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Physician Challenges
And with more and more doctors
being employed by hospitals, health systems
are working to establish practice mod-
els that seek to make themmore pro-
ductive to help control costs. Louisiana
currently ranks about in the middle
nationally for the annual physician
component of health expenditure
costs, with doctor costs totaling
$7.8 billion annually in the state.***
Nationally, physician expense runs
about 27 percent of total healthcare
costs.
The new healthcare delivery system
reality is that doctors, hospitals, and even
patients can no longer operate in a vacuum,
independent of each other.
Of course, no healthcare gets delivered
anywhere without a doctor’s order.
U.S.
Healthcare Journals
spoke to three Louisiana
physician leaders and one national physician
practicemanagement expert about the chal-
lenges physicians face in this new order, as
well as their strategies for dealing with epic
shifts in healthcare delivery.
“Physicians control all the significant
levers for costs – fromwhat tests are ordered,
if medications should be brand name or
generic, and what kind of procedures need
to be performed,” said Floyd “Flip” Roberts,
MD, Vice President of Clinical Affairs for the
Louisiana HospitalAssociation. “Froma phy-
sician standpoint there is a lot of frustration
because payers are also trying to get their
hands on the levers too. So there is always
someone else in the roomalso trying to pull
the right lever…this can be exhausting.”
Dr. Roberts, a pulmonary and critical care
specialist, noted that for physicians, prac-
ticing medicine has become more compli-
cated as information sharing, quality report-
ing, and documentation standards become
more vigorous. He supports the concept, as
these requirements are intended to allow all
physicians to care for any given patient any-
where, over time, but these new standards
come with a price.
“The conversion fromvolume-based (tak-
ing care of ill patients) to value-basedmedi-
cine (keeping patients healthy, also known as
population healthmanagement) is a very dif-
ficult transition,” he said. “There is a burden
Doctors have a lot on their minds these days.
The top nine medical concerns, according to the physician advocacy group the
American Medical Association, include healthcare regulations (especially as
delivery is being reshaped by the Affordable Care Act), issues such as health data
security, and the evolving health insurance market (such as bundled payments).*
To this list, the American Medical Management Group adds chronic care
management and improving meaningful use in electronic health records.**