“Change definitely will be happening. And change happening will be difficult.”
That’s the message I delivered at the Healthcare Financial Management Association (HFMA) Annual Meeting in Minneapolis this week. As this year’s keynote speaker, I promised those in attendance that the future of healthcare will be rife with opportunities to improve quality, broaden access and lower costs. At the same time, I cautioned that improving healthcare in the future will mean leaving much of medicine’s past behind.
In the past, we used to say that “all healthcare (like all politics) is local.” That won’t be true in the future, not with telemedicine’s ability to eliminate time and space as barriers to fast and effective care. Studies show demand for virtual care will increase by 38% over the next five years and that change will prove difficult for many in medicine.
In the past, doctors were taught to “save a life no matter the cost.” This mentality helped save lives, but also led doctors to over-test and over-treat patients. In fact, 30 cents of every dollar spent on healthcare is wasted on ineffective or unnecessary services. In today’s world, cost matters, especially as our nation digs out of an $8 trillion debt left by the Covid-19 pandemic. On average, Americans spend twice as much on healthcare as other wealthy nations, yet our clinical outcomes rank last among global peers. As insurers and payers look for ways to trim costs, healthcare-focused venture funds invested $89 billion in startup funding—with many bets being placed on new models of care that will revolutionize healthcare delivery while making healthcare more affordable and access. If doctors and hospitals don’t lead the process of transformation and figure out how to lower healthcare costs, they will be left behind. Others will step up in an effort to cure what Warren Buffett calls the “tapeworm in the American economy.”
Finally, medicine in the past was a universally fulfilling profession, offering doctors autonomy, mastery and purpose. But in the evolving landscape of healthcare, those intrinsic motivators are being redefined. Autonomy, which once stood for the independence and agency to decide a best course of treatment for patients is being replaced by evidence-based medicine and algorithmic care—for the benefit of patients but to the detriment of doctor satisfaction. Mastery, once defined by physicians as doing a little of everything, is increasingly defined by higher volumes of a narrower range of procedures with far greater expertise. The purpose of medicine, too, is changing as doctors are being called upon to maximize health and prevent disease rather than being lauded for their ability to respond in times of emergency.
Change is coming. And it will be difficult, especially for doctors who either don’t see it coming or can’t hear it knocking loudly on the exam-room door.
I would like to thank Joe Fifer, president and CEO of HFMA, for invitation and opportunity to speak in front of a lively and engaged audience during this year’s conference. Thanks also to HFMA national chair Tammie Jackson for her wonderful introduction and to policy director Katie Gilfillan for organizing an incredible event and making sure everything went smoothly.
The Healthcare Financial Management Association (HFMA), celebrating its 75th anniversary this year, is the largest finance leader focused organization in the country with over 75,000 members. HFMA members include finance leaders from hospitals, medical groups, insurance companies and the overall business community.
For leaders in healthcare finance, I highly recommend you attend next year’s annual meeting. I can guarantee it will be a superb educational experience.
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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Pearl’s newest book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients,” is available now. Follow him on Twitter @RobertPearlMD.
