Obamacare is changing the image of the doctor we know and love

Obamacare is changing the image of the doctor we know and love. For better or worse, gone are the days of a physician carrying a black bag and making house calls. The new-age doctor is someone who is probably comfortable communicating via text message (secure, of course), or by email.

With the rising demands of a new dimension of healthcare delivery, where doctors need to see more patients to make up for lower reimbursement, you will soon see some innovative ways by which doctors will be communicating with patients, and still getting paid.

As of last year, about 30% of doctors reported using email to communicate with patients, and about 18% of those surveyed used text messaging.

But there is still a large percentage of physicians who are concerned about privacy and security. This may change, however, as insurance companies may start to reimburse for electronic forms of communication.

In addition to email and text, an increasingly popular means of doctor-patient communication is video conferencing. Many services have evolved that enable physicians to conduct these video chats with their patients quite effectively, and charge for the consultation.

It’s been predicted that more than 50% of doctors will start working for a hospital or a hospital-owned system in the next year. If that happens, there will be increasing attention paid to the measurement of physician efficiency. Physicians will be compensated based on their ability to effectively communicate with patients, and ensure patient compliance.

As employees of hospitals, physicians may actually start seeing fewer patients as their hours shrink, and they start working more like hourly employees. It is possible that we may see a disruption in the continuity of care as physicians adopt this new schedule.

Ironically, an increase in the percentage of employed physicians could actually have an effect contrary to the intent of the Affordable Care Act to increase access to healthcare.

The work environment for a physician is clearly changing dramatically as there are increased demands for doctors to become more savvy in technology. In the short term, consumers could find it challenging to get the care and information they need, as the healthcare industry transforms itself.

Sreedhar Potarazu is an ophthalmologist and founder and CEO of Vital Spring Technologies. He blogs at Business and Policy.

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  • http://www.facebook.com/profile.php?id=881580563 Kristy Sokoloski

    A number of doctors even before the healthcare law got enacted were looking to find ways to reduce the number of hours that they work. The reason for this is because some of them (who are parents) want to have more time to spend with their families. As for the ways to communicate with the patient face to face visits will still be an important part of the patient’s healthcare needs because not everything can be seen clearly through that means. Also, some patients may not feel comfortable with the idea of video conferencing nor would they be able to afford to do it even if they were ok with the idea. As for “Physicians will be compensated based on their ability to effectively communicate with patients, and ensure patient compliance” I could see where the first part could be a good thing up to a point. The reason I say that is because there are more and more articles coming out talking about how to help doctors learn how to communicate more effectively with their patients. I also say this from personal experience with some doctors in the past where we were not able to communicate very well and it only caused confusion. In relation to the second point. I don’t think that’s going to change any time soon. The reason for that is because it’s still up to the patient to decide if they want to comply with the treatment regimen or not. Especially since cost is still a factor in whether or not the patient will be able to have the treatment in the first place.

    • Suzi Q 38

      You can have two hours of scheduled patients via I pad video or your computer while your baby sleeps in the next room.
      If you have to get to the baby, just say, just a minute, please.
      If you have to take a bathroom break, ask to call them back in 10 minutes. This could be really good for a physician that desires more time with his or her family.
      Maybe have a full day or video appointments. Think of the driving time to and from work you will save, not to mention the gas.

  • Dave

    As someone with a passion for health policy, I don’t understand why Obamacare is getting the blame for this. You could have written this same piece in 2007 or 2001 simply by deleting the word ‘Obamacare’ and I remember reading similar articles myself at the time. I understand why politicians make such distortions and blame the ills of medicine on this not-yet-fully-implemented law — that’s how their game is played, after all — but why would physicians do the same when it serves neither their own interest nor the truth?

  • mothygoroxathotmail

    The A C A is changing how doctors work. It is not paying for early readmissions. We are doing a community wide pilot…. I am the doc on wheels with black bag… Going to houses to see sick people who need attention, but cannot get to their PCP due to circumstances. I will report back at how it changes things.

  • amolutrankar

    Dr. Potarazu, I have two comments.

    One, I’m not sure that this is a consequence of Obamacare/ACA so much as it is the natural influence of advancements in technology, digital communication, and cloud-based interfaces on patient care. It makes sense that, after these innovations have pervaded very nearly every other major industry, they would make their way into healthcare as well.

    Two, I’m not sure patient access during the transitional phase is the right way to frame the issue. Instead, I would say that any physician who isn’t comfortable adapting to the new framework of medical practice should rightly be pushed out. These are essential tools for patient engagement, diagnosis, and treatment, and they should be rightly obligatory.

  • Molly_Rn

    House calls????!!!!! Went out in the early 60′s. And black bags went out with……well when your residency was over. Don’t blame the Affordable Care Act for many of the changes that happened when the insurance companies discovered pre-existing conditions and DRG was invented.

  • http://www.facebook.com/virginia.scanlan Virginia Scanlan

    This is a boon for trial lawyers. Doctors will be decimated in court for recommending treatment via electronic conferencing. Another double bind for doctors. I’m sure you noticed that there was no tort reform in the ACA. But, of course, many of the academicians who pushed the ACA, never paid out of pocket for liability coverage. Too much involvement by techies will lead to patients being treated like robots.

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