Careers in Anesthesia are Changing, with Opportunities Outside Hospitals
Careers in anesthesia treating non-hospital patients is at the cutting edge of technique and skill while offering greater work-life balance.
Put simply, value-based care puts the quality-of-care front and center. As opposed to current fee-for-service models that push quantity, value-based care is a payment model that uses effectiveness, a more holistic approach to treating a patient, and health outcomes to determine reimbursements paid to physicians, hospitals, and health systems.
Under a value-based care model, insurers incentivize doctors to improve the overall health of a patient, rather than treating a specific malady. This could include introducing wellness measures into their patients’ lives as well as prioritizing preventative care that reduces the risk of more serious illness later in life versus optimizing the number of tests, time at a facility, surgeries, and patient consultation in the former and current healthcare systems.
But in the complicated healthcare ecosystem of patients, physicians, health systems, hospitals, insurers, and lobbying groups, the above definition of value-based care is often distorted, says Mobile Anesthesiologists CEO Scott Mayer. While most, if not all, agree on the “Triple Aim” of better care, lower costs, additional access to treatment, and healthier people, just how to enact this varies greatly.
“If we’re going to use [the Triple Aim], we can talk about things in a way that I think physicians, insurance carriers, patients, everybody can be aligned. But what’s happening right now is that definition is getting skewed to how people want it to be portrayed, given their own personal priorities or objectives.”
-Scott Mayer
For instance, an insurance group may filter a value-based care approach through the lens of overall cost reduction. They may limit physicians treating patients under their coverage to a preset number of tests or medications or procedures. But such a myopic approach may undercut quality and telegraph to patients, physicians, and members that they have a flawed understanding of the whole of value-based care. Further, a preponderance of adverse outcomes would almost certainly drive that insurer back to a previous higher-cost coverage model.
Physicians’ groups, hospitals, and health systems, conversely, may overextend in terms of quality, ordering batteries of tests, medications, and procedures that, needed or not, bring in money. For physicians, their oath and significant liability ride on going above and beyond in the name of patient care. For the hospital, revenue must be generated, and when your business model is contingent on billable services, that is how it is accomplished.
It is then easy to see why value-based care, though theoretically an ideal goal for our healthcare system to work towards, becomes such an amorphous thing.
If the fee-for-service model is to be put to rest, then the most important factor to implementing an effective value-based care model is long-term alignment among the various players.
“If you’re going to move towards [value-based care], you’ve got to move into it in an aligned, cohesive and collaborative way,” says Mayer. “I feel everybody’s looking at it from just their lens and that’s what’s causing this very ambiguous, clouded definition. Because even if people believe, big picture, that is the definition of Triple Aim, access to care, reduced costs, quality, they’re all going about it in a way that’s easier and more personally selfish, kind of self-guiding, achieving their goals themselves, versus looking at it through other’s lenses and what’s best for the patient in the end.”
This alignment requires a big leap forward in how we operate our healthcare system for all parties involved. Insurers will have to restructure how they reimburse physicians and hospitals who will have to do the same regarding how they generate revenue and look at budgets. Patients will have to adjust to healthcare that is palpably different than what most currently experience.
Change such as this has, to a degree, already happened in healthcare. The COVID pandemic uprooted many aspects of our lives; a visit to see a doctor, either in their office or the hospital, was anathema to many people. Suddenly, telehealth, an option that insurers and other industry influencers had long resisted or put on the back-burner as too complicated or were nervous about the unknown consequences from the move, was the most viable way forward for many types of visits. With the pressure on, the government and insurers quickly figured out how to reimburse physicians for this variety of care and support the efforts, and what’s more, it is here to stay.
We learned, in this time of national crisis, that we can accelerate change in a big way without destroying our healthcare system. So, it begs the question, what more can be done? How will further disruption be enacted and in what form will it come? Mayer sees reason to be optimistic post-COVID.
“Some of the people in organizations that have fallen short disrupting healthcare, were really beaten down by the lobbyists and the politics and all the influence and power of health systems, insurance carriers, government, etc.,” says Mayer. “I think people are going to find their inroads, they’re going to find their channels, because it has happened before. I think as long as people have hope and they have evidence that it has happened before, it’s going to give them enough to at least try. I think that’s what at least is exciting is I think we do have generations of people that are opening their eyes to possibly that this could be done in a new way, in a better way, and won’t stop until they see the change that is so badly needed.”
Careers in anesthesia treating non-hospital patients is at the cutting edge of technique and skill while offering greater work-life balance.
With a nursing burnout crisis not looming, but here, what role can office-based procedures play in reducing stress?
Mobile Anesthesiologists' Dr. Heike Knorpp shares her insights on trust in the physician-patient relationship and how office-based procedures can impact that.
Alarms have long been sounding about the looming physician burnout crisis facing healthcare and the nation at-large. The pandemic only intensified feelings of depression, depersonalization, lack of professional satisfaction, and emotional exhaustion. The American Medical Association recent reported on findings of a Mayo Clinic study that found during the Omicron wave of the pandemic, a...
Expanding - not disrupting - sites of service broadens access while bringing down overall costs.
Dr. BobbieJean Sweitzer, past president of the Society for Ambulatory Anesthesiology (SAMBA), shares her insights on where the field is going
Dr. David Mayer shares insights into how critical protocols and safeguards can ensure office-based procedures and patient safety align.
Moving procedures into the office setting checks all the boxes when it comes to the quadruple aim.
Cost transparency benefits patients, providers, and payers, so why is the industry so averse to it? Tina Mentz share her thoughts on the importance of sunlight in healthcare spending.
Health systems need to differentiate from new players offering easier access and lower costs. Office-based procedures could be the key.
Office-based procedures have a proven track record of safety and myriad benefits for urologists, patients, and payers alike.
Office-based procedures are growing in popularity as a way for independent practices to grow. So what are the benefits and key considerations physicians must make to safely bring procedures into their own space?
Armed with a commonsense approach to lowering healthcare costs, anesthesiologist Dr. Marlon Michel is safely, conveniently, and comfortable helping dentists shift their sites-of-service.
More-and-more, medical procedures are being performed safely, conveniently, and affordably in physician's offices and clinics.
Today's post is part III of our ongoing series about moving procedures out of the hospital and into ambulatory surgery center and office-based environments. Today, we're discussing changing patient demographics and market signals.
Today's post is part II of our ongoing series about moving procedures out of the hospital and into ambulatory surgery center and office-based environments. We're discussing the contributing factors to the site of service shift, and its benefits to patients and doctors alike. Last week, we covered advances in surgical procedures and anesthesia. This time, we're addressing the rise of office healthcare technology.
Reason #1: ADVANCES IN ANESTHESIA AND SURGICAL PROCEDURES The modernization of anesthesia, particularly outsourced anesthesia, has played a clear role in the site of service transition to office-based procedures. The healthcare industry is undergoing a dramatic transformation. The past decade has seen a steady increase in surgical procedures moving away from hospital environments into surgery...