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Adapting to Reform is Critical to Medical Practice Success


The healthcare business model has irrevocably changed. Medical practices must adapt to survive and thrive.

I recently attended Houston's 2012 HealthCare Symposium, which provides a good overview of the hot nonclinical topics in healthcare.  This year's title said it all:  "2012 Regression or Progression:  Your Choice."

A session on the elections and the Affordable Care Act began the symposium, which was presented by the local chapters of the American College of Healthcare Executives, the Medical Group Management Association, and the Healthcare Financial Management Association, as well as the Houston CPA Society. 

The panelists' message was crystal clear: "This is going to happen.  There will be tweaks, but the framework and timelines are established.  The only rational course of action is to figure out how to thrive in the new model."  Some audience members wanted to argue the merits of healthcare reform, but the panelists would not engage in a debate of what they regarded as a settled question.

The second session was titled "Accountable Care Organization:  An Operational Perspective."  In several years of attending these symposia, I have never seen a session focused on operations.  There were two major points of this session:

  • Medicine has traditionally focused on clinical progress and performance and has been generally dismissive of efforts to improve operational effectiveness and efficiency.
  • Operational improvements are essential to the continued successful practice of medicine, in both ambulatory and non-ambulatory settings.

The lunch session was fascinating, but not necessarily in a good way.  The lone speaker was the publisher of Houston's daily paper.  He announced the paper's commitment to regular, extensive coverage of healthcare and began asking questions to gauge the audience's thinking on a number of issues.  Unfortunately, the questions were essentially unanswerable because they were based on faulty premises that disclosed an almost complete ignorance of the current healthcare environment. 

Given that the speaker has recognized the importance of changes in healthcare enough to commit resources to cover the topic, it was scary to think how little average citizens know or understand.

The day left me with two important, overarching takeaways:

  • It is time to accept the fact that the healthcare business model has irrevocably changed.  As with all major disruptions, the only option is to adapt or die.  Those who invest their energies in understanding the new environment can thrive.
  • Operations management in healthcare has been neglected and is the most likely source of funds to make up for diminished reimbursements.  Thirty percent of the work in any office adds no value, and at least some of it causes errors.  Experience has taught me that the percentage in a medical office or clinic is closer to fifty percent. Improving operations management is the most likely source of funds to make up for diminished reimbursements. 

As the title said, "2012 Regression or Progression:  Your Choice."

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