What Worries You the Most About Our Healthcare System?

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We started identifying about a decade ago that there was a shortage of physicians. And more and more and we see primary care doctors decreasing. We see some specialists increasing around the chronic diseases but not enough to take care of the patient population that we have, and what worries me is that now affordable care act which I support moving from volume to value I support looking at outcomes improvement.

But a followed care act will bring 38 million patients that are going to rely on a primary care physician model, and it's probably going to take those patients six to seven months to get an appointment with a primary care doctor. So what is going to happen is that they're going to end up going back to the emergency department for primary care and when they are discharged from the emergency department, they are going to be asked to follow up with their primary care physician, and since that also is going to be a difficult one once again, they are going to end up coming back to the emergency department and those hospitals are going to be penalized for that readmission if it happens within 30 days.

Also what worries me is when I look at health organisations today, I'm starting to see that the fact that we're moving to a patient eccentric model is, making some of this health organisations think that the answer is to lay off people on the inpatient side to cut costs, and move more into the ambulatory mobile outside off the four walls of the hospital.

What they are not taking into consideration, is that you need a layer between the patients and the physicians and you could have redeployed those people into the ambulatory model and be able to manage that population health not only not laying off people and contributing to the economic crisis but eventually be able to hire more people and get more reimbursement from the new models.

So what we're seeing today is that there are certain healthcare organizations that are very visionary and they are realizing that this is the time that you innovate, this is the time that you bring transformation. Those are consolidating, they are acquiring more physician offices they are forming a kind of care organization with other organizations in the region and the once that are cutting costs by laying off people, they are the ones that eventually are getting acquired by the visionary ones.