We will move our petition for the pilot residency program for PhA from change.org into Gofundme.com. Please ask your friends, colleages, families, etc. to support us, here is the link:
https://www.gofundme.com/ca-amp-the-us-need-more-family-mds

If supporters want to donate for this petition, PLEASE DONATE TO our organization directly!

Sep 29, 2018 — 

Good news: I just received the first draft of our Physician Associate Act Initiative!

Sep 22, 2018 — 

PhA-American Physician Associates, Inc.

1208 Elgin Street

San Leandro, CA 94578

www.usapha.org

5103315453

AmericaPhA@gmail.com

 

Sponsorship Invitation Plans for The PhA Organization

By Founder/President/CEO

These suggestive sponsorship ideas are subjective to change

The PhA Organization is short for The American Physician Associates, Inc.

www.usapha.org

Our Mission – The PhA Organization a 501(c)(3)

Healthcare is a human right; as a result, practicing medicine is also a right of healthcare professionals.

 

A solution for US person foreign-train MDs to close the disparity gap for quality healthcare access for the American/Californian community confronting the serious problem of shortage of physicians especially primary care physicians.

 

Our nation is struggling with the broken healthcare system on many aspects. One of them is the shortage of medical doctors. From a reliable resource, the shortage of MDs at this time is about no less than 30,000 national-wide as a humble number of estimation; however, in the next decade and later on with the increase in population, it only worsens. Shortage of providers is the main cause to lead to quality healthcare access disparity.

 

To be able to practice medicine independently, a physician must have a powerful piece of paper, a medical doctor license. However, the current medical licensing system in the US has become intricate, redundant, and wasteful; it effectively prevents many qualified MD professionals to be able to properly licensed. So, it turns out to be a counter-productive system to supply for the high demand of public healthcare services.

 

Among the physicians and medical graduates who are prevented from finalizing their MD licenses, foreign-trained US physicians are the worst victimized professionals. There are many external and internal causes that expose their vulnerability to the current ineffective licensing system. In my book, Survival Skills for USMLEs and Medical Licensing in the US, I have articulated all the issues, small and big ones.

 

Please visit our website: www.usapha.org

 

 

 

WHAT YOU CAN OFFER OUR ORGANIZATION

1- Legislative support: the support to make Sacto governor office to authorize for these milestone goals and ultimate goals to support the PhA Organization businesses and any and all its subsequent businesses necessarily.

• Help the PhA Organization to reach each of it milestone goals and the ultimate goals: (elaborate more details): these milestone goals are expected to be launched and developed through a period of 5 to 10 years or more or less, it depends on many variances and unexpected events.

 

These milestone goals can be simultaneously executed at the same time if needed and are not supposed to be waited in line.

 

+ First milestone goal: From the ECMFG certificate into The PhA license

+ Second milestone goal:

• Obtain the list of foreign-trained MDs who are currently living in US soil, especially California.
• Pilot program (PhA medical residency) for PhA Physician Associates in Northern California, especially the Central Valley and the East Bay of the Bay Area, underserved areas of Northern California, grant the PhA license to the graduated PhAs from the PhA residency program.

+ Third milestone goal: administration of the PhA Physician Associate licenses by the PhA Organization: (Collecting authentic medical education from medical schools for each and all the potential PhA Physician Associates who enter the residency program for PhA as pilot and later is an established PhA residency program, USMLE scores, clerkships, working histories from foreign countries and in America, etc.)

+ Fourth milestone goal: Spread the Pilot program throughout other areas of California statewide

+ Fifth milestone goal and so on: tbd

+ Ultimate goal: From PhA License into MD license and merge into the current mainstream of MD practicing workforce.

 

2- Promotion-Advertisement-Media broadcasting support:

 

• Help the PhA Organization to promote their PhA project to statewide California businesses and residents so the whole population be aware of the coming of a new medical professional license with professionals who can provide quality of healthcare.
• This promotion advertisement should be aggressive to meet with the election timeline when it is due.
• Both online and onsite

3- Educational programs support:

• Help the PhA Organization to develop professional educational programs for potential PhA Physician Associates in medical practice. E.g. the extensive review programs on USMLEs to prepare these PhAs to enter the pilot program are one of the very first professional educational programs. There are a lot more later coming into sight.
• Help the PhA Organization to develop educational program and connection to the general public in primary care.

4- Technical support:

• Help the PhA Organization to develop their very first website and any subsequent websites for its businesses.
• Help to develop and to maintain applications for devices, electronic gadgets, online and onsite communications, remote communications, computer systems, etc. More detail should be elaborated when it comes to the time.

