Addressing Anticipated Growth Opportunities in Your Practice

The forecast for overall economic growth might be disheartening, but not so when it comes to physician offices. According to projections by the Bureau of Labor Statistics, physician offices are projected to see a decade of significant job growth.

The Bureau projects total US employment to increase by approximately 15.3 million jobs between now and 2018, with better than 25 percent of those jobs coming in the healthcare sector.

“Some of the fastest growing professions are in healthcare, including the areas of medical technology, physical therapy, and x-ray technicians,” says Harry Jacobson, MD, CIO at Vanderbilt University Medical Center. “Having said that, on the doctor’s side, we’re facing shortages virtually everywhere.”

As such, Jacobson explains, physicians will not only need to work smarter, they’re going to need the assistance of a strong supporting cast. “The shortage of physicians is actually going to drive an employment opportunity for non-physician healthcare professionals, because we’re going to need more of them to pick up the slack.”

Increasing productivity

Jacobson points out that however physicians change the number of people they employ in their practice, the net result is going to have to be greater productivity due to the increase in overhead. Two key components to increasing productivity are technology, and modifying the practice workflow.

“We can’t be tied to the way we used to do things,” Jacobson says. “We need to change the workflow so that it requires the least amount of human intervention and unnecessary duplicative efforts.”

Jacobson paints the scenario of a physician seeing a female patient in his office on Monday morning. The patient explains that she went to the emergency room on Friday evening because she was having chest pains. Tests were run and a prescription was written, but the patient didn’t bring the prescription with her and she can’t remember what it was for.

The physician leaves the examination room and asks one of his nurses to track down what happened when this patient went to the emergency room on Friday night.

“Not having the information in front of you at the time you are seeing the patient is a huge inefficiency,” Jacobson says. “Not only does it keep you from making the best decisions, it changes workflow and decreases productivity. Having better supporting technology will allow physicians and non-physicians to work smarter.”

Working as a team

Jacobson says that another challenge to being more productive is that physicians, by and large, are compulsive about wanting to do everything they can for their patients. Sometimes that means they don’t want the intrusion of a nurse practitioner or physician assistant in their practice. “Giving up some of the things they do to other people who are perfectly qualified to do them is difficult for physicians.”

That dilemma stems from the fact that academic health centers train health professionals in their own silos, Jacobson explains.

“We train physicians in medical schools, nurses in nursing school, and pharmacists in pharmacy schools. But healthcare delivery is a team sport. However, it’s pretty hard to expect all these folks to work together as a team if they haven’t practiced and trained as a team.”

Jacobson says the working-as-a-team aspect is one of the major challenges facing the health profession’s education enterprise.

“Before we turn these [health professionals] out and sick them on the public, we need to teach them how to work as a team. When you do that, you not only create the culture around teamwork, you also teach them the way that workflow can be more efficient working as a team.”

Increased awareness

Do physicians recognize the need to change practice workflow and increase productivity? Jacobson believes there’s greater awareness now than ever before. And the driver of that increased awareness is the shortage of physicians.

Practical realization that they need help in order to get through the day is making physicians more aware that they need to assemble a team that can work together.

The other factor, Jacobson says, is physician reimbursement, which has been decreasing over the last decade. “As a result of declining reimbursement for any given service, physicians realize they have to be more productive and do more to maintain their income. And if they’re going to be more productive and spend less time with each patient, then they’re going to have to shift that work to other healthcare professionals.

The remaining challenge, Jacobson notes, is finding a way to pay for some of the increased infrastructure that physicians have, and are going to need to have, that’s centered largely around educating, coaching, and maintaining patient compliance.

“If insurance companies and the federal payers don’t appreciate the fact that there should be some reimbursement for this kind of prevention and education activity, there’s going to be a continued challenge to the physician’s economics.”