of rapidly accelerated social, political, and environmental change. Spiraling costs of medical care, consumer activism around health care delivery, an aging population, and growing evidence of climate change are just some of the big currents of change. These trends are national and global in scope, and as such, far beyond any one profession or sector to shape or control. It remains for the medical profession to understand the currents of the time and adapt in order to thrive in the future.
Regulatory environment in flux
Hospitals and clinicians continue to struggle with a regulatory framework designed to improve higher quality of care yet may be creating additional barriers to access and efficiency. The passionate debate about health care costs and coverage is ongoing at the national level and appears to be a central issue on the minds of voters. Although the outcome of the debate cannot be foreseen, it will be left to the medical profession to maintain standards of care. Although the Affordable Care Act may not be repealed, the federal government’s role may diminish as policy is likely to be made by state politicians and bureaucrats.1 As a result, organizations operating in multiple states may find it difficult to develop organization-wide business strategies. And with the shift to value-based reimbursement and issues related to data breaches regarding private patient health care information, many health care professionals will need better support and documentation tools to remain compliant. This puts a large burden on medical organizations to invest even more in information technology, data management systems, and a wide range of training up and down the organizational chart. Keeping up with the needs of physicians for secure data management will be costly but critical.
Patients will feel climate change
Environmental factors affecting the air we breathe are of primary concern for patients with a broad range of cardiorespiratory conditions.2 Healthy but vulnerable infants, children, pregnant women, and the elderly may also feel the effects.3 Air pollution, increased levels of pollen and ground-level ozone, and wildfire smoke are all tied to climate change and all can have a direct impact on the patients seen by chest physicians.4 Individuals exposed to these environmental conditions may experience diminished lung function, resulting in increased hospital admissions.
Keeping up with the latest research on probable health impacts of these environmental trends will be on the agenda of most chest physicians.5 Professional societies will need to prepare to serve the educational needs of members in this regard. Continuing education content on these topics will be needed. The field will respond with new diagnostic tools and new treatments.6 Climate change may be a global-level phenomenon, but for many chest physicians, it means treating increasing numbers of patients affected by pulmonary disease.
Mind the generation gap
The population in the United States is primarily under the age of 65 years (84%), but the number of older citizens is on the rise. In 2016, there were 49.2 million people age 65 or older, and this number is projected to almost double to 98 million in 2060. The 85-and-over population is projected to more than double from 6.4 million in 2016 to 14.6 million in 2040 (a 129% increase).7
The medical needs of the aging population are already part of most medical institution’s planning but the current uncertainty in the health insurance market and the potential changes in Medicare coverage, not to mention the well-documented upcoming physician shortage, are complicating the planning process.8 Almost all acknowledge the “graying” of the population, but current approaches may not be sufficient given the projected the scale of the problems such as major increases in patients with chronic illnesses and the need for upscaling long-term geriatric care.
Planning for treating a growing elderly population shouldn’t mean ignoring some trends appearing among the younger population. E-cigarette use among middle- and high-school students may be creating millions of future patients with lung damage and nicotine addictions.9 Government intervention in this smoking epidemic is lagging behind the rapid spread of this unhealthy habit among young people.10 In 2019, health coverage of adults has begun to decline again after a decade of gains, and the possibility of this becoming a long-term trend has to be considered in planning for their treatment.11,12
References
1. Statistica. “Affordable Care Act - Statistics & Facts,” Matej Mikulic. 2019 Aug 14.
2. American Public Health Association and Centers for Disease Control and Prevention (2018). Climate Change Decreases the Quality of the Air We Breathe. Accessed 2019 Oct 7.
3. JAMA. 2019 Aug 13;322(6):546-56. doi: 10.1001/jama.2019.10255.
4. Lelieveld J et al. Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions. Eur Heart J. 2019;40(20); 1590-6. doi: 10.1093/eurheartj/ehz135
5. European Respiratory Society. CME Online: Air pollution and respiratory health. 2018 Jun 21.
6. Environmental Protection Agency. “Particle Pollution and Your Patients’ Health,” Continuing Education for Particle Pollution Course. 2019 May 13.
