Executive Vice President's Report
Predictions

Philip H. Gilbert, Executive Vice President

Instead of dialing one of the numerous psychic hotlines to determine what the future holds for physicians, I picked up a copy of an American Medical Association publication An Environmental Analysis, a report designed to assist in planning for the future. Based on health care trends, the following is the predicted impact for physicians:
  1. Physicians in training today, except those entering pediatrics, will spend 50% of their time treating patients over 65.
  2. Physicians will see increasing numbers of patients with several chronic diseases. These patients will require improved coordination of care and, therefore physicians will have to spend more time coordinating care. Payment to the physician for coordinating this care will become an increasing issue.
  3. Physicians will experience increased pressure from baby boomers to increase quality and decrease costs.
  4. Physicians will face increased pressure to practice population-based preventive medicine such as administering immunizations, reducing personal risk-taking, and detecting risk factors.
  5. Physician involvement in school-based health clinics will become a common strategy for providing care to underserved children and adolescents.
  6. Physicians will treat more non-English-speaking patients, which may introduce third party intermediaries between the physician and patient.
  7. Physicians will be under pressure from health plans to improve communications with patients in a cost-effective manner. They not only will need to tailor communications for low-literacy patients, but also understand multicultural and multilingual demands.
  8. Physicians will be treating patients with pre-symptomatic illness, diffusing the age specific orientation to disease and moving disease management to a life time coordination of care.
  9. Physicians will need expanded education regarding the impact of the Human Genome Project on human health, the appropriate use of genetic testing, and the provision of adequate counseling and support for patients regarding test results. A need to be informed on ethical, legal, and social implications of genetic testing will continue.
  10. CME will be increasingly important because of the Human Genome project, increased patient access to health information and direct marketing by pharmaceutical companies to patients.
  11. Public Health programs at all levels will be under increased pressure to expand their activities.
  12. Health disparities will challenge local and national government programs and alter patterns of health care.

I would recommend that each of you obtain a copy of this 30-page very well done and to the point publication by the American Medical Association. Again, the title is An Environmental Analysis: Trends, Impacts, and Opportunities. You may obtain a copy of the report directly from the AMA, or better yet members can e-mail me at evp@dcmsonline.org and I will see that you get a copy.

August, 2000/ Jacksonville Medicine

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