Someone recently asked me: how do you think doctors will learn new things over the next few years?
I was puzzled by the question, because I think another bigger question precedes it: what is influencing how doctor’s practice medicine, taking up what little time they have and how will that impact how they learn over the next few years? Reality is, doctors are learning new things every day — and not just medicine! It’s not learning that is the issue, it is how they evolve in the face of such tumultuous changes and still stay on top of their medical news.
The list of what is consuming a doctor is pretty daunting, and I will illustrate the complexity of the following issues by using infographics to give some dimension.
The issues seem clear (and though I list several that I view as hugely influential, this is not exhaustive, though the topic is exhausting!)
1. HUGE practice pressures doctor’s have never seen before. Wolters Kluwer put out some disturbing findings from a bi-annual HCP attitudinal study (http://www.wolterskluwerhealth.com/News/Pages/Survey-Physicians-Reveal-Top-Challenges,-Financial-Management-Concerns-and-Focus-Areas-for-Next-3-5-Years-.aspx):
Physicians were also asked about likelihood to leave their current practice in the next one to two years. Findings show that 34 percent said they are very or somewhat likely to leave. The top reason is that it is hard to make their practice profitable, as cited by 29 percent of physicians. Another 15 percent say the field is no longer rewarding.
Among other findings:
- 83% of physicians find it challenging to keep up with the latest research
- 80% at least sometimes use browsers such as Google and Yahoo for information, coming in as the second top physician information source after professional journals (84%)
- 55% of physicians use both smartphones and tablets in their daily practice
- Primary uses of smartphones are accessing drug information (72%), communicating with nurses and other staff (44%), accessing medical research (43%) and accessing evidence-based clinical reference tools at the point of care with patients (42%)
- Mobile apps are the most heavily used digital/social media channel for physicians, used by 24%
2. Practice Technology/EHR: the shift from a human to technology-based practice. The looming Meaningful Use 2 guidelines, which will make information transparent (Meaningful) but the User Experience difficult (Use). And of course, when I bring up UX, the implication is that people will want to have an easy experience with their records across all devices/screens:
3. Becoming patient-centric: patients are being legislated to have more influence and control over their medical choices (despite lack of transparency, poor health literacy and FDA over-regulation of Communications.) What is more seminal is that patient-centricity will alter the current imbalance of the patient-physician dialog which is too fast, highly scripted, emotionally charged and not satisfying, and leaves patients with more questions than answers. Not that there aren’t a thousand good reasons for this imbalance, i.e. practice pressures, but it a reality that needs to, and will, change. Just read from Verilogue how dominant the physician is. Gee, wonder why almost 25% of Rx are never filled and adherence is low.
4. Patient Empowerment: Doctor as equal to patient, not the authority figure. This trend addresses this patient-doctor dialog imbalance — one that clearly impacts patient health. Ask patients how “transparent” they want their EHR Notes (specifically, their doctor’s unfiltered notes) to be, and this is one survey results:
5. ACA/Outcomes/Adherence: while 7 out of 10 