The Business of Health Care: Bending the Cost Curve - Jan. 17, 2014

The successful implementation of phase two of the Patient Protection and Affordable Care Act in January and its goals of affordable, accessible universal health care will require a focus on value for businesses, health care providers and the government.

As this implementation begins, the Center for Health Sector Management and Policy at the University of Miami School of Business Administration on January 17, 2014 will host the third in its series of premier health care impact conferences: The Business of Health Care: Bending the Cost Curve.

This conference promises to offer an unparalleled opportunity to exchange ideas on the business of health care and the impact of health care on businesses at this critical time.

The Business of Health Care: Bending the Cost Curve.
Jan 17, 2014
BankUnited Center
University of Miami
1245 Dauer Drive
Coral Gables, FL 33146

Learn more and register here.

2013 Deloitte Survey of U.S. Physicians

The 2013 Deloitte Survey of U.S. Physicians shows:

Most U.S. physicians are concerned that the future of the medical profession may be in jeopardy and consider many changes in the market to be a threat. They believe that the performance of the U.S. health care system is suboptimal, but the Affordable Care Act is a good start to addressing issues of access and cost.

Most also believe that:

• Medicaid and Medicare reimbursements may be problematic, prompting many physicians to limit or close their practices to these enrollees.
• Physician-hospital integration is expected to increase.
• Clinical decision support information technologies that reduce unnecessary services and increase clinician adherence to evidence-based practices are of interest to physicians.

These are among the survey results in the new report from the Deloitte Center for Health Solutions and includes considerations for health care industry stakeholders.

See you at the Health Care Innovations Summit DC 2012 #cisummit

I'm heading down to the Health Care Innovations Summit DC 2012 today. If you'll be attending, I look forward to seeing you there!

The Center for Medicare & Medicaid Innovation is co-hosting the first ever Care Innovations Summit, an HCI-DC event, on January 26, 2012, in Washington, DC in collaboration with the Office of the National Coordinator at HHS, The West Wireless Health Institute, and Health Affairs to facilitate dialogue and drive action towards the three-part aim: Better care and better health at lower cost through continuous improvement.

Watch the event here: http://hcidc.org

Follow the Twitter hashtag #cisummit

@DrJosephKim quoted in this @CNN @Money article about health care #jobs

I'm quoted in this CNN Money article titled, "Health care jobs a bright spot for hiring." Many people choose to pursue careers in health care because of the job stability associated with the health care market. These days, even in a depressed economy, there are many new health care jobs that are being added on a regular basis. Why is this happening? Here's the bottom line: the aging population coupled with changes driven by health care reform will add a number of new jobs in the health care industry.

There are also changing trends in the ways hospitals are hiring physicians or practice groups. Many independent private practice physicians are choosing to be employed by hospital systems and they are choosing salaried models of reimbursement. When a hospital hires a private practice physician to work as a salaried physician employee, that's considered a new job for the hospital. Technically, the physician switched from working as an independent contractor to a salaried employee for the hospital. The hospital records that they added and filled a new job position.

In reality, these health care job statistics published by the U.S. Bureau of Labor Statistics may be a bit misleading right since so many physicians are switching from the private practice model to a salaried model.

Standard & Poor's Health Care 2011 Conference: Trends and Rating Considerations

Standard & Poor's Health Care 2011 Conference: Trends and Rating Considerations

Date: Tuesday, June 7, 2011

Location:

Standard & Poor's
55 Water Street
Conference Center
37th Floor
New York, NY

Registration is complimentary

Time: 8:00 a.m.-1:30 p.m.

Presentations include:

• Economic Perspective on U.S. Health Care
• Health Insurance Sector Review
• Not-for-Profit Health Care Sector Review
• Corporate Health Care Sector Review

Health care reform changes will drive more physicians to leave clinical medicine

It’s hard to find many physicians who are excited about the upcoming health care reform changes. Most physicians are complaining and some are preparing for early retirement. There are a growing number of physicians who are actively preparing for a non-clinical career transition so they can escape patient care and go into administration or business. If we could graph physician enrollment into MBA programs, we’d probably see a noticeable increase that started in 2009 or 2010. Many physicians are pursuing an MBA so they can get prepared for the non-clinical world of business.