7. U.S. Department of Health & Human Services. Administration on Aging. 2017 Profile of Older Americans. Accessed 2019 Oct 7.
8. Association of American Medical Colleges. Complexities of Physician Supply and Demand: Projection from 2017 to 2032. 2019 Apr.
9. Miech R et al. Trends in Adolescent Vaping, 2017-2019. N Eng J Med. 2019 Sep 18. doi: 10.1056/NEJMc1910739
10. Ned Sharpless, MD, Food and Drug Administration Acting Commissioner. “How the FDA is Regulating E-Cigarettes,” 2019 Sep 10.
11. Congressional Budget Office. Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2019 to 2029. Washington D;C.: GPO, 2029
12. Galewitz P. “Breaking a 10-year streak, the number of uninsured Americans rises.” Internal Medicine News, 2019 Sep 11.
Note: Background research performed by Avenue M Group.
CHEST Inspiration is a collection of programmatic initiatives developed by the American College of Chest Physicians leadership and aimed at stimulating and encouraging innovation within the association. One of the components of CHEST Inspiration is the Environmental Scan, a series of articles focusing on the internal and external environmental factors that bear on success currently and in the future. See “Envisioning the Future: The CHEST Environmental Scan,” CHEST Physician, June 2019, p. 44, for an introduction to the series.
We are living through an era of rapidly accelerated social, political, and environmental change. Spiraling costs of medical care, consumer activism around health care delivery, an aging population, and growing evidence of climate change are just some of the big currents of change. These trends are national and global in scope, and as such, far beyond any one profession or sector to shape or control. It remains for the medical profession to understand the currents of the time and adapt in order to thrive in the future.
Regulatory environment in flux
Hospitals and clinicians continue to struggle with a regulatory framework designed to improve higher quality of care yet may be creating additional barriers to access and efficiency. The passionate debate about health care costs and coverage is ongoing at the national level and appears to be a central issue on the minds of voters. Although the outcome of the debate cannot be foreseen, it will be left to the medical profession to maintain standards of care. Although the Affordable Care Act may not be repealed, the federal government’s role may diminish as policy is likely to be made by state politicians and bureaucrats.1 As a result, organizations operating in multiple states may find it difficult to develop organization-wide business strategies. And with the shift to value-based reimbursement and issues related to data breaches regarding private patient health care information, many health care professionals will need better support and documentation tools to remain compliant. This puts a large burden on medical organizations to invest even more in information technology, data management systems, and a wide range of training up and down the organizational chart. Keeping up with the needs of physicians for secure data management will be costly but critical.
Patients will feel climate change
Environmental factors affecting the air we breathe are of primary concern for patients with a broad range of cardiorespiratory conditions.2 Healthy but vulnerable infants, children, pregnant women, and the elderly may also feel the effects.3 Air pollution, increased levels of pollen and ground-level ozone, and wildfire smoke are all tied to climate change and all can have a direct impact on the patients seen by chest physicians.4 Individuals exposed to these environmental conditions may experience diminished lung function, resulting in increased hospital admissions.
Keeping up with the latest research on probable health impacts of these environmental trends will be on the agenda of most chest physicians.5 Professional societies will need to prepare to serve the educational needs of members in this regard. Continuing education content on these topics will be needed. The field will respond with new diagnostic tools and new treatments.6 Climate change may be a global-level phenomenon, but for many chest physicians, it means treating increasing numbers of patients affected by pulmonary disease.
Mind the generation gap
The population in the United States is primarily under the age of 65 years (84%), but the number of older citizens is on the rise. In 2016, there were 49.2 million people age 65 or older, and this number is projected to almost double to 98 million in 2060. The 85-and-over population is projected to more than double from 6.4 million in 2016 to 14.6 million in 2040 (a 129% increase).7
The medical needs of the aging population are already part of most medical institution’s planning but the current uncertainty in the health insurance market and the potential changes in Medicare coverage, not to mention the well-documented upcoming physician shortage, are complicating the planning process.8 Almost all acknowledge the “graying” of the population, but current approaches may not be sufficient given the projected the scale of the problems such as major increases in patients with chronic illnesses and the need for upscaling long-term geriatric care.