5- Human resources support:

• Help the PhA Organization to search for talents to work for the organization and its subsequent businesses. They can be employees, contractors, and/or volunteers, etc. basis.

6- Facilities, means and/or physical and service modality support:

• Help the PhA Organization with physical office(s) and other professional and general facilities necessary for the businesses.
• Help the PhA Organization in any and all of their activities that serve its mission. For example: campaign means, meetings with the general public that need revenue, a location, communications, etc.

7- Financial support:

• Delineate financial plans to sponsor all the above needs from the PhA Organization.

 

WHAT BENEFITS YOU GET FROM OUR ORGANIZATION

All direct sponsors, indirect sponsors, donators, volunteers, etc. are listed in our thanking list of honors.

A- AS (A) DIRECT SPONSOR(S):

1- SUPPER STAR DIRECT SPONSOR:

a- What you offer: at least three or more of the full or a major portion of the full featured services of the above list of the seven needs for the PhA Organization. There would be detailed delineation of the terms, conditions, executions and managements of the projects of sponsorship.

b- What you get:

• Your businesses, individual entit(ies) are addressed in both speaking and written at conferences, meetings, seminars, etc. across statewide or nationwide where the PhA Organization Founder/President/CEOand/or PhA Organization Representatives give the talk session(s).
• Your businesses, individual entit(ies) are displayed on our front page websites as slide show with different frequencies, durations, etc. These features would be discussed in more detailed terms and conditions when the actual contract(s) between the PhA Organization representative(s) are delineated.

Plus:

• Your company logo prominently placed on the back of all the event shirts.
• Recognition as a Gold Sponsor during our event through the PA announcements
• Opportunity to have your “promotional items” made available at any and all event.
• Your logo not only on our sponsor page but also on our main page.
• Your logo on all our flyers sent out to the public.
• Company supplied banner to be put up at all events.
• Certificate of Recognition

 

2- FIVE STARS DIRECT SPONSOR:

a- What you offer: at least two or more of the full or a major portion of the full featured services of the above list of the seven needs for the PhA Organization above. There would be detailed delineation of the terms, conditions, executions and managements of the projects of sponsorship.

b- What you get:

• Your businesses, individual entit(ies) are addressed in both speaking and written at conferences, meetings, seminars, etc. across statewide or nationwide where the PhA Organization Founder/President/CEOand/or PhA Organization Representatives give the talk session(s).
• Your businesses, individual entit(ies) are displayed on our front page websites as slide show with different frequencies, durations, etc. These features would be discussed in more detailed terms and conditions when the actual contract(s) between the PhA Organization representative(s) are delineated.

Plus:

• Your company logo prominently placed on the back of all the event shirts.
• Recognition as a Gold Sponsor during our event through the PA announcements
• Opportunity to have your “promotional items” made available at any and all event.
• Your logo not only on our sponsor page but also on our main page.
• Your logo on all our flyers sent out to the public.
• Company supplied banner to be put up at all events.
• Certificate of Recognition

 

3- FOUR STARS DIRECT SPONSOR:

a- What you offer: at least one or more of the full or a major portion of the full featured services of the above list of the seven needs for the PhA Organization above. There would be detailed delineation of the terms, conditions, executions and managements of the projects of sponsorship.

b- What you get:

• Your businesses, individual entit(ies) are addressed in both speaking and written at conferences, meetings, seminars, etc. across statewide or nationwide where the PhA Organization Founder/President/CEOand/or PhA Organization Representatives give the talk session(s).
• Your businesses, individual entit(ies) are displayed on our front page websites as slide show with different frequencies, durations, etc. These features would be discussed in more detailed terms and conditions when the actual contract(s) between the PhA Organization representative(s) are delineated.

Plus:

• Your company logo prominently placed on the back of all the event shirts.
• Recognition as a Gold Sponsor during our event through the PA announcements
• Opportunity to have your “promotional items” made available at any and all event.
• Your logo not only on our sponsor page but also on our main page.
• Your logo on all our flyers sent out to the public.
• Company supplied banner to be put up at all events.
• Certificate of Recognition

 

4- THREE STARS DIRECT SPONSOR:

a- What you offer: partial yet functional services sponsorship of any one or more of the featured services of the above list of seven needs for the PhA Organization above. There would be detailed delineation of the terms, conditions, executions and managements of the projects of sponsorship.

b- What you get:

• Your businesses, individual entit(ies) are addressed in both speaking and written at conferences, meetings, seminars, etc. across statewide or nationwide where the PhA Organization Founder/President/CEOand/or PhA Organization Representatives give the talk session(s).
• Your businesses, individual entit(ies) are displayed on our front page websites as slide show with different frequencies, durations, etc. These features would be discussed in more detailed terms and conditions when the actual contract(s) between the PhA Organization representative(s) are delineated.

