Updated: Jun 22
It seems that indiscriminate market drifts are forfeiting Independent Physicians. Can we stop the bleed?
Those of us who have been following the independent medical practice state of affairs for the past decade, I am sure, have also been worried about their survival amidst the merit-based physician reimbursement model. If so, they should probably start worrying more, as the quota of independent physicians and private medical practices has dropped further below 50% for the first time, according to a study published by American Medical Association (AMA). According to the agency, physicians are less often working in privately-owned practices. Instead, they are seeking employment in more extensive settings such as hospitals. American medical association reports that only 49.1% of its 3,500 national survey respondents worked in private practice as of fall 2020, dropping from the 54% reported in 2018. This change is the most significant shift the AMA has observed since 2012. It’s also the first time the proportion has ever dropped below 50%. The results seem to be the acceleration of the existing physician drift since 2012 and possibly enhanced by the COVID-19 pandemic so that even some physicians are leaving medical practice altogether. For every physician, medicine is a rewarding experience, but only if they can spend as much time as possible with their patients. But due to the increasing administrative burdens to achieve high performance, private practices will require to allocate over 10% of their time to administrative tasks only to keep competitive swiftness with the large organizations such as hospitals, health systems, and other physician employers. In other words, they lack the tools to stay in the game.
The Healthcare trends of 2021
In recent years the landscape for private independent medical practices has shifted to an unbearable level to the physicians. Although every healthcare debate is around easing the burden on medical procedures and extending public healthcare coverage options to citizens, politics also will prevail throughout 2021. There will be a particular emphasis on programs that have bipartisan support, including payment policies that further move away from fee-for-service reimbursement and toward models that drive lower-cost and higher-quality outcomes. It is most likely that whatever passes the liberal-controlled congress and senate will entail policies that will uphold more mandates and lots of economic-based approach to a healthcare problem. Value-based reimbursement is moving forward without high-level evidence supporting its effectiveness in improving health care quality. Nonetheless, it seems un-surprisingly convincing enough for the Biden administration to move forward with value-based care, hoping to improve medical quality and reduce costs. Even if it does what it is labeled to do, the biggest downside is that it will place an unnecessary burden on already exhausted physicians.
The shortage of certain health products amid the COVID-19 pandemic sparked the nation’s attention to how dependent the globalist molded countries rely on overseas markets for critical supplies, drugs, and equipment. That is why many justify manufacturers to produce medical products domestically, which is easier said than done. Achieving this vision requires decentralizing resources, empowering small businesses versus large corporations, and implementing transparency initiatives, requiring corporations to share vital information with the government, including supply sources, centers of manufacturing, redundancy and contingency protocols, and more. The concept of bringing production home, nonetheless takeover of the global market by giant corporations and creating interconnectedness between them will resist happening because fundamental policies are lacking to remove the healthcare market corporate monopoly.
In 2020 COVID-19 pandemic exposed the inadequate nature of public health data systems and technologies, as it still relies on technology from the last century, including manual data entry and fax forms. For 2021, there will be a discussion over the government’s access to reliable public health data using syndromic surveillance via modern systems. However, that still calls for a system that is affordable for independent physicians. Its usability matches that of the clinicians and not bounds the physicians to a set of algorithms.
Until the COVID-19 pandemic, telehealth remained underutilized in most markets, primarily due to policies that limited reimbursement for telehealth services to rural clinics and those in two-sided risk models. But the pandemic turned the table. It will be vital to know which virtual visits are most appropriate and the safe and reliable criteria in the year ahead. There will probably be a need to tying virtual visits to in-person seamlessly to help reduce leakage and maintain ancillary services, follow-up appointments, and prescription levels. Then again, today, we can find hundreds of independent telehealth organizations in the market, some of which are evolving to cover the necessities of the in-person visit. Two thousand twenty-one medical practices are likely to change their measurement of critical metrics regarding what and how often it is being measured. That also requires physicians to adapt to such changes, which hinder them further. Medical practices are not the only ones suffering. The American Dental Association reported that 72.7% of Connecticut dentists had lower patient volumes since the pandemic.
Our Globalist system wants large Corporations in dominance
“Few larger healthcare systems are in a position to lobby for the types of payment models which might be easiest for them to adapt to.”
Many physicians want to maintain their independence, but they face cost pressures and administrative burdens from which doctors who work in large healthcare systems are shielded. That means it’s getting tougher every year to run an independent practice. Diagnosing illness and prescribing a course of treatment is enough of a challenge for any clinician practicing in any setting. But for the independent doctor, this challenge is just one of many. Doctors who give up their private practices to join large care networks like hospitals do not feel the same pressures as independent physicians. Because often more large networks have staff whose time is devoted to overcoming those hurdles to providing care. Those doctors can focus all their attention on patient care. But smaller clinics and independent practices do not have teams of experts who focus on regulatory and compliance issues. The doctors in these settings must add these duties to their already considerable workloads.