Planning for treating a growing elderly population shouldn’t mean ignoring some trends appearing among the younger population. E-cigarette use among middle- and high-school students may be creating millions of future patients with lung damage and nicotine addictions.9 Government intervention in this smoking epidemic is lagging behind the rapid spread of this unhealthy habit among young people.10 In 2019, health coverage of adults has begun to decline again after a decade of gains, and the possibility of this becoming a long-term trend has to be considered in planning for their treatment.11,12
References
1. Statistica. “Affordable Care Act - Statistics & Facts,” Matej Mikulic. 2019 Aug 14.
2. American Public Health Association and Centers for Disease Control and Prevention (2018). Climate Change Decreases the Quality of the Air We Breathe. Accessed 2019 Oct 7.
3. JAMA. 2019 Aug 13;322(6):546-56. doi: 10.1001/jama.2019.10255.
4. Lelieveld J et al. Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions. Eur Heart J. 2019;40(20); 1590-6. doi: 10.1093/eurheartj/ehz135
5. European Respiratory Society. CME Online: Air pollution and respiratory health. 2018 Jun 21.
6. Environmental Protection Agency. “Particle Pollution and Your Patients’ Health,” Continuing Education for Particle Pollution Course. 2019 May 13.
7. U.S. Department of Health & Human Services. Administration on Aging. 2017 Profile of Older Americans. Accessed 2019 Oct 7.
8. Association of American Medical Colleges. Complexities of Physician Supply and Demand: Projection from 2017 to 2032. 2019 Apr.
9. Miech R et al. Trends in Adolescent Vaping, 2017-2019. N Eng J Med. 2019 Sep 18. doi: 10.1056/NEJMc1910739
10. Ned Sharpless, MD, Food and Drug Administration Acting Commissioner. “How the FDA is Regulating E-Cigarettes,” 2019 Sep 10.
11. Congressional Budget Office. Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2019 to 2029. Washington D;C.: GPO, 2029
12. Galewitz P. “Breaking a 10-year streak, the number of uninsured Americans rises.” Internal Medicine News, 2019 Sep 11.
Note: Background research performed by Avenue M Group.
CHEST Inspiration is a collection of programmatic initiatives developed by the American College of Chest Physicians leadership and aimed at stimulating and encouraging innovation within the association. One of the components of CHEST Inspiration is the Environmental Scan, a series of articles focusing on the internal and external environmental factors that bear on success currently and in the future. See “Envisioning the Future: The CHEST Environmental Scan,” CHEST Physician, June 2019, p. 44, for an introduction to the series.
We are living through an era of rapidly accelerated social, political, and environmental change. Spiraling costs of medical care, consumer activism around health care delivery, an aging population, and growing evidence of climate change are just some of the big currents of change. These trends are national and global in scope, and as such, far beyond any one profession or sector to shape or control. It remains for the medical profession to understand the currents of the time and adapt in order to thrive in the future.
Regulatory environment in flux
Hospitals and clinicians continue to struggle with a regulatory framework designed to improve higher quality of care yet may be creating additional barriers to access and efficiency. The passionate debate about health care costs and coverage is ongoing at the national level and appears to be a central issue on the minds of voters. Although the outcome of the debate cannot be foreseen, it will be left to the medical profession to maintain standards of care. Although the Affordable Care Act may not be repealed, the federal government’s role may diminish as policy is likely to be made by state politicians and bureaucrats.1 As a result, organizations operating in multiple states may find it difficult to develop organization-wide business strategies. And with the shift to value-based reimbursement and issues related to data breaches regarding private patient health care information, many health care professionals will need better support and documentation tools to remain compliant. This puts a large burden on medical organizations to invest even more in information technology, data management systems, and a wide range of training up and down the organizational chart. Keeping up with the needs of physicians for secure data management will be costly but critical.