Plus:

• Your company logo prominently placed on the back of all the event shirts.
• Recognition as a Gold Sponsor during our event through the PA announcements
• Opportunity to have your “promotional items” made available at any and all event.
• Your logo not only on our sponsor page but also on our main page.
• Your logo on all our flyers sent out to the public.
• Company supplied banner to be put up at all events.
• Certificate of Recognition

 

B- AS (AN) INDIRECT SPONSOR(S) and DONATOR(S):

1- DIAMOND INDIRECT SPONSOR:

a- What you offer: $200,000 – $500,000

b- What you get:

b- What you get:

• Your businesses, individual entit(ies) are addressed in both speaking and written at conferences, meetings, seminars, etc. across statewide or nationwide where the PhA Organization Founder/President/CEOand/or PhA Organization Representatives give the talk session(s).
• Your businesses, individual entit(ies) are displayed on our front page websites as slide show with different frequencies, durations, etc. These features would be discussed in more detailed terms and conditions when the actual contract(s) between the PhA Organization representative(s) are delineated.

Plus:

• Your company logo prominently placed on the back of all the event shirts.
• Recognition as a Gold Sponsor during our event through the PA announcements
• Opportunity to have your “promotional items” made available at any and all event.
• Your logo not only on our sponsor page but also on our main page.
• Your logo on all our flyers sent out to the public.
• Company supplied banner to be put up at all events.
• Certificate of Recognition

 

2- GOLD INDIRECT SPONSOR:

a- What you offer: $50,000 – $199,999

b- What you get:

• Your businesses, individual entit(ies) are addressed in both speaking and written at conferences, meetings, seminars, etc. across statewide or nationwide where the PhA Organization Founder/President/CEOand/or PhA Organization Representatives give the talk session(s).
• Your businesses, individual entit(ies) are displayed on our front page websites as slide show with different frequencies, durations, etc. These features would be discussed in more detailed terms and conditions when the actual contract(s) between the PhA Organization representative(s) are delineated.

Plus:

• Your company logo prominently placed on the back of all the event shirts.
• Recognition as a Gold Sponsor during our event through the PA announcements
• Opportunity to have your “promotional items” made available at any and all event.
• Your logo not only on our sponsor page but also on our main page.
• Your logo on all our flyers sent out to the public.
• Company supplied banner to be put up at all events.
• Certificate of Recognition

 

3- SILVER INDIRECT SPONSOR:

a- What you offer: $10,000 – $49,999

b- What you get:

• Your businesses, individual entit(ies) are displayed on our front page websites as slide show with different frequencies, durations, etc. These features would be discussed in more detailed terms and conditions when the actual contract(s) between the PhA Organization representative(s) are delineated.

Plus:

• Recognition at all event
• Recognition as a Silver Sponsor during our event through the PA announcements.
• Your company logo placed on the back of all the event shirts.
• Your logo on our website sponsor page.
• Company supplied banner to be put up at events.
• Certificate of Recognition

 

4- BRONZE INDIRECT SPONSOR:

a- What you offer: $1,000 – $9,999

b- What you get:

Plus:

• Recognition at all events
• Your company logo placed on the back of all the event shirts.
• Your logo on our website sponsor page.

• Company supplied banner to be put up at events.
• Certificate of Recognition

 

5- COMMUNITY INDIRECT SPONSOR:

a- What you offer: $100- $999

b- What you get:

• Recognition at all events
• Your logo placed on the back of all the event shirts.
• Your company logo on our sponsor page.
• Company supplied banner to be put up at events.
• Certificate of Recognition

 

6- Donators: any amount below $100

You will be listed in our donator list.

 

 

 

 

Investing in the Future HealthCare System:

 

 

2018 Sponsorship Agreement Form

 

Sponsors Name:  _________________________________ Contact Person:  _________________________________

 

Address:  _________________________________________________________________________________

 

Phone: ______________________________ Email:  _______________________________________________

 

Signed:  ______________________________________________________________ Date:  _______________

 

 

 

 

 

 

	Please return this form and payment to: American Physician Associates www.usapha.org 1208 Elgin St. San Leandro, CA 94578 Questions:  AmericaPhA@gmail.com 510-331-5453     Questions? Email: AmericaPhA@gmail.com

Summary of The PhA Project- Physician Associates Project

Healthcare is a human right; as a result, practicing medicine is also a right for healthcare professionals.

The current healthcare system is facing a tough challenge of shortage of medical doctors to serve the community. According to the AAMC (American Association of Medical College) Study in early 2018, America would face a shortage of 200,000 physicians projected from now to 2025.