Recently, I’ve also been speaking with a growing number of physicians who are looking for opportunities to get involved in non-clinical opportunities while they continue to practice medicine. These physicians are blending their clinical career with a parallel non-clinical career. I know some physicians who are working in business during the day and moonlighting in the ER on the weekends. Others are working part-time in the hospital and consulting on their non-clinical days.

Organizations like the Society of Physicians with Non-Clinical Careers are seeing significant growth in membership.

If you’re considering a possible career transition in the near future, I encourage you to receive our updates from NonClinicalJobs.com so that you can learn about the different types of job opportunities that are possible. Jumping out of clinical medicine isn’t an easy transition for most physicians. You probably won’t make the transition overnight, so get informed so that you’re prepared when that transition day arrives.

McKinsey & Co webinar on Accountable Care Organizations

McKinsey & Company is hosting a series of web-based presentations for medical students, interns, residents and fellows. The presentations provide an opportunity to learn more about our firm and the work we do. These events have been created specifically for healthcare professionals and feature discussions of topical issues in healthcare. They also allow you to hear from and ask questions of McKinsey consultants with backgrounds in healthcare. The next presentation topics are:

Making Unicorns Real - Accountable Care Organizations and the Post-Reform Healthcare Environment

Ongoing economic trends combined with the impact of healthcare reform make the insurer-provider intersection one of the most exciting areas of change in the United States today. Due to the formidable challenges facing the development and execution of Accountable Care Organizations (ACOs), they are often referred to as unicorns. Is the age of accountable care truly upon us? What is required of insurers and providers to realize a transformation in United States to bring better quality care to more people at lower cost?

Date: Tuesday, April 12th
Time; 7:00 - 8:00 p.m. ET

To RSVP for the WebEx presentation, or to register to receive more information on career opportunities with McKinsey & Company, please click on the following link:

http://www.surveymonkey.com/s/AccountableCareOrganizations04122011

Recommended Reading for HealthCare Executives

The Wall Street Journal Health Blog recommends the following 2 books as "Recommended Reading for HealthCare Executives:"

Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery

Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience

Good bye 2010 and hello 2011. Happy New Year!

I would like to warmly wish everyone a Happy New Year! I feel like 2010 flew by and I'm sure that 2011 will move quickly as well.

As debates continue regarding the constitutionality of the Patient Protection and Affordable Care Act (PPACA), a number of physicians will choose to pursue alternative careers outside of clinical medicine. The New Year could be a great year for physicians transitioning out of clinical medicine as the economy recovers and allows companies to create new jobs.

40% of physicians to leave clinical medicine?

Here's are a few snippets from a recent Healthcare Finance News story:

The Physicians Foundation, based in Boston, released the results of a survey conducted by Merritt Hawkins, a national physician search and consulting firm, which indicates growing dissatisfaction among doctors as they struggled with less time for patient care and increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations.

According to the survey, healthcare reform could intensify existing problems for doctors and worsen the shortage of primary care doctors, making it more difficult for patients to access quality care.

• 40 percent of physicians said they would drop out of patient care in the next one to three years, either by retiring, seeking a non-clinical job within healthcare or seeking a job out of healthcare.

What will happen to the health care system if 40% of physicians leave clinical medicine to pursue non-clinical opportunities? I think that many physicians are hoping that the health care system will change, but the current reform law has too many gaps and holes. I suppose that's what can happen if we rush through some major changes and try to fix a huge burden like the health care crisis.

"Short and Long Term Effects of Reform on the Healthcare Market" on ReachMD

I'd encourage you to listen to this ReachMD program titled, "Short and Long Term Effects of Reform on the Healthcare Market." The host for the show is Tim Rush, president and founder of Healthcare Staffing Innovations (HSI). Here's a brief description of that ReachMD segment which is a part of a new series called, "Your Career In Healthcare."

