Practice survival hinges on new models, technology

Yet another report--this one released by the Physicians Foundation--paints a bleak picture for the future of physician practices as we know them. The report, which cites "dire challenges" to practices posed by falling physician visits, rising operating expenses, retiring baby boomers and plummeting morale, offers a number of policy recommendations to improve physicians' working conditions.

Among other recommendations, the report calls for:

  • The reduction of physician reporting requirements that do not result in cost savings or measurable reductions in patient risk
  • A new debt-relief system for young physicians
  • Continued development of new practice models such as patient-centered medical homes and direct-pay systems
  • Elimination of disparities between what hospitals and practices can charge for the same service

In addition, the report stresses that greater adoption of technology and innovative practice models will be critical for organizations to survive. According to the report, new practice models hold promise for diversifying physicians' services and for improving physician productivity. "Moreover, digital technologies that enable real-time claims management and payment, automate dictation and coding and improve physicians' communication with each other and with patients could lower overhead costs and enable more efficient practice," the report states. "Medical practice innovation holds the key to private practice being a viable alternative to salaried employment for the next generation of physicians."

Moreover, author Jeff Goldsmith, noted that existing physician-led models, such as independent practice organizations and physician-sponsored health plans, provide examples worth watching. "Physicians' willingness to organize to manage population health risk will be essential to regaining control over their professional lives," he wrote. "The alternative is to continue to have their clinical decisions micromanaged by health plans and Medicare."

Indeed, according to an article from California Healthline, health systems that have more established health IT systems and experience with integrating care, such as California's Kaiser Permanente, report higher physician satisfaction and morale.

According to an internal annual survey of Permanente Medical Group physicians, the scores are currently higher than ever, Robert Pearl, the organization's executive director and CEO, told Healthline. "On a scale of five, we're getting an average of 4.75 across thousands of physicians," he said. "I think the reasons are pretty straightforward. Having the technology we need and being recognized on a national level for the work we're doing is very gratifying."

To learn more:
- see the report (.pdf) from the Physicians Foundation
- read the article from California Healthline