Healthcare is unlike any other industry for a ton of reasons, a few I found the time to ruminate upon this morning.
What industry does not know its costs? There are examples of providers performing this analysis, but most community hospitals, ambulatory care centers and primary physician offices operate from ignorance on this information. How can providers negotiate payer contracts without this knowledge? This information will become increasingly important as the industry evolves from traditional payment models (introduced in this class) with ones based on quality of care and outcomes. This begs the question, how will we measure quality care and outcomes? The answer will inevitably involve more consumer involvement.
How will the industry respond to the increasing demands upon the primary physician? Today’s reimbursement models force physicians to fit more patients into their daily routine, while still making the same amount of income. This model will eventually change the face of healthcare, and perhaps for the better. Demands on physicians to stay current with new clinical data, juggle a schedule of seeing thirty-six patients a day and “practicing the art” seems super-human and may be outdated. These demands combined with an alarming decrease in physician ranks will create a new layer between the patient and the science. This new layer may be satisfied with Nurse Practioners or Physician Assistants, or a skill-set not yet defined that focuses on data gathering and psychological insight.
How can patients do to better the system? Medicine addresses our physical vulnerability and fear of death, which are the darkest of human emotions. Physicians must have a serious sensitivity towards the emotional needs of patients, and one could argue society’s reaction towards death has worsened in the last fifty years. For many years of pain or confinement to bed are better alternatives to accepting the inevitable. We expect our physicians to be the best scientist and psychologist all wrapped up into one package, but how have we changed as consumers? We need to bear a larger portion in the direction of medical care, and the systems that provide medical information to the consumers must be simplified for all. Health data banks, where consumers store health information and pay for data analysis, will emerge and become the centers of our data. And finally, and arguably more difficult, is that we require a change in attitude regarding death. Fear of death is the motivation behind the largest portion of healthcare expenditures. Has our consumer psychology forgone quality of life in favor or quantity? Changing these attitudes will not happen overnight and will not be easy. Each of us facing our ultimate demise need to do so with dignity and faith that death is a beginning to a larger chapter in our existence.