OXEON Partners Co.

 I have been searching for positions in the medical field that satisfies my hunger and love for health care, working with people, being hands on, and especially learning.  Human resources, I think, is the most important and most expensive resource in health care. So when I came across Oxeon Partners in New York, NY. It seemed like the perfect fit for me. Oxeon is Greek for 'relationships' and the company seemed to have the same morals and values that I as a person hold for myself- to value people more than anything especially their power to drive innovation and transformation in the health care industry. Oxeon partners works in healthcare technology and services market to transform the way healthcare is delivered and paid for clients and partners who transform the way health care is delivered and paid for; the exceptional executives we recruit are the drivers of this change at the most innovative companies in the healthcare industry. 

Oxeon Investments take equity stakes in companies that are not search clients of Oxeon Partners and do the search work for companies where we do not own equity; however, the majority of their search work and largest investments are with companies where both occur.I don’t have experience in this area but I started contemplating about some of the challenges that companies like Oxeon face.       

    

  It seems to me that the main thing is to match the needs of the clients (which are the health care companies) with the right candidates who have the right set of skills for those positions. However, I do see  two problems: sometimes a problem that has to do with the candidates and the other with the client. Problems with the candidates: very often we hear for example it is difficult to find the right candidate. One the candidates might not have the complete set of skills that the company needs which I don’t think is the reality because there are so many young people who are educated in variety of schools but they might not know that they have those skills or how to articulate the

so, I was thinking of maybe even cataloging the skills needed and then to keep them in mind and when the position opens you have options to pick from.

  Problems with companies, on the other hand, is that: they might not be able to write down the job description right (For instance, it might be vague or not clear enough to attract clients) so it makes it difficult for us recruiters to find the right people. This I believe is what makes this job so interesting. Today you have the ability to go onto linked, monster.com, etc, and search for skills. And probably give the possibilities to work pro-actively with potential candidates to train them and to coach them on how to write their resumes and even to advise them on what kind of training they might need.

    

 I think because of Obamacare and the drastic changes in health care lately, it isn’t new skills that have changed but the combination of skills that have changed. And Health care really needs information technology for management purposes. So, finding the right people who have the leadership/management skills, the knowledge, and a deep understanding of information technology IS another challenge. 

All in all I really enjoy being around others and understanding their needs. And I think that my unique life experiences have molded me into this compassionate individual with a deep appreciation of people’s different cultural backgrounds.

Being born and raised in a developing country Albania I’ve always had a deep passion for helping others. I think Because of my opportunity to come to America I realized early on my responsibility and obligation to help others in any way shape or form. I think this reflects onto everything I have been involved in from shadowing/volunteering at various hospitals/clinics (even in one in Albania) to being part of clubs that were very involved in charitable organizations.

 Although I was very passionate for the position and their goals as an company, their process of recruiting new workers became terminated. As unfortunate as it was because I felt as though I could have accomplished so much, through this process I learned more about a branch of healthcare that I other wise would have never set my eyes on. 

At the end of the day, no matter what company it is, who you are hiring, and the people you want to sell you- it is of the utmost importance to find people who have the same goals in life as your company because those people will put in their sweat, blood, and tears into every day they work for you. Finding the 'right' people is sometimes not as hard as it might seem because everyone has a life purpose and more times than not- it is about helping others and being connected to others in a way that makes us different from all other creatures of this earth- it is what makes us human.

For companies like Oxeon who are just a branch of the health care field, it is necessary to find people that are able to adapt to the ever changing industry of health care due to the legislation but overall due to technology and especially IT. Companies are seeing every day that inventory of skills they need is scarce or depleted. 

Coming to the United States from a third world country has given me a new perspective on how medicine is practiced in different areas of the world. I have seen both extremes where people in Albania are unable to receive treatment because of non-existent health insurance plans and how sick people in the United States can live relatively normal lives due to the effectiveness of medical care. This is how the health care organization delivers care through leadership and the people in these organization.

These experiences have made me aware of an important facet of medical care and the profession of the physician. Besides treating diseases and restoring the health status of the sick and injured, physicians have a duty to work hard to preserve the health of people, and protect their health potential by preventing diseases and injuries not only in one by one basis but the entire populations.


 *I do not own these images, they were found on various tumblr sites. Please let me know if any are yours and I will give you credit for them. Thanks so much!

Capitation

 Capitation:

Capitation is an arranged payment for health care providers (i.e. doctors, medical groups, hospital, or integrated health systems) that are paid a set fee for a period of time whether or not the individual seeks care. Patients are usually contracted with a type of managed health care plan such as an HMO, regardless of the finances of that individual's care. Rates are affected by factors such as race, sex, type of employment, and geographical location that influence the cost of providing care.  

