Category: Physicians

Is radiology doomed?

published date
October 7th, 2016 by
fear-courage-tablet-shows-scared-or-courageous-100287697
Which path to take?

The radiology profession is a famously paranoid lot, often worried about encroachment on imaging from non-radiologists, competition from teleradiology, reimbursement squeezes, and more. Auntminnie.com is a good place to go to observe how these worries play out.

The latest article, Will machine learning turn radiologists into losers? is a case in point. It reports on a New England Journal of Medicine article that asserts that machine learning will replace radiologists. Images will be sent straight to algorithms, bypassing radiologists completely, they say. There are differences of opinion on how soon this will happen, but an appreciation that once the electronic tools are good enough they will be preferred.

As a patient I’m all in favor of faster, more accurate, and cheaper interpretation of images and if that means there’s no future role for radiologists, so be it. But actually what I hope is that radiologists start to assert themselves as diagnostic quarterbacks, helping to organize and analyze information from pathology, genomics, lab tests and physical examinations. They can work with teams of clinicians in new ways, to speed diagnosis and treatment decisions.

I am aware that some enlightened radiology leaders are already thinking in these terms. I hope the fears spurred by the development of machine learning will accelerate the movement.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

——-

By healthcare business consultant David E. Williams, president of Health Business Group.

Dr. Joshua Newman, GM for Healthcare at Salesforce, discusses telehealth solution

published date
September 6th, 2016 by
Dr. Joshua Newman, MD, MDHS, Chief Medical Officer, Salesforce
Joshua Newman, MD –Salesforce’s Chief Medical Officer

I really like Salesforce’s Health Cloud approach to patient engagement and am excited to see the company add telehealth to the platform. I caught up recently with Dr. Joshua Newman, who is Chief Medical Officer for Salesforce and also General Manager of Healthcare and Life Sciences.

In this podcast interview we discussed the following:

  1. (0:12) How has the rollout of Health Cloud gone since our last discussion about a year ago?
  2. (2:03) There are other telehealth offerings on the market already. Is the new Health Cloud offering different or better?
  3. (4:21) Who is the target user? Is the telehealth solution aimed at particular types of providers or patients?
  4. (6:55) Is there a return on investment? What drives it?
  5. (9:02) Is this mainly a mobile solution?
  6. (9:55) How does the telehealth solution fit with other Health Cloud offerings?
  7. (12:38) What else can we expect from Health Cloud over the next year?

I came away with the conviction that there is the potential for significant impact as the platform matures, health care-specific partners are brought on board, and as customer/patient engagement practices in healthcare catch up with the rest of the economy.

I’m looking forward to hearing more, especially with the big Dreamforce conference coming up in October.

By healthcare business consultant David E. Williams, president of Health Business Group.

Are men comfortable with female physicians? Other factors to consider

published date
September 2nd, 2016 by

female-doctor-with-stethoscope-around-her-neck-100147037

Nuzzel showed me that my friends have been sharing a new athenainsight: Are male patients comfortable with women doctors?  The post uses athenahealth billing data to demonstrate that male patients are less likely to return to female physicians than they are to male physicians, but for female patients the sex of their doctor doesn’t make a difference.

Athena’s conclusion is that men may be “less enthusiastic than women about seeing physicians of the opposite” sex. The article links to a Quora exchange, where all the respondents indicate that as patients they are equally comfortable with women as they are with men.

These findings are interesting, but I don’t think they tell the whole story.

When my long-time primary care physician retired I looked for a new doctor. I believe in the value of long-term relationships so wanted to pick someone I could be with for 15 years or more. I wanted someone affiliated with my preferred health system, with excellent clinical and at least decent communications skills, and around my age (late 40s).

My retiring physician recommended a female colleague in a practice close to where I live, who fit the bill. He had been involved in her training and had worked with her.

Like the Quora respondents, I was comfortable with being examined by a female physician. As I’ve written, I’m also comfortable being examined by a physician who is a friend.

But, although it was further down my list of criteria, I did have the sex of the physician somewhere on my list of factors. Why? Because at least on average, men work more hours and retire at an older age, making them more likely to be available to patients when needed.  One survey showed that 44 percent of female physicians worked part time, compared with 22 percent of men. Another showed 25 percent of women compared to 12 percent of men.

