Monday, September 19, 2011

Crisis

AOMA's President Jan D. Zieren, D.O., MPH, FACOFP, dist. updates the AOMA membership on her president's message from her inauguration (see original text here).


As promised, the USS AOMA is afloat and sailing the seven Cs.  The first sea we are crossing is CRISIS.  The Chinese pictograph for crisis is made up of two characters, one standing for opportunity, the other for danger. There are often two sides to the issues and concerns of this healthcare crisis.  Many see the “danger” in what appears to be coming down the path.  Others are optimistically seeing opportunities to what may be.  Both sides are aware of the challenges in sailing through reform ahead.

The physician-patient relationship is such a key to quality healthcare.  With the significant potential of newly insured patients there will be a need for more primary care providers, the logical entry point to the system. Several years of discussion, planning and encouragement to implement Medical Home status by primary care physicians stemmed from this very premise.  Health plans appreciate that physicians are a key to the care of their members and send alerts and clinical insights to the physicians to assist in keeping tabs on their members (the physicians’ patients).  Now physicians and health plans as well as facilities are building up accountable care organizations with hopes of improving care, saving money and providing useful information to the physicians.

Preserving the physician-patient relationship seems tantamount to other components of this reform storm.  With a projected serious increase in numbers of insured members in America, how much of a shortage of physicians will there be?  If we wish to continue the idea of physicians and patients in a relationship for health care, the potential need could escalate to over 45,000 more physicians needed in 2014!  There are physicians who may choose to retire early. One estimate found suggested 33% of physicians practicing today will retire over the next 10 years.  Most students are not choosing primary care specialties for their residency training.  Some practice trends have physicians working part time, opening medical spas, shifting into administration or even limiting themselves to VIP practices – all of which further reduce access to primary care for patients.

Health plans have been primarily concerned with corporations and businesses to supply programs to members.  A much lesser percentage of individuals have sought personal care packages from the health plans.  Will that ratio change dramatically with reform?  What impact could that have on this “quality” of physician-patient relationships?

Legislation to raise the debt ceiling and cut deficits most certainly will crunch into Medicare reimbursements for physicians.  Physicians are demanding a permanent fix to the SGR and it was left out of the deal.  If there are already physicians dropping as Medicare providers and future serious SGR cuts loom, how many more will have tough decisions as to whether they will continue providing for Medicare patients.  This would reduce access for Medicare patients to physicians and at a time of projected Baby Boomer influx to Medicare.

The officers of the USS AOMA continue to serve and maintain watch on the winds of the reform storm and are available for questions, conversation and informative updates.  We will hit the port of Tucson November 12-13, 2011 for the Fall Seminar.  Come aboard!

No comments:

Post a Comment