What happens when small medical practices fail? Nothing good.
Here’s my interview with Dr. Nisha Mehta on advocating for healthcare professionals during COVID-19.
– Hey everybody, it’s Doctor Z. Okay, one thing that nobody is talking about in the media right now is what is happening on the ground to small physician medical practices around the country. And here’s the punchline, they are going out of business. So the independent doctors and nurse practitioners, PAs, everybody who’s hired in those little practices have suffered about a 50% or more decrease in the amount of patients they’re seeing because we’re still in this broken fee-for-service model where those doctors and staff only get paid when they see patients and do things to them. So if that’s the way we’re paid, which is dumb by the way, then those guys go out of business when COVID-19 hits even during a time when we need these frontline practitioners more than ever. Why is that? Because people are avoiding the doctor, because tele-health takes a while to spin up, especially for some of these smaller practices that don’t have those resources. They’re not paid that well for tele-health and only now is Medicare saying okay, maybe we should do something. And these type of businesses fall through the cracks of the kind of federal assistance that seems to prefer large companies that already have a ton of money. And so they don’t get the assistance that they need. And so what ends up happening? These ma and pa shops and larger groups of endocrinologists and gastroenterologists who are losing money hand over foot, a lot of these practices only have like three months of operating costs in cash to be able to support this. They’re having to lay off nurses and medical assistants and techs and others in the group. When the COVID crisis is over there’s gonna be nobody there. What’s gonna happen is what’s already been happening which is private equity companies and big, huge businesses are gonna buy up these remaining doctors. And what’s that gonna do? It’s gonna jack up the cost of care. This is a serious, serious emergency. Like all this B.S., the people are like, “Oh, you guys are heroes, healthcare practitioners!” Okay, put your money where your mouth is and help these people that are trying to help you. And the other thing is maybe it’s time that we overthrew the entire card of how this thing is paid for, right? Things like direct primary care where it’s a flat fee per patient per month to take care of patients, right? My friends at Hint Health and others, we at Turntable Health did that model. So it’s like a membership to a gym. So you can still take care of your patients without having to do things to them. Phone call, Skype, email, however you need to manage them, you can do it for that flat monthly fee. And those guys are doing a lot more stably in this environment, still able to take care of patients compared to their fee-for-service companions who are, by the way, burned out, morally injured, having to churn through high volume, do all the documentation. All that disappears in direct primary care. So there are ways to do this. We need better government support. We need to support these independent practices. We need to make tele-health a serious thing that’s reimbursed correctly. We need a national licensing body so that it isn’t just state to state to state, so you can actually cross lines when your patients are in different states. That’s the future. Every other industry does it. Why are we still stuck in the past? And when we talk about this people obsess in the media about oh, should we be using cloth masks, which is the stupidest thing I’ve ever heard. Why aren’t we talking about these frontline practitioners? And this is our chance to actually make healthcare better. So the call to action is this. Share this video, okay? Look into some links I’m gonna include about other ways you can help. Check out the interview I did with Nisha Meta about how we can support doctors who have these huge malpractice fees and all these other things and form a better collective around this. And it’s not just about doctors. It’s about nurses, and MA’s, and everybody who works in these practices. Or else the future of medicine after this is over, and I’ve talked about this is our opportunity to have change, the future of medicine is gonna be much worse than it was before this. And we can actually have the opposite happen. We can make it brighter if we pay attention now and never forget what’s going on now. All right, guys, I love you, we out!