The economics of being a practicing physician: greater frustration, lower income, more defensive
One-half of physicians believe they’re not fairly compensated for their work – in particular, those working in primary care. Only 11% of doctors considering themselves “rich.” Medscape’s 2012 Physician Compensation Report compiled data from over 24,000 U.S. physicians across 24 specialties and found the bulk of physicians to see themselves working harder and 1 in 4 making less money than last year. This has led to growing frustration and worry, where some physicians are resenting the large pay gap between specialists and primary care. That frustration looks poised to increase with doctors concerned that accountable care will further eat into
Americans continue to self-ration health care in the economic recovery
Even though Inside-the-Beltway economists have said The Great Recession of 2007 is officially over, it doesn’t look that way when you ask consumers about health spending in 2012, based on results from a survey conducted on behalf of the American Osteopathic Association (AOA). One in 5 U.S. adults is trying to lower their personal health spending. One in four is seeking free or alternate sources of health care. Overall, 1 in 5 people says their health has been negatively impacted by the economy. The AOA discovered that people in the U.S. whose health has been negatively impacted by the economic downturn were
Leverage the American DIY attitude for health
As I leave Asia, where I’ve been for the past two weeks, for the U.S. today, I am reading the daily newspaper, the Korea Joongang News. On today’s op-Ed age is The Fountain column titled, Embracing the do-it-yourself attitude. In it, Lee Na-ree writes, “Making something with your own hands is part of the American pioneer spirit.” He describes the Maker Faire events and the project of Caine’s Arcade, a game developed by a Los Angeles boy who used auto parts from his dad’s shop. Na-ree observes that Americans are ‘regretting’ mass consumption. Health Populi’s Hot Points: I happened upon
A $132 doctor’s visit in Hanoi, Vietnam: a diagnosis, value-based health care and a new friend
$132 won’t go far in a U.S. emergency room, but in Vietnam, it gets you first class treatment, a highly-trained and empathetic French doctor, and cheap prescriptions, as well. You could call it Presidential treatment, as a certificate from the White House was proudly displayed in the lobby waiting area sent in appreciation of great care received by President George W. Bush. After arriving in Hanoi two nights ago, following three airline flights over nearly 24 hours, our daughter developed a rough cough that gave her chest pains. We gave the condition one day to improve and then spoke with
Patient engagement and medical homes – core drivers of a high-performing health system
It was Dr. Charles Safran who said, “Patients are the most under-utilized resource in the U.S. health system,” which he testified to Congress in 2004. Seven years later, patients are still under-utilized, not just in the U.S. but around the world. Yet, “when patients have an active role in their own health care, the quality of their care, and of their care experience improves,” assert researchers from The Commonwealth Fund in their analysis of 2011 global health consumer survey data published in the April/June 2010 issue of the Journal of Ambulatory Care Management. This analysis is summarized in International Perspectives on
Wellness Ignited! Edelman panel talks about how to build a health culture in the U.S.
Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative
Superconsumers and value mining: health care’s uber-trends driving care, everywhere
There’s a shift in power in health care moving away from providers and suppliers like pharma and medical device companies, toward patients and payers. This is the new health world according to Ernst & Young‘s latest Progressions report called, The third place: health care everywhere. What’s underneath this tectonic shift is the need to bend that stubborn cost curve and address public health outcomes through behavior change. E&Y says look for new entrants, like retailers, IT companies, and telecomms, to be part of the solution beyond traditional health care stakeholders. These participants will be part of both delivery of care
Employers shopping for value in health – Towers Watson/NBGH 2012 survey results
Employers expect total health costs to reach $11,664 per active employee this year, over $700 more than in 2011. Employees’ share of that will be nearly $3,000, the highest contribution by workers in history. In 2012, workers are contributing 34% more to health costs than they did 5 years ago. The metric is that for every $1,000 employers will spend on health care in 2012, workers will pay $344 for premium and out-of-pocket costs. Still, health care cost increases are expected to level off to about 6% in 2012, that’s still twice as great as general consumer price inflation. with
Moving from operational efficiency to personalized healthcare value – IBM on redefining success in healthcare
A health system that’s built to last: this is the latest sound-bite echoing through health policy circles. The theme of sustainability is permeating all matters of policy, from education and business to health care. Enter IBM, with a rigorous approach to Redefining Value and Success in Healthcare: Charting the path to the future, from the group’s Healthcare and Life Sciences thinkers. What’s inspiring about this report is the team’s integrative thinking, bridging the relationship between operational effectiveness built on a robust information infrastructure that enables team-based care (the “collaboration” aspect in the middle of the pyramid), which then drive personalized healthcare