Patients will feel climate change
Environmental factors affecting the air we breathe are of primary concern for patients with a broad range of cardiorespiratory conditions.2 Healthy but vulnerable infants, children, pregnant women, and the elderly may also feel the effects.3 Air pollution, increased levels of pollen and ground-level ozone, and wildfire smoke are all tied to climate change and all can have a direct impact on the patients seen by chest physicians.4 Individuals exposed to these environmental conditions may experience diminished lung function, resulting in increased hospital admissions.
Keeping up with the latest research on probable health impacts of these environmental trends will be on the agenda of most chest physicians.5 Professional societies will need to prepare to serve the educational needs of members in this regard. Continuing education content on these topics will be needed. The field will respond with new diagnostic tools and new treatments.6 Climate change may be a global-level phenomenon, but for many chest physicians, it means treating increasing numbers of patients affected by pulmonary disease.
Mind the generation gap
The population in the United States is primarily under the age of 65 years (84%), but the number of older citizens is on the rise. In 2016, there were 49.2 million people age 65 or older, and this number is projected to almost double to 98 million in 2060. The 85-and-over population is projected to more than double from 6.4 million in 2016 to 14.6 million in 2040 (a 129% increase).7
The medical needs of the aging population are already part of most medical institution’s planning but the current uncertainty in the health insurance market and the potential changes in Medicare coverage, not to mention the well-documented upcoming physician shortage, are complicating the planning process.8 Almost all acknowledge the “graying” of the population, but current approaches may not be sufficient given the projected the scale of the problems such as major increases in patients with chronic illnesses and the need for upscaling long-term geriatric care.
Planning for treating a growing elderly population shouldn’t mean ignoring some trends appearing among the younger population. E-cigarette use among middle- and high-school students may be creating millions of future patients with lung damage and nicotine addictions.9 Government intervention in this smoking epidemic is lagging behind the rapid spread of this unhealthy habit among young people.10 In 2019, health coverage of adults has begun to decline again after a decade of gains, and the possibility of this becoming a long-term trend has to be considered in planning for their treatment.11,12
References
1. Statistica. “Affordable Care Act - Statistics & Facts,” Matej Mikulic. 2019 Aug 14.
2. American Public Health Association and Centers for Disease Control and Prevention (2018). Climate Change Decreases the Quality of the Air We Breathe. Accessed 2019 Oct 7.
3. JAMA. 2019 Aug 13;322(6):546-56. doi: 10.1001/jama.2019.10255.
4. Lelieveld J et al. Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions. Eur Heart J. 2019;40(20); 1590-6. doi: 10.1093/eurheartj/ehz135
5. European Respiratory Society. CME Online: Air pollution and respiratory health. 2018 Jun 21.
6. Environmental Protection Agency. “Particle Pollution and Your Patients’ Health,” Continuing Education for Particle Pollution Course. 2019 May 13.
7. U.S. Department of Health & Human Services. Administration on Aging. 2017 Profile of Older Americans. Accessed 2019 Oct 7.
8. Association of American Medical Colleges. Complexities of Physician Supply and Demand: Projection from 2017 to 2032. 2019 Apr.
9. Miech R et al. Trends in Adolescent Vaping, 2017-2019. N Eng J Med. 2019 Sep 18. doi: 10.1056/NEJMc1910739
10. Ned Sharpless, MD, Food and Drug Administration Acting Commissioner. “How the FDA is Regulating E-Cigarettes,” 2019 Sep 10.
11. Congressional Budget Office. Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2019 to 2029. Washington D;C.: GPO, 2029
12. Galewitz P. “Breaking a 10-year streak, the number of uninsured Americans rises.” Internal Medicine News, 2019 Sep 11.
Note: Background research performed by Avenue M Group.
CHEST Inspiration is a collection of programmatic initiatives developed by the American College of Chest Physicians leadership and aimed at stimulating and encouraging innovation within the association. One of the components of CHEST Inspiration is the Environmental Scan, a series of articles focusing on the internal and external environmental factors that bear on success currently and in the future. See “Envisioning the Future: The CHEST Environmental Scan,” CHEST Physician, June 2019, p. 44, for an introduction to the series.