Dr. Wes Fisher just framed something out in a way that I hadn’t thought about before. He essentially explained that Physicians were being herded into large groups run by Hospitals or other organizations. In his post, he characterizes this mass movement and the effect it will have on healthcare as “the Big Squeeze” referring to how savings will be extracted from the system. What is not clear is where such savings will be coming from, though traditionally the Physicians tend to feel the squeeze most, with actual level, depth and quality of care being the next pain point (no pun intended).
Physicians, Dentists, Psychologists, Physical Therapists, Diagnostic services, and myriad other Healthcare Professionals complain to us daily of the downward pressure on their salaries from employers, when they have them. Meanwhile, independent providers who offer amazing services direct to the public or contracted through employers are doing better than ever and making patients very satisfied. ”The Big Squeeze” is a good metaphor, but it is like squeezing a squishy tube, making a barbell shape. On one end is the harried doctor trying to get 40 patients in per day and the other is the independent Physician Group that is adapting by going direct.
Case in point: one of the best clinicians I know, who just experienced a 12.5% pay cut from his employer, just said to me, “I saw 26 patients in 7 hours. If I am only paid $XX per visit, that is all I can afford to give in that time.” Another recent report was from a world class Physician who was just advised that his research projects would be cut unless he could bring in more clinical revenue to fund them. Ultimately, the patient is who pays for the squeeze, both in time with the doctor and advanced care options.
Conversely, in New York and elsewhere, average premiums went up 12.5% this year too. Coupling these bi-directional changes, the problem looks more like “The Big Easy.” Obamacare shifts power to the Payer even further, leaving Physicians and Patients in the lurch. If efficiency is gained by consolidation, then why are insurance plans and hospitals the ones who have cost overruns and need premium increases to stay in business while patients pay more and Physicians get paid less?
The other end of the barbell is the path of Direct-Pay ‘Concierge for the masses’ Innovators like Garrison Bliss (Qliance), Mike Catausan (Exclusive MD), and Aaron Blackledge (Care Practice). This is a significant break from tradition and not everyone is prepared to burn their bridges yet (but boy do their patients rave about them!) The good news is that there is a happy middle that, while squeezed, can also do well. The difference is all about being better at marketing.
I realize that seems like a non-sequitur. Let me elaborate. Insurance companies deliver patients in exchange for low negotiated rates. Thereby, they are a marketing middleman. In fact, 30-40% of all insurance premiums go to marketing, administration, and profit, or, in other words, they stay in the insurance company. By comparison, 14% goes to doctors. If Physicians and Hospitals disintermediate the process and market directly to patients, we hypothesized, and are now proving, that it is possible to cut out 30% of the cost of care while being paid better and faster, with less work. The patients love it too because they finally get what they pay for, great care with a doctor who has time in this case.
We need look no further than dentistry as an example. Only about 50% of Americans have dental insurance because going direct is a viable option. There is competition in the marketplace and the best dentists command the highest fees. On average, Dentists do almost as well as Physicians according to the latest US government Bureau of Labor Statistics data (although I suspect the standard deviation is higher.) Your average dentist also operates with far less staff than your average physician. Why? Less administrative work related to being paid. In the end, dental care is far less expensive, highly innovative, and attracts great talent. Why? Because it operates in a relatively transparent and efficient market. FairCareMD helps dentists with marketing too to improve the efficiency there as well.
So the next question is, “how do we market directly to the public?” Doctors are trained as healers, not marketers. Everyone is searching online now for doctors but getting to the top of search is an expensive proposition and so are websites. We attacked this problem with the intent to disrupt the status quo. We broke apart the search algorithms and can now reproducibly put any provider on the top of local organic (not paid) search results for the terms they care about. Next, we made it almost free.
Designed by doctors, and owned by no one but my team I, we have set up a platform that allows all medical and dental providers to market very efficiently and be paid fairly without giving up your Insurance panels or engendering any risk. After fighting payers for years to get doctors paid better, the best solution, I concluded, was to solve the essential problem – that of inefficient contracting, marketing, and administration. Their costs are a burden on all of us and our system can help payers as much as everyone else by automating these processes.
You don’t have to give up your practice or panels, we merely provide a way to begin to change things in favor of doctors and patients. I agree, Obamacare or something like it was inevitable. The system needed change, but the Big Squeeze is just more of the same and the train wreck for doctors and patients is most definitely coming. One way to protect your practice and your patients from even faster visits with less care is FairCareMD.
Invest in the future of your practice by accepting more direct pay patients today. It will also help you attract insurance patients too!
As I promised, next steps are here:
You can just follow this link and sign yourself up OR we can facilitate:
1. Send your CV and photos of you and your office to FightBack@FairCareMD.com or Fax to (917) 832-1706
2. Tell us a little bit about your practice. No more than 500 words (email please!.)
3. We will configure your preliminary profile and set you up some offers for your practice. You modify to suit your needs and set your fair fee criteria. Put in your credit card info and wait a few days to get to the first page. We now have dozens of docs showing up position 1 in their zip codes, so we know it works. In some cases, we have the top 7 positions – all for one practice in that case. I kid you not, check it out.
Total time spent: less than an hour
Total cost: $30 a month. If you don’t like it, cancel at any time.
Then wait for your FairCareMD profile to rise to the top of search in a week or so and get more patients willing to pay fairly and directly.
Why is it so cheap? Because we don’t take the traditional marketing approach. We won’t be showing up at your office or taking you to lunch. We don’t have an army of marketers coming to detail you. We expect you or your staff to take over your account and treat it like a facebook or linked in page. (We do offer full service, but that costs extra.) Here you just get access to the best system out there for marketing your practice for less than a dollar day.
Call (954) FAIR-CARE today if you have questions.
Tags: Affordable Care, Cash-only Practice, change we can make happen today, Quality of Care
