Stephanie Bouchard, Managing Editor, Healthcare Finance News

Stephanie Bouchard is Managing Editor at Healthcare Finance News. She covers physician practices, ambulatory facilities and community care. Follow Stephanie on Twitter @SBouchardHFN.

At MGMA, uncertainty about the future of healthcare

SAN ANTONIO | October 23, 2012

A panel discussion taking place at MGMA-ACMPE’s annual conference in San Antonio Monday morning focused on the state of healthcare, with an eye toward the future.

Topics ranged from the upcoming election’s impact on the Affordable Care Act and healthcare reform to overutilization, but the most intense response came during discussion of the predicted doctor shortage and the practicalities of compensating for it.

While it may be difficult to accept, said Rich Umbdenstock, president and CEO of the American Hospital Association, “We’re not going to get the numbers of physicians, or frankly, even nurses, that we’re going to need.”

Noting that physician shortage predictions in the past came to naught, Jeremy Lazarus, MD, president of the American Medical Association, said that how severely the workforce may be impacted is hard to judge because it isn’t known how models such as accountable care organizations and other team-based care models will affect workforce needs. No matter how things develop, though, he stressed, what patients want is team-based care lead by doctors.

A ripple of disbelief swept the crowd when Carolyn Pare, president and CEO of Buyers Health Care Action Group (BHCAG), disagreed with Lazarus, saying, “Not all people I talk to say they want to talk to a doctor. As a matter of fact, a lot of people say they would prefer not to talk to a doctor.”

Pare didn’t elaborate further, but Umbdenstock added that the degree of comfort patients have with receiving care from different types of practitioners varies and the healthcare industry should be responsive to the care delivery wants of patients.

The panelists, on the whole, agreed that the future workforce – medical students – is not being taught, currently, how to deliver care in team-based models, and that changes to medical education to support such models must happen.

As part of the panel discussion, the panelists also shared which issues are important to their constituents.

Among their concerns:

A lack of definitive guidelines from the federal government and how to tackle quality, safety and costs – Allan Korn, MD, senior vice president, chief medical officer, Office of Clinical Affairs, Blue Cross and Blue Shield Association
What will happen with the exchanges and the Cadillac tax – Pare
How hospitals can move from the current system to one in which they take on more financial risk and accountability for quality and safety – Umbdenstock
The 2 percent sequestration cuts and the 27 percent sustainable growth rate (SGR) cut – Lazarus

View the discussion thread.

Showing 3 Comments

Shannon Breymaier say: As millions of Americans

October 23, 2012 | 17:16 PM GMT

As millions of Americans obtain health insurance and can access ongoing health care, the AMA supports physician-led health care teams that ensure health care professionals work together to meet the surge in demand. The vast majority of Americans agree: According to a recent AMA survey, 86 percent of respondents said that patients benefit when a physician leads the primary care team. Physicians and other health professionals have long worked together to meet patient needs for a reason – the physician-led team approach to care works. Patients win when each member of their health care team plays the role they are educated and trained to play.

Sue Ann Jantz say: The problem with non-physician practitioners...

October 23, 2012 | 15:34 PM GMT

.... is that they DON'T TAKE CALL. If the patient is ok with that - the problem is not serious and not chronic or doesn't worsen - then fine, see an APRN. Anywhere -- Walgreens, Walmart, Emergent care, or heck, on the street corner.

But if you want follow up, someone to "ride herd" on your problem(s), someone to be there at 2 AM, everybody wants the doctor. See, administrator or insurance company executive is awake at 2 AM, so they have no idea what is happening then.

I also point out that the "doctor shortage" is also a "doctor mal-distribution." Nobody, it seems, wants to be on call, including the doctors. Or, if they are, they want to be paid for it, and that is where we are headed. We will pay for the work at 2 AM - whether in the ER or the insurance coverage.

Jeff Bauer say: Carolyn Pare's comment on non-physician practitioners

October 23, 2012 | 12:44 PM GMT

Being in the audience at yesterday's opening session of the MGMA annual conference, I really disagree with Stephanie Bouchard's report that "a ripple of disbelief swept the crowd" when Carolyn Pare said that many patients were quite willing -- or even eager -- to talk about their health problems with someone other than a physician. To the contrary, the audience interrupted her with perceptibly positive applause. Ms. Pare did an excellent job noting that a large and growing number of Americans are pleased with the care they are receiving directly from qualified non-physician practitioners. The crowd's response to her comments would be more accurately characterized as a spontaneous indication of support for a real, proven solution to our health system's problems. Many studies show that many patients are extremely satisfied with the services they receive from nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, clinical pharmacists, and other health professionals who have as much or more training than physicians in their areas of clinical expertise. To downplay these findings and to mischaracterize the audience's response is to miss the overall point of the opening session -- we've got to reinvent the way health care is delivered because the old models of care are unsustainable. Really.