Monday, February 8, 2010

Hospitals and Doctors,- Physician Business Ideas -What’s Galvanizing Physicians And What They Plan to Do in 2010

In early January Daniel Palestrant, MD, founder and CEO of, wrote to the 112 000 physician members of is the premier physician social networking site and on it you will find political opinions, clinical suggestions, diagnostic observations, and hints from a variety of specialists. It is open-ended and open-minded, and on occasion, controversial.

Here briefly, are Doctor Palestrant’s notes on what is likely to take place in 2010:

1. In Massachusetts, the State has started linking licenses to accepting patients. In essence, this is forcing to participate in State programs against their will. Federal programs may soon have the same conditions for practices.

2. New data shows lack of tort reform is costing the U.S. $50 billion a year rather than the $5 billion original estimate. Tort reform is the number #1 reform priority among doctors.

3. The support of the AMA was “bought” by the Obama administration through a “special arrangement” on CTP coding. The AMA makes the bulk of its income, $300 million, through coding, not member services.

4. Mayo’s “opting out” of accepting Medicare patients in one of its Arizona clinics is a sign of things to come.

5. Physicians will continue to pursue alternative business models – concierge practices, cash only practices, worksite clinics, hospital employment, among others – and to abandon third party dependent payment models - in order to stay in business.

6. Ultimately, strain of staying in business and becoming more productive will re-unite patients and physicians and start to squeeze out the countless interlocutors who created much of the inefficiencies in our health care system. It will be a tough couple of years for patients, especially senior citizens and those with lower income, as their access to physicians is increasingly jeopardized as the physician shortage worsens.

7. EMRs are finally gaining momentum. Their greatest application and the reason for their increasing adoption, however, will not necessarily be in improving patient care or creating efficiencies, EMRs hold tremendous promise for establishing more efficient billing and transaction processing. EMRs are becoming a financial imperative, not a clinical one.

8. The AMA will reinvent itself. With less than 1 in 5 physicians actually AMA members, there is much discussion among physicians about a class action law suit, accusing the AMA of misrepresenting themselves as representing this country's physicians and/or pursuing damages from the AMA. While I understand the appeal this holds for so many physicians, I do not think it is in the best interest of physicians in this country or patients. The AMA is well into an effort to re-brand themselves as a public health, rather than physician advocacy organization.


Beth said...

RE: In Massachusetts, the State has started linking licenses to accepting patients.

Do you have any more information on this disturbing claim? I read the MA license requirements on-line, both for initial license and for renewal, and did not find any explicit requirements.

Thanks for posting this.

Richard L. Reece, MD said...

I have no specific information other than Dr. Palestrant's comment that it is in the works. Given the primary care shortage in Massachusetts and the long waiting times, however, I can see where it might be under consideration by Bay State officials. I will be interviewing Dr. Palestrant in several days, and I will ask him for specifics.

Beth said...

That would be great. I look forward to reading the interview.

Dorthy said...

The chap is absolutely just, and there is no question.