Large health systems Combine Software and People to get over administrative and regulatory hurdles — independent practices should do the same. On the other hand, large systems like hospitals and the insurance industry seem to appreciate complex and intricate medical practice models and policies. To them, it resembles a “murky water to the fisherman.” While physicians are striving to compete with them on administrative grounds, they have a better chance of convincing doctors that working for a corporation is more convenient.
Now that corporations have cracked the ground for extensive data mining, it will be doubtful to ease the environment for independent physicians and private medical practices. Historically corporations have relished the lavishness of personhood, collective impact of their sponsors, money, and technology. Nowadays, they are on the threshold of exercising that ability by reading the human cognizance, admission to their data without breaking a single law. They are endowed by possessing the intelligence (Artificial) and learning mind of their own. But:
“As large corporations are gaining full control of our healthcare system, disregard for the compassionate physician intervention is becoming progressively apparent, giving way to cookie-cutter medicine.”
Can Independent Physicians survive the dominance of Hospital Health Systems in the competitive sphere?
Some people are optimistic about the return of private practices. And those are probably the ones who either aren’t involved in medicine or line up with the other 50% who are still in training. Regardless, every independent physician practice must be equipped with modern tools and strategies to stay in business. It is important to remember that current healthcare policies do not deliberate between a small medical clinic and a large hospital. But physicians are a culture of complainers with little proactivity. Their Blackhat thinking attitude often works to their advantage, but the rest of the time not! So, the quick answer to the question is not if they fail to change their practice attitude. One may think complaining is just venting off, giving them a chance to let out some frustration. Today’s millennials want more options and more straightforward; if they feel they can get that from the larger systems, they will be empowering the wrong sort of healthcare, thus “Corporate Medicine.”
So, it has much worse effects on everyone if we take the path of utter soul-draining. Healthcare is Suffering from Groupthink Syndrome. Personalized healthcare requires Personal Autonomy, something Population Health will at no time offer. That means that physicians often tend to reach unanimity given the Blackhat thinking attitude even if it is deprived of ultimate reasoning or appraisal of the impacts. Groupthink is typically based on a collective longing not to upset the equilibrium of the group. Such conservative nature of our medical communities has played against doctors’ interest and placed them in a bench-warming position. Now is the perfect time for the revolution of Private Medical Practice. Before we can see such a revolution, we must first acknowledge that modern healthcare is a swamp stuffed with political mud and legislative murk. To the irony, almost every penny spent on healthcare is merely converged on emptying vast amounts of healthcare dollars into corporate pockets.
With increasing legislative mandates that are the byproducts of a stalemate amid administrative shortcuts and consecutive failures, keeping up with the complex bureaucratic provisions is becoming harder by the day. Once again, independent clinics need qualified people and properly validated technology to work in tandem. Systems that realize this are some things for which independent doctors should be striving. When doctors have this management structure, they will no longer be in the menace of falling behind schedule.
“When it comes to independent physicians’ practice survival, it is not about a solution you offer, as it is about how your solution will collaborate with the others.”
The government red tape that is often implemented to address some of the healthcare hurdles doesn’t help the problem; instead, they create a monopoly, which follows the rules of paternalism by limiting individual’s autonomy and option, intending to facilitate the interest of a few others. On the other hand, Health information technology is driving the physician practice route towards an unfamiliar sphere. Its contributors are merely dictating how physicians must practice and how much they should earn. In other words, the value of their work is not decided between them and the patient but merely determined by data analysts’ algorithms.
All in all, Simplicity is the keystone to a successful healthcare problem. And technology is supposed to do just that. Indeed, a modern medical practice needs a face Lift. But that facelift comes with specific rations. Personalized care, transparent approach, and accountable policy are desired, or otherwise, every solution will fall short. The Legislators’ efforts in creating incomplete transparency from the birth of the product to the consumer will fail to flourish authentic value of medical service and facilitate genuine accountability. Hence, it will prohibit the delivery of quality products at an affordable cost to one group over the other. Physicians and patients must petition transparency on all facets from the start to the end. It’s time to set the market free and increase competition so that quality products can be dispersed to patients empty of dominion and corporate cost control. The system must encourage physicians towards establishing personalized care. Likewise, medical communities must be vested in an environment where the quality of care is defined by that particular professional service, bereft of go-betweens, and unfair corporate corner. The government must pledge to maintain a healthcare system devoid of exploitation. One hundred percent transparency is a must, lengthwise, employing full accountability at the step of the way. Only subsequently can private clinics enjoy the technology, solutions, and innovations.