Becker's ASC Review

24 THOUGHT LEADERSHIP The healthcare trends scaring physicians By Patsy Newitt F rom consolidation to physician shortages, seven physicians recently spoke with Becker's to discuss the healthcare trends they're wary of in 2023. Question: What healthcare trends are you wary of in 2023? Editor's note: Responses were edited lightly for brevity and clarity. Robert Chavez, MD. Internal Medicine Specialist at NYU Langone Health (New York City): e other trends that are concerning are poor payer behavior, predatory large emergency room groups, horrendous No Surprises Act process, artificially low Medicare and Medicaid payments and Kaiser Permanente cutting reimbursement between 40 and 70 percent. Eric Eskioglu, MD. Neurosurgeon based in Charlotte, N.C.: Currently half of practicing physicians are over the age of 55 and getting ready for retirement. With an increasing elderly population and demand for more complex medical issues, I see the physician supply versus demand coming to a head soon. I worry that the same trends which have become permanent in "traveling nurses" are emerging in physicians, especially with the millennials and Gen Zs. I expect to see more temporary physician demands with people opting for higher pay, more time spent with family and different geographical venues to combat physician burnout. I truly believe machine learning and artificial intelligence will be the way to overcome these issues. With medical knowledge doubling every 72 days, we need to relegate memorization and patient data search to artificial intelligence, lessen the cognitive burden on physicians thereby increasing the amount they spend on higher judgment problem-solving skills on their patients' healthcare. Marsha Haley, MD. Clinical Assistant Professor of Radiation Oncology at University of Pittsburgh School of Medicine: e physician and bedside nursing shortages have worsened since the pandemic. Some politicians use "quick fixes" for these issues instead of investing in long-term solutions such as increasing residency positions and investing in quality nursing education and nurse retention. One trend over the past several years has been to increase the scope of practice for non-physicians, resulting in the replacement of physicians. Taif Mukhdomi, MD. Interventional Pain Physician at Pain Zero (Columbus, Ohio): e healthcare trend I am most wary of in 2023 is that there may be less options for care for patients. With the growing trend of consolidating care under hospital systems, health insurance- owned care teams and private equity-backed provider groups, the future of healthcare continues to change. While the overarching goal of the healthcare system remains maximizing efficiency and outputs, not every aspect of healthcare can be managed as a business. Healthcare isn't and shouldn't be viewed as an "efficient" endeavor, since the human condition isn't always predictable. Declining reimbursements for private practitioners encourages formation of groups and consolidation to help providers sustain their practice models, but I fear consolidation leads to less competition: Certain sectors of healthcare don't face the challenge of healthy competition. is leaves patients with fewer options for care. With that being said, this poses a great opportunity for new private practice groups to take advantage of being nimble and thriving in the changing healthcare climate. omas Sweet, MD. Hematology and Oncology Physician at Southern California Permanente Medical Group (San Diego): I am wary of accelerating wages for healthcare workers except for physicians further exacerbating income prospects. In my field, I am also concerned about rapidly accelerating cost of treatments sometimes for marginal benefits. What the ASC industry will look like in the next 10 years By Patsy Newitt Three industry leaders joined Becker's to discuss what the ASC industry will look like for the next decade. Question: What will the ASC industry look like in the next 10 years? Editor's note: These responses were edited lightly for brevity and clarity. Leslie Jebson. Regional Administrator at Prisma Health (Greenville, S.C.): Continued evolution in surgical technique and anesthetics will continue to allow for higher- acuity, more complex procedures to migrate toward the outpatient arena. Cost containment pressures from payers will continue to encourage the movement to outpatient or one-day surgical/procedural interventions. Additionally, staffing and lifestyle considerations will continue to make the ASC environment one of the most desirable from a clinical and clerical support staffing perspective. Underutilized ASCs will introduce more cardiology and cardiovascular procedures. Some legislative changes at state-specific levels will influence the site of care. Anthony Kalloo, MD. Gastroenterologist and Chair of Maimonides Medical Center's Department of Medicine (New York City): More advanced providers performing endoscopic procedures like screening colonoscopy under the supervision of gastroenterologists similar to the model of CRNAs who perform anesthesia under the supervision of anesthesiologists. Erika Wilcox, BSN, RN. CEO and Administrator of Surgery Center of Boerne (Texas): The ASC industry is limitless. We have seen this through the last several years of higher-acuity cases being performed in these settings with arguably better outcomes and satisfaction than inpatient stays. Total joint replacements, spine cases and cardiovascular service lines are prime examples. While patient selection is key, candidates who would have been an immediate "no" for an ASC setting are having their health barriers addressed and becoming great candidates. n

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