Which events of 2008 most affected and will continue to affect practicing physicians?
Here are my top 3.
First, is Medicare’s institution of “never” events, where payment is denied for certain medical errors. In addition to uncontroversial events like operating on the wrong patient, Medicare has also included conditions where total prevention is impossible, including patient falls and hospital acquired infections. By doing so, hospitals will now be motivated to increase the amount of admission testing, to ensure that any complication that a patient acquires was already pre-existing, and doctors will now think twice about admitting or performing procedures on the sick and elderly – the patients at highest risk for complications.
Next, is the recession’s impact on health care. These difficult economic times prevent patients from undergoing routine exams and seeing their doctor regularly, decreasing volume at both physician offices and hospitals. In our fee-for-service system, doctors will be under more fiscal pressure than ever to break even.
Finally, how can we ignore the election of Barack Obama as our next President? Along with a Democrat-controlled Congress, this represents a fundamental shift in health policy, and the best chance in a generation pass meaningful health reform legislation. Expect a focus on supporting primary care, decreasing the number of uninsured patients, reforming the physician payment system and potentially confrontational negotiations with the pharmaceutical and health insurance industries. I don’t see any way how the physician practice environment cannot change with 2008’s dramatic shift in the political climate.
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