'Business of medicine' turning physicians to factory workers, physician exec says

Administrative and financial expectations for physicians are increasing, and Vikas Patel, MD, says they're affecting care quality. 

Dr. Patel is the executive vice chair of University of Colorado Medicine in Denver. He joined Becker's ASC Review to discuss the biggest threats to physicians. 

Editor's note: This piece has been edited lightly for clarity and brevity. 

Dr. Vikas Patel: The biggest threat facing physicians right now is the business of medicine. Medical care for physicians has become much more of a business from every aspect compared with what used to be the 'art' of medicine. Physicians are now pressured to see more patients in the clinics and document more irrelevant aspects of the visit, far more than spending time getting to know their patients and understanding their patients' problems. Office procedures, such as injections, add to this, as injections garner more reimbursement than just an office visit, not to mention the "ancillaries" of imaging, physician therapy, etc. All of this pressure comes from decreased reimbursements and a need to cover the "overhead" costs of a practice. So if costs go up, physicians are pressured to increase throughput and find other ways to cover the cost of patient care.

This aspect increases when it comes to the inpatient and surgical aspects of medical care. The pressure to do more surgeries and do them faster rather than focusing on the best outcomes increases. This also adds pressure to physicians to market themselves more and better and to jump into sexy new treatments that have not been proven to be effective. 

What’s even worse is the increasing trend of hospitals employing physicians. This, then really becomes a business employment and the primary goal of any business (even nonprofits) is to generate revenue. Physicians are then the focus to see more patients and pressured to do more procedures and surgeries. This becomes even more of a factory mentality with a tremendous focus on throughput.  

When you pair this with the trend of hospital reimbursements regularly increasing and physician reimbursement decreasing, this last trend of physician employment will inevitably continue. Physicians won’t be able to survive in private practice, and they will have to resort to hospital employment. Thus, the business of medicine is swallowing up physicians and making them factory workers.

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