Physicians need new skills for boomer demand
DM, outcomes tracking add value to practices
They’re demanding, they’re outspoken, they want hard, cold facts — and there are a lot of them. They’re the baby boomers and as they age and need more medical care, they will likely create headaches for your practice. The baby boom population represents an opportunity as well as a challenge for physician practices. They will be receptive to cutting edge technology and new treatment methods but they’re going to want to know upfront what the outcome will be.
There are so many of them that practitioners are going to have to scramble to take care of their health care needs. At they same time they will be unwilling to wait weeks for an appointment or cool their heels in your waiting room.
This means that physicians are going to have to increase their efficiency and deal with the new patient loads effectively. They’re going to have to keep track of their disease management and treatment outcomes to provide the information this new health care population wants.
Lean on nurse practitioners, PAs
"Physician assistants and nurse practitioners are probably the physician’s first line of defense against the future patient — the angry and demanding baby boomer with Internet access," says William J. DeMarco, president of DeMarco & Associates, a Rockford, IL, health care consulting firm.
Nurse practitioners and physician assistants give physicians an opportunity to see the severely ill, most challenging patients but still accommodate patients with routine problems.
"To be successful in the future, physicians need to ask if every patient that walks through their office needs to be seen by a physician," adds Randall Killian, MS, MBA, executive vice president of the National Association of Managed Care Physicians in Glen Allen, VA.
Physicians are adding physician assistants, nurse practitioners, and even social workers to their practices to deal with patients who have psycho-social, in addition to medical needs.
"There are a lot of issues, particularly with the medically underserved and the elderly, that are not medical but social issues and should involve a patient education effort rather than a physician visit," Killian says. Among these are nutrition, preventive measures, and education on chronic disease, he says.
In addition to excellent customer service, the next generation of patients is going to want performance statistics, DeMarco says. That’s why it’s essential for physicians to look at performance measures, being able to track how many people with a particular problem had a good outcome with no recurrence, and with no extra costs. "They are looking for a guaranteed outcome but they can accept performance statistics to assure them they’ll have a good outcome," DeMarco says.
You also may need to show the patient of tomorrow how you stack up against your peers in managing chronic diseases, says DeMarco. In fact, from a business standpoint, disease management may be the best way to deal with the increasing health care needs of the next generation, Killian adds. Efficiency from a business perspective is the ratio of input to output, Killian points out. In medicine, efficiency means the best outcomes at the lowest cost, he says. "Whether you call it disease management or health management, it is in essence combining the business and clinical piece of the practice to get the best outcome at the least cost," he adds.
With disease management, or more correctly, health management, physicians are focusing more on preventive care and maintaining wellness. Until recently, disease management has been a pie-in-the-sky approach to patient care, Killian adds. "Health plans and pharmaceutical companies partnered together and developed great disease management models," Killian says. However, practicing physicians often didn’t have the time to implement the models, he adds.
Killian tells of a panel discussion during which a family practitioner was asked what he thought of a particular disease management plan. "I don’t have time to look at disease management models. I spend all my time treating patients," was the reply.
The National Association of Managed Care Physicians is concentrating on helping physicians implement disease management programs. "We have great models that have been approved by the medical directors of health plans but getting the physicians to implement them is where the rubber meets the road," he says. The association has held seminars in 2000 on the subject and has others planned for 2001.
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