Transitions In Healthcare Do Not Mean Lower Standards?

Submitted By pamhucks
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Transitions in healthcare do not mean lower standards
By Pam Hucks
The intent of the Affordable Care Act (ACA) was to provide health care coverage for the 30 plus Americans who had none. American health care has been facing workforce shortages for decades and is not prepared to handle the massive increase in patient care either efficiently or effectively (Anderson, 2014, p.1). The aging baby boomer population is adding a strain to healthcare with more complex medical needs, chronic issues and comorbidities. There are not enough available to offset the influx of new customers or oversee the increased care needs of the aging population. Medical schools are increasing their enrollment, but the number of qualified professors and instructors and the number of residencies has seen little change. As hospitals tighten their financial belts or close their doors, the chance of increasing residency opportunities dwindles. Health care systems are struggling to stay financially stable in a time when hospital volume is down and the push to do more with less is up. Pressure to meet pay for performance and value based standards is creating tension between physicians and administrators. There is a need to control and measure quality, improve patient satisfaction, and to reduce adverse outcomes and medical errors in order to qualify for reasonable reimbursements (Doulgeris, 2014). Medicare reimbursement requirements have already moved from fee for service to pay for performance and implemented the Physician Quality Reporting System. The ACA is expected to follow this path. Many physicians in single or small practices are finding themselves going from employer to employee in order to continue their practice. The image of being an independent, financially secure physician is changing, and the new image is less appealing. A recent survey revealed that one third of the physicians questioned, if given a choice, would choose another profession outside of medicine, and nearly 60 percent would not recommend medicine as a career (Anderson, 2014, p.11). Dissatisfaction includes loss of autonomy in practice, overloaded schedules, limitations by managed care organizations, government requirements to qualify for payments and to avoid penalties, higher malpractice rates, and frustration with the current instability in healthcare finances. All of the changes and limitations in healthcare will undoubtedly affect decisions to pursue a career as a physician. They will also affect the decision of current physicians as to how long they remain in practice.
Healthcare is in a transition. The Association of American Medical Colleges has predicted that within the next ten years there could be a physician shortage of around 90,000 (Bernstein, 2015). Utilizing more advanced practice nurses and physician assistants may help lower the shortage, but as the shortage impacts care, concessions will have to be made. Collaboration between health systems, providers, payers, and government agencies will have to occur. It is not likely that these concessions and collaborations will include allowing low performing individuals to become health care providers or that health care quality benchmarks will be lowered just to put doctors in the office. Pay for performance will most likely continue to be the standard for payment and those standards need to be maintained if there is to be any accountability in health care. American
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