Comments on: Will integrated systems become a reality in American health care?

By: Dawn

Dawn — Fri, 09 Oct 2009 02:25:55 +0000

We have a large system taking over healthcare in Orlando – employing 200 physicians in its own ‘multispecialty group’ while presenting them to the public as if they are independent practices. Statistics shows as they funnel patients to their own physicians, established practices’ volume goes down. How can we stop it? How could patients and private practice physicians work together to preserve private practice. I personally do not want to be herded through a system based on corporate interest rather than on what is best for me as a patient — and not even know I am IN the system. I want my private practice physicians to thrive and be around for when I or people I love need them. I am not willing to sit back and resign myself to the end of private practice, but don’t know how to take effective action. Any ideas? E-mail me!

By: Anonymous

Anonymous — Sat, 07 Feb 2009 01:36:00 +0000

Not quite like that : physician turnover is higher in such groups, care is less personal and the patient is often a number. If big businesses would be so great, american economy would be mostly big businesses. The truth is, most americans are still employed in small and medium sized businesses.

By: Anonymous

Anonymous — Sat, 07 Feb 2009 01:32:00 +0000

I worked for the Big Mama colossus integrated system in my region for several years, bought into partnership, etc

It was an inefficient, wasteful, and frustrating to doctors and patients alike. Not always for everyone of course or it wouldn't continue to exist but enough that it's name has become a bit of a joke. There are both more doctors and patients who used to be their in town than their are who are there now.

Small group practice is the most efficient place to provide specific services. Loosely affiliated physicians can provide good integrated care if they will make the effort. Doctors in a big multispecialty clinic can provide poorly coordinated care if everyone is too busy infighting to talk or doesn't bother to plow through the in-house EMR.

By: Anonymous

Anonymous — Fri, 06 Feb 2009 13:44:00 +0000

i understand that kaiser, which uses epic emr (i believe), cannot share information between its own divisions. iow, kaiser northern california cannot share information with kaiser southern california.

if that is the case, we should really pause and consider whether we are ready the push for merging practices will save money, presumably through emr adoption/less unnecessary and duplicate testing, or whether we need to push for standardization of emr data first in order to best take advantage of the economies offered by larger multispecialty practices? simply merging practices will not likely save a lot of money to the health care system.