This Is What Physicians Need To Do In The Evolving Healthcare World.
Updated: Jan 27, 2020
Physicians are increasingly dissatisfied with the multiple layers of bureaucracy and regulations that have complicated the practice of medicine. The general sense of unhappiness among physicians is palpable. To add to this we have all become familiar with the phenomenon of Advanced Practice Providers (APPs) replacing physicians at various organizations. The buzz on many physician blogs is how APPs are increasingly becoming a threat for primary care. Many institutions have been hiring APPs rather than expanding residency positions. There is hue and cry among many physicians. It is time for physicians to reassess their role in healthcare, rather than feeling threatened by a very important clinician-force (nurse practitioners or physician assistants). Practically most hospitals and practices in the country are hiring APPs to improve patient access to the clinicians. Let me explain.
Traditionally, a physician’s value in the health care industry has consisted primarily of the provision of quality healthcare to patients. Job security was never a concern, and there was always the option of seeing more patients to increase one’s earnings. Meanwhile, the healthcare landscape has undergone a transformation in recent times. Hospital administrators, pharmaceutical executives, operation managers, and insurance executives have come to the fore as part of the evolving healthcare system. APPs too have carved out a niche and have created value for themselves over the last several decades. It is increasingly evident that physicians are no longer able to maintain the same value to an organization as before by merely seeing patients. They must offer something beyond direct clinical care if they are to remain relevant and continue to be at the helm of the healthcare system.
Introducing innovation, improving efficiency, increasing patient satisfaction, and quality improvement are key to clinical care models. Although providing "doctor"-level care is the backbone of the healthcare model, the role of the above mentioned parameters has increasingly gained importance, and provide an avenue for physicians to mold their role and once again create value in this new health care landscape. Physicians who have contributed to or participated in these parameters have been able to assume leadership roles alongside their clinical duties. Those who have failed to realize the importance or even resisted the inception of these parameters are feeling more and more sidelined.
Interestingly, only 5% of leadership positions in hospital systems are held by physicians. Although many of the executive positions such as CEO, CFO, or COO are managed by administrators, there are numerous leadership positions such as CMO, department chair, clinic director, trauma director, stroke director, etc. that are in fact led by physicians or surgeons. Unfortunately many of these positions are determined based on seniority rather than true leadership potential or expertise. This bias is important to identify and correct since certain physicians may not have administrative or leadership skills despite seniority, creating a formula for poor physician-led administration and the resulting unfavorable downstream effects.
In summary, the idea that physicians will continue to maintain their value within the healthcare system by remaining in their traditional roles as healers is increasingly becoming obsolete. Physicians must contribute more than direct clinic care in order to create value and maintain their worth in their practice, hospital, or a healthcare facility. If physicians are to continue to thrive as an entity and feel valued, there is no choice but to step up their game in the twenty first century, or risk continuing to be dictated by their non-physician supervisors and bureaucrats and feel threatened by advanced practice providers. The importance of creating value as a physician in the new healthcare landscape is something that needs to be reiterated to all physicians and doctors-in-training.
Atif Zafar, MD
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Atif Zafar, MD is the author of the book "Why Doctors Need To Be Leaders: A Call To Action Amidst The Evolving Complexities of Healthcare". He is a neurologist, a researcher, an entrepreneur, an advocate, mentor, coach, and a life-long student of neuroscience and leadership. He can be reached at atifzaf@gmail.com.