We all know that healthcare reform may change the way healthcare professionals practice medicine, but how might reform also change the way in which we either find employment or staff our facilities? Joining host Tim Rush to discuss the short and long term effects that healthcare reform might have on the the healthcare employment market is Phil Miller, vice president of communications for the country's largest temporary healthcare staffing business, AMN Healthcare.

Are we seeing more physicians choosing to leave clinical practice and pursue non-clinical job opportunities? Listen to this ReachMD segment to learn more. (login required for ReachMD)

From the Sermo Blog: Doctor Leaving USA

On the Sermo Blog, you'll read this story from a U.S. physician:  Doctor Leaving USA

Intro from Daniel Palestrant, Founder & CEO of Sermo
The Sermo community responds to a physician who has decided to leave America and practice elsewhere after the passage of health care reform. Many physicians feel their interests were sidelined in the reform debate and passage.

I'm sorry.

Some may say i'm weak, some may say I've given up too soon. What they CAN'T say about me is that I didn't try. I stood out on the street on my Saturdays off and tried to rally for "real" health care reform. I've offered to hold forums for other docs to discuss ways we can inform the public and our patients...I've passed out fliers in the doctors lounge at my hospital. I've done it all and I've seen everything fail. I'm tired. I can't go on in this country for another 20+ years.

I've been sued once already and now (icing on the cake), I have a former patient, an illegal alien who is considering suing my practice. I don't see the light at the end of the tunnel. I've been beat up and I'm not doing it anymore. I love this country and I LOVE my practice and even worse, I'm damned good at what I do. But now, I chose to do it somewhere else. Somewhere where people don't expect me to produce the world for them and say "thank you" for the care I've provided and don't argue with me about EVERYTHING.

I know I'm not a martyr but someone can let Mr. Obama know that a perfectly good, board certified physician is deciding to call another country home because I can't take it anymore!!!

Here's a link to the Sermo Blog post.  

I think this person may also want to consider a career transition into a non-clinical career. Then again, practicing medicine in a different country could be a better option, especially if you pick the right country.  I've always had an interest in international health care issues. What happens if you move to a different country and then that country goes through similar health care reform?

ACPE 2010: Focus on Physician Leadership

I've been in Washington D.C. attending the 2010 ACPE (American College of Physician Executives) Annual CME Conference. Many of the sessions have been focusing on Physician Leadership. Take a look at some of these session titles:

• Hospital and Health System Board Leadership
• Coaching & Mentoring Physicians to Higher Performance
• Leading on the Edge: Complexity in Health Care
• Leadership Summit
• Managing Physician Performance
• On the Frontline! Leadership for Department Heads
• Leadership & Governance for Group Practice Board Members

If you're interested in learning how you can become an effective physician leader, I encourage you to join ACPE and to attend the ACPE meetings. Physician leadership is becoming a critical theme in the era of healthcare reform. So, whether you're a practicing physician, an administrative physician, or an independent consultant, get involved with ACPE.

How many doctors will leave medicine this year?

Several sources of information have suggested that doctors may be more likely to leave clinical medicine by 2014.  Groups (including us here at NonClinicalJobs.com) have conducted surveys, some have published their results, others are probably afraid to publish them.  On Investors.com, we see one story titled, "45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul." This was published back in September 2009. I wonder how these numbers will change now that we're in April 2010.  Then, the Medicus Firm published a survey on the NEJM  and suggested that "Health Reform May Lead to Significant Reduction in Physician Workforce." This survey was conducted before the reform bill was passed. How have physician attitudes been affected?

Here on NonClinicalJobs.com, we surveyed our members last month and here's what we found when over 100 physicians responded to our survey:

Demographics:

• 31% primary care/general medicine, 60% specialists

When asked, "Do you support the new health care reform bill?"

• 28% say yes, 52% say no, 20% say "I'm not sure yet." 

When asked, "now that the health care reform bill has passed, are you more motivated to leave clinical medicine?

