Wharton Business School recently held its annual healthcare economics conference, this year titled “Disruption Amidst Uncertainty.” The “disruption” in the title does not carry the traditional definition of the word or its negative connotation. Instead, it’s the economic process that allows a new idea to grow and eventually replace the status quo, the way telephones once disrupted telegrams, or the way Apple has disrupted the personal computer industry. In the economic sense of the word, it’s a force for good for consumers and for innovators.
That process is taking place across healthcare and is doing so on an unprecedented scale, driven by ideas, innovation, and uncertainty in America’s biggest industry.
Improved genomic testing allows us to anticipate impending disease for certain individuals and treat even before its onset. For years we have used our knowledge of the link between genes BRCA1 and BRCA2 with breast cancer, for example, and have been able tell patients how likely they’ll face cancer in the future. Using the same techniques we’ll soon be able to do the same for any disease in any patient, and choose the right medication based on that patient’s genetic profile.
On the other end of the industry, we’ve seen change in models for patient care and reimbursement. Now more than ever there are emerging models that break traditional molds and challenge longstanding concepts. Institutions like Kaiser Permanente and Geisinger Health System have developed conglomerates based on responsibility sharing. Insurance companies such as Independence Blue Cross are creating their own provider networks. Startup companies are taking a more direct-to-consumer approach, creating apps like Pager and Medicast that allow patients to pick up their phones and request a house call just as they might request a car with the now ubiquitous Uber app. This experimentation with the creation of different provider networks and payment models is bringing us more efficient models and improving the delivery of care to patients.
Another, more fundamentally disruptive trend is the movement of care out of the hospital. Flu shots are administered at Rite Aid, X-rays are performed at Minute Clinics, and Walmart is preparing to provide entire outpatient services at its stores. Already the mammoth company has opened in-store clinics staffed by nurse practitioners, charging $40 for each visit. Care is spreading further from the hospital and closer to patients’ homes and even their smartphones, making healthcare more accessible and convenient.
A lot of this change is being driven by one thing: consumerism. While patients once looked to their doctors as the keepers of their health, they are far more empowered today. Access to information was the first turn in this direction. With portals like WebMD and Healthgrades, patients have a better idea of who to go to and what to expect than ever before.
On top of that, there is increasing accountability placed on the patient. Insurance plans come with higher deductibles and coinsurance, pushing enrollees to take charge of their health. With that amount of choice and liability placed on the consumer, the basic principles of an open market come into play. People will go to minute clinics and urgent care centers if that is who will provide care most cost-effectively. They will turn to their smartphones if the latest apps offer the most convenience. Traditional medical institutions will have no choice but to adapt and improve.
There are enormous forces of change in our healthcare system today, and a number of industries are harnessing those forces. Those industries were physically in the room at Wharton’s healthcare economics conference, with insurance executives, consulting firm vice presidents, 20-something year old CEO’s, economics professors, and MBA students discussing the future of the nation’s healthcare industry.
Notably absent, however, were physicians. A handful of attendees were once or even still practitioners of medicine, but as a whole the medical profession was at home or at the hospital, either disinterested, too busy, or unaware.
Physicians should be at the forefront of this movement for better care, ensuring that healthcare changes in the interest of medicine and not of industry executives. All parties should play a role, including the Silicon Valley startups and the pharmaceutical giants who have already brought change to the system, but as soon as physicians leave the room medicine no longer has a say in its own future. We need more physicians taking action across all of these sectors, and enabling medical professionals to steer America’s healthcare in the right direction. Physicians can, with the right people playing the right roles, give the country a healthcare field that allows medical doctors to best deliver care to patients, rather than one in which care is delivered around them.
There is great disruption amidst uncertainty in today’s medical industry. It is time for physicians too to harness the energy and innovation behind that disruption and work to once again become the leaders of today’s medical field.