Category: Future of Healthcare and Medicine

Visits To Primary Care Physicians Are On The Decline

Check this out. What you will see is a report indicating that office visits to PCP’s have dropped significantly over the last several years. So, you think, the patients are showing up to see NP’s and PA’s? Not so fast. This report also indicates that the rise in visits to the non-physician providers, as the chart above demonstrates, accounts for only half of the lost PCP visits. As another surprise, you will also see commentary indicating that any shift from physician to non-physician providers is NOT providing the cost savings that one would anticipate. Bottom Line. While I found these statistics to be interesting, this report left me with three questions.  First, if only half of the PCP shortfall is accounted for by non-physician providers, where the heck did the rest of the visits go?  Second, how can there be no cost savings if visits shift from physicians to non-physicians? Third, what does this trend mean for our businesses?    Inquiring minds want to know!

Flirting With Functional Medicine

Check this out. What you will see is a riff by our old friend The Country Doctor, pictured above, on the topic of functional medicine. In this post, he reveals that he is starting to integrate some of the principles of this discipline into his practice. But there’s more! Embedded in this post is a 20-minute video that clearly explains the underlying principles and practices of functional medicine. Watch it. There you will learn that rather than treating symptoms and diseases, FM deals with protecting and energizing the body’s systems and mechanisms that, when abused, lead to the negative sequelae that physicians spend their time treating. A lot of this makes a whole bunch of sense. Bottom Line. Think about it. Functional medicine brings with it a whole different modus operandi for physicians and patients alike. No longer is the doctor’s day divided into 15-minute modules of patients presenting symptoms and doctors prescribing therapies. The doctor/patient interaction becomes much more consultative. Educational. Holistic. And yes, time consuming. As a result, functional medicine will be, for the foreseeable future, much more likely to be the stuff of concierge practices and less likely to be found in production line clinics. What new business opportunities, and challenges, would such a shift in focus bring to our businesses? Like I said … Think about it!

Faith Popcorn—Then And Now

Faith Popcorn. Futurist. I have been following her work for years. In the good old days, she was predicting trends in such books as Clicking, pictured above. Example. She predicted “cocooning,” a movement which saw American families increasingly choose to remain safe at home together rather than venture out. So what? Burgeoning sales of home-entertainment devices, home theaters, etc. That’s what! Scroll forward. Check this out. What you will see is Faith’s brief slide show on how she sees the future of healthcare morphing. For example, important shifts in demography, like the description of a child as being “gender fluid.” Other important shifts in healthcare delivery, like self-driving clinic pods that bring medical care to your door. Take a few minutes and go through the slide show. I think you will find it thought provoking and potentially eyebrow raising. Bottom Line. Having gone through this slide show several times now, I am left to wonder as to why I don’t see more of this “futurist stuff” going on in our vertical. Presentations at our conferences? Articles in MM&M and other trade publications? I am left with two possible interpretations. The first one is that even though there is probably no vertical that will be morphing as fundamentally and rapidly as healthcare, we are not paying the attention to predicting the future that we should be. That would be a shame, since pundits like Popcorn have the tools to help us to make these predictions with rigor and accuracy. The other interpretation is that Popcorn and her colleagues are working with select, forward-thinking companies in our vertical, but doing so quietly to gain a competitive advantage. Amazon? J.P. Morgan? Berkshire Hathaway? I’m guessing option B. So what? Those companies that are not looking out a decade or two into the future better get started in doing so, or they will be left way behind as the future unfolds. That’s what!

Is She Too Cute To be A “Good Doctor?”

Sandra Scott SimonsMaybe! Check this out. According to Dr. Sandra Simons, the ER physician pictured above, doctors attempting to practice medicine against the metric of patient satisfaction might just lead to this conclusion. Seems that young female physicians are going so far as to put their hair up in buns and wear fake glasses to “sell” patients on their being good enough to “satisfy” patient needs. “Sell,” in fact, is the damning word here. This article is replete with examples of physicians having to spend their time on convincing patients that they are satisfied, rather than on practicing good medicine. In a clever metaphor, she asks rhetorically what would happen if we ran schools based on student satisfaction. All day recess, no homework or tests and peperoni pizza for lunch every day is what would happen. Patient satisfaction determining how “good” medicine is? How about a cheeseburger on the way to the OR, or getting me out of the ER faster rather than appropriately treated? Patients, she rationally notes, are just that.  Patients. They are not “customers.” Bottom Line. Study Dr. Simons’ article carefully. You will see that she tees off, I believe quite appropriately, on both patient satisfaction and quick medicine as dangerous, and in fact ridiculous, metrics of “good medicine.”   Will 2018 see the powers that be come to recognize this absurdity and do something about it? Stay tuned!

