American Healthcare: Shifting The Narrative

America, with its congress and legislation, has been focusing on symptom management based health policies and curative measures for decades. But is this truly the best approach?

Both physicians and patients are realizing that there needs to be a serious conversation about the type of care that we focus on in America. Our nation is still stuck on prevailing epidemics. Since 1950 up till now, these epidemics have shifted from infectious diseases to chronic ones. Half of the American population suffer from one or more chronic illness. Diabetes, obesity, heart diseases, strokes, opioid addiction, and many others are affecting American’s quality of life. Around 117 million Americans, suffering from such chronic conditions, are actually costing the nation a projected 794 billion dollars. These are not infectious diseases that are spreading uncontrolled, and these are not isolated incidents that take place in a third world country. These are by and large fully preventable chronic diseases.

The global conversation is focused on infectious diseases. Most of our annual funding for worldwide healthcare is directed towards HIV and AIDS and other infectious diseases, leaving simple chronic illnesses forgotten. Does it make sense? Surely not! Not when chronic illnesses are killing and affecting the lives of millions, every day! Resources need to be better allocated; and, the health care system needs to be reconfigured to accommodate easily preventable chronic conditions.

Is America on the path to implementing better healthcare coverage and preventive measures? Many states, like Maine, Utah, Kentucky, and Arkansas, are ruling for waiver applications. They are trying to set premiums for Medicaid beneficiaries, as well as adding many coverage rules. For them, individuals benefiting from Medicaid need to be prevented from re-enrolling in health insurance once they fail to pay their premiums; and, as a result, lose the coverage. This is an unproductive approach that can have a significant impact on society. Insurance coverage should not be reshuffled. Our nation needs to start programs that screen and address root causes of illnesses; and, develop effective preventive measures. The goal is to improve the health of the American population and save our nation millions of dollars.

The USA is over-spending on health care, yet is ranked last in terms of overall health and mortality among the top seventeen developed nations. This overspending with disproportionate results is referred to as “medical waste”. Our system is not coordinating care properly nor applying efficient preventive measures. Unnecessary treatments, that would have been easily preventable, as well as medical errors,  are on the rise. Healthcare accessibility and affordability are burdening both patients and doctors.

Our nation spends one of the highest amounts per capita on healthcare - and yet in overall health, we consistently rank below many countries who spend less - our return on investment is not very high.

Americans have skyrocketing rates of chronic disease. Health care professionals do not coordinate well among each other, and there is poor access to patients’ comprehensive medical records. Treatments are rushed, medical tests are getting duplicated due to uncertainty. One out of four patients is suffering drastic consequences because of highly preventable mistakes.

Patients are dying due to skipped care, misinformation and the inconvenience of our health care system.

Worst of all? Physicians are NOT being paid according to the quality of care they are delivering. The whole system is turning into a big ball of chaos, leading to maltreated patients, wrongly used insurance policies and physician pay not increasing at the rate it should be. America needs to have a serious conversation about how we treat preventable diseases, and also how to compensate physicians more fairly.

Common Mistakes Many Physicians Make

While America’s entire health care system is struggling, physicians have their own kind of practice-related struggle. A successful doctor is not the one who overworks himself. He’s not the one who builds an empire of a clinic.

One of the most dramatic mistakes a physician can make is thinking that seeing as many patients as they can for office visits somehow improve their financial situation.

That's only exhausting to physicians and usually leads to staff bloat without an appropriate return on investment (or return on time).

After reviewing hundreds of clinics across America, at Heartwise we’ve found that an efficient primary care office should be generating 80% of revenue from diagnostics and 20% from office visits. This is the ratio that the most successful primary care clinics in America use.

However, diagnostics should not take up too much of the physicians time. A physician is just one person and needs to delegate and when patients get diagnostics.

Another area that physicians make mistakes in is buying very expensive medical equipment, that insurance stops reimbursing a year later. Every single year there’s a new fad in the world of medicine. Physicians start buying new promising medical equipment, at a very high cost and market them as the latest and greatest new invention. From medspa equipment to allergy testing to compounding creams - it seems like every year there’s a new fad that makes the rounds in the medical community. A year later, new machines hit the market; and, the physician’s previous equipment or service will age out. That same machine that was just bought, less than a year ago, stopped dripping revenues; and, the doctor starts running in circles. This is what we call “shiny object syndrome”.

A successful practice is not the one chasing after shiny objects. It’s the one that is based on steady powerful evidence-based protocols and which puts patient care first. In the long run, clinics that understand both the business side of running a clinic, as well as the importance of patient care, are always the ones that win out in the end.

Another mistake adopted by physicians, which is becoming very widespread, is exhausting the patient with unneeded testing. Unnecessary testing and labs can be overwhelming for patients - and prevent them from coming in more frequently for care. Clinics will not skyrocket their revenue from stressing the patient out and making them more fearful of medical care. A physician will make more profit by targeting more patients; however, not at the expense of the quality of care. That being said, a health caregiver needs to wisely manage his time and look for tools to help him succeed.

Another mistake many clinics make is “staff bloat”. Hiring a big team of personnel, like nurses, technicians, secretaries, billing managers, and others can often lead to higher overhead without adding profit to his or her practice. Having a concise well-picked team is the key to success.

Many physicians often attempt to increase their patient base through heavy social media marketing efforts. While these can sometimes help, often when not managed properly they can consume existing profits while not bringing a positive ROI number.

If you have social media marketing going on, do you know the ROI off the top of your head? If not, it may be wise to reconsider if that’s the best approach to growing a clinic. Having a higher overhead will not bring success and fame. A physician should be able to focus on the quality of care that is being offered to every patient, and often the clinic will grow organically.

Finally, it is wise to realize that patients always look for added values to their doctor’s visit. From the personal touch at the front desk, to free coffee in the waiting room - patients always refer and review clinics highly when they feel like they are getting personal attention and warmth from the physician and staff. They need an evidence-based practice, with the most accurate results. They do not want to go through unnecessary and duplicate tests, with a possible inaccurate diagnosis. They need stability, skills, assurance, and affordability.