The conversation around healthcare costs has become central in political and social debates. Employer spending on healthcare services increased by 44% per enrollee from 2007 to 2016, translating to billions in additional costs for business and employees.
Essential to the reform debate, but rarely considered, is how our current approach affects the individuals at the core of the delivery system—independent physicians and other providers—and how the livelihood of this group affects healthcare cost and quality.
Independent physicians and physician groups—relieved of some of the administrative burdens they face in the corporate environment—are empowered to deliver more personalized care experiences for patients and are a linchpin in the search for the quadruple aim: improved population health, better patient experience, better provider experience and reduced costs.
Traditionally, independent physicians, especially primary-care providers, have been the first in line to address patient health issues. Often armed with detailed patient histories and relationships that have benefited from a practice’s continuity and longevity, these practitioners can treat more than acute need and make good on the promise of holistic care. Still, the chosen fix for healthcare’s cost and quality struggles has generally ignored this group, favoring consolidation driven by the idea that bigger institutions can produce lower-cost, high-quality outcomes. However, there is conflicting evidence that these unions produce as promised.
Over the past decade, regulation-driven administrative burdens fueled the “urge to merge” and an increasingly untenable environment for physician success and contentment. Back in 2009, the Health Information Technology for Economic and Clinical Health Act was signed into law. Policymakers framed it as an opportunity to promote the adoption of healthcare IT—specifically electronic health records—where interoperable technology would improve continuity of care.
Instead, providers invested in transitioning to a records system that did little to advance sharing and care continuity. True interoperability remains elusive.
The current operating reality is demoralizing for doctors. According to a recent survey from Athenahealth, 25% of practicing physicians feel professionally isolated at least once a week, while 6% reported having those feelings daily. For doctors who reported feeling isolated daily, 77% of them reported symptoms of burnout. These findings portend a crisis, particularly alongside the threat of physician shortages.
Interestingly, research suggests that despite these challenges, independent doctors are happier practitioners than their employed colleagues and less likely to burn out. Studies also show that physician-owned practices have significantly lower preventable hospital admissions. The bottom line is independent physicians are crucial to an effective healthcare marketplace.
We will keep debating policy for reforming U.S. healthcare. But if this system continues to place unwieldy demands on providers, we are doomed to remain on the current course. To change our path, we must reaffirm the important role that independent doctors play in the healthcare ecosystem. Investment in technology, resources and talent that fit the needs of doctors is essential.
For example, the simple act of collecting patient data directly from patients, then making it available to providers and payers, should be embedded in our healthcare experience. Privia Health’s Patient Reported Quality Data program collects required quality data directly from patients and loads the results into their health record. In an 11-month period, Privia collected more than 50,000 patient responses, resulting in an estimated 520 days in saved office time for care teams.
With more complete patient records, care gaps are closed and patient engagement is better as providers ensure patients are following up on critical actions like getting a flu shot and appropriate cancer screenings. Time is better spent speaking with patients about their concerns rather than chasing facts and figures for a chart.
When doctors can care for patients without the burden of excessive paperwork, technology and exchanges with payers, they are at their best. The result is a more efficient, less wasteful system that achieves better health and cost outcomes while restoring the joy of practicing medicine.