What Independent Physicians Need to Stand on Their Own Bottom

Let every tub stand on its own bottom.

William Bullein,  MD )1515-1575), Dialogue Against the Fever Pestilence 1564)

I have just written a book Direct Pay Independent Medicine and Surgery  and sent it to the publisher.  The thesis of the book is that there is a resurgence of independent  physicians and surgeons who charge directly and with total transparency for their services without using intervening  3^rd party administrative or managerial services. The idea behind this thesis is this is this:  Physician and surgeons using this approach will achieve greater simplicity and  will dramatically lower costs without using middlemen.

In writing the book,  I was acutely aware that these direct pay practices are unlikely to succeed and catch fire without  three  essential elements:  

·         One, capital to finance their expansion.

·         Two, marketing to announce their arrival and availability.

·         Three,  cloud-based  organized information  and data services to enhance their credibility, quality, and outcomes.

Without business models that contain these three elements,  the direct pay medicine and surgicial movement  may die aborning.   

Into this vacuum steps Farzad Motashari, MD, former coordinator for IT for the Obama administration  and champion of  physician EHR adoption. He is a fervent believer in use of data to improve physician performance to improve health outcomes.   He further believes that independent physician support is necessary if  primary physician led  ACOs (Accountable Care Organizatins) are to succeed.

After resigning several years ago as Obama’s IT coordinator,  he founded Aledade, an organization devoted to promoting the cause of private independent physicians,  whom he believes are indespensable if health reform is to succeed.   From Venrock, a venture capital  firm founded by the Rockefellers in 1969,  he has just received $4.5 million to advance the cause of independent physicians.

Here are several of his comments on the mission of Aledade and his personal beliefs:

“Empowering doctors on the front lines of medicine with cutting edge technology that helps them understand and improve the health of all of their patients has been the mission that’s animated my career. That’s Aledade’s mission – and we’ve assembled the best possible team to guide our doctor partners to success in the ACO space.” 

“Aledade will offer primary care doctors services to form an ACO that include on-site clinical support, EHR optimization, implementation of an integrated data and technology platform, quality reporting, provider benchmarking, real-time ADT notification, identification of high-opportunity patients, and patient outreach. “

“I have also found my cause. It’s to help independent primary care doctors re-design their practices, and re-imagine their future. It’s to put primary care back in control of health care, with 21st century data analytics and technology tools. It’s to support them with people who will stand beside them, with no interests other than theirs in mind. It’s to promote new partnerships built on mutual respect, and business arrangements that will truly reward them for the value that they uniquely can bring- in better care coordination, management of chronic diseases, and preventing disease and suffering. It’s to achieve lower cost through better care and better health. ” 

“Aledade offers primary care doctors with the tools to create their own ACO. The platform provides physicians with help to understand regulations, support from an on-site medical director, EHR optimization, and performance reports based on data that the platform collects. The platform also offers tools so that physicians can connect with their patients. The company will take a percentage of the money the physician saves when using the platform.”

“It’s to help independent primary care doctors re-design their practices, and re-imagine their future. It’s to put primary care back in control of health care, with 21^st century data analytics and technology tools. It’s to support them with people who will stand beside them, with no interests other than theirs in mind. It’s to promote new partnerships built on mutual respect, and business arrangements that will truly reward them for the value that they uniquely can bring- in better care coordination, management of chronic diseases, and preventing disease and suffering. It’s to achieve lower cost through better care and better health.”

“I believe in this. And this is the mission of our new company. And to realize it, we will be back at the vanguard, helping to lead this transformation in health care that has been underway for years but is quickening and coming faster than ever before.”

I wish Dr. Motshari luck.   He does not mention direct medical surgical care, and I am not a big believer in ACOs,  but I like the thrust of his arguments about promoting new partnerships between  independent primary care physicians and new business arrangements.  With his help,  independent physicians may be able to stand on their own bottoms.