The healthcare sector has experienced unprecedented change over the last ten years. Similarly, the roles of physicians have tremendously transformed during this period. Specifically, Salmond & Echevarria (2017) state that increased roles of physicians at the hospital level has contributed to the need for more doctors. Although medical schools have increased their capacities of producing doctors, the increasing populations have ensured that doctors continue to be in high demand not only in the US but also in all other parts of the world. According to Hall & Lord (2014), primary care physicians have started to play the role of gatekeepers ensuring that they regulate the access of the patients to the specialists. Additionally, private practice has been affected by the passage of Patient Protection and Affordable Care Act (Obamacare) which has expanded insurance coverage and thereby tied the payments to physicians in private practice to quality and efficiency (Hall & Lord, 2014). This paper makes an analysis of the different ways in which the traditional roles of healthcare professionals have evolved over the last ten years.
Gone are the days when healthcare practitioners could be seen carrying their black bags and making house visits. The last decade has seen doctors transform into using technology rather than having to meet the patients physically (Salmond & Echevarria, 2017). There has, however, been a rising demand for new dimensions of healthcare delivery. Specifically, physicians have to see as many patients as possible so that they can make up for the small amounts of reimbursements. Doctors are increasing finding out innovative ways of meeting with their clients to supplement their pay. Hall & Lord (2014) opine that the quality and efficiency of the services offered by physicians have been the key factors to consider in evaluating the role of doctors. Over the last ten years, doctors have started to be paid based on their ability to have an effective as well as efficient communication with their clients and ensure that they comply. This practice is different from that of the past where the role of physicians was to offer services to the patients, and the matter of compliance was not the concern of the doctors (Hall & Lord, 2014). The increasing demand for healthcare services has seen doctors change from face-to-face meetings with their patients to the use of technology.
The healthcare reforms brought about by Obamacare have served to make private practice unsustainable as the traditional models of practice obsolete. Specifically, the expanded insurance coverage has ensured that quality metrics are used in making hospital payments to the physicians (Hall & Lord, 2014). Quality has been more empathized as neglect by private physicians to report quality measures and adhere to the Accountable Care Organizations (ACOs) attracts penalties. It has recently been hard for the private practice doctors to afford the critical investment required in the achievement of the current delivery models. In an interview with physicians in 2008, 84% of the 12,000 physicians interviewed indicated that their income from practice was flat or decreasing (Tilburt et al., 2013). Additionally, more than 90% reported that their morale was negative. As a result, those in private practice have encountered a hard time since the passage of the 2008 health reforms brought about by Obamacare.
Physicians are moving towards group practice to negotiate advantages, increase profits and ensure improved quality of healthcare. Currently, according to Salmond & Echevarria (2017), a majority of doctors are working in group practice in the form of midsize and single specialty groups. The deployment of physicians in large healthcare organizations and the requirement to use integrated delivery systems have necessitated large group practice. However, the challenges that have arisen in these groups is the failure to offer information on the formal constituents of a group practice as well as failing to regulate the sizes of the group practice (Kash & Tan, 2016). Insufficient evidence exists in literature to show an overview of group practice trends. The situation has worsened from the reimbursement cuts to the Medicare amounts to the physicians. The cuts, which started with a 21% rate, have been responsible for the small payments that the doctors have been getting (Tilburt et al., 2013). The reasons given for the cuts were that the amounts would be used to reduce the costs of healthcare. However, in the view of Kash & Tan (2016), this action greatly affected the motivation of the physicians, as it is a significantly reduced the reimbursements that they received after offering their services.
In conclusion, the last ten years have seen tremendous changes in the roles of physicians. Specifically, the health reforms brought about by Obamacare have had huge effects on the roles of doctors. More specifically, healthcare practitioners have started to favor group practice to increase their profits and health care quality. However, the challenge has been the failure to provide a formula for the composition of the groups as well as their sizes. Additionally, the current regulatory framework has been unfavorable to private practitioners who have to deploy current models of delivering their services including Accountable Care Organizations (ACOs). The focus on payment has been on the quality and effectiveness of healthcare making physicians more focused on quality. These changes coupled with the increasing need for health services has significantly affected the roles of doctors.
Hall, M. A., & Lord, R. (2014). Obamacare: what the Affordable Care Act means for patients and physicians. Bmj, 349(7), g5376-g5376.
Kash, B., & Tan, D. (2016). Physician Group Practice Trends: A Comprehensive Review. Journal of Hospital & Medical Management.
Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopaedic Nursing, 36(1), 12-25.
Tilburt, J. C., Wynia, M. K., Sheeler, R. D., Thorsteinsdottir, B., James, K. M., Egginton, J. S., ... & Goold, S. D. (2013). Views of US physicians about controlling health care costs. Jama, 310(4), 380-389.
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