Monday, August 3, 2015

Grassroots Private Doctors United. Is It Too Late?

A new non-profit organization, United Physicians and Surgeons of America (UPSA) has been formed. Its purpose it to “protect doctor/patient relationships and to let physicians practice medicine without restraint from non-medical entities. Its website is www.letmydoctorpractice.org UPSA just held their first meeting , The Summit of the Summit, in Keystone, Colorado from July 20-26.

Forty one speakers addressed these issues.

1. Disruption of doctor-patient relationships

2. Loss of clinical autonomy

3. Regulatory and paperwork burdens

4. Dysfunction of suboptimal electronic medical records

5. Demands of certification

Forty one speakers included: cardiologists, a Senator, writers and authors, medical society presidents, CEO of the Physician Foundation, the founder of the Free Market Association of America, a Merritt Hawkins representative, concierge physicians, surgeons, family physicians, ophthalmologists, a nurse, an anesthesiologist, political policy and online analysts, internists, gastroenterologists, otolaryngologists, urologists, an endocrinologist, orthopedic surgeons, and physician representatives from the United Physicians and Surgeons of America.

The underlying purposes of UPSA are to unify the medical profession at the grassroots, to develop leaders across the primary care/specialist spectrum, to describe the current threats to medical practice in America, and to introduce problem solvers and entrepreneurs who have developed or led organization producing effective innovations for the private sector of medicine .

I have spoken to those who attended. All agreed it was a bang-up meeting, teeming with useful pragmatic ideas. But most to whom I spoke were tentative when I asked, were the ideas too little and too late? Most agree there was no turning back the clock, and we must go forward from the bottom-up.

Many of the movements affecting physicians – massive consolidation of insurers and hospitals, near-ubiquitous presence of electronic medical records in doctors’ offices, relentless growth of Medicare and Medicaid, aspects of ObamaCare such a protecting those with pre-existing illnesses, supplementing or replacing private physicians with PAs and NPs, emergence of thousands of retail clinics, and decline of private practices with physician hospital employment are already well advanced and irreversible.

But physician innovations - focused outpatient diagnostic and treatment facilities, physician-owned urgent care centers, concierge medical practices, direct pay ambulatory surgical centers, and physician-led virtual telemedicine outreach organizations – are out there and doing well. It is never too late for the right ideas.

It strikes me what physicians are fighting is top-down control by consolidated “outside” organizations like big government, big insurers, and big hospitals . A top-down physician organization like the AMA cannot effectively counter these consolidated entities. But a unified bottom-up physician entity, organizing and coordinating innovative physicians at the grassroots, might be just the ticket for a physician counter revolution.

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