Since physicians, hospitals, or health care system is responsible for their member's health regardless of costs, it motivates the health care providers to provide health screenings, immunizations, prenatal care, and other preventative care to enrolled members. 

Health care providers' primary focus under capitation is on preventative health care. There is a greater financial reward in prevention of illness than in treatment of the ill. These plans keep providers away from the use of expensive and newly developed treatment that maybe nonetheless be less effective.

After expenses, this model is based on economics where the remaining revenues are divided evenly among the group of physicians. The majority of patients enrolled in a health care plan will never use the health care services within any given month. Capitation, therefore, is meant to balance out the patients that DO utilize most of health care services within the month.  This type of model discourages over-utilization. 

There are drawbacks to this model as it assumes that all physicians are equally productive, skilled and motivated to work for the group's best financial interest.  There could be within these groups physicians who are high producers with little long term incentive along with those on the more extreme end who are considered 'low producers' may ride on the finanical coattails of those more productive physicians.  The reason as to why single specialty groups still use this model is because all of these services are valuable and necessary to those groups of individuals who are in fact looking to work in a full-service practice.

 

TWO KINDS:

There are two kinds of capitation. The first is Global capitation which involves whole networks of hospitals. The second kind of capitation is when physicians work together to receive a set monthly payment for enrolled health plan members. The providers sign a contract with a health plan to cover the care of groups of members, and must determine a method of dividing up the capitated check among themselves. Capitation that is not under global capitation is a capitated payment contracted to a specific provider group (i.e. a physician group or a hospital) 

DEBATE:

Payment from capitation has become a major issue in federal government's medicare managed care program and an even larger area of controversy. Many health plans and providers have left the government's medicare managed care programs because they feel that capitated payments are too low (compared to those in competitive managed care markets like North and South California, Portland, Oregon, and other markets) to provide the sufficient kinds of preventative care services (that capitation should theoretically encourage) and subsequently an overall successful process. 

To make up for the low payments, physicians and other providers may withhold care or provide less expensive care to save money. But, this creates an inherent conflict of interest. For example, care providers might substitute a generic drug for a name brand pharmaceutical.

When a bonus or incentive is added into this set salary, physicians think about how, when, and under what circumstances the sum is paid. 
(For most physicians starting out, min income guarantee (w/ or without bonuses) is the most used model.)This type of salary is usually seen in HMOs, academic settings, and large corporate/physician owned practices. The benefits of this set income salary is that physicians know how much they will earn for that month and provides a sense of security for new physicians. However there is very little long term financial incentive if there is no ownership. This, therefore, could ultimately discourage entrepreneurship by supporting minimum work ethics. 

Too many health plans offer physicians bonuses for efficiency from following 'utilization management' guidelines (aka, guidelines that try to keep the use of health care services within a certain limits on patients and doctors) and subsequently creates ethical conflicts of interest. Physicians end up being rewarded to make conservative decisions on the care they provide for their patients. (B)

 On the other hand, fee-for-service health insurance coverage has been criticized for encouraging excessive and unnecessary care by physicians. Physicians might order extra tests on patients knowing that they are unnecessary so that he or she will be paid extra for these services. 

So, the question remains; Which is better? Capitaiton which discourages entreprenourship by supporting min work ethics or fee-for-service health insurace coverage where phsyicians overcompensate by being encouraged to provide excessive care to patients? 

Physicians and hospitals find that they often lose money on capitated contracts, and end up going back to discounted fee-for-service payment. However, capitation will remain a major method of managed care payment for organized physician groups in the West Coast and in regions of the United States. (B)
 

Implications of Capitation on Physicians and Patients?: 

  “Physicians need to understand their personal objectives. If they’re interested in a very collegial environment, they might not want to be in a group where each physician is paid on his or her own production, because that will be pretty competitive,” says Cornett. (C)

Nowadays, the patient doctor visit is now more difficult and complicated than ever before. The number of different health plan contracts alongside the different rules about which drugs the doctor can prescribe and the authorizations that are necessary for referral of patient to see a specialist are just some of the factors that can complicate the patient visit. Essentially, physicians are paid a percentage of either billings or collections, or they are paid based on the resource-based relative value scale units assigned to procedures or patient-visit types. The overhead costs of the practice — both fixed and variable — are allocated among the physicians. (C)  In order to maintain income levels, physicians are seeing more patients making the average patient visit to be about 10 minutes long. (B) 

Because of the constraining time limits during a patient doctor visit (of about 10 minutes) that patients should be prepared before walking into the doctors office. They should do research on the web before AND after the visit. This way patients will have specific questions prepared for their doctor that will not only give the patient a sense of peace knowing that all their questions have been answered but also in knowing that the visit was a proactive and productive one. Educating themselves will make a more effective visit on time and financially pressured physicians.