As a foreign-trained MD from Saigon, Vietnam, Katherine Miller, now a Vietnamese American of Northern California for 17 years, The Founder of the PhA Organization, has delineated a solution to close this disparity gap for quality healthcare access by a new pathway that tries to fit foreign-trained MDs who live in the American soil as a very enriched ready resource of medical professionals, and who already obtained the ECFMG certificates to return to practice medicine, primary care so to serve the community with high demand of primary care/family physicians.

The PhA Project is the short form for the PhA-eAML Project acronym for the Physician Associates in Services and the Eco-saver Attainable Medical Licensing Project. This is a huge and lengthy project that can have the strong impact to revolutionize the current cumbersome and reality-detached medical licensing system into a more realistic, practical, and energy-saving, eco-friendly licensing system that can effectively and sincerely serves the needs of quality healthcare for the diverse communities. The PhA Project mission is to supply quality mid-level medical providers with the title PhA Physician Associates, via a licensing process with a pertinent residency program for PhAs from six to nine (6 to 9) months and possible extensions, to serve the communities especially underserved areas of California and eventually nationwide. The practice scopes of these PhAs are higher than NP Nurse Practitioners and PA Physician Assistants, but lower than practicing MDs. So, they would work under supervision of licensed MDs with the ratio of ten to fifteen PhAs are reported to one licensed MD. Their scopes of practice are considered flexible based mainly on the safety of the community they provide the services.

Their clinical experiences and medical professional knowledges are constantly revamped by strenuous CME activities under many different means and methodologies, including basic and advanced technologies that would be designed to fit with the clinical practice circumstances.

In general, after three to four years of PhA Practicing, PhAs with all their activities are recorded meticulously by the electronic medical record and licensing record system would eventually finalize their MD licenses and they can merge into the current MDs mainstream.

Katherine Miller, MD

Founder/President/CEO

 

About our Founder

 

My story -Katherine Miller, MD can be found at: http://www.usapha.org/dr-katherine-miller-story/

Katherine T Miller is a medical doctor graduated in 1996 from The University of Medicine of Hochiminh City, Saigon, Vietnam. The primary reason for her immigration to the US is in search of personal freedom and social justice. She does not want to live in a communism that has mutated into a muddle of “red capitalism” that even worsens human rights in Vietnam. With the clear perspective of a medical doctor, she has soon found out she does not belong there. She came to the US and proud to become US citizen 2007. She is an American at heart; however, her previous country and its Vietnamese people are still in her heart.

Since there are no medical licensing examinations in Vietnam for practicing medicine, all new medical graduates start working as physicians after they receive their MD diplomas, same story for Katherine Miller. She entered eighteen (18) months of OBGYN training at the biggest OBGYN hospital in Saigon and graduated with a certificate of preliminary OBGYN specialist. Then, she had practiced medicine as primary care physician at multiple general hospitals and OBGYN hospitals and medical facilities, clinics in Saigon, Vietnam. She then also attended nine (9) months training of general and OBGYN sonogram that added into her rich skills in serving the patients and earned her a great deal of clinical experiences for the last seven (7) years practicing medicine in Saigon, Vietnam before she immigrated to the US at the end of 2002.

Since her move to the US in 2002, she has stayed at the same town, San Leandro, The East Bay of the San Francisco Bay Area, Northern California. Living in the underserved area of the East Bay, she has experienced and sensed the shortage of primary care physicians.  Although she has entered public schools such as CSU East Bay, Chabot College, and City College of San Francisco (Stem Cell Technician Certificate earned) to enjoy learning about the American and Californian diversity culture, never strayed away from her ultimate goals, has Katherine always yearned to return practice medicine; she eventually found out the challenging path of medical licensing.  For the primary reason of why she came to the US, she was not initially informed about this. In her book, “Survival Skills for USMLEs and Medical Licensing in the United States”, she explained the most disadvantageous group of foreign-trained US doctors that has known zero information about the intricate and puzzling medical licensing.

From meticulous work and tremendous devotion, she passed all the USMLEs (United States Medical Licensing Examinations), the same licensing examination for domestic-trained MDs including USMLE step 1 as basic medical sciences, USMLE step 2 CK clinical knowledge, and USMLE step 2 CS clinical skills with verification of medical school transcripts and diploma from Saigon Vietnam. She was granted the ECFMG certificate in 2011. Her medical school from my previous country, Vietnam, has forced her to pay them $2,500 for just sending the official transcript to the ECFMG (The Educational Commission for Foreign Medical Graduates). It was the price of freedom!

