How will doctors adjust to being told what to do?

The best doctors are not only intelligent and compassionate, but adept at weighing medical evidence and looking for answers beyond the obvious.

Their adjustment to the new-normal of the health-care industry in the coming years of implementing the Affordable Care Act will not be easy, says Ken Weixel, Columbus-based leader of Deloitte’s U.S. Healthcare Practice.

A provision of the law that seems to have its future assured with Tuesday’s election results creates an institute for “comparative effectiveness” research. Its mission is to review and conduct research on what tests, medications and procedures lead to the best patient outcomes – such as radiation pellets vs. surgery for prostate cancer. Eventually, insurance would preferentially pay for what the evidence shows is best. Ideally, that reduces overall health-care spending.

“It’s going to have to come with physician acceptance,” Weixel said Wednesday in a talk before the Ohio Society of CPAs.

The business side of running a doctor’s practice will change, too, he said. With a greater number of insured people, an emphasis on prevention and a shortage of primary care doctors (internists, family docs and pediatricians), the physician’s role in primary care will shift to a supervisor of a team that includes nurse-practitioners, physician assistants and allied health professionals who will be delivering most of the annual checkups and strep swabs.

The future is more murky, he says, but it’s also possible the independent physician practice will disappear because nearly all doctors will become employed by hospitals or health insurers. That will take away the administrative headaches of running a small business, but means independent-minded, naturally inquisitive clinicians will have to act like employees and listen to what their bosses tell them to do.

By Carrie Ghose, Columbus Business First
Posted by: Scott W. Yates, MD, MBA, MS, FACP

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