The COVID-19 pandemic has changed medical practices, so physician trends will reflect innovation in care delivery influenced by the long pandemic.
“Physician trends toward a desire for more modern and innovative healthcare solutions should not be a surprise to anyone because transformations have been part of the industry dialogue for quite some time. But the pandemic has accelerated the need for innovation in the physician setting,” said Amel Hammad, managing director of consulting firm Riveron, based in Chicago.
10 top trends affecting medical practice
1. Technology grows in importance
“Now more important than ever, innovation and use of technology is key to performance,” Hammad said. “Physicians will need to continue to invest in technologies that allow them to provide the same type of visit they would provide in office, virtually.”
Andy Colbert, managing director of healthcare finance for Ziegler in Chicago, added, “The biggest opportunity on the clinical side will be population health management and patient engagement tools that sit on top of the EMR platform. From an administrative perspective, I expect to see continued innovation as it relates to billing, coding and automation to cover all components of the revenue cycle -- from charting to billing.”
While technology becomes an important component of healthcare, so do cybersecurity fears. Medical practices need to be prepared for these threats, Colbert said.
“Expect to see continued investment in cybersecurity over the next year, and I wouldn’t be surprised to see more practices hire chief security officers with medical backgrounds,” Colbert added.
2. Practice consolidation and outsider investments
“2022 is going to be another robust year for physician practice consolidation,” Colbert said. “Private equity firms are going to continue to look for ways to help physician groups drive scale and bolster operations. Significant focus will be on enabling continued investment in outpatient-related care, where medical services can be delivered at lower costs than hospital-based settings. In addition, I expect to see increased joint venture opportunities for hospitals that are looking to partner with physician groups to enable outpatient initiatives.”
Colbert anticipates greater investments in group medical practices and management services organizations (MSO).
“Since, in many states, investors aren’t legally allowed to own physician groups directly, investors will purchase the MSO operations and not the medical group directly,” Colbert explained. “In doing so, they leave medical groups to be owned and operated by the physician groups directly, allowing physicians to continue their central clinical decision making. The investor’s strategy is driving scale and efficiency across nonclinical activities, such as billing, collections, human resources and other back office initiatives while enabling physicians to keep their focus on clinical activities.”
3. Medical practices to become more consumer oriented
“When medical professionals say ‘patient-centric care,’ we're really going to have to mean it,” said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company and TDC Group in California. “We're going to have to mean it in the kind of customer-service-forward way practiced by corporations like Amazon or Nordstrom or FedEx.”
What will that customer service look like? Anderson explained: “We need to improve the staggeringly expensive hospital experience. We need to stop requiring outpatients to see multiple doctors, labs and imaging centers in different locations at different times, and hope that someone thoughtfully acts on the results. Retail medicine has already made enormous inroads into primary care by providing rapid access at convenient locations at lower cost.”
4. Growth of retail medicine
Retail medicine is now an important part of primary care delivery in the United States, reported experts at TDC Group. It is poised to become even more so. Powerful partnerships between traditional integrated delivery systems and some of the large pharmacy chains make data from millions more people available to expand the database for retail medicine
Some examples offered by the TDC Group: Walgreens is the first national pharmacy chain to offer full-service provider offices co-located at its stores on a large scale. Amazon recently opened its online pharmacy and is preparing to acquire and manage provider networks.
Hammad agreed that retail and private pay will continue to grow.
“As the community is looking for convenience, there are many organizations that have been able to identify and remedy longstanding pain points encountered by patients during their experiences in healthcare systems,” Hammad said. “Though the shift to retail healthcare and private-pay models are not new concepts, related solutions are becoming more complex as there are more and more options that are available to the healthcare consumer.”
5. Physician demand greater than supply
The Association of American Medical Colleges reported a projected shortage of physicians by 2034 of up to 124,000. With such great demand, the physician job market in 2022 should remain strong, with plenty of opportunities for both permanent and locum doctors.
6. Advanced practice clinicians provide primary care
Advanced practice clinicians (ACPs) will become the primary care providers for many Americans, reserving physicians for complex cases, due to a physician shortage and increased demand due to more people being insured, TDC Group reported.
“APCs have been integral to healthcare delivery and will grow increasingly so as the demand for patient care increases,” said Laura Kline, MBA, CPCU, senior vice president of business development at The Doctors Company and TDC Group. “However, independent APCs will face higher stakes than their employed counterparts. They will have risks and exposures similar to physician practices.”