My personal experience reinforces those statistics. The recommended primary care doctor works part-time. Other  female physicians my family sees have taken time off to care for sick family members and attend to other family issues. One retired in her 40s to take care of sick parents. Working less or taking time off doesn’t make them bad doctors or bad people –quite the contrary, it may even keep them fresh or help them stay connected with patient needs– but it does have an impact on availability and longevity of the relationship.

In the end I chose the female primary care physician my retiring doctor recommended, and I plan to stay with her. But I’m also adjusting my expectations about primary care. For one thing I’m focused more on the relationship with the overall practice, rather than just with my personal doctor.

The practice seems to do a reasonable job of working together as a team, and I hope this will serve its patients as well or better in the long term than the more traditional and familiar one-on-one doctor/patient relationship. If it doesn’t turn out that way then my likely next step is to switch to a concierge practice rather than seek out a male physician.

Image courtesy of stockimages at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Sutter's Dr. David K. Butler on EMR-enabled transformation

published date
July 21st, 2016 by
AAEAAQAAAAAAAANJAAAAJDc5NTY4YWViLTM4NTctNGI1Mi04YjlhLTg1Mjc4NDAxMzNkNg
Dr. David K. Butler

Dr. David K. Butler came to healthcare as a digital native, unwilling to accept the paper-based status quo. In about a decade he went from using Microsoft Word to make medical notes legible to being named Epic Systems Physician of the Year for his contributions to the field of EMR implementation and optimization.

Butler is VP of EHR Optimization and Transformation at Sutter Health. In this podcast interview, I asked him to share his opinions and expertise. You’ll hear interesting perspectives on workflow, video games, and more.

  • (0:13) You went into medicine to be a practicing physician. How did you get interested in EMRs?
  • (2:58) EMR implementation has supporters but also detractors. What do you say to people who complain that EMRs have ruined the practice of medicine?
  • (6:36) In a decade you went from your first insight on electronic record keeping to being name Epic Physician of the year. How did it happen? What does it mean?
  • (9:32) How do video games fit into your view of how an EMR should operate?
  • (12:50) You work near Silicon Valley. What are you seeing from startup companies there? How do you advise them?
  • (16:18) What changes do providers need to make in EMR utilization as they shift from fee-for-service to value based payments?

By healthcare business consultant David E. Williams, president of Health Business Group.

Worksite clinics 2.0? Interview with Crossover CEO Scott Shreeve

published date
March 21st, 2016 by

ID-10023490

I first encountered Dr. Scott Shreeve about a decade ago when he put forth an expansive framework for Health 2.0. We caught up again recently to discuss his next generation worksite clinic company, Crossover Health. I really enjoyed the podcast interview and am bullish on the company. Here’s what we discussed:

  1. (0:10) How does Crossover compare to a traditional primary care practice, patient centered medical home, concierge practice, urgent care center or traditional worksite clinic?
  2. (0:54) You have an onsite model and near site model. How do they work?
  3. (1:59) Many workplace clinics are for very large companies. What size of companies do you work with?
  4. (4:17) What companies do you work with? What is your geographic focus?
  5. (5:34) Is it mostly for younger, tech employees or does it vary? Do you adjust the way the clinic is set up if it’s for a different population?
  6. (7:32) You make a big deal of calling people “members” instead of patients, and you can charge on a PMPM basis. Are those two things related?
  7. (9:57) You compare your cohort v. a traditional cohort, and do fewer referrals. Why is a low referral rate good? How do you handle the referrals that do occur?
  8. (12:11) Primary care is a burnout job. What kind of clinicians do you attract? What is your value proposition for them?
  9. (14:36) What technologies do you leverage? How fundamental is technology to your model?
  10. (16:33) You had a recent investment from Norwest Venture Partners? What’s the reason for taking investment? And why Norwest?
  11. (18:18) Why the name Crossover Health?

Image courtesy of renjith krishnan at FreeDigitalPhotos.net

—-

By healthcare business consultant David E. Williams, president of Health Business Group.