Links:
(A)http://www.pbs.org/wgbh/pages/frontline/shows/doctor/care/capitation.html
(B)http://www.hci3.org/content/capitation
(C)http://www.nejmcareercenter.org/article/physician-compensation-models-the-basics-the-pros-and-the-cons/
 *I do not own these images, they were found on various tumblr sites. Please let me know if any are yours and I will give you credit for them. Thanks so much!

Three Parent Babies in the UK

Its official- United Kingdom is the first country in the world to allow three parent babies. In other words, three people are involved in creating one child. This technique involves altering the egg or embryo before transferring it into the mother. By using the donated DNA from a third party, it will eliminate risk of genetic disorders that parents might pass on.

Legalizing this procedure will specifically help women with mitochondrial diseases. Muscular dystrophy, heart, lung and liver failure are just some of complications having a defective mitochondria inflicts on these individuals.

The donated DNA that is used is the mitochondria of a healthy female donor. Mitochondria (aka. the power houses of the cell) converts food into energy. Through in-vitro fertilization the DNA of two parents are combined with the mitochondria of the female donor. 

It is important to note that this procedure will only be used sparingly on women who have defective mitochondria. 

The Process: 

Two eggs (one egg from the mother and the other from the healthy female donor) are fertilized with the father's sperm at the egg/embryo stage. The parents genetic information is inserted into the donor's embryo which has everything except for the mitochondria. 

The second method is to use the nucleus of a mothers egg cell which will be placed directly into a donor egg, replacing the original nucleus.

Therefore, the resulting embryo would have nucleus from its parents and mitochondria from the donor. The donor DNA is said to contribute less than 1 percent to embryo's genes. 

Ethical Concerns:

It's techniques cross a fundamental scientific boundary as the changes performed on the embryo will be passed on to it's future generations. 

From an evolutionary standpoint, we as a species will become dependent on such procedures and technology to reproduce and survive. This will greatly affect the natural process of evolution in eliminating negative mutations throughout generations. Although every species at one point will become extinct, it is possible that this may lead to a premature extinction of our species. 

"Think about bone marrow transplants,"Peter Braude, emeritus professor of obstetrics and gynecology at Kings College London, told the BBC. "Let's say unfortunately you have leukemia and you have to have your bone marrow radiated for the cancer to be killed and then it is replaced by bone marrow from someone else - say me. Effectively from that time onwards, you will have circulating in your body DNA from me. You won't be related to me, you may be grateful to me, but you will have DNA from a third person circulating in your body."(A)


This procedure is an incredible leap for science and proves that scientists worldwide are working hard to create the possibility of a better/ healthier life for us all. But at what cost?


The destruction of the human embryo as part of the process of creating three parent babies- is it worth it? Would you love your child any less if he or she did not have a defective mitochondria? If both parents have come to the agreement that maybe caring for a child with possible muscular dystrophy or organ failures will be too difficult to deal with- shouldn't adoption be the next reasonable option?  

There are many children in the world suffering from hunger and diseases who are left to fend for themselves without parents and often times without hope. 

What has happened to the human existence where our ego pushes us to creating the perfect children? When you claim a child as your own (adopted, biological, etc) he or she IS the perfect child because they are yours. That kind of connection between parent and child creates the purest form of love- unconditional love.

We have no idea what kinds of effects (i.e. genetic mutations, diseases, defects, etc) these procedures will have on these scientifically engineered babies in the future.



U.S. Food and Drug Administration held a meeting to discuss the techniques and scientists warned it could take decades to determine if they are safe. Experts say the techniques are likely being used elsewhere, such as in China and Japan, but are mostly unregulated. (C)

 Lisa Jardine, who chaired a review into the techniques conducted by Britain's fertility regulator, said each case will be under close scrutiny and that doctors will track children born using this technique as well as their future offspring. She acknowledged there was still uncertainty about the safety of the novel techniques. (C) 

Ultimately, going against mother nature through designing babies is very dangerous step because there is still so much we do not know or understand. It will be unfortunate to bring a child into this world hoping for a pain free healthy life only to have them develop a new unknown more painful untreatable disease. There is no such thing as a 'perfect' human and if we continue to pursue this ridiculous notion we will continually be let down.

Links: 

(A) http://www.nytimes.com/2015/02/04/world/europe/britain-nears-approval-of-fertilization-technique-that-combines-dna-of-three-people.html?_r=0

(B) http://www.washingtonpost.com/news/speaking-of-science/wp/2015/02/03/british-parliament-is-voting-on-three-parent-babies-today-heres-how-one-baby-can-have-three-peoples-dna

(C)http://www.huffingtonpost.com/2015/02/03/babies-dna-3-people_n_6604490.html

 *I do not own these images, they were found on various tumblr sites. Please let me know if any are yours and I will give you credit for them. Thanks so much!