Meeting Tomorrow’s Challenges
As a member of several boards and committees, I have had the opportunity to speak with a lot of physicians on what they see as the problems. I have also collaborated with physicians who are in leadership positions within their health systems and are trying to do the right thing for everyone.
Together, through team work, we are making a difference
Managing Pain Points within HealthCare
Kudos to physician leaders within healthcare provider organizations as well as the American College of Radiation Oncology (ACRO), American Medical Association (AMA), and Washington State Medical Association (WSMA). Teams of physician leaders meet regularly and work with regulators (Medicare/Medicaid), health plan executives, legislators and others to solve issues such as reducing administrative burdens, increasing time spent with patients, and ensuring that digital relationships and other care models incentivize care of all patients including the most vulnerable. Work with fellow board members as Past President and Board Chair of the American College of Radiation Oncology and as the Washington Medical Association Delegate to the AMA who serves as Chair-Elect of the AMA Council on Medical Service has helped improve patient satisfaction and outcomes. Young physicians in the trenches lead the way to use digital technology to help take the hassle out of healthcare.
Largest hassle – an unstable federal reimbursement model and uncertain regulatory environment
Each of us has seen firsthand how increasing administrative burdens and reduced payments have led to early retirement among our older colleagues. If hospitals and physicians are to invest in their practices, then we need payment stability and transparency for drug coverage, pre-authorizations, and charges. In 2022, the AMA released this graph:
Benefits of Interoperability
Around the world, banks participate in interoperable payment networks. This lowers costs and speeds transactions. Similarly, we need EHR to be fully interoperable. But few solo or small hospitals or physician practices can bear the cost of advanced technology and stay afloat financially. Northwest Cancer Clinic was paperless in 2012. This helped reduce administrative costs, decreased time to payment, enhanced team work among physicians, and allowed patients fast access to their test results.
Stress and Work/Life Balance Issues
It has always been tough to avoid burnout given the high pressure we operate in when we make life-altering decisions on a constant basis. Being held accountable for issues we cannot control only adds to this stress. We need physicians with real-life experiences taking care of patients to lead the way with these new models being tested.
Scope of Practice Issues
The authority of CRNAs has been a hot-button issue for our colleagues within American Society of Anesthesiologists as APRNs make other incursions throughout medicine in the states. Meanwhile, the VA’s pursuit of the nurse-only model may be the first of many aggressive new challenges that we will see that will test the notion of physician-led care. This affects employed and non-employed physicians equally because we all face autonomy and decision-making challenges if the team is led by a non-physician. We need to be vigilant to protect patient safety as efforts to lower health care costs turn increasingly to expansion of scope for non-physicians.
Increasing Medical School Debt
According to an AAMC report, the cost of non-resident tuition mushroomed from an average of $25,000/year to $60,000/year between 1997 and 2016 (non resident tuition). This may increase the growing shortage of primary-care physicians as medical students opt for higher-paying specialties. While our AMA works to reduce the number of years of physician training, we need more solutions to this problem. With their much-shorter education requirements, more college students with an interest in medicine are choosing to become PAs or APRNs. Some physician colleages are even leaving for investment banking or other jobs at Wall Street after their training.