Then, the worst has yet to come, she found out about the huge blockade to finalize MD licenses because of the cumbersome licensing system that lead to the discrepancy of the waste of foreign-trained MDs versus the serious shortage of MDs to provide care for the increasingly demands of physicians in near and far future. The absurdity of the current medical licensing is here. Passing all the USMLEs does not help to make a MD ready to practice medicine. The ECFMG certificate is only used for applying into medical residency while medical residency has become the big roadblock for finalizing medical doctor licenses. According to an AAMC study in early 2018, there would be at least 200,000 MDs shortage projected in twenty (20) years!

She has been volunteered as a medical interpreter and clinical assistant for over ten (10) private practices of local physicians with various specialties: three primary care offices (3) in San Leandro, Hayward, three OBGYN offices (3) in Castro Valley and Hayward and NAPA, one pediatrician office (1) in San Leandro, one ophthalmology office (San Jose), one urology surgery office (1) in Napa, two internal medicine offices (2) in San Leandro and Castro Valley. She has been a visiting physician observed at Saint Rose OBGYN hospital, NAPA Valley Hospital, Stanford Hospital, Eden Hospital and Emergency Room. Indulging herself into these clinical activities yet with minimum permission of hands-on experiences, Katherine Miller could still learn a lot of clinical experiences and how the medical and healthcare system in America operate via her critical thinking capability. She has deeply understood the intricate healthcare system and how the business built on the for-profit foundation, a huge change from a non-profit charity purpose on healthcare system before the 1950s.

Hindsight is 20/20 as the saying goes. Thousands of foreign-trained medical doctors and even about a few hundreds of domestic-trained doctor annually are unable to “secure” a residency slot. (Sarcastically, it is said “secure a residency slot”). They are totally blinded about this huge barricade until getting too close! The frustration only worsens. She had applied for medical residency all over the US for four (4) continuous years without success, wasting thousands of dollars annually. The same disturbing stories are like thousands of other doctors, both foreign-trained and domestic-trained!

Since 2011, Katherine Miller has been studiously researching about the medical licensing system in the US via local libraries, university especially medical school libraries, and talking with people in related fields. She wrote the book based on what she has found and wanted a better change for the current cumbersome licensing system. She has delineated the PhA Physician Associate Project as the solution to bring back foreign-trained MDs who live in American soil to be able to practice medicine in a new pathway with a new license PhA Physician Associates, a mid-level provider that is higher than PA physician assistant and NP nurse practitioner, but still a little lower than licensed MD. These Physician Associates PhA would work in the real medical settings (instead of the restrained boundaries of teaching hospitals) for three (3) to four (4) years with meticulous online and onsite credentialing (based on the evaluation system of our current residency systems) to validate their clinical work and CME participants. These PhAs are eventually able to finalize their MD licenses. This approach is much more realistic and practical that directly meets with the demand of physician shortage as the endemic near and far future.

Please watch these three video clips:

Video 1: the current American Medical Licensing system:
https://www.youtube.com/watch?v=7lpdCqQKZJs

Video 2: The PhA Project
https://www.youtube.com/watch?v=c7uYAPJ3vng

Video 3: Estimation of the number of unmatched foreign-trained MDs gone wasted:
https://www.youtube.com/watch?v=M3upT6SQ6J4&t=1s

The current petition with over 770 supporters all over America and other countries:
https://www.change.org/p/california-governor-petition-for-california-governor-to-approve-pilot-program-as-a-medical-residency-for-pha

Since 2014, she has researched and understood the basics American political system for legislation changes. She has been in contact with more than ten (10) government offices including local (district 13 and surrounding districts) assembly members and senator offices and Sacramento Offices of the Governor, Office of Professional and Business Development (She submitted to the office chief consultant and manager the SUNRISE BOOK answering over seventy (70) questions on how a new medical license established to the safety of the public), etc. in the effort to promote her PhA Project. She also initiated the online campaign for the Pilot medical residency program for Physician Associate PhA. (https://www.change.org/p/california-governor-petition-for-california-governor-to-approve-pilot-program-as-a-medical-residency-for-pha)

The majority of these government offices have approved the idea to be able to promote into a new legislation and encouraged her trying to work on the PhA Organization growth so the entities can take on the wheel to launch the project successfully.

She has also struggled to survive a normal life. She had previously experienced as a tutor for Vietnamese language, mathematics and life sciences and social sciences for junior high school students in Saigon, Vietnam previously and Northern California in 2006 to 2011. She is currently working as a caregiver nurse and a medical interpreter, working fifty (50) to seventy (70) hours a week with minimum wages to make my end-meet.

At the moment, with the success of the online petition on change.org (please see the link above), the legislative Counsel Office has accepted into drafting the PhA Project idea into an initiative for The State of California official election. Dr. Miller has been working with a deputy legislative counsel since March 2018.

