Healthcare, like all things, is in a constant state of flux and evolution, with most of what is now accepted standard of medical practice arising only in the last century. When, how, and from whom we receive our care has changed drastically as advances in medicine, technology, and our understanding of evermore granular elements of the human body and its afflictions have changed how we interface with healthcare.
If you are of a certain age, think back to the first time you received your annual flu vaccination. It was likely in your pediatrician or family doctor’s office. That is just as likely no longer the case today, nor is it even the norm for most people.
“Who thought 20 years ago, getting your flu shot at Walgreens would be the norm, or now getting my COVID vaccine test at CVS, Jewel, or Walmart,” says Mobile Anesthesiologists CEO Scott Mayer. “That would have been so foreign and now it’s expected. Pharmacies are so much more than picking up a prescription and each evolution continues to be accepted given the convenience, cost, comfort, and simplicity of it.”
We are naturally skeptical of big changes in how we receive our healthcare. For many, the idea of receiving something as simple as an injection anywhere other than a physician’s office or hospital seemed once suspect. But the convenience, efficiency, safety, and affordability of pharmacy-administered vaccines eventually won over the public.
This was one of the first and biggest leaps forward in the push for true value-based care in the U.S., as the population no longer needed a scheduled office visit for their yearly flu vaccine which could cost them hours of their time and hundreds of dollars.
In the same vein, where we are receiving medical procedures, such as minimally-invasive surgeries, is further moving the needle in the right direction in regards to healthcare spending.
Colonoscopies, vein ablations, ACL repair, endoscopies, myomectomies, and the list goes on are all examples of procedures commonly done in physician offices and clinics today. More and more, these procedures and others are migrating out of HOPDs and ASCs and into in-office and clinic-based surgical suites. Physicians see higher reimbursements, more control over their schedules and improved professional lives, insurers pay far lower per procedure, and patients enjoy lower costs and the convenience that comes with treatment in their own doctor’s office not to mention the hours of time saved by everyone involved.
Adding to this migration are advances in surgical techniques, medical technology, and anesthesia that are making it easier than ever before for physicians to more wholly own patient and preventative care.
But what does the future hold in regards to procedures performed in offices and clinics? Quite a bit, explains Mayer, especially in terms of access to timely care and interventions, a lynchpin of value-based care.
“In terms of revolutionizing this, what’s very unique and so dynamic about the procedure suite, is it can be anywhere,” he says. “There are actually trailers that they build, they’re accredited trailers. They’re built for GI or pain management, they either have scopes for endo procedures or C-arms for pain injections. They’ll pull up to rural areas or attach to physician offices to provide these necessary and mainstay outpatient procedures where they don’t have surgery centers or hospitals within a reasonable distance.”
Rural areas aren’t the only places standing to gain from expanding procedural sites of service. Urban and suburban locales could see expanded options as pharmacies and paid insurance providers enter the patient care sector.
Just as one now gets that vaccination without hesitation at their CVS, Walgreens or Walmart, one may soon visit an in-house medical practitioner for a quick check-up or physical while shopping for groceries and filling a prescription. When access to care is made easier and more convenient, it follows that more people will receive needed health screenings and early interventions that can save both lives and dollars.
So, could the local pharmacy be a place where, in the not-so-distant future, we receive minimally-invasive procedures, such as colonoscopies and endometrial ablations, that help prevent more serious illness later in life?
“Site of service can mean anywhere,” Mayer notes. “That is where I think that, if you’re really going to be a disruptor, if you’re going to be really innovative, [you have to think] about it in that type of way, where you can have access to care for these procedures. Remember, the majority of healthcare dollars are spent towards the end of somebody’s life on the biggest illnesses they face including heart disease and cancers.”
As in-office and clinic-based surgical suites are already established practice in healthcare, the major hurdle to an even more radical shift in sites of service is educating physicians, policymakers, insurers, and patients on the safety and benefits that come from bringing this level of care closer to the public that needs and deserves it.
It will also require a vanguard of practitioners, healthcare companies, and insurers who eschew the status quo in favor of value-based care models rooted in wellness and preventative measures. Now is the time to act. We have proven with telehealth that we don’t need to wait longer for better, more convenient, and less costly care. Let’s accelerate the evolution of other value-based care models and initiatives that do the same and are waiting to be adopted and accepted when they are already proven.
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