What Is The Future Of Collaborative Medicine?

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Author(s): 
David Edward Marcinko, MBA, CMP, and Professor Hope Rachel Hetico, RN, MHA, CPQH, CMP

   Today, it is not uncommon to have three generations in a healthcare practice. We have the Baby Boomers, Generation X and now, Generation Y (also known as the Millennial Generation, Echo Boomers or the Trophy Generation). This newest generation of physicians has grown up with the Internet. They “get” the technology but do not always understand how to forge identities as physicians. Consultant Bruce Tulgan opines that Gen Y is going to be “the most high-performing civic-minded workforce in the history of the world, but they are also going to be the most high maintenance workforce in the history of the world.”6

   Gen Y is completely comfortable with Health 2.0 initiatives. Rather than trying to get these people to conform to traditional healthcare business models, they should be empowered to lead the way into the future. On the other hand, some Baby Boomers are saying with sadness, “Medicine sure isn’t want it used to be.” Generation X is saying, “It’s about time things changed.” The latest generation to enter the medical workforce, Gen Y, is saying, “Ready or not, we are here. Get used to it.”

   The era of Health 2.0 is not about controlling or dictating. It is about participation, empowerment and communication. Technology is not an end but the means to sharpen the questions a patient might ask when speaking to a medical professional.

How Will Health 2.0 Impact Podiatrists?

We believe the biggest implication of Health 2.0 for DPMs is through artificial intelligence. For example, soon patients may use a sophisticated search engine to input the following query:

    “I want to find a board certified female podiatric surgeon who’s done at least 100 Austin HAV repairs, who operates every Monday near my house, who takes my insurance at XYZ surgery center, and who has never been sued, speaks Farsi and enjoys playing the flute.”

   Instantly, results would be back with an offer to set up an appointment.

   What is the primary question going forward? Where on the Web do you want to go to interact with others about podiatry related topics? Is the digital podiatric workforce leading or lagging in adoption? Consider the following three potential scenarios.

   1. Patient centered care (demand-driven) versus podiatrist centered care (supply-driven). Patient centered care is the antithesis of command control podiatry, in which patients are engaged collaborators rather than passive followers. This market responsive model has the following characteristics.

• 24/7/365 access versus 9 to 5 banker’s hours
• Early technology adopters versus late technology adopters
• Patient selected caregivers versus practice/MCO selected caregivers
• Patient time sensitive versus patient time insensitive
• Low office overhead versus high office overhead
• Fewer full-time employees (FTEs) versus more FTEs
• Same day open access medical services versus appointment scheduling
• Quality care versus quantity of care
• Preventative culture versus repeated interventions
• Physician-patient satisfaction versus enterprise-wide frustration
• Next generation healthcare versus last generation delivery chain
• Generalists versus surgeons
• Professionalism versus merchantism

   2. The micro-podiatry practice business model. The emerging “micro-practice” model may be an ideal structure for podiatry given its limited body scope. A low overhead, technology driven, labor reduced, electronically connected and often mobile practice allows more doctor control and patient face time. It is ideal for those patients who pay cash, have a high deductible insurance plan or high co-pays. It is also ideal for an aging population and the renaissance of primary podiatric medicine on the horizon, despite some misguided surgical mavens and the Council on Podiatric Medical Education (CPME), which is too surgically oriented, or concierge practices.

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