Over the years, healthcare become more database driven and less trial-and-error. This would not have been possible without the help of technology, due to the increasing amount of data available from research studies conducted throughout the years. Doctors in 2018 and the years to come will use models that offer more personalized approaches to care, including checkups, testing, diagnosis, prescription, and treatment. The data gathered will allow healthcare systems to become more accurate and comprehensive in their assessments, thereby reducing medical expenses and workloads, all the while improving patient care.
In today’s day and age, you are probably well aware that computers are better at organizing and bringing up important health-related information, including a patient’s medical history and management guidelines. What’s more, computers have lower rates of medical errors. As a physician, although you should take advantage of tools and trends that offer benefits to modern medicine, such as computers, you should also be able to overcome challenges that may arise from these changes. In striving to remain devoted to medicine, spending time on uncompensated tasks and working with EHR’s time demands are just some of the changes that you will see in 2018. Here are some of the obstacles that you may face - splitting your time and attention - and how to overcome them.
- Physician burnout – With today’s increasing health regulations, you may find yourself torn between patients and paperwork, as well as payers and patient requests. “I was waking up as tired as when I went to bed and I was going to bed incredibly tired. I had intense physical and emotional exhaustion and doubted whether I was actually making a difference in medicine for such incredible sacrifices,” said Dan Diamond, primary care physician. Though you may not be able to change a whole culture or organization, you can start by changing your own mindset and remembering what drove your passion for medicine in the first place. “As empowered givers, physicians can work to make the members of their team successful and then rally the team to look at the teams around them in their medical sphere of influence and do what we can to make the other team successful. I don’t see how we can go forward as a profession any other way,” said Diamond.
- Uncompensated tasks – Physicians spend an excessive amount of time on uncompensated tasks, such as non-clinical tasks and family conferences. These tasks account for more than 20% of your workday and on an annual basis, this causes you to lose around $50,000 in revenue. Although it may not be possible to completely remove uncompensated tasks from your schedule, you can redirect your efforts toward tasks that help generate revenue for your practice. Moreover, you can hand over tasks that do not have to be completed by a healthcare professional with a medical license to other staff members within your practice.
- EHR time demands – Electronic health records (EHRs), have shown great promise in improving patient outcomes and ensuring safe health delivery. Yet, you may find yourself struggling to use such systems due to the challenge in splitting time between your patients and your computer. In fact, the average physician spends 30-50% of a patient appointment looking at EHR documentation. So, what can be done to improve engagement? “The key to a good EHR is the minimal touching of keys,” said Jerry Hizon, the owner of Motion Sports MD. You can start by preparing pre-made templates and placing your laptop in a position that allows you to face the patient and make steady eye contact.
- Third-party payer interference – It can be frustrating when a patient shows up at your door in need of treatment that requires prior authorization. “I don’t get paid extra for the scan, so why does a nurse from an insurance company have to sign off on that? How is that about saving money?” said David Belk, MD. Interference from third parties, such as insurance companies, can cost your practice both time and money. So, how can you deal with prior authorizations in a more efficient manner? Document the details, keep your staff members up to date on regulations, be aware of medications that require prior authorization, and work with third-party payers. Additionally, share the information with your staff members so that you can all familiarize yourselves with which requests get approved or denied more easily.
- Patient loyalty – With the rising costs of prescription medications, as well as deductibles and copays, patient adherence remains quite a challenge. “All patients care about is the cost of prescriptions, even patients who are wealthy. Especially for older patients who are on multiple medications, it’s a big chunk each month depending on what they’re taking,” said Damon Raskin, internist and addiction medicine specialist. Experts recommend that you should address such problems by talking openly about the issue and confronting your patients, prescribing generics whenever possible, turning to technology for comparison prescription shopping, helping patients find financial aid, and partnering up with pharmacies.
- Patient disrespect – While technology has allowed patients to be able to Google their symptoms, read online doctor reviews and read other patients’ stories, it has also altered the doctor-patient relationship. Today, most patients are diagnosing themselves based on what they read on the internet and they come into your office convinced that they know their exact diagnosis. Unfortunately, information on the internet is not always accurate and reliable. In order to respond to the pressures of feeling undervalued and disrespected, you can start by guiding your patients to legitimate websites and inform them that there are two sides to social media and the internet: the good and the bad. By raising awareness, you can build acknowledgment and mutual respect.
- Healthcare quality measure incentives and disincentives – As of this year, the finalized version of the Medicare Quality Payment Program of 2018 was released. One particular change that you may have noticed is the qualification conditions for enrollment in the Merit-based Incentive Payment System (MIPS). “Physicians are supplying data, but it stops there. Getting little direction from CMS is a universal frustration for all offices I talk with” said Owen Dahl, a practice consultant. In order to make raise quality measure incentives, you should focus on what you do best, taking into consideration the areas within your practice that require improvement and the type of clinical care that you frequently provide.
- Value-based care initiatives – With the growing costs of compliance reporting and the changing reimbursement scene, a large percentage of physicians have been obliged to sell their own practices or join larger practices. To remain as independent as possible, you should change your practice model, join an Accountable Care Organization (ACO), become a Patient-Centered Medical Home (PCMH) or add ancillary services to your practice.
- Changing the reimbursement scene – “CMS should equip patients with the information they need so they can choose the providers that they feel deliver high value. Patients must have the tools and incentives to seek value and quality as they shop for services—the competitive pressure that results will drive the system towards efficiency,” wrote a CMS representative in an email. As a physician, in order to move along this new approach to quality measurement, you should restructure quality measures to promote increased patient engagement, greater flexibility, and improved patient outcomes.
- Changing healthcare insurance marketplace – If you see patients who have insurance, you should be careful about monitoring changes made to the Affordable Care Act (ACA). “The Republicans have a major stake in exaggerating the problems of Obamacare. They imply that it’s affecting all healthcare when it’s not. Now, if you are a doctor caring for marketplace patients, it is going to affect you. I’m not minimizing it, but I just think the politics of it overwhelm the reality of it,” said Robert Berenson, internist. Although you should not become overwhelmed by such changes, you should merely be aware and continue to focus your efforts on Medicare and Medicaid.
- A number of obstacles face modern physicians, like physician's burnout.
- Be aware of interference from third parties that interrupt your medical flow.
- Be aware of federal changes to health insurance that may or may not affect your patients.