The self-care economy: OTC medicines in the U.S. deliver value to the health system
U.S. health consumers’ purchase and use of over-the-counter medicines (OTCs) generate $102 billion worth of value to the health system every year. Half of this value accrues to employers who sponsor health insurance for their workforce; 25% goes to government payers (e.g., Medicare, Medicaid); and, 25% returns to self-insured and uninsured people. For every $1 spent on OTCs, $6.50 is saved by the U.S. health system, shown by the chart. For millions of health consumers, OTCs substitute for a visit to a doctor’s office: most cost-savings generated by OTC use are in saved costs of not visiting a clinician, as discussed
On the road to retail health: healthcareDIY and primary care, everywhere
At the ConvUrgent Care Symposium in Orlando, attendees from the worlds of clinics, ambulatory care, hospital beds, pharmacies, medical devices, life sciences, health information, health IT, health plans, academic medical centers and professional medical societies came together to share and learn about the morphing landscape of retail health. The topline message: primary care is everywhere, and based on the response to my keynote talk this morning, every stakeholder segment gets it. My mantra, courtesy of the U.S. Surgeon General Regina Benjamin: don’t look at health in isolation, that is, where the doctor and hospital are. Health happens wherever the person
Stop SOPA
Health Populi’s Hot Points: Please stop censorship in the United States of America. Click on this hyperlink to easily contact your Congressional representatives and express your opinion on SOPA and PIPA – two laws that would limit basic freedom in the marketplace of ideas and commerce.
The social determinants of health – U.S. doctors feel unable to close the gap and deliver quality care
Most U.S. primary care physicians realize the health of their patients is largely out of their hands — with their social needs ranking as important as addressing their medical conditions, according to the 2011 Physicians’ Daily Life Report, conducted on behalf of the Robert Wood Johnson Foundation by Harris Interactive in September-October 2011, results published in November 2011. In fact, unmet social needs are directly leading to worse health for Americans, say 9 in 10 doctors. With that recognition, most physicians feel they’re unable to address patients’ health concerns caused by unmet social needs. This has led to most doctors confessing
Make 2012 the year of living health-fully
When I would meet up with clients and friends during the latter half of 2011, people whom I hadn’t seen for months would do a double-take when they saw me. “What have you done?” they have asked. In this first post of 2012, I will share with Health Populi readers my story of 2011 — a year of living health-fully for me. One of the blessings of my work-life is that I have access to some of the great minds in health and health care. But not until I began to personally harness their wisdom, intentionally incorporating what they’ve learned into my own life-flow and
Retail health is hot, especially for the young, affluent and not particularly sick
Walmart issued a Request for Information to expand its retail health footprint in the communities in which the world’s largest company operates. That was a strong sign that retail health has surpassed a tipping point. Now, there are hard data to support this observation from a RAND Corporation research team. Trends in Retail Clinic Use Among the Commercially Insured, published in the November 25, 2011, issue of The American Journal of Managed Care, quantifies retail clinic utilization among a group of Aetna health plan enrollees between 2007 and 2009. In those two years, use of retail clinics grew 10-fold. RAND looked
Primary care, everywhere: how the shortage of PCPs is driving innovation – especially for patient participation in their own care
The signs of the primary care crisis in America are visible: A growing number of visits to the emergency room for treating commonplace ailments Waiting lists for signing up with and queuing lines to see primary care doctors Fewer med students entering primary care disciplines Maldistribution of primary care practitioners (PCPs) in underserved areas, rural, exurban and urban. The implementation of the Affordable Care Act will (try to) enroll at least 30 million newly-insured health citizens into the U.S. health system. That’s the objective: whether being insured will actually provide people access to needed primary care is a big question given the current supply of
How an EHR can help manage population health
There’s a lot of chatter about Meaningful Use in the context of electronic health records adoption; if you Googled the term today you’d find millions of references to the concept. The Centers for Medicare and Medicaid Services (CMS)’s website offers three main components of Meaningful Use as specified in The American Recovery and Reinvestment Act of 2009: – The use of a certified EHR in a meaningful manner, such as e-prescribing – The use of certified EHR technology for electronic exchange of health information to improve quality of health care – The use of certified EHR technology to submit clinical quality and other
Walmart and Dr. Sam: a retail player in accountable care in 2015?
