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Nurses and the Reinvention of Primary Care
Nurses and the Reinvention of Primary Care
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Introduction
The importance of nurses in cannot be underestimated as far as the sustainability of the healthcare sector is concerned. Indeed, nurses make up the single largest proportion of healthcare provider in the U.S, not to mention that they make up the first contact point for the patient in a large number of settings (Naylor & Kurtzman, 2010). They work in varied healthcare settings usually taking the lead in management, accountability and clinical roles pertaining to creative primary care models. However, the primary care system in the United States has been experiencing a myriad of problems including shortage in the workforce that jeopardizes the provision of services. Indeed, there has been a steady decline in the number of medical residents and students that enter the primary care or pursue careers in family practice or general internal medicine. Naylor & Kurtzman (2010) examined literature pertaining to nurse practitioner’s participation in the healthcare workforce so as to quantify and comprehend their roles in primary healthcare. The research revealed that patient outcomes such as satisfaction, social, emotional and physical functioning, and mortality rates for those that see nurse practitioners were equivalent to that of those who see physicians (Naylor & Kurtzman, 2010). Further research showed that patients who see NP had higher levels of satisfaction, longer consultations, more tests, with deficiency in appreciable variations in processes of care, patient outcomes or resource us.
However, nurse practitioners face a number of barriers in their effort to practice optimally. First, state laws limit the scope within which the nurse practitioners can operate and prevent them from offering the all-inclusive primary care services that their educational preparation and licenses allow them to offer. In addition, nurses are under disparate payment policies that ensure that their remuneration is lower than that of physicians despite doing similar work. On the same note, there exists professional tensions from varied healthcare professionals for the control of the compensation and professional practice, which has hindered efforts b nurses to be independent.
Nevertheless, the effectiveness of nurse practitioners can be enhanced through removing unnecessary restrictions so as to allow for independent practice that is devoid of regulatory requirements for supervision, collaboration and direction (Naylor & Kurtzman, 2010). In addition, payment structures should be reviewed so as to equalize their payments, which should be complemented by holding nurses accountable for their contribution to enhancing the value of primary care. On the same note, nurse-managed centers should be increased and professional tensions addressed through reinforcing inter-professional teams (Naylor & Kurtzman, 2010). Lastly, it is imperative that pipeline expansions are funded so as to increase the overall workforce in primary care.
While this article encompasses a lot of information, the fundamental point revolves around irreplaceable nature of nurse practitioners in enhancing primary care. Unfortunately, their optimal functioning is usually hindered by institutional bottlenecks such as unequal payment structures and professional tensions. While issues such as payment structures have to be changed through policies, it is imperative that all the professionals in the healthcare sector collaborate so as to create a conducive work environment, as well as ease tensions between the groups.
The information incorporated in this paper, therefore, would not only be crucial to nurse practitioners themselves but also to the policy makers especially with regard to payment structures. However, nurse practitioners can use this information in determining the areas to which they can expand their services such as the rural areas. On the same note, it underlines the importance of respectful collaboration between the varied healthcare professionals for the enhancement of the quality of primary care.
References
Naylor, M.D & Kurtzman, E. T (2010). The Role of Nurse Practitioners in Reinventing Primary Care. Health Affairs, 29, no.5:893-899
The Ideal Price For Any Product Or Service Is One That Is Acceptable To Both Buyer And Seller
The Ideal Price For Any Product Or Service Is One That Is Acceptable To Both Buyer And Seller. From The Buyer’s Standpoint, The Right Price Is A Function Of Product Purchase Value And Other Competitive Choices In The Marketplace. From The Seller’s Viewpoint, There Are Many Potential Pricing Objectives, But The Basic Concern For Almost All Business Is To Price Products To Maximize Both Sales And Profit. (Discuss)Contents
TOC o “1-3” h z u The Ideal Price For Any Product Or Service Is One That Is Acceptable To Both Buyer And Seller. From The Buyer’s Standpoint, The Right Price Is A Function Of Product Purchase Value And Other Competitive Choices In The Marketplace. From The Seller’s Viewpoint, There Are Many Potential Pricing Objectives, But The Basic Concern For Almost All Business Is To Price Products To Maximize Both Sales And Profit. (Discuss) PAGEREF _Toc377805064 h 1Step 1: the market structure determines the price structure PAGEREF _Toc377805065 h 1Step 2 the demand curve. PAGEREF _Toc377805066 h 2Step Three- Competitive Price Range PAGEREF _Toc377805067 h 3
The equilibrium price is the price at which the consumer and the supplier are both willing and able to trade at, and the market clears without excess demand or supply. A consumer is always subjective; this means consumption is based on the level of utility achieved from the consumption of a commodity (Cryns, 2002). The higher the level of utility the more the consumer is willing to purchase the good, the only constrain is the budget: the amount of money available to the consumer for spending. However excess consumption of a commodity leads to diminishing utility which results in a decline in the quantity consumed.