As busy as a bee, she has officially found The American Physician Associates, Inc. short form as The PhA Organization in September 2017. She has been still running the organization as its very early stage with very limited modalities and trying to search for sponsors, donators, etc. to help its growth. The PhA Organization has obtained its 501(c) (3) as nonprofit tax exempt status last February 2018.

References:

USMLES AND MEDICAL LICENSING IN THE UNITED STATES SURVIVAL SKILLS Paperback – October 10, 2016  by KATHERINE THUY MILLER (Author, Editor)

 

https://www.amazon.com/dp/1365442438

 

www.usapha.org

 

https://www.change.org/p/california-governor-petition-for-california-governor-to-approve-pilot-program-as-a-medical-residency-for-pha

 

http://www.usapha.org/dr-katherine-miller-story/

 

https://www.linkedin.com/in/katherine-miller-164239b7/

 

https://news.aamc.org/medical-education/article/new-aamc-research-reaffirms-looming-physician-shor/

 

 

PhA-American Physician Associates, Inc.

1208 Elgin Street

San Leandro, CA 94578

www.usapha.org

5103315453

AmericaPhA@gmail.com

 

 

 

 

 

 

 

Jun 1, 2018 — Hello supporters

I just talked with a deputy legislative counsel yesterday. She is in charge for our project bill initiative drafting.

There are some highlights she mentioned and I will discuss more details in the next couple of days with you.

thanks and stay tune with me

Katherine Miller, Founder/President the PhA Organization

Jun 4, 2018 — https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us?utm_source=Better+Mailing+List&utm_campaign=2066fb6a53-EMAIL_CAMPAIGN_2018_03_27_COPY_02&utm_medium=email&utm_term=0_8e19a17e64-2066fb6a53-269747741

Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S. Physicians advocate for changes in how deaths are reported to better reflect reality Release Date: May 3, 2016
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10 percent of all U.S. deaths are now due to medical error. – Click to Tweet
Third highest cause of death in the U.S. is medical error.- Click to Tweet
Medical errors are an under-recognized cause of death. – Click to Tweet

Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error in the U.S. Their figure, published May 3 in The BMJ, surpasses the U.S. Centers for Disease Control and Prevention’s (CDC’s) third leading cause of death — respiratory disease, which kills close to 150,000 people per year.

The Johns Hopkins team says the CDC’s way of collecting national health statistics fails to classify medical errors separately on the death certificate. The researchers are advocating for updated criteria for classifying deaths on death certificates.

“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” says Martin Makary, M.D., M.P.H., professor of surgery at the Johns Hopkins University School of Medicine and an authority on health reform. “The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used.”

In 1949, Makary says, the U.S. adopted an international form that used International Classification of Diseases (ICD) billing codes to tally causes of death.

“At that time, it was under-recognized that diagnostic errors, medical mistakes and the absence of safety nets could result in someone’s death, and because of that, medical errors were unintentionally excluded from national health statistics,” says Makary.

The researchers say that since that time, national mortality statistics have been tabulated using billing codes, which don’t have a built-in way to recognize incidence rates of mortality due to medical care gone wrong.

In their study, the researchers examined four separate studies that analyzed medical death rate data from 2000 to 2008, including one by the U.S. Department of Health and Human Services’ Office of the Inspector General and the Agency for Healthcare Research and Quality. Then, using hospital admission rates from 2013, they extrapolated that based on a total of 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error, which the researchers say now translates to 9.5 percent of all deaths each year in the U.S.

According to the CDC, in 2013, 611,105 people died of heart disease, 584,881 died of cancer and 149,205 died of chronic respiratory disease — the top three causes of death in the U.S. The newly calculated figure for medical errors puts this cause of death behind cancer but ahead of respiratory disease.

“Top-ranked causes of death as reported by the CDC inform our country’s research funding and public health priorities,” says Makary. “Right now, cancer and heart disease get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.”

The researchers caution that most of medical errors aren’t due to inherently bad doctors, and that reporting these errors shouldn’t be addressed by punishment or legal action. Rather, they say, most errors represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability.

“Unwarranted variation is endemic in health care. Developing consensus protocols that streamline the delivery of medicine and reduce variability can improve quality and lower costs in health care. More research on preventing medical errors from occurring is needed to address the problem,” says Makary.

Michael Daniel of Johns Hopkins is a co-author on the study.

Jun 1, 2018 — Hello supporters

I just talked with a deputy legislative counsel yesterday. She is in charge for our project bill initiative drafting.

