Healthcare is undergoing a big transformation… both for good and for bad.
Here are my thoughts about what the future holds, from a strategic risk point of view.
A few months ago, I had the amazing opportunity to hear first-hand the problems that medical doctors are facing. As an attendee of the Washington State Medical Association’s annual meeting, I enjoyed a full day of sessions and House of Delegate discussions on pressing issues. I spoke with physicians at all points in their career path: students just finishing med school, physicians at their peak, and those about to retire.
Read more about what happened here:
My Experience at Washington State Medical Association’s 2019 Annual Meeting
What Doctors Think About the Future of Medicine
The healthcare industry has changed significantly from when I entered the field in the mid-2000’s as a medical transcriptionist. Since then, I have been manager, analyst, director, and now work as a consultant.
In my conversations with physicians, I find that they are trying to make a difference in a landscape that continues to erode the public’s trust and respect for the field of medicine. Obviously, this is a very complicated issue; but most people don’t get the chance to hear directly from doctors, and I think their perspective is really valuable in this discussion.
Here are my observations.
Biggest Challenges for Practitioners
The doctors I spoke with seemed rather pessimistic about the future of medicine and don’t expect it to change anytime soon. They mentioned 4 main reasons why they are frustrated with their profession:
Paperwork, burnout, profitability, and positioning.
Several doctors said their biggest headache is dealing with Electronic Health Record (EHR) systems and documentation requirements.
Many doctors I talked to mentioned that electronic health record systems “bring nothing but headaches.” The general consensus is that EHRs can cause:
- reduced productivity,
- more complicated workflow, and
- a loss of trust in the system for which they work.
This is an especially significant topic, since my post-graduate training was on EHR strategies — specifically, how to maintain the integrity of healthcare data while transitioning to new support roles. (My 2011 thesis at The College of St. Scholastica was called Documentation Roles in an Electronic Health Record Environment).
Practitioners — especially primary care physicians — will continue to face barriers in documenting patient encounters. Many of these challenges stem from software systems that are not intuitive. Many systems require physicians to input data that does not follow the natural pace of providing care.
This can result in:
- reduced communication and misunderstandings
- higher frustration and wasted time for physicians
- a disconnect between the physician and their patient.
For healthcare organizations in which I have worked and consulted, the decision to implement a software system is complex and costly. Unfortunately, physicians will likely continue to work within the structured requirements of electronic record systems that add more to their workload, rather than reducing it.
Another commonly discussed topic faced by many physicians is the lack of support they feel from the medical community.
Several attendees said they were only able to attend the conference because they have stepped away from active practice. A few physicians testified before the House of Delegates Hearings about their disappointment in the lack of support during investigation of professional conduct, even if the allegations were found to be untrue.
Quite a few attendees were students or new to the profession. I also heard that many WSMA members did not attend the conference, likely due to an extremely heavy workload. One doctor shared that he had worked 70 to 80-hour weeks for several decades, before finally retiring a few months prior. His newly found “free time” was the only reason he was finally able to attend the conference.
This pressure is also a leading factor in the alarming increase in the rate of physician death by suicide, estimated at 400 deaths each year. (Read more about the initiatives such as The KavuMD™ Project in my previous article). While support is available, the root causes of burnout and overwhelm are due to out-of-touch leaders, a punitive legal environment, and low reimbursement for services.
Physicians also told me they feel conflicted between wanting to serve patients who have the greatest need and would otherwise not get proper care, and their desire to run a profitable practice.
This was a topic that many people discussed objectively, yet I got the sense that very few doctors felt free to share their personal struggles with the conflict between patient care and financial gain.
The topic of profitability — and financial gain — hits a nerve with doctors, because it is one of the reasons they went into medical school (though not the only reason). Costs continue to rise in the healthcare industry. And although it is a difficult subject to talk about, it’s important; because without profitability, there is no way to create an independent practice that can serve patients long-term and build equity for the practitioner to retire comfortably. Without a profit margin, private healthcare is impossible to sustain.