For a producer, his aim is always maximize profits by equating the price to the marginal cost. However this is usually possible when the firm is large and can experience economies of scale, for most small sized firms, economic operation is usually set to be above the shut down price (Smith, 2011). In this case the average variable cost is maintained at a lower point to ensure that the price is higher and there are enough returns to sustain the firm.
Price determination is not an easy task for any firm as the price set has to be acceptable for maximum sales and enough to cater for all the expenses of the company. The following steps are used:
Step 1: the market structure determines the price structure
The structure of the market will determine the price to be set by the firm. This is because in a perfectly competitive market structure the price is determined by the market forces and the firm is a price taker. In this case any changes in the prices can lead to major loses for the firm because there is perfect distribution of information in the market. The price is predetermined for the firm (Schindler, 2011).
In a monopolistic market structure, price competition is a major advantage as goods are close substitutes and are slightly differentiated by package, brand name and prices (Hunt, 2008). However price wars can lead to complete shut-down of small firms that are unable to experience low costs as a result of economies of scale (Smith, 2011). Oligopolistic market structure price is determined by the market forces. Price wars are highly discouraged due to the kinked nature of the demand curve, slight price changes can lead to major financial losses and loss of market share control.
Step 2 the demand curve.It aids in establishing the elasticity of the demand for the product.
Price D2
D*S
D1
P*
Q* Q2 Quantity
D* is the initial demand curve for the product, it slopes from left to right indicating two factors about the product:
It is a normal product whereby increase in the price leads to a decrease in the demanded. P* and Q* are the equilibrium price and quantity respectfully. S is the supply curve.
It is has an elastic demand whereby changes in the price level leads to an inverse change in the quantity demanded.
An increase in the quantity demanded, shift of demand curve from D* to D2, leads to an increase in the price of the commodity. However if the company maintains the same price there will be more sales than before. From Q* to Q2, since most of the companies will increase their prices, the firm will have a higher market share control.
lefttop1= 2012
2= 2011
3= 2010
Series 1 = Nike
Series 2 = Puma
Series 3 = Adidas
Step Three- Competitive Price Range
Competitive price range is based on the analysis of the price ceiling and price floor as well as the equilibrium price. Ceiling price is the maximum price that the consumers are willing to pay for the products while the floor price is the minimum price that the firm is willing to sell the products (Hunt, 2008).
In order to increase the utility obtained by the consumers, the consumer surplus should be less than the producer surplus. Given the fact the equilibrium price is $75, while the ceiling price is $150 and the floor price is $50. Then we can graphically analyze the industry market as follows:
D Sconsumer surplus P* producersurplusQ*
P* is the equilibrium price = $75. This means that since the market clears at P* the company should charge the same price or higher. But in most market structures the firms will charge a price closer to the ceiling price in an effort to increase revenue and profits. The firm should charge a price that is closer to the equilibrium price and increase the quantity sold.
Improvement of the quality of a product also determines the price of the goods. The better the quality the higher the price and the reverse is also true. The pricing strategies should be based on the following:
Cost pricing – the average variable cost curve should always be below the marginal cost curve. Marginal cost should be equated to the price of the commodity (Schindler, 2011).
Penetration price – it should be relatively low in order to attract clients. Once a substantial clientele base has been established then the price can be increased slowly.
