Tag: Jane Sarasohn-Kahn

3 in 5 Physicians Would Quit Today If They Could

Being a doctor isn’t a happy profession in 2012: 3 in 5 doctors say that, if they could, they’d retire this year. Over three-fourths of physicians are pessimistic about the future of their profession. 84% of doctors feel that the medical profession is in decline. And, over 1 in 3 doctors would choose a different professional if they had it all to do over again.

The Physicians Foundation, a nonprofit organization that represents the interests of doctors, sent a survey to 630,000 physicians — every physician in the U.S. that’s registered with the AMA’s Physician Master File — in March-June 2012. The Foundation received over 13,000 completed surveys back. Findings from these data are summarized in the Foundations report, A Survey of America’s Physicians, published in September 2012.

Morale among physicians is much lower than it was in 2008, as shown in the first chart. Five years ago, less than 1 in 2 doctors would opt to retire; that’s up by over one-third. What’s driving doctors toward pessimism are the least satisfying aspects of practicing medicine in 2012, including:

Concerns about liability, 40%
The hassle of dealing with Medicare, Medicaid and government regulations, 27%. Over 52% of doctors said they’ve limited access to Medicare patients to their practices, or they’re planning to do so.
Lack of work/life balance, 25%
Uncertainty about health reform, 22%
Paperwork, 18%. The survey found that physicians spend over 22% of their time on non-clinical paperwork, resulting in a huge clinical productivity loss.
EMR implementation as a “least satisfying” aspect of work is quite low on the roster of concerns, with only 9% of doctors noting that as a prime concern in 2012.

As a result of uncertainty due to health reform, regulation and finance/reimbursement, the percent of physicians who remain independent will drop to 33% in 2013, Accenture forecasts, from 57% in 2000, 49% in 2005, and 43% in 2009. Aligning with a health system/hospital gives doctors more economic security and fewer administrative hassles.

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Safe Skyping: The Evolving Doctor-Patient Relationship

Skype and videoconferencing have surpassed the tipping point of consumer adoption. Grandparents Skype with grandchildren living far, far away. Soldiers converse daily with families from Afghanistan and Iraq war theatres. Workers streamline telecommuting by videoconferencing with colleagues in geographically distributed offices.

In the era of DIY’ing all aspects of life, more health citizens are taking to DIY’ing health — and, increasingly, looking beyond physical health for convenient access to mental and behavioral health services.

The Online Couch: Mental Health Care on the Web is my latest paper for the California HealthCare Foundation. Among a range of emerging tech-enabled mental health services is videoconferencing, for which there is a growing roster of choices for platforms that market a variety of features beyond pure communications.

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Pre-Conferences kick off Health 2.0

We were coding up a storm yesterday (Saturday) at the Health 2.0 Developer Challenge Code-a-thon and that goes on today–you can even stop by the PariSoma Loft to see the live judging at 3pm — with $13,000 in prizes on the line.

But the main act is starting up TODAY with 4 fabulous pre-conferences.  Don’t forget these are FREE to anyone registered to attend the main conference and to doctors, patients and employers as appropriate for their sessions. There’s also an Innovation Exchange with the Beacon Communities which has some public availability.

The Pre-Conferences: Patients 2.0 brings together more than 150 patient activists. Doctors 2.0 has several leading physicians on stage and in the audience, and more than 15 demos and active panel discussions. Employers 2.0 has leading employers again on stage and in the audience (Wanna meet Facebook’s head of benefits? -scan the badges!) and more demos than you can shake a stick at–as long as some cool case studies from Pfizer on wellness and Cisco on worksite clinics.Continue reading…

The Doctor is Social

Doctors and hospitals are going social, adopting social media for professional and clinical use, based on surveys conducted in mid-2011 by QuantiaMD and Frost & Sullivan and the Institute for Health Technology Transformation (iHT2).

In Doctors, Patients & Social Media, dated September 2011, QuantiaMD and the Care Continuum Alliance report a high level of physician engagement with online networks and social media. Two-thirds of physicians are using social media for professional purposes, and see potential in the use of these channels to facilitate patient-physician communication. The survey found a cadre of “Connected Clinicians” who use multiple media sites to positively impact patient care. Over 20% of clinicians use 2 or more sites.

Only 1 in 10 physicians is familiar with one or more online patient communities, as the first chart illustrates. Among those who know about at least one community, a majority believe the sites have a positive impact on patients (either very positive or positive in the survey response). This is true across various condition categories, especially for rare diseases, cancers, chronic conditions, maternal and child health, and wellness/prevention. As one physician shared anecdotally, “Patients can share their stories, learn from others, spread knowledge, and instill hope.”

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U.S. Hospitals Face Gloomiest Economic Outlook in 20 Years

Revenues = volume x price. This is the financial reality for every organization that makes its money serving customers, whether for-profit or not-for-profit.

For the U.S. hospital sector, both volumes and prices are falling, leading to a depressed top-line. Reimbursement reductions from Medicare, Medicaid and commercial health plans are all under pressure: that’s the ‘price’ part of the equation. On the volume multiplier, the recession economy has caused patients to delay care, such as elective surgeries. Hospitals are forced to scrutinize every aspect of operations, according to Hospital Revenues in Critical Condition; Downgrades May Follow, from Moody’s Investors Service.

Moody’s points to declines in inpatient admissions, and falling outpatient indicators including ER visits, outpatient visits, and outpatient surgeries, all due to the “sluggish economy,” the agency wrote.

Exacerbating the negative bottom-line impact is the continued growth of uncompensated care: that is, health services provided to patients who leave the hospital without paying their bill.