There are some highlights she mentioned and I will discuss more details in the next couple of days with you.

thanks and stay tune with me

Katherine Miller, Founder/President of the PhA Organization

https://news.aamc.org/medical-education/article/new-aamc-research-reaffirms-looming-physician-shor/

The United States will face a significant shortage of physicians fueled by population growth, an increase in the number of aging Americans, and retirement of practicing doctors.
None

The United States will face a shortage of between 40,800 and 104,900 physicians by 2030, according to a new study commissioned by the AAMC. Released March 14, 2017, the study found that the numbers of new primary care physicians and other medical specialists are not keeping pace with the demands of a growing and aging population.

“There is going to be a significant workforce shortage under all of the likely projections. We see that, quite frankly, only getting worse as the population ages,” said Janis M. Orlowski, MD, AAMC chief health care officer.

The report’s findings are consistent with AAMC estimates from 2015 and 2016. This year’s analysis, conducted by the global information company IHS Markit, extended the date of the projections by five years, from 2025 to 2030, to account for the time needed to fully train a physician who would start medical school in 2017.

For primary care, the estimated shortage will be between 8,700 and 43,100 physicians by 2030. Non-primary care specialties—including medical specialties, surgical specialties, and other specialties—are expected to experience a shortfall of between 33,500 and 61,800 physicians. In particular, the supply of surgeons is projected to have little growth by 2030, but projected demand is expected to increase, resulting in a shortage of between 19,800 and 29,000 surgeons by 2030. For other specialties—emergency medicine, anesthesiology, radiology, neurology, and psychiatry, among others—the projected shortage is between 18,600 and 31,800 physicians by 2030.

The primary factors driving demand are population growth and an increase in the number of older Americans, according to the study. The total U.S. population is expected to grow by about 12% by 2030. Also by 2030, the number of U.S. residents aged 65 and older is expected to increase by 55%, and the number of people aged 75 and older will grow by 73% during the same period.

“This makes the projected shortage especially troubling, since as patients get older they need two to three times as many services, mostly in specialty care, which is where the shortages are particularly severe,” said AAMC CEO and President Darrell G. Kirch, MD.

For all specialties, retirement decisions of practicing doctors will have the greatest effect on future physician supply, the report notes. More than one-third of all active physicians will be 65 or older in the next 10 years.
Factors affecting projections

For the second consecutive year, the 2017 report includes a special analysis of the needs and health care utilization of underserved populations. According to these data, if barriers to utilization were removed and all Americans accessed health care at the same levels as insured, non-Hispanic white patients, the United States would have needed up to 96,800 additional doctors in 2015. About three-quarters of those physicians would have been needed in urban areas.

“There is going to be a significant workforce shortage under all of the likely projections. We see that, quite frankly, only getting worse as the population ages.”

Janis M. Orlowski, MD
AAMC

“With this report, people need to understand that if there were equitable utilization, the workforce needs would be even greater. This is an important issue to remember as we plan for a more equitable future,” Orlowski said.

This year’s study, for the first time, examined how achieving certain population health goals—reducing obesity and diabetes, for example—would affect physician demand. The report concluded that meeting these goals would initially result in a slight decline in physician demand, but an overall increase in demand would occur by 2030 because of increased life expectancy.

“As we work on improving certain chronic diseases, you might think that the need for physicians goes down, but it actually goes up because people live longer,” Orlowski said.

As life expectancy goes up, this scenario would slightly increase demand for some specialists, such as geriatricians. But the need for other specialists—endocrinologists who manage diabetes, for example—likely would go down if fewer people required specialized care for chronic diseases.
Averting the shortage

Multiple approaches will be necessary to address the pending shortage, Orlowski said. The AAMC supports a multipronged solution that includes delivery innovations, team-based care, and better use of technology. But the “biggest solution,” Orlowski said, will be training more physicians.

The AAMC continues to advocate for increased federal support for an additional 3,000 residency positions annually over the next five years. Although medical schools have expanded class sizes, it will be hard to increase the overall number of practicing physicians without greater support for graduate medical education.

“We urge Congress to approve a modest increase in federal support for new doctors,” Kirch said. “Expanded federal support, along with all medical schools and teaching hospitals working to enhance education and improve care delivery, would be a measured approach to solve what could be a dangerous health care crisis.”

Petition for California Governor to approve pilot program as a medical residency for PhA
Katherine Thuy Miller started this petition to California Governor Office – 1315 10th St, Sacramento, CA 95814 California governor Jerry Brown Office and 2 others

https://www.change.org/p/california-governor-petition-for-california-governor-to-approve-pilot-program-as-a-medical-residency-for-pha

The PhA-eAML Physician Associate Project mission is to bring back US citizen foreign-trained MDs to serve California and eventually nationwide. US foreign trained Medical doctors can practice independently with a new license called PhA Physician Associate. The new license is the solution once and forever to indefinitely close the drama of foreign-trained MDs mistreatment since the ECFMG established in 1956!

