My answer: I expect we’ll see physicians shift from not only providing direct patient care to also managing care teams and populations. To achieve this broadened vision of what it means to be a physician, our best course is to be the leaders in embracing innovation and moving to a next-generation delivery model. Prepare for individualized, longitudinal approaches to care that address the whole patient and will allow, in fact mandate, a much broader definition of “clinician.”
One reason this feels scary to some is that most healthcare organizations are still highly physician-centric. In other words, doctors still provide the lion’s share of care directly to patients. However, if we don’t proactively reimagine care delivery, we’re going to be cornered into change sooner or later. The pandemic drove an evolution in financial models, which paved the way for a virtual care explosion. And technology will continue to hold our feet to the innovation fire for the foreseeable future.
Maybe that sounds alarming, but I ultimately think it will get us to a place that’s much better for health systems, payers, and yes, even clinicians.
Technologies and delivery systems aren’t evolving in a vacuum. Financial and regulatory changes are also shaping our care models—and ultimately, our organizations. For example, regulatory flexibilities during the pandemic paved the way for an explosion in telehealth visits. In turn, virtual care and remote monitoring are making it easier and more efficient for providers to manage patient populations.
Forward-thinking healthcare organizations have anticipated the intersection of shared-risk, value-based care; alternative care venues; expanded care teams; and personalized monitoring able to capitalize on the diagnostic advantages of longitudinal monitoring. These organizations are moving away from a physician-centric, episodic care system and reinventing themselves as integrated, end-to-end service solutions able to create shared-risk models of care and manage longitudinal care through a team approach. After years of resistance to value-based reimbursement, they’re starting to see risk as a competitive advantage.
These market forces are challenging long-held assumptions about the business of healthcare. For example, up until a few years ago, we saw a clear separation between payers and providers. In many cases, their interests were actually at odds. Today, payers are acquiring physician groups and providing direct care to their members. Essentially, they’re becoming “payviders,” with the infrastructure and management capabilities to deploy population health.
Given these massive shifts on the horizon, how can health systems, hospitals, and physician groups adapt?
First, leaders should understand they have options. Some parts of our system—for example, tertiary care—will remain physician-centric for some time. One reasonable tactic is to focus on competing in this space using traditional delivery models and building market share through competitive pricing.
However, for those excited about taking a lead in innovation and healthcare’s digital technology evolution, my first advice is to focus on integration. Whether you’re a physician group, a department, a hospital, or even a health system, consider how you can link up with other entities to ensure care continuity. Often, this means blurring traditional boundaries and roles. For example, an emergency medicine group might work with patient care navigators and community organizations to address patients’ social needs.
The key to leading your organization into an uncertain and rapidly evolving future is creating an atmosphere that embraces adaptation (perhaps even over innovation). While you can’t precisely predict the future, you can influence your organization to embrace macro trends like standardization, automation, artificial intelligence, and virtual care. Accepting failure, encouraging open discussion, building risk and investment tolerances, and educating stakeholders on new technologies and how they can impact care delivery are all necessary components of a successful adaptation culture.
A great example from my own experience is Vituity’s EHR transition. Fifteen years ago, we didn’t know exactly how or when EHR mandates would impact our practices. Still, we prepared by creating awareness and incentives around one component of EHRs: electronic discharge instructions. By leveraging clinician champions to help implement new technologies, developing financial incentives for deployment, and evaluating and communicating the impact of electronic discharge instructions, we were able to provide our clinicians with an early introduction to a component of EHRs with a significant clinician value proposition. As a result, when the EHR mandate eventually came down, Vituity was better positioned for a smooth transition, with greater clinician acceptance and even willingness to lead implementation at our practice locations.
Finally, it’s time to open your organization up to new definitions of “care” and “provider.” At Vituity, this has probably been the number one factor that has helped us to adapt across the decades and remain competitive. We were among the first national physician partnerships to welcome advanced providers, scribes, and patient care navigators into our clinical workforce. And we intend to add to that roster as new roles emerge. We recognize the changing landscape and embrace how our evolving system will allow for more complete, comprehensive, and accessible care.