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nurses

The robot nurse

We are living in the future, for better and for worse.

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A friendly one-armed, bright-eyed robot is roving the hallways of Medical City Dallas’ Heart and Spine hospitals, helping nurses with routine tasks that previously took time away from patient care.

Nicknamed Moxi and regarded as one of the staff, the robot is equipped with sensors to help it navigate, and even anticipate people’s movements, as it travels across hospital floors. Medical City Dallas partnered last fall with Austin-based artificial intelligence firm Diligent Robotics Inc. to become the first North Texas hospital to employ a robot full time in a clinical setting.

“When we were opening up the hospital back in October, one of the things we wanted to really focus on was being an innovation center and bringing new technology to the health care setting,” Medical City Chief Operating Officer Josh Kemph told The Dallas Morning News.

When a nurse is interacting with it in a way that would normally trigger an error message, Moxi instead emits pleasant beeps and chirps to notify them. Some patients even have their own names for the assistant, which has its own Instagram account run by Diligent.

But Moxi is so much more than just a pretty face.

Texas will face a shortage of more than 71,000 nurses by 2030, according to the Texas Health and Human Services Commission. And with the demand for nurses expected to only continue increasing, Medical City Dallas director of surgical and procedural services Stefanie Beavers says she hopes it will also make it easier for the hospital’s existing workforce to optimize their day-to-day work.

“This really offers health care facilities an opportunity for the nursing workforce to focus on patient care and be directly at the bedside versus taking them away, and allowing their time to be truly dedicated to patient care tasks,” Beavers said.

It never crosses the threshold into patient care, instead delivering things like blood samples back and forth to a lab and updating patients’ medical records instantaneously for hospital staff.

“She’s really meant to be a team member that’s supporting you in the background,” Beavers said.

For now, at least, Moxie is a modern version of the FBI mail robot, which does simple drudge work like delivering specimens and allowing the human nurses to do more important things. It’s also a lot cheaper to employ than human nurses, or human nurses’ aides, and in the way of driverless cars, it’s just a matter of time before they have the capability to cross that threshold into patient care. That may be 20 or 30 years down the line, but it’s out there somewhere. I just hope we can have a productive conversation about what that will mean for the rest of us before it happens.

We need more doctors and nurses

If the state of Texas ever expands Medicaid, or less likely does something on its own to improve access to health care for its residents, it’s going to have to confront a different problem: A persistent shortage of doctors and nurses.

As of May 2011, the demand for nurses in Texas exceeded the supply by 22,000. Members of the Texas Nursing Workforce Shortage Coalition, which includes about 100 medical centers and hospitals statewide, warned in a letter that “without stable, continued funding for nursing education, this gap will widen to 70,000” by 2020.

Physicians are hardly faring better. The Association of American Medical Colleges estimated that there was already a shortage of 7,400 physicians nationwide in 2008, and fully implemented health care reform would widen that shortage to more than 130,000 physicians by 2025.

Texas has a ratio of 165 doctors for every 100,000 residents. That falls far below the national average of 220 physicians for every 100,000 people, earning Texas the ranking of 42nd in the nation, he said.

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Texas legislators reduced support for nursing education by $17 million, or 36 percent, during in 2011.

Physician students also have fallen victim to a tightening budget.

Never let it be said that there’s a problem our Legislature can’t make worse by cutting funding for it. That letter from the Texas Nursing Workforce Shortage Coalition can be found here. This problem isn’t limited to Texas, either. Part of the problem with doctors is specialization – as the story notes, there’s plenty of plastic surgeons and dermatologists, but far too few general practitioners, who tend to make a lot less money than their peers. It’s a complex problem and it’s going to take some creative thinking to tackle it.