Executive Vice President's Report
Crystal Ball - Part 3 The Final Session

Philip H. Gilbert, Executive Vice President

 

Some of you have asked for one more look into the future predicted impacts for physicians.

Again, I returned to the American Medical Association publication - An Environmental Analysis Impacts, and Opportunities. I regret that the AMA reports that they no longer have copies of this publication. I found it to be one of the best if not the best presentation of trends in years not only for physicians but hospitals and patients as well. Turn off the lights and look into the crystal ball.

  • Physicians will face increasing pressure to offer a complete package of services (one-stop shopping) for patients, especially for care of chronic diseases.
  • With increased competition for medical services, physicians are going to need to be aware of patient's needs. Physicians will need to focus on patient's needs. Physicians will need to focus on services including the expansion of hours, reducing waiting times, and other strategies that will increase patient satisfaction.
  • A re-thinking of medical education to prepare physicians to practice in the changing environment and the changing face of the physician/patient relationship.
  • Because failures of some major teaching hospitals and community hospitals are imminent, physicians face increasing problems in caring for patients in hospital settings. Physicians may be forced to find alternative sites for delivering patient care, which may hasten an increase in physician joint ventures.  Physicians will be increasingly challenged by patients to justify their diagnoses and treatment decisions.
  • Patients increasingly view physicians as technicians and increasingly are willing to switch physicians.
  • Increasing competition for incorporation of technology advances in physician practices will accelerate calls for certification by procedure or even licensure by specialty discipline.
  • Disease and demand management programs for well patients will proliferate.
  • Business savvy physicians will be more successful in adapting to the dynamics of the marketplace and choosing potential business partners.
  • To effectively oversee capitated contracts, physicians need to understand the implications of assuming risk and strategies to manage it. The public will perceive a conflict of interest on the part of physicians taking part in such risk assumptions.
  • Physician report cards, clinical outcome measurement, and clinical practice guidelines will affect the image of physicians.
  • Restricted access to care creates conflicting pressures on physicians. Despite policies that restrict access to physicians, managed care plans and purchasers evaluate physicians' non-clinical skills such as telephone response times and communication styles. In effect, access is a new dimension of quality of care.
  • Certification in specific disease states will be a criterion for physician selection by managed care organizations in the future.
  • Advances in medical science and technology will enable physicians to do more for their patients then ever before. Physician satisfaction with patient-care aspect of medical practice should increase.
  • Insurance products with low premiums and high out-of-pocket costs may become more popular as the cost of health coverage plans is shifted to the individual and family.
  • Access to care will remain "tiered" - consumers with considerable discretionary income and insurance, consumers with some insurance, but little or no choice of coverage, and the uninsured.
October, 2000/ Jacksonville Medicine

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