• 33% say yes, 23% say no, 23% say they've already left clinical medicine, 1% say they're retired, and 20% selected "other"

When asked, "Are you more motivated to switch to either a cash practice or a concierge/boutique practice?"

• 28% say yes, 19% say no, 25% say they're not in clinical practice, 14% say these practice models are not relevant to me, 5% say they're already in a cash practice

When asked, "What percentage of your physician colleagues are thinking about leaving clinical medicine?"

• 12% say "less than 5%," 11% say "5 to 10%," 19% say "10 to 30%," 18% say "30 to 50%," 7% say "more than 50%," and 33% say "not sure."

When asked, "How do you think your medical career will change over the next 5 years?"

• 24% say "I will stay in my current practice," 9% say "I will move to a salaried position," 12% say "I will change my practice model (cash or concierge), 52% say "I will leave clinical medicine," and 3% say "I will retire."

When asked, "How many years have you been in practice?"

• 7% say "never practiced medicine," 16% say "less than 5 years," 23% say "5 to 10 years," 30% say "10 to 20 years," and 24% say "more than 20 years"

So, how many physicians will leave clinical medicine in the near future? How many doctors will look for alternative careers? How many will be searching for non-clinical jobs?

Primary care doctors plan to scale back or quit by 2014

As I read posts on Sermo related to health care reform and Obamacare, I realize that we're seeing more evidence that physicians (particularly primary care physicians) are planning on scaling back or quitting by 2014.

2014 is the magic date where the health care reform laws will get fully implemented. People will have insurance, but they may face tremendous difficulty finding doctors if doctors are getting ready to scale back or retire early. Primary care physicians are anticipating a significant salary decrease in 2014. Will that really happen? Or, will most of them transition out of clinical medicine before they stick around to find out?

The health care reform bill will boost traffic to this website

In the wake of major health care reform in this country, we will see more physicians considering non-clinical career options. Those who use Google to find information about non-clinical jobs will probably end up here. Others may find this site through word-of-mouth referrals. I'm collecting data to see how traffic to this site evolves now that the health care reform bill has passed.

Over the past few months, I've been very busy coaching physicians who wish to transition into non-clinical careers. This week, I received a handful of e-mails from physicians who are interested in finding non-clinical jobs. Is this just the beginning? How many more physicians will seriously consider a career transition out of clinical medicine? How many will make active plans to leave medicine?

Medicus Firm survey in the NEJM: Health Reform May Lead to Significant Reduction in Physician Workforce

The Medicus Firm recently conducted a survey titled, "Physician Survey: Health Reform’s Impact on Physician Supply and Quality of Medical Care." The results were published on the NEJM (New England Journal of Medicine) here, but then it appears that the NEJM removed the information and placed a link to the Medicus Firm and emphasized:

The opinions expressed in the article linked to above represent those of The Medicus Firm only. That article does not represent the opinions of the New England Journal of Medicine or the Massachusetts Medical Society.

So, let's take a look at the survey conducted by the Medicus Firm. They state: "Health Reform May Lead to Significant Reduction in Physician Workforce."

Here are some relevant snippets from the survey report:

• Nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.
• “What many people may not realize is that health reform could impact physician supply in such a way that the quality of health care could suffer,” said Steve Marsh, managing partner at The Medicus Firm in Dallas. “The reality is that there may not be enough doctors to provide quality medical care to the millions of newly insured patients.”
• Based on the survey results, health reform could, over time, prove to be counterproductive, in that it could decrease patients’ access to medical care while the objective is to improve access.
• Doctors want change, but only 28.7 percent of physicians responded in favor of a public option as part of health reform.
• An overwhelming 63 percent of physicians prefer a more gradual, targeted approach to health reform, as opposed to one sweeping overhaul. 

We need to encourage physicians to stay in medicine and to care for all these people who need medical care. If all our doctors left clinical medicine to pursue non-clinical careers, who's going to take care of us? Some physicians may be tempted to switch to a cash practice or a concierge model. How will that help all those patients who will gain access to the public option?

