Blog | Tuesday, October 21, 2008

Visiting the dark side at MGMA

Learning about the business of medicine can be fun, even inspiring. I'm looking forward to writing up MGMA sessions on reducing no shows and improving the wait room experience for upcoming issues of ACP Internist.

But this afternoon, a couple of sessions wavered in the delicate balance between profit and clinical motives. First, a hospital exec who was trying to up his patient satisfaction scores explained how his organization told their docs to improve patient contact by thinking about "how you would do things differently if you valued the person in front of you." Implication being that the average patient previously had no value?

Then I went to a session on a topic that always riles our high-minded readers: medical spas and retail medicine. (I didn't mean to be there. The "Day in the Life of an EMR Physician" session was unexpectedly cancelled.) And it was painful.

The speaker (a lawyer) started off by talking about the impending primary care shortage. Which seems to me like an argument against spa medicine, since we might need those few docs who are left for real clinical care, but I suppose it's also a market opportunity. Anyway, apparently these spas are offering everything for which patients will open their wallets, from massage and Botox to hormone replacement therapy. Wait, isn't HRT a medical therapy that you should provide to patients based on the (substantial, hotly debated) evidence rather than the price they will pay? (I didn't get to ask.)

After a brief discussion of all those pesky regulations that medical boards and government regulators impose on the fortune-making possibilities of medicine, we moved on to retail clinics. The speaker predicted that more physicians will be getting offers to supervise in-store clinics that are staffed by NPs and PAs. The bad news is, legal constraints mean they might actually have to do work, like reviewing charts. "It's not just show up at WalMart every two weeks and pick up a paycheck," he said.

I know, physicians need to be paid, and medicine is still a capitalist enterprise (although after banking, who knows what's next). But after my foray into the biz of medicine, I'm ready to hop back over to clinical side of the wall.