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Practicing In A Post-ACA World

Fri, 03/28/2014 - 1:18pm
Mike Schmidt, Editor, Surgical Products

This article will appear in the upcoming April print issue of Surgical Products.

The debate is over...

The Affordable Care Act is law and the effects of the controversial, landmark legislation are beginning to take shape. Now all that’s left for the hospitals to do is react accordingly.

Without a doubt, addressing the impact of the Affordable Care Act is no easy task for hospital personnel. The reason for this is a simple one: No one really and truly knows what the future holds for the field of medicine.

Dr. David Rosen, President of Midwest Anesthesia Partners, however, has an opinion: The Affordable Care Act has forever altered the way medicine will be practiced in the future.

“Ultimately, it’s going to be a completely different animal in the next 10 years or so – and not always for the better,” he says.

Dr. Rosen’s concerns regarding the future of medicine are partially due to the prevailing feelings of uncertainty among he and his clinical colleagues about the Affordable Care Act and the fact that he’s noticed a “tremendous slowdown” in the amount care they have provided during the first two months of 2014. Furthermore, he adds, there is also a growing debate among healthcare providers about whether quality of care may be compromised.

As a result, Dr. Rosen and his colleagues are convinced that there has never been a better time for hospital facilities to closely examine their operations with improvement in mind. More specifically, this means taking a data-based approach to targeting inefficiencies and unnecessary cost, fostering better communication, retraining staff, and adopting key best practices.

“We do see this big emphasis on cutting costs, getting patients out sooner, and making sure that they don’t come back,” says Dr. Rosen.

One way this has been accomplished by Midwest Anesthesia Partners is through the implementation of a preoperative process that has dramatically reduced the number of same-day cancellations and same-day delays.

“We realize the surgeons are under a tremendous amount of pressure to get the patients out of the hospital,” says Dr. Rosen. “We are proud to always work with the hospital and our surgical colleagues to ensure that is possible. Efficiency is absolutely the key, and that means doing the most in the least amount of time with the quickest turnaround.”

If efficiency is the key to improvement, then effective communication is one of the means to achieve it.

“There is improved communication going on between the nursing teams, the surgical teams, and others,” says Dr. Rosen. “It’s definitely one of the positives of (the Affordable Care Act). We’re all talking to each other much more. We all have the same goals, but they haven’t always been on the forefront. Now people are communicating better.”

While he is quick to point out that these efforts were taking place prior to the passage and implementation of the Affordable Care Act, the uncertainty and consternation surrounding the law’s existence have made them all the more important for the medical community to consider and undertake.

“I don’t want to give too much credit to the Affordable Care Act because this is something we were talking about for years,” says Dr. Rosen. “We’ve made an effort over the last several years to improve care, even more than in years past. Certainly we’ve redoubled that recently because we see the tremendous scrutiny that we are all being placed under.”

One reality that Dr. Rosen expects to continue in the age of the Affordable Care Act is consolidation. Increased focus on cutting costs and meeting performance targets have led many physicians to sell their respective practices to larger entities. 

“Right now if you are a resident finishing your training, your expectation isn’t to be a solo practitioner, your expectation is to work for an entity, whether that’s a hospital, a healthcare system, or even a private corporation,” he states. “I think what you’re going to see is that is one of the unfortunate downsides of all this consolidation and focus on cost.”

However, there is still reason to be optimistic about the future of medicine. That's because, according to Dr. Rosen, the slowdown he and his colleagues saw during the first two months of 2014 won’t last.

It’s no secret the population in the United States is expanding and aging. That equates to more illnesses and ailments that will require treatment in the future, and healthcare providers must be ready and willing to meet that demand, he says.

Dr. Rosen and his colleagues have been working diligently to combat both the real and presumed effects of the implementation of the Affordable Care Act by addressing problem areas and inefficiencies, trying to reduce unnecessary cost, engaging in better communication, working to develop the skills of their fellow staff, and adopting key best practices.

“These are goals we’ve been working toward and will still hone in on and refine,” he says. “They are truly achievable and we’ve seen them happen.”


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