Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

5 things that confuse me about health care today

Praveen Suthrum
Tech
May 23, 2018
Share
Tweet
Share

Say we met ten years ago. And you asked me: Would health care delivery be more complicated in the future?

I would’ve said, “No, it would be simpler!”

Pointing you to technology trends, I would’ve told you that health care transactions will indeed become more automated, much simpler. Repeatable administrative tasks would be tech-enabled and algorithm-driven.

My company started life in billing claims for doctors. Back then I was quite sure billing would become less complicated in the future. Insurances and health care providers would want that.

But I was wrong. Actually, very wrong.

I would’ve never guessed any of these things that baffle me about our industry today.

#1: It would cost more for doctors to make the same money

There’s more work to be done for every claim. For example, doctors and their staff spend more time on prior authorizations than ever before.

While billing represents a bulk of the burden, there are many costs that add up. Such as technology, staffing or coding. Doctors are left with no choice but to meet these expenses. If they don’t, they don’t get paid.

#2: Health care law would get more and more complicated

On January 1st, 2017, a new law called MACRA went into first gear. It tracks physician performance.

MACRA adds to the long list of regulatory mandates that practices already need to comply with. The law is applicable to roughly 55 million clinicians. It’s 2,398 pages long.

We find doctors struggling to interpret the law, leave alone moving in the direction of incorporating mandates.

ADVERTISEMENT

#3: Technology, intended to simplify life, would end up making doctors miserable

Technology in the form of poorly designed EHRs adds to the burden of practicing medicine today. Some doctors feel that it hurts their relationship with their patients. Some quit medicine altogether unable to deal with the technology.

Mandates require that doctors use certified technology to document their cases. If they don’t, they will get paid lesser.

#4: Coding would be another avenue for insurances to delay payments

When ICD-10 arrived, clinical codes exploded to 155,000 from an earlier set of 17,000. Insurances have begun to demand greater specificity for codes that doctors submit.

For example, earlier you’d use 530.11 as ICD-9 code for Reflux esophagitis (a digestive disease). Under ICD-10, you have to get specific, and code “K21.0 – Gastro-esophageal reflux disease without esophagitis.”

Doctors aren’t used to documenting this way. So specifically. The result is more avenues for insurances to deny or delay claims.

#5: In a world of desperate medical need, many doctors would actually give up medicine

Burnout. Lack of enthusiasm. Depression. Long work hours. Increasing burden of bureaucratic tasks. There are many reasons for doctors to drop out of medicine.

To become a specialist doctor, you have to spend four years in medical school and nine more years to train under a specialty. Imagine the kind of frustration a doctor must face in order to give it all up.

Our long, messy path to the future

For businesses, it makes sense to develop products or services solving these problems.

However, I worry about the kind of long, messy path we keep traversing as an industry. A path that only gets murkier.

If we met today and you asked me the same question. Would health care delivery be more complicated in the future?

Pointing you to today’s technology trends in artificial intelligence or machine learning, I’d still say, “No, it’ll be simpler.”

Without question, health care delivery will be easier and more automated.

Maybe I’m stuck in a Groundhog Day. With an industry that repeats itself around me.

Praveen Suthrum is president and co-founder, NextServices and blogs at redo | healthcare.

Image credit: Shutterstock.com

Prev

To change the culture, start with clinical education

May 22, 2018 Kevin 1
…
Next

My spouse is your doctor. And there's no one else I'd rather share him with.

May 23, 2018 Kevin 5
…

Tagged as: Practice Management, Public Health & Policy

Post navigation

< Previous Post
To change the culture, start with clinical education
Next Post >
My spouse is your doctor. And there's no one else I'd rather share him with.

ADVERTISEMENT

More by Praveen Suthrum

  • What does colon cancer screening have to do with self-driving cars?

    Praveen Suthrum
  • Private equity in gastroenterology: Is it the future?

    Praveen Suthrum
  • Seeing the effects of the opioid crisis play out live

    Praveen Suthrum

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • America leads the world in high tech care and health care costs

    Mark Kelley, MD
  • Why health care replaced physician care

    Michael Weiss, MD
  • Health care workers should not be targets

    Lori E. Johnson
  • Health care is not a service commodity

    Peter Spence, MD, MBA

More in Tech

  • How I stopped typing notes and started seeing my patients again

    William S. Micka, MD
  • How AI is reshaping preventive medicine

    Jalene Jacob, MD, MBA
  • Why clinicians must lead health care tech innovation

    Kimberly Smith, RN
  • Why medical notes have become billing scripts instead of patient stories

    Sriman Swarup, MD, MBA
  • a desk with keyboard and ipad with the kevinmd logo

    AI in health care is moving too fast for the human heart

    Tiffiny Black, DM, MPA, MBA
  • Why AI in health care needs the same scrutiny as chemotherapy

    Rafael Rolon Rivera, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • Healing from medical training by learning to trust your body again [PODCAST]

      The Podcast by KevinMD | Podcast
    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • Healing from medical training by learning to trust your body again [PODCAST]

      The Podcast by KevinMD | Podcast
    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

5 things that confuse me about health care today
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...