Healthcare is moving beyond the four walls of a physician's office and into the same places consumers buy groceries, toilet paper and holiday gifts.
Three orthopedic surgeons connected with Becker's to answer, "How do you feel about non-healthcare entities dipping their toes into the healthcare space?"
Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.
Next question: What is an orthopedic trend that you think is overrated and why?
Please send responses to Riz Hatton at rhatton@beckershealthcare.com by 5 p.m. CDT Thursday, Oct. 26.
Note: These responses have been lightly edited for length and clarity.
Philip Louie, MD. Spine Surgeon at Virginia Mason Franciscan Health (Tacoma, Wash.): We live in unprecedented times with various economic forces driving consumers (and in this case, patients) to change some of their fundamental behaviors. Inflation-wary Americans have started shifting more of their budgets away from goods, and toward services — especially healthcare. Health spending, which is projected to reach $5.2 trillion nationally by 2025 (according to CMS), has become an alluring growth avenue for many large retailers. This growing interest in healthcare among some of the country's largest retailers is coming at an interesting time — when American consumers are essentially pulling back on discretionary purchases in the face of persistent inflation.
How about from the healthcare provider perspective? Here is the ideal situation: Although U.S. healthcare largely continues to operate in a fee-for-service model, many of the investments by the big retailers are emphasizing value-based care — which theoretically could lead to a concentrated focus on prioritizing preventive care. Furthermore, the additional capacity and focus on in-home, specialty and primary care could not only improve access for underserved patients and those with limiting social determinants but could also help further advance pay-for-performance over fee-for-service. These retailers could also accelerate.
From an orthopedic surgery perspective, the verdict is still out. How will patients be properly worked up and referred? How will these retailers improve access to orthopedic surgeons — moreso, how will they choose which orthopedic practices to send their patients to? There will be a new push to demonstrate quality of care and maximizing outcomes — a la Center of Excellence Programs.
Alan Reznik, MD. Chief Medical Officer of Connecticut Orthopaedics (Hamden): The more healthcare becomes transactional, the less patients will have the warm and fuzzy feelings about their treating provider. The less power MDs will have in the system, the human touch will be replaced by episodic algorithmic care. The outliers, contraindications and reliable transfer of information will take a back seat to overarching standards. I worry that the ability to innovate will be stifled by the one-size-fits-all mentality based on older data because its proven, and newer treatments will not be approved. The constant scrutiny of the pre-approval process will cross the line for deciding treatments or indirectly, and de facto, become practicing medicine without a license.
Thomas Schuler, MD. Founder of Virginia Spine Institute (Reston): Healthcare requires compassionate, trained medical providers to do what is in the best interest of their patients. Strong ethics are essential to truly provide what is in the patient's best interest. The patient-doctor relationship is essential to the privacy and best medical decisions to be reached for each patient's individual situation. Large bureaucracies rarely achieve customized, individualized quality service. Profit margins and management costs negatively impact the patient's and provider's reality and experience. This is just a step toward business-coordinated socialized medicine. Probably some improvement over government-coordinated socialized medicine, but it is not the best care for the individual patient. Patients who desire the best care for their needs will not achieve their goals with big company systems.