According to the Association of American Medical Colleges, the supply of advanced practice registered nurses and physician assistants is predicted to more than double during the next 15 years, TDC Group reported. Ideally, this change will enable physician specialists to focus their efforts where they are most needed.
7. Cost reductions and providing valued-based care
Another physician trend is a continued need to examine ways to reduce costs for providers and patients alike, and the emphasis industry-wide in 2022 will be on new solutions to provide value-based care, said Thom Herrmann, CEO of Intuitive Health in Plano, Texas.
“There’s an ongoing shift to break down some of the traditional barriers that often drive people to seek the highest level of care, which most patients see as the emergency room,” Herrmann said. “Many patients don’t know the severity of their condition, but they know that the ER is open 24 hours a day, seven days a week. Now, there are more health care choices than ever before, so patients don’t have to choose the traditional ER as the first choice for medical care.
To meet the demand for reduced health costs and improved accessibility, there will continue to be a greater emphasis on implementing nontraditional care delivery methods, such as telehealth, virtual care services or broadly available walk-in hours. Such approaches reduce costs while improving clinical outcomes, Herrmann continued.
8. Telemedicine crossing state lines
Patients and physicians have grown to like telemedicine and the efficiency and convenience it brings to patient care. During the COVID-19 pandemic, states made it easier to practice medicine remotely, including many that allowed physicians to treat patients across state lines.
“While federal legislation is unlikely to preempt states’ rights to license providers, we predict that federal legislation will be introduced to further facilitate telehealth across the country, including permanently allowing employers to add telehealth benefits options to their private plans,” said David L. Feldman, MD, MBA, FACS, chief medical officer at The Doctors Company and TDC Group. “Opening care across state lines will continue to be accomplished by state action with federal support and, perhaps, the adoption of the Uniform Law Commission’s Model Telehealth Act. This would create a national telehealth provider registry to allow healthcare providers with a clean disciplinary record to offer limited telehealth-only services across state lines.”
Virtual care reimbursements are more broadly available than ever before. While the shift to telemedicine is not moving as quickly as initially predicted, this care method will continue to expand, Herrmann said.
“Payers are finding ways to provide reimbursement for alternatives to in-person care, to make it easier on patients and providers,” Herrmann added. “Virtual care can increase accessibility and provide additional choices for patients to receive care.”
9. Transitions to home-based care
While not new, caring for people at home is gaining traction. Intuitive Health reported growth in home-based dialysis, home-based chronic wound treatment, and home-based occupational and physical therapy.
One of the more significant innovations is the emergence of at-home inpatient care, long the domain of the hospital. Innovations in patient monitoring and changes in reimbursement have opened the door for certain lower acuity admissions to be handled in the comfort of the patient's own home. When care is delivered directly to the patient's residence, the person can maintain routines and a sense of normalcy, avoid trips to the hospital and potentially experience lower costs.
"The goal of at-home health care is to help people feel comfortable with the medical treatments they're receiving and help them stay healthy,” Herrmann said. “Additionally, receiving care in a patient's home is convenient and can sometimes result in faster treatment and improved outcomes.”
10. Life with COVID
Longtail effects from COVID-19 will affect all aspects of medicine, TDC Group said.
Even previous mild COVID-19 cases that did not require hospital visits can result in symptoms surfacing a year later. Many have been treatable, but an increasing number of COVID-19 patients are experiencing dysautonomia, which affects the nervous and immune systems, leaving them more vulnerable to other recurring and chronic illnesses that can lead to long-term disability. In studying COVID-19’s long-term effects, some neurology reports have indicated similarities in the brain chemistry of COVID-19 patients and Alzheimer’s patients.
Coping with COVID-19 also entails a focus on mental health. Healthcare professionals, including physicians, are exhausted and past their breaking points, said Gail Gazelle, MD, assistant professor of medicine at Harvard University and master certified coach.
“Levels of burnout in physicians are high, especially given the added demands of the pandemic, and many physicians are moving to a different practice or, for some, simply throwing in the towel on the career they worked so hard to attain,” Gazelle said.
The country has not seen the last of the novel coronavirus.
“Now that we know more about COVID-19 and the efficacy of the vaccine, the ‘end’ of this is not a realistic consideration, and healthcare organizations cannot wait until pandemic phases are over to make changes that appeal to patients and, ultimately, enhance an organization’s long-term profitability and relevance,” Hammad said.