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Most Americans Don’t Yet Perceive the Benefits of EHRs

Consider all the stakeholders with something to gain by moving from paper health records to digital electronic records. Who do you think would gain the most from EHRs, and who the least? A survey from Xerox finds that the among all the groups American adults say have the least to gain through EHRs is, the most common response is…patients.

29% of people aren’t really sure who’s to gain from moving to EHRs.

To better understand Americans’ views on electronic health records (EHRs), Xerox polled 2720 adults 18 and over in May 2011.

The topline finding is that 83% of people have concerns about digital medical records.  The most concerning issue is that “my” personal health information could be hacked, cited by two-thirds of people. The second most common concern is that  digital medical record files could be lost, damaged or corrupted (noted by 54%)  and that personal health information could be misused (52%). Another worry is that a power outage or computer problem could prevent providers from accessing health information, cited by 52% of people surveyed.

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Prospecting for Gold

3 in 4 of the Fortune 50 companies are part of the U.S. health economy in some way. Only 1 in 3 of these is in traditional health industries like pharmaceutical and life science companies, insurance, and businesses in the Old School Health Care value chain.

2 in 3 of the Fortune 50 companies involved in health are in new-new segments. In their report, The New Gold Rush, PricewaterhouseCoopers (PwC) identifies four roles for “prospectors” in the new health economy which will represent 20% of the GDP by 2019:

  • Fixers
  • Connectors
  • Retailers, and
  • Implementers.

These are the disruptive roles that will be played by new, non-traditional entrants seeking their piece of the health care economy.

Jane’s Hot Points: This week marks the second annual Health Care Innovation Week in metro Washington, DC. Each day held a different meeting addressing some aspect of disruptions in health care. Today marks the second annual Health Care Data Initiative meeting, to be held at the National Institutes of Health in Bethesda, MD, where I will participate in a health data-palooza organized by the Health 2.0 Conference.

“Connectors” will play an all-important role today and in the new-new health economy. PwC says that Connectors succeed “by linking information and technology across the health system. They provide meaningful analysis and context so that clinicians and consumers can make better decisions about health behaviors.”

As physicians and providers continue to adopt electronic health records, and use them more deeply and smartly, consumers will be doing the same in their world via USB-connected blood pressure devices, digital glucometers for managing diabetes, WiFi weight scales, and a score of mobile health apps to track real-life, personal data. Without interoperability and connectivity between these siloed applications, the “gold” can’t be mined. Providers won’t optimize clinical decisions at the point of care, and consumers won’t be empowered to stay as well as they could or manage chronic conditions as effectively as they would in a data-liquid health world.

Jane Sarasohn-Kahn is a health economist and management consultant that serves clients at the intersection of health and technology. Jane’s lens on health is best-defined by the World Health Organization: health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. She blogs regularly at HEALTHPopuli.

The Doctor is In (and Using an iPad)

The past year has seen a huge jump in the number of hours that physicians spend online; at the margin, the increase is due to physicians’ use of online via mobile platforms.

Meredith Abreu-Ressi, President of Manhattan Research, shared her insights into the firm’s study, Taking the Pulse (v. 11), with me today. The top-line finding of the annual survey is that health professionals have quickly adopted mobile platforms in health — with special attention paid to Apple products, the iPhone and the iPad.

Manhattan Research has tracked physicians’ use of online health resources for over a decade. They’ve found “plateaus” and “jumps” over the years, largely related to changes in bandwidth. In the early days of doctors’ use of online health sites, they spent two to three hours a week seeking information online. As faster speeds became available to physician offices, such as T1 lines, those hours increased to five, then to 8 as more doctors accessed the Internet via cable and DSL.

This year, the survey found that 30% of doctors have an iPad. In the firm’s 2010 survey, the device hadn’t even been released. This is tremendous adoption in the first year of any device, particularly among the user group of physicians.

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The New Cost-Conscious Doctor

Doctors practicing in the U.S. are becoming increasingly conscious of the increasing costs of health care. Most consider themselves cost-conscious, and are considering the impact of their practice patterns — in terms of prescribing medicines, tests, and procedures — on the nation’s health bill. In fact, most physicians feel they have a responsibility to bring down health costs.

This perspective on physicians comes from the survey report, The new cost-conscious doctor: Changing America’s healthcare landscape, from Bain & Company, published in March 2011. Bain spoke with over 300 U.S. physicians to assess their perspectives on managing costs, drug and device usage, and standardized care protocols.

The top-line finding is that, regardless of physician demographic — whether male or female, salaried or productivity-based, specialist or generalized, urban or rural, young or mature, doctors uniformly see that they must change clinical practice patterns to accommodate the realities of health economics.Continue reading…

Healthcare unwired: nearly half of US consumers are willing to pay

40% of U.S. consumers are willing to pay for remote health monitoring devices and services that would send their medical data to doctors, according to PricewaterhouseCoopers’ Healthcare Unwired (PwC). 51% of consumers would not buy mobile health technology.

The uses of mobile health most attractive to consumers are monitoring fitness and welling (cited by 20% of consumers), physician monitoring of health conditions (for 18% of people), and monitoring a previous condition (for 11%).

88% of physicians would like to see patients monitoring various parameters at home, their highest priorities being weight (65%), blood sugar (61%), vital signs like blood pressure (57%), exercise (54%), calories (36%), pain (36%), and sleep patterns (35%).

Those people most attracted to mobile health technology include men more than women, people who have individual health insurance policies (vs. group health/employer-based), and more healthy people.

PwC’s Healthcare Research Institute (HRI) gauges the remote/mobile monitoring device market range value from $7.7 billion to $43 billion, based on the prices people would be willing to pay.

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