But profit and altruism can go hand in hand. I was encouraged to see and hear how many doctors make incredible personal sacrifices to ensure that care is available — even if it results in a financial impact for them personally. As far as I could see, no one at this conference appeared to choose affluence over serving their patients with the highest quality of care.
When I pulled into the parking garage, 3 physicians stepped out of ordinary-looking cars (a Hyundai Sonata, a Toyota Corolla, and a Nissan Altima). Obviously, not all doctors prefer ordinary cars (I did see a Porsche, a Tesla, and a Mercedes Benz). But it was refreshing to see that there is a real emphasis, at least in the physicians I met and observed in Washington state, to connect with patients and provide a high level of quality even if it comes at a personal cost.
I hope this will continue to be the case; we need empathetic, patient-focused medical leaders to find a balance between providing excellent care and generating a profit, all without compromising their ethics.
From what I observed, the way medicine is delivered will continue to evolve in ways that could have a negative impact on patients.
One example is with the rising popularity of unscientific quack treatments, new self-diagnosing technology, and nutritional dietary supplements. There is a a shift from physician-driven diagnosing to patient-led diagnosis and care. We are already seeing signs that without a trained medical professional, self-directed care can have a disastrous result on patient health.
In order to protect consumers, it will be important to educate patients on the value physicians can provide in a way that cuts through the consumerism noise.
This is only possible when practitioners build trust with their patients and understand how to properly position their expertise in a crowded market.
Although many physicians are choosing not to open independent medical practices, it is still possible to remain independent as long as there is a well-designed plan for market positioning.
From my perspective, the medical field will continue to evolve in ways that could negatively impact patients. The cost of obtaining the highest quality of healthcare services continues to reach levels never before seen in human history.
We are already seeing a shift in primary care providers. Traditionally this has been MD and DO physicians, but a shortage of qualified physicians has forced the medical industry to find alternative roles to handle primary care, such as Nurse Practitioners and other roles.
Another trend is patients’ reliance new technology that is not necessarily corroborated by medical professionals. Self-diagnosis could lead to misinformed treatment and poor management of health conditions.
I am also seeing a worrying trend toward consumer reliance on unproven quackery products and services — which are often used by patients seeking pain relief and alleviation of serious medical conditions (such as cancer, multiple sclerosis, migraine headaches) as well as mental health conditions such as depression, anxiety, and autism. By heavily marketing unsubstantiated “solutions,” unethical companies can make millions of dollars at the expense of vulnerable people.
For more on this, check out What to Do if Your Doctor Promotes Multi-Level Marketing
In my opinion, the best way to start reversing these healthcare trends and create a better future is for the medical community to recognize barriers that cause patients to mistrust the current standard of care. This goes beyond clinical work; it also has to do with the patient’s perception that their experience is important, and that their opinion is valuable.
Feedback from patients is often used to create enticing marketing messages and to improve quality measures, but often their feedback does not translate into fixing the deeper problems. One simple step can change this: When leaders actually step into the experience of patients.
What would happen if executives in the highest level of medicine actually saw, felt, and heard what it’s like to receive care? What if top execs and doctors stepped into the shoes of their Foundational Staff and served meals, changed linens, and cleaned floors for a day?
Healthcare administrators have a long way to go if they want to rebuild trust with patients. They could start by acknowledging the problems of:
- inaccessibility and inequity,
- unreasonable costs,
- a sub-par patient experience,
- policies that punish patients rather than treat them like partners, and
- a lack of empathy from providers and members of management.
Only by recognizing and responding to these risks will we see long-term change to the entire system of medical care.
Interested in hearing how you can reverse a toxic workplace? Find out more here.
Grace LaConte is a business consultant, writer, workplace equity strategist, and the founder of LaConte Consulting. Her risk management tools are used around the globe, and she has successfully reversed toxic work environments for clients in the healthcare and non-profit fields. Grace specializes in lactation law compliance & policy development, reducing staff turnover after maternity leave, and creating a participatory work culture.