Merger Mania

CVS Yeah, I know. By the time this blog gets posted, we will all have read a gazillion articles about the CVS/Aetna deal. BUT. I found this one to be especially insightful. I like the candor of the article. The point it makes that the exact nature of the synergy that this union will produce is still unclear. And that the damned thing might fail, either by being blocked by regulatory forces or by failing to realize the anticipated synergies. Bottom Line. That having been said, the article acknowledges what I think we all believe, i.e., this is going to work. SO. We all better start thinking about what “work” will look like, and the impact that will have on the delivery of health care, healthcare marketing and marketing research, and virtually everything else that touches us as professionals in our vertical.

Hospitals Should Be Cold/Sterile/Clinical Right???

TED Wrong!!! Check out this TED talk. From it, you will indeed learn a form of counterintuitive thinking that needs to be embraced. Here’s the idea. “Architecture can be used to heal.” Through proper design, buildings can be constructed that can have positive impact on medical outcomes. A shame, the presenter observes, that better use is not made of this well-known, but less than salient, fact. Bottom Line. A gazillion years ago when I wrote my Ph.D. dissertation in psychology, I cited the work that had been done on mental hospital design. Make state hospitals (remember them?) a series of buildings with long halls, and you can make crazy people pace those halls and get crazier. Conversely, as this TED talk reveals, simple ideas like providing each patient with her own hospital window can have a positive effect on physical health outcomes.   Isn’t it time to start to put these ideas to work?  

Evolutionary Medicine

Screen Shot 2017-07-28 at 3.39.39 PM Check out this NYT article. In it, you will see an interesting discussion of “evolutionary medicine.” Huh? Meaning, the study of other cultures, and the history of other cultures, to gain insights as to what “natural” genetic factors and remedies might contribute to diseases and their resolution. In other words, the study of human beings in urban environments in the U.S. and other developed countries doesn’t give us the whole picture. Not by a long shot! Bottom Line. Compared to screening millions of molecules in the laboratory in hopes of finding a cure for such conditions as Alzheimer’s, this cross-cultural research might prove to be very efficient! 

Robots As PCP’s???

Screen Shot 2017-05-22 at 11.33.49 AM Will your iPhone soon be able to make a better diagnosis of what ails you than your doctor can? Check this out!  A U.K. health company is investing big bucks on this vision of the future. Soon, patients in five London boroughs will be using an app rather than a doc as an initial clinical point of contact. As Ali Parsa, CEO of Babylon maintains, we wouldn’t make a weather forecast without a computer, so why would we have a physician attempt to make a diagnosis without one? Bottom Line. Talk about disruptive! The technology is clearly in place to support this vision. Sort of exciting, really. Could app health end run telehealth as the wave of the future? Stay tuned!

An Interesting Alliance!!!

Screen Shot 2017-05-15 at 2.19.44 PM Who is joining forces in the photo shown above? Go here and you will discover that the VA, the VFW and Walgreens are joining forces to better serve the mental health needs of veterans. I sense a win-win-win here. Given its well-publicized service drops, the VA can certainly use a PR boost. I am guessing that the VFW, which has largely fallen off the radar, can use a little consciousness raising. And Walgreens, that has announced its intent to establish a position in what might be referred to as “retail psychiatry,” certainly has a lot to be gained by reducing the stigma attached to mental health problems. Bottom Line. Will the whole be greater than the sum of the parts here? Hopefully! I have said before, and will say again here, that I believe that rational partnerships are important for the future of healthcare. Sure, many announced partnerships are simply fluff and go nowhere. Others wind up being tremendous successes. The difference? The realization that in order for partnerships to really work, they must be rationally conceived and carefully nurtured!  We will see if that happens in this case. I hope so!

Do Patients Have A “Right To Try?”

ASCO Frankly, I’ve sometimes wondered about this. What if you are a terminally ill patient, find a clinical trial that might provide your last hope, and get rejected from participation? “Right To Try” legislation deals with this thorny situation. As you will see in this ASCO position paper, legislation is being debated at both the state and federal levels that would provide “expanded” access to drugs for terminal patients outside of clinical protocols. Of interest here is the fact that ASCO, the group of physicians most directly involved with such patients, has come out against expanded access. Reason? They believe that RTT legislation would not substantially increase access, and that the risks of such legislation outweigh the benefits. Bottom Line. This is a tough one. Take some time, read the position paper and see what you think. I think I disagree with ASCO. But they have though a lot more about this issue than I have. Maybe too much!