editor’s
NOTE
Welcome to The Machine
Welcome my son, welcome to the machine.
Where have you been?
It’s alright we know where you’ve been.
You’ve been in the pipeline, filling in time
controlling too much of the market and dictating higher prices, as well as decreasing
consumer choice. Physicians for their part
grumble about having less freedom in their
practice of medicine and having to follow
the rigid guidelines of their new employers.
But an issue that consistently crops up in
our reporting is fragmentation—a lack of coordination
among practices, hospitals,
clinics, home health agencies, insurers and anyone
else who knows something
about the patient that everyone else needs to know. It
all boils down to transitions
between caregivers and facilities, and I’ve yet to talk to a medical or
information professional who thinks those
transitions are being managed well, by their
own organizations or their partners.
While it’s going to hit some rough patch-es, the transition to The Machine has the
potential to do a much better job coordinating that care, to the big benefit of patients.
Medical freedom will give way to consistency, certainly, but I’m not sure how much
anyone should worry about that payoff.
Pink Floyd used The Machine in the pejorative to wail about how society was grinding away at individualism. But what does
health care have to gain from maintaining
physician independence at this juncture?
That passage from one of Pink Floyd’s
signature songs is a segue into this month’s
cover story (page 24) focuses
on the current sprint by physicians toward hospital employment, which comes as
no big surprise.
A spate of compensation
surveys finds physicians
across the board, but especially primary care docs,
rapidly losing their financial
footing as ever-less money is coming in and
ever more is going out to shore up their information technology and billing infrastructures, pay higher malpractice premiums
and keep pace with increased demands
from insurers and patients.
It’s reflexive nowadays to lament the
passing of the little guy in our economy, be
it the Mom and Pop stories being put out of
business by Wal-Mart, or the solo practitioner who wants to practice medicine his or
her way without bending to the will of the
corporate suits at expanding multi-hospital
super health systems.
So independence is being traded for a
steady paycheck, an old story in this economy. It may taste bittersweet to many physicians, but I’ve yet to hear exactly what the
health care industry stands to lose.
Right now the consolidation is creating tension in some small markets, where
regulators are worried about health systems
EDITOR-IN-CHIEF Greg Gillespie
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