‘Tis the season…perhaps, era…for scenario planning in health. The activity consumes a lot of my consulting time these days for stakeholders falling under the broad umbrella of “health.” With the news that Sam’s Club will offer health care for $99 out-of-consumers’ pockets, it got me wondering…where might Walmart be in the health care ecosystem in a few years, say 2015? Sam’s Club launched The Prevention Plan in January 2010, with a partner, U.S. Preventive Medicine. The “Plan” isn’t a health plan, per se; it’s a year-long subscription that gets the user some coaching for managing health risks. Step 1 is a blood
Another bullish forecast for mobile health
In the wake of last week’s mHealth Summit in Washington, DC, there’s yet another bullish forecast on mobile health to consider. The Promise of Mobile Health asks the tagline question: “Bigger than DTC?” Euro RSCG’s Life 4D group, published the paper in November 2010. Survey data in the report followed up its October 2009 digital health survey in September 2010 among 502 American adults. Euro RSCG rightly points out that consumers’ health needs are 24×7: “they take their healthcare needs with them.” The firm believes that the biggest barrier to wider consumer adoption of mobile health is the low penetration of “suitable mobile devices among consumers.” The report’s survey
Patients’ use of online health tools will grow–especially for self-diagnosis, prevention, and treatment options
Most patients and doctors alike are currently using some type of online tool in the “understanding, management, and guidance” of health care, according to a survey from IMI Healthcare – Voice of the Market. Virtually all physicians, and 73% of patients, are using some kind of online health tool. Based on the IMI Healthcare survey methodology, these tools include health content sites, used by 57% of patients and 77% of doctors (e.g., WebMD, mayoclinic.com); general search sites (e.g., Wikipedia), used by 48% of patients and 68% of doctors; health association sites (e.g., American Heart Association), used by 19% of patients and
A primer on primary care
More patients find doctor is not in, NPR asserted on August 30, 2010, as part of its ongoing series covering the primary care shortage in America. To understand why this statement is so important, let’s go back to the definition of “primary care.” The American Association of Family Physicians says the domain of primary care includes the primary care physician, other physicians who include some primary care services in their practices, and some non-physician providers. Central to the concept of primary care is the patient, according to AAFP. Thus, the first definition of primary care, AAFP says, is “care provided by physicians specifically
Addressing the primary care shortage: the importance of community health centers, coupled with mobile health technology
The Affordable Care Act (ACA), aka health reform, will move 32+ million Americans to the insured population, and looks to the primary care ‘front-end’ of health care delivery to take in these newly-covered patients. Today’s USA Today reports on the primary care shortage in America. How to reconcile the influx of new patients in the U.S. health system with the deficit of primary care providers? First, the Community Health Center is one part of the solution to the primary care supply challenge. Furthermore, CHCs are integrated into ACA, seen as a key component for redesigning American health care delivery to improve quality, lower
Help wanted: primary care docs, nurses and health information professionals
In the coming months and years, I anticipate that Monster.com and other online job services will grow their revenues from the health industry. Three important studies this month confirm that, while health care eats up nearly one-fifth of the U.S. economy, there are shortages of professionals to fill two important jobs that are growing: primary care physicians (PCPs), nurses, and health information technology (HIT) workers. Let’s talk about the doctors, first. The Journal of the American Medical Association (JAMA) reports this week that doctors cut back their working hours since 1998 to 2008. At the same time, the second chart
People without a connection to a primary care doctor don’t proactively manage health
The relationship between patients and their physicians is a key driver in how and if people proactively manage their health. But cost often gets in the way of that relationship between a patient-consumer and a primary care doctor. The #1 reason why Americans deter proactive health care is cost. No American, whether insured and unemployed or working and covered, is immune from postponing or otherwise actively managing care when they are still well, according to a survey from IBM on health consumers in the U.S. 55% of Americans say they can’t afford the cost of wellness visits out-of-pocket. This is
I was invited to be a Judge for the upcoming CES 2025 Innovation Awards in the category of digital health and connected fitness. So grateful to be part of this annual effort to identify the best in consumer-facing health solutions for self-care, condition management, and family well-being. Thank you, CTA!
Thank you Team Roche for inviting me to brainstorm patients as health citizens, consumers, payers, and voters in the Healthcare Transformers series.
For the past 15 years, the annual CES conference in Las Vegas has been my go-to meeting for updating my research and network in digital health and consumer-facing electronics that people find meaningful for their well-being, families, and home lives. I'll be back in Vegas in January for a full week of Media Days, one-on-one meetings, and speaking about my perspectives on health consumers.