The USMLEs are the American standardized quality for practicing medicine. Its importance and influence on international medicine practice is beneficial for both America as one of the most powerful nations of the world and the international nations to match themselves to a realistic system for their levels of quality of healthcare services. The pursuing of USMLEs by foreign-trained MDs from all over the world is one of the diversity beacons that would continue to bring about the refreshing American Dreams and keep remaking America and the world history closer to perfection. We, foreign-trained MDs who have been proud to be US citizens bring on our citizenship responsibility to maintain and to flourish the great stories of remaking America and the world in this spectrum of the profession of humanity.

The reason for this PhA project is because these foreign-trained MDs, who had attended and graduated from medical schools approved American-Accredited Medical Education Standards from foreign countries from all over the world, though already pass all the USMLEs (step 1, step 2 CK, step 2 CS and obtained the ECFMG certificate) are unable to finalize their MD licenses because they are rejected to work in medical residency programs in which their MD licenses would be granted (the biggest excuse is these doctors have graduated more than three years out of medical schools). This renders thousands and thousands of wasteful MDs talents for the American public while America has been facing serious shortage of physicians in present, near, and far future! It is a stark reality! The whole picture is rather a contradiction of the absurdities of the current licensing system that has become detached from sincerely serving our communities.

To be able to practice medicine in the US, any professional should have a powerful piece of paper called the license.

The current medical residency has been mistreating US citizen foreign-trained MDs in many ways: they practice age discrimination, they sponsor visa for freshly graduated international MDs who are not related to the US to outsource resident jobs that should be placed for US citizen foreign trained MDs besides domestic trained MDs.

This phenomenon has been in the past, present and surely still continuing into the future unless we take some resolute actions. Although there have been many movements trying to solve the problem by expanding more residency slots, opening new medical schools, etc. these kinds of approach only gives more power to residency programs and opening more medical schools only aggravate the burden of the already-sickening system and to continue mistreating US-FMDs.

This phenomenon should be explained as “The Swiss Cheese Effect” in wrong management when one fault from the previous section leads to mistakes in the next and next steps in a process of management. This does not mean to name and/or to accuse any individual. However, it needs to be addressed exactly the problem.

Understanding this painful and intricate problem, we have found the PhA American Physician Associates to carry on the mission as a new license called Physician Associates so that there is an independent pathway for foreign-trained MDs who can work for a few years e.g. three to four years before they eventually finalize their MD licenses.

To be able to realize this ultimate goal, first of all, a pilot program should be sanctioned by the California Governor Office. The governor should approve for The PhA organization or a sponsor entity e.g. the Office of Statewide Health Planning and Development OSHPD (https://www.oshpd.ca.gov/ to be able to carry on the pilot program of PhA Physician Associate residency and placement into jobs in California so that this pilot program would eventually spread out statewide when it works out right.

The description of the pilot program: a six months with possible 3 months extensions of residency for PhA Physician Associates. The residency program is designed according to the standard of any existent primary care residency program in California for MDs with modifications for PhA level of scopes of practice. The levels and scopes of practice of PhA would be higher than PAs as Physician Assistants and NPs Nurse Practitioners, but lower than licensed MD and PhAs are supposed to collaborate with licensed MDs at the ratio of one licensed MD for every ten to fifteen PhAs.

We need the governor to approve for the PhA organization to establish this pilot program to prove that US person foreign-trained MDs with ECFMG certificates can do a good job just like any other licensed MDs to serve the community. From here, the new license PhA will come into sight in the new law.

Once the establishment of the program developed and well organized, there would be open doors for other types of foreign-trained MDs besides US person foreign-trained MDs.

We sincerely ask all and everybody, no matter what, where and who you are, MDs or any professionals or the public, US persons or internationally located, to support this project because of both its short-term and long-term benefits would be tremendous to serve many small and big issues of our current broken healthcare system for the US as nationwide and even internationally when it develops full-fledged.

Please visit the PhA organization website: www.usapha.org

Please donate to:

paypal.me/USAPhA

Please support this petition.

Thanks

Katherine Miller, USFMD-Founder of the American Physician Associates

This is a great article to advocate for our PhA Project:

http://www.njbiz.com/article/20160906/NJBIZ01/309069998/shortage-of-solutions-opening-more-medical-schools-alone-wont-solve-the-coming-doctor-shortage-in-new-jersey

Shortage of Solutions: Opening more medical schools alone won’t solve the coming doctor shortage in New Jersey