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9 Issues Facing Doctors in 2013 (and After)

Joe Cantlupe, for HealthLeaders Media, December 27, 2012
  1. Overutilization. Whether it's stents, angioplasty, or spine and cardiovascular surgeries, excessive and unnecessary clinical procedures are creating a growing uproar among doctors themselves, as well as academics, and in some cases, government investigators. In a recent speech, Don Berwick, MD, former administrator for the Centers for Medicare & Medicaid Services, said 50% of stenting and coronary bypass surgeries performed today don't resolve symptoms and don't extend life or prevent heart attacks. Stents are under the microscope now more than ever, especially with the recent focus on the for-profit hospital chain HCA in the wake of a New York Times report. Then there's the tendency for physicians to fall in love with expensive medical devices, particularly implantable ones used in cardiology and orthopedic procedures, and the companies that make them. A General Accountability Office report points out potential problems of the physician–device maker connection.

  2. Embrace the data. More than 69% of primary care physicians reported using electronic medical records in 2012, up from fewer than 46% in 2009, according to a Commonwealth Fund report published in Health Affairs. Yet the presence of this technology is among the reasons U.S. doctors are moving out of their existing private practices and toward hospital employment, according to a report from Accenture. For physicians to fully embrace EMRs, health systems must improve record-keeping and quality controls, Goodman says. "From a doctor's perspective, they are being bogged down in collecting information as well as compliance issues," hesays.

  3. Malpractice malady. The HealthLeaders Media 2012 Industry Survey shows that a whopping 58% of physician leaders said they ordered a test for a procedure primarily for defensive medicine reasons in the past year. But their worries may make things worse, keeping mistakes under wraps or encouraging too many tests or procedures

  4. Teamwork. Team-based protocols and efficiency approaches are more and more important today. "One of the problems of medicine is that a lot of people are very stuck in their preconceived notions of what is right and wrong, and things are not as well understood as one would hope," neurologist Thomas Hemmen, MD, PhD, director of the stroke program at UC San Diego Medical Center, recently told me. Another physician leader, Michael J. Dacey, MD, FACP, senior VP for medical affairs and CMO for Kent Hospital in Warwick, RI. told me earlier this year that doctors "must be more collaborative, work as a team. There's a different-mindset."

For physicians looking ahead to the New Year, that about says it all.

Maybe politicians should take a page from this playbook, too?


Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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