• Adam Tabriz, MD

The Bitter Reality Of The Competitive Medical Practice Landscape

Independent Physicians Are Facing Newer And Bigger Competitors In 2022; But Can They Handle The Reality?

Illumination Initially published this article on Medium!


Photo by Dima Mukhin on Unsplash

In August 2017, I published a short article titled "Actual Practice Management Will Require New Thinking." Within the piece, I shed light on the reality of disruptions physicians were facing and how important it was for independent medical practices to adopt new strategies to be competitive. Similarly, I tried to elaborate on how physicians needed to adjust attitudes towards the new reality.

In May 2021, I touched on another actuality about physician practices. That is how the Blackhat thinking attitude of the physicians does not play in their favor concerning medical practice management, even though it had benefited them regarding patient care.

Today the challenges for independent medical practices have quadrupled. That has been invariably more ominous for physicians who have fallen into the trap of the bureaucratic system of "the so-called Primary Care."

As it is evident based on a publication in the January 2022 edition of the Medical Economics Journal, medical practices and independent physicians, in particular, are facing a steeper competitive landscape today. Although such a radical change was knowingly inevitable, the COVID-19 pandemic further enhanced the contenders.

The pandemic introduced much bigger and more robust competitors like Walgreen, CVS, Walmart, and Amazon. In most cases, the imminent need for virtual care, Telehealth, and retail urgent care services opened the healthcare market doors to these fierce disruptors. Yet not surprising enough, the end of the COVID Lockdown had little or no effect on reversing the virtual care market. That is why Walgreens has invested $5.2 billion in VillageMD for rolling out retail clinics in its pharmacies. CVS has invested in MinuteClinic and HealthHUB primary care services in many of its branches across the USA. Conceivably, Amazon and Walmart are not going to be left out.

It seems evident that physicians and independent medical practices will be a secondary option to the patients. That is because they will receive "get to the point" and "focused problem-oriented care for the same or competitive rate as if they visit a family doctor. Furthermore, the independent physicians will have to do more under the Value-based care model for the same reimbursement rate. Even more disturbing is that according to the Medical Economics Journal report:

“Physicians will likely have to deal with growing competition from telehealth-only providers.”

According to the publication, physicians are no longer the only option for patients. That is an addition to the already burdened medical practices by escalating administrative workload and bureaucracy.

Backed by venture capital firms, giant tech corporations, and pharmacy chains, retail and virtual medical care is becoming more prominent than a competition a traditional medical practice can endure without a contemporary mindset.

Physicians must try to contemplate the realities, such as UnitedHealthcare announced earlier this year it is launching a "virtual first health plan." That health plan encourages patients to select an online physician as their first contact for medical care and only refer to in-person visits if the virtual doctor approves.

Although the concept of a Virtual first Health plan is another red flag that deserves a separate discussion, it is a sign that independent physicians must act decisively and fast. In no time, staffing, prior authorizations, and electronic health records (EHRs) will become secondary issues for independent medical practices.

Let us only imagine that the corporate-based retail clinics take care of the most straightforward medical cases that would take a few minutes to evaluate. On the cross side, independent physicians will take over the most complex cases with limited time plus piles of administrative work!

The Answer To The Lack Of Independent Physician Competitiveness Rests In the Medical Care Delivery Logistics Infrastructure.

The most prevailing explanations for the physician's survival amid the medical practice's corporate takeover are somewhat valid but still insufficient. For example, today, the utility of Telehealth is a plus, as millennials frequently seek more convenient ways to receive medical care. Corporations have long acknowledged that trend. That, in part, also enables physicians to be available even during the off-hours, something retail clinics are here to do!

Millennials want easy and convenient access to medical care. That includes shorter wait times and easy access to care. That is why independent medical practices should be able to avail online scheduling options. Automated text message reminders and updates on wait times are valuable tools that medical procedures can offer to their patients. That will create an insight on patients that their physician truly cares.

Competitive medical practice streamlines the patients' pre-visit paperwork, like filling out forms and completing questionnaires. Similarly, patient checkout also needs to be flawless. After all, all of us are familiar with the headache of watching the waiting room walls and holding clipboards hard in hand, waiting to be seen by the doctor, or waiting in line to check out while we should be at home resting.

The new patient mindset is that they expect prompt retorts to their questions communicated via email or an EHR messaging portal.

But, all said and done with, one thing independent physicians and medical practices must also embrace is that easier it is to say than consider it done!

Independent physicians are on the verge of extinction. As of the 2021 American Medical Association (AMA) report, the number of physicians practicing independently in the United States is below 50% for the first time in medical practice history.

What makes the difference is that physicians should embrace change, not resist it merely because they need comparable resources. Yet, independent medical clinics also need a different infrastructure than large entities—the kind of solution that ensures all human workforce, the right technology-driven automation, and secure decentralized cyber connectivity. We must remember that software-only solutions are insufficient to keep independent medical practices afloat.

Overzealous dependence on 3rd party practice workflow automation will have paradoxical outcomes on physician productivity. Physicians will end up working like Robots for computer automated alert systems.

But, convincingly, shouldn't it be the other way around?!

Likewise, we should not downplay the role of patients in the process of rejuvenating medical practice. We should start by putting patients in the driver role, that is, by giving them full ownership of their health information.

Patients deserve transparency. Because it builds trust, and compliance and, most of all, is the most robust strategy for prevailing over the competitor. Patients will invariably empower their physicians, given the sincerity of the doctor-patient bond.

One reality is unmistakable; to address every aspect of the current competitive healthcare milieu based on what we just discussed, independent physicians would benefit from a logistic infrastructure acclimating to all those requirements. And that system is a "Cyber-Physical-Human System" (CPHS).

Indeed, CPHS is a cyber network where every person, or entity, irrespective of location and distance, independently search, find, acknowledge, share, exchange, purchase, and sell any service or product. The system is a 3rd party entity that works for medical practices and not the other way around. The solution is the one that furnishes all the corporate-level resources and tools for Independent Medical Practices at a very affordable cost, so they can be efficient, compliant, and competitive without losing their independence to the corporate cartel.

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