To read the Medicus Firm report about the physician survey titled, "Physician Survey: Health Reform’s Impact on Physician Supply and Quality of Medical Care," click here.

Many physicians will leave clinical practice due to health care reform

Recently, I had the chance to poll physicians (and I'd like to thank all those physicians who helped me with this). It was an informal poll, but I wanted to know how many physicians were planning on leaving clinical practice now that the health care reform bill has been passed. It's no surprise, but an overwhelming majority of physicians were more determined to look for a transition into the non-clinical field of medicine. To some, this may mean a career in administrative medicine. To others, it could be medical writing or medical education. Some want to get into the pharmaceutical industry.

In the past, many physicians would have indicated a strong desire to work for insurance companies. That trend has changed and I think physicians recognize that career opportunities in the health insurance industry may be diminishing as the government rolls out a public option and creates some serious competition.

How will patients receive proper medical care if so many existing physicians choose to leave clinical practice? What's going to happen in areas where physician shortages are causing patients to drive several hours to receive care? More physicians may plan to retire early instead of hassling with the public option and with the electronic health record requirements outlined in the HITECH Act.  Our nation will experience some significant changes in the health care world, but will these be overwhelmingly positive or negative for the public?

Health Care: Rx for MBA Job Blues

There's an interesting article on BusinessWeek titled, "Health Care: Rx for MBA Job Blues."

To grab your attention, you'll see this under the title: Health care is one of the few bright spots in an otherwise dismal job picture for b-school grads, and reform, if it happens, has the potential to make it brighter still

So, what types of opportunities are opening up for MBA graduates as the nation prepares for some significant health care reform? The article places a considerable amount of focus on health IT (health information technology) and electronic health records. After all, we're going to see $25.8 billion (or is it $36.5 billion?) set aside for health IT through the HITECH (Health Information Technology for Economic and Clinical Health) provisions found within American Recovery and Reinvestment Act of 2009 (ARRA). 

Click here to read the BusinessWeek article.

Growing interest in non-clinical career opportunities among physicians

How many physicians do you know who have chosen to leave their clinical practice? There's no doubt that physicians are getting burned out. Many are tired of fighting insurance companies and even more physicians are getting discouraged about reductions in reimbursement. This has caused some physicians to drop Medicare and Medicaid. Others have switched to cash-only or concierge/boutique practice models. Then you have your group of physicians who have simply decided to leave clinical medicine to pursue career options in the world of non-clinical medicine.

The vast majority of physicians are actually not aware of non-clinical career options beyond common examples such as working for a pharmaceutical company, being a consultant for a major consulting firm, or reviewing medical charts. Some physicians think about "administrative medicine," and they don't envision themselves being happy spending 100% of their time with administrative paperwork. For most physicians, the administrative component is the worst part of being a physician.

The reality is that there are a host of non-clinical opportunities for physicians who have a variety of interests beyond clinical medicine. The problem is that we don't learn about these opportunities during medical school. We don't go through non-clinical rotations during our clinical clerkships. Medical students and residents don't get paired with non-clinical mentors who can teach us about career options on the "business" side of health care. They don't learn about jobs in medical writing, market research, health informatics, or venture capital. They also don't learn how to enter the pharmaceutical or biotechnology industry. When they start to look at various job posts, they see terms like "2 years of industry experience required." How can they break in if they lack formal industry experience? Where do they get started? Do they need additional training and education? Many physicians seem to have a common misconception that a formal degree in business is required if they wish to be successful in the non-clinical world. Some choose to pursue an executive MBA with hopes that they may venture off into the non-clinical sector someday.

As physicians get burned out they are looking for alternatives. Physicians are hearing a lot of discussion around health care reform, but little discussion about tort reform. As a result, many are feeling discouraged because their voices are not being heard by politicians and decision makers. In the setting of major health care reform, many physicians are anticipating that their workload will increase and their reimbursement will decrease. Should these physicians leave clinical medicine and pursue non-clinical career options? Who will end up providing medical care if physicians leave their clinical practice and choose to work for some type of health care company?