Financial Headwinds, Continued Burnout, and How Concierge Medicine May Be the Cure for What Ails You – Updated
In healthcare change is inevitable, but for independent physicians already facing headwinds that threaten to topple private medical practices in 2025, the prospect of a new administration is sparking even more concern. To help decipher the implications of an evolving healthcare landscape, Medical Economics hosted an exclusive webinar with industry thought leaders Specialdocs CEO Terry Bauer and Coker Chairman Max Reiboldt, tapping into their collective century of experience guiding physicians on career strategies.
Here are some of their sage insights on why concierge medicine offers one of today’s – and tomorrow’s – most viable solutions to retaining independence in the face of declining reimbursements, rising operating costs and relentless burnout:
- The economic squeeze continues. “Now representing just 22% of all practices, the independent physician is in real danger of disappearing altogether,” observed Bauer. “The combination of increasing costs to operate a traditional practice and ongoing cuts to Medicare reimbursements have contributed to an overall 29% downward slide in Medicare compensation over the last two decades.” Reiboldt noted that while there has been a trend toward tempering cuts to basic reimbursement codes essential to delivering primary care, he expects to see “legitimate reductions across the spectrum spurred by genuine efforts to get federal spending under control.” Still unresolved is the fate of the latest cuts to Medicare reimbursement, set to occur on January 1, 2025 if no action is taken before Congress adjourns in December.
- A shift from prescriptive to permissive, was Bauer’s expectation of the new administration’s attitude toward healthcare regulation. Reiboldt agreed, saying there will be a much diminished focus on enforcing antitrust regulations, “letting the handcuffs come off, so to speak.”
- Recent reports of payers’ larger medical loss ratios and decreased earnings were also explored, as Reiboldt said: “Commercial payers are still doing well, albeit maybe not as well as they have historically. But if they continue to raise their rates for those they insure while not raising or worse yet lowering provider reimbursement, there will be an even stronger inclination toward the Specialdocs model and concierge medicine.”
- Saving primary care. Despite their undisputed position as the foundation of our healthcare system, Bauer said primary care physicians have been consistently unappreciated. Reiboldt agreed, saying these physicians have a significantly positive impact on the entire system, influencing everything from surgeries to inpatient services to ambulatory care. Future options for independent primary care physicians remain extremely limited however – employment by a hospital system, becoming part of a larger multi-specialty group, or changing to a concierge medicine practice.
- A model for value-based care. According to Reiboldt, the shift from fee-for-service to fee-for-value spurred by passage of the Affordable Care Act in 2010 has gained prominence that may not yet be deserved. Bauer maintained that concierge medicine is the only model that consistently delivers on the pillars of value and quality in healthcare, bringing significant benefits for physicians, patients, payers and the healthcare system. He cautioned that physicians who succeed in the model are motivated not by an opportunity to earn more money, but to spend more time with their patients. “What they value most is the ability to ask more questions and address all issues at each visit, and not wake up in the middle of the night worried that something important was missed,” said Bauer.
- The tech effect. A measured assessment of the potential of artificial intelligence (AI) in healthcare was offered. Considering both the expense of integrating technology and risk of professional liability, Reiboldt was skeptical about its impact, saying, “The jury’s still out on AI. If we can prove it works and help bend the cost curve for medicine, I’m all for it. But I don’t know that 30 years of a relationship with your primary care physician can ever be replaced by AI.”
Bauer was more optimistic about AI’s role in easing the administrative burden in a practice by taking on tasks such as dictation, coding, insurance claims filing, and patient scheduling: “I picture primary care doctors in a traditional fee for service practice with one hand on the keyboard, one hand on the door, and sweat on their brow because there’s 20 people in the waiting room, and 5 already in the exam rooms. Eventually AI may help relieve doctors of the need to spend time on data entry and bring the focus back to the physician-patient relationship.” But noting that AI was still in its nascent stages, he said “sometimes being too early is a lot like being wrong.”
Remote monitoring of glucose, blood pressure, heart rhythms, etc. received an enthusiastic thumbs up from both. “The results are tangible, helping to cut costs and keep you out of the doctor’s office when you don’t need to be there,” said Reiboldt. - Reasons for optimism. Citing his many years of collaboration with physicians, Reiboldt said he has the greatest respect for their dedication to meeting the highest standards for care despite working in a system that’s broken in many respects. Bauer agreed, adding that the current chaos may ultimately inspire real opportunity for transformation. “At Specialdocs, we believe more strongly than ever that concierge medicine is a lifesaving solution, providing unequalled satisfaction for physicians at every stage of their career,” he said.
What is your outlook for 2025? If you’re looking for the independence to practice your best medicine and achieve a rare work-life balance, then consider filling out our brief STEP form to help us determine if you’re a good candidate for concierge medicine. Specialdocs Consultants is here to answer all your questions and guide you every step of the way towards building your concierge practice.