Quality pricing – the higher quality products should be placed at a higher price. It’s not only because higher quality goods are more costly to manufacture but because it creates a need to be better and get the better quality for the consumer (Schindler, 2011).
Third degree price discrimination – different people should pay different prices for the commodities. Children clothes should less expensive as compared to adult clothes made by the same company (Smith, 2011).
References
Cryns, S. D. (2002). Internet Pricing Strategies for E. Business, Colombia Publishers
Hunt, E. K. Nesiba, R. F. (2008). Economics: an Introduction to Traditional and Progressive views, Macmillan Publishers
Schindler, R. Schindler, R. M. (2011). Pricing Strategies: A Marketing Approach, Cambridge University Press, London
Smith, J. T. (2011). Pricing Strategies: Setting and Managing Price Levels, Oxford University Press, New York
History of Martin Guerre
History of Martin Guerre
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Introduction
The rising popularity of mobile learning devices (electronics and media), together with the mounting quantity of e-books, learning and teaching have been given a new look over the recent past. Learning of history and other related principles must be reviewed urgently. This (uprising of electronic and media use) is pushing the educators to have a re-look at the education curriculum and instructional philosophy. Median and electronics have re-animated debates regarding the study nature of learning literature and history in the modernized world. However, the reverse does not seem to loose value regardless of the great impact that electronics have caused. Books are still valid and are employed. The paper in-depth reviews the merits and demerits that are associated with both the ‘book learning technique’ and the electronics. In the aid and achievement of the above objective, one story is used “The return of Martin Guerre”. The paper compares the history perspectives that are depicted by the two methods. Both the advantages and disadvantages aspects of learning about the history depicted in the text and film versions are illustrated. At the end, the best method (among the two) that can be used in achieving desirable outcomes of learning and education is brought out. This is based on the review of history as depicted in the text “The return of Martin Guerre” and the film. The conclusion might not be valid in other fields.
Text: merits and demerits
The outdated as some people say that this is not always true. In “The return of Martin Guerre” text, the history is well illustrated and the aspects look at in depth. In the actual reading of the text, on which the whole preceding action is anchored, both the learner and the educator will have a good opportunity and hence will have the ability to reveal and understand elements of literary that are used in the setting. He/she will quick connote and appreciate the use of plot, characters, point of view, tone, subject matter, conflict, metaphor, and mood in the text. These can be used in expressing of the feelings and experiences that the early people underwent; history of the past. The reader will have the ability and interest to articulate the efficiency of the author’s employ of the above mentioned elements and how they assisted in developing the scenes and actions in the text. The writer can be felt as a woman. In the text, the influences that the women had in the past and roles in the community are brought out clearly as opposed to film. The voice she uses in describing the actors seems to some extent, maternal and becomes polite to the women in the play. Bertrande is portrayed as being extremely kindly.
This is absent in the film version. The inheritance custom that are used in comprehending the cultural background and chronological era in which “The return of Martin Guerre” is rooted can be best understood when one reads the text. The reader will automatically assess the helpfulness of the author’s approach, and he/she will take pleasure in the literary knowledge and additionally build up enduring reading routine. By going through the play (text) the learner will view the past ages as they are clearly explained unlike the film. By looking at a variety of aspects of the play the reader gets an image of the times, experiences, atmosphere through which the charters underwent. And also the student will have knowledge of the effects of rulers during those times and easily compare them to the present life situation. The learners will be motivated to read and look for more information regarding a given character. One of the problems associated with the learning of history through book techniques is that in case the student to not like reading, the book will be boring and hence the history aspects not looked at. Very few students will have interest in reading “The return of Martin Guerre”.
The film: merits and demerits
There exist several reasons to say that using films in history learning will better the learning and maintenance of allied textual material.
From the watch of the film, visual and verbal explanations are employed and this makes learning more effective. This brings that great importance of media. The implication that one obtains and benefits when watching the film is that he/she will appreciate the use of ‘current moment’ and images that will present the actual scene. The readers is thrown but to the times and moments in which the setting took place. The images and sceneries can tell more about the economical times during that era. It is impossible to give the actual pictures of the court, the transport method used-the horse-pulled-cats- cannot be pictured as they are in the film. As a consequence, with the pictures and sceneries identified, the viewer will create associations which will make comprehension easy. The film will act as a clue that learner uses to remember and it also assist in the creating schema. There are a lot to be done with the images, scenes, people and their dressings in the learning of history. The film acts as a window into the Martin’s experience at those times are illustrated. The charter as well as the places are seen and hence can be related. The other importance of watching the film is that the actual characters help to develop the connections and relations amid them. The nature of learner’s interaction with the educational contents is changed frequently. This makes it less boring as compared in cases where the teacher is boring or unfriendly. Undoubtedly, the films form vital part of chronological analysis. Normally, we do not just want to know what took place, but we as well desire to have knowledge on the reasons as to why they took place. This is better solved by film than the text. What motivating factors that leads people to perform as they are illustrated. Most scenes, pictures, people and actions that will go unwritten will be captured in the films. Not all the aspects can be written in the text but the film gives illustrations as the viewer is as if he/she is present at that place at that particular time. By viewing the film, the learner will have the actual picture of the times. All the biasness that the author had about the charters as she favors other characters is not present in the film. The characters are given what they deserve and the actual picture brought out. No aspect of the setting can be hidden as in text that might not bring out the actual and real picture of the place. This is the advantage of using films. It is therefore true to say that in text, not all things are revealed as in the films. The court and its elements are not brought out clearly in text but the film brings out the clear picture. The two media in this case do not tell the same story. There are enough reasons to support the fact that they do not.
Contrary, we have its (film’s) demerits. Suppose the learner is third grader, he/she might not understand the language used. The student will become a fun of the film and not learner. The play will not be followed and will be more confusing to such students. The entertainment then becomes the next alternative when he/she is watching the film. The other demerits of utilizing films as educating method is that without proper guidance and directions, more aspects of the film will be majored into but not their intended education purposes. The film can be soothing or boring as well.
Conclusion
It is clear and evident from the two media that various media fail to illustrate the same story. One always becomes more detailed than the other in one aspect or the other. It all depends on the viewer and the aspect to be captured. When the historical aspect is to be studied, it becomes better when one employs the film rather than the text. The two mediums (text and film) do not have same citations. One another publishers a book and perceptions by other readers and performers tend to differ. The same story might mean two various things when the other aspects are considered rather than the history. The same script are at times misunderstood by the actors and this has caused most books to loose meaning with time as different performers have various perceptions to any given single idea in the original text.
Now, as in the present moment, with the increase of the electronic use, information is being passed through methods that seem to be spectacular and are new, but minus any proposal that this can in the long run result to incomplete understanding or unsatisfactory closing answers. In cases where the material illustrated in a film relies with the related text, the two presentations of similar information results to improved as compared to single technique (either media or text).
Presently, the learning of history has taken a new look. The learning methods have been varied to fit the new era and student interest. The principles to be learnt seems to be constant but the techniques and method used in teacher tend to differ. History however changes as new things are learnt over time and so the techniques used in learning and tutoring. All in all, trying to make the subject/unit more realistic and appealing still remains the factors to be considered in attention retention. Suppose a student understand better by film than text, then that should be employed. In cases where the films are preferred, film should be used. At times both should be utilized.
In actual sense not method can be preferred to the other. It all depends on the reader, viewer and the individual. All the two techniques of learning history have merits and demerits and the magnitude of merits or demerits of any technique is individual-dependent. As per my personal opinion, the use of books is more helpful than the employ of films in History learning. The books (as per my argument) give adverse information, analysis and can as well act for future reference. The books gives details about any given idea and matters in details not as the films.
Recommendation
I strongly recommend that in the learning and teaching of history, the majority of materials to be employed should be in written form but not film. The use if film should not be ignored as well. Though film is as well and better in some aspects, but the future and development of learning atmosphere is lacking. They (films) seem to be for the present alone and not for future and they are further more entertaining than educating. One can get entertained when watching “The return of Martin Guerre” and fails to look at the educating aspects. The use of books/texts on the other hand boosts the retention and enhances the students’ reading interest. For great educational foundation and retention is the use of texts.
Reference:
Davis, N. (1983). “The Return of Martin Guerre”. Cambridge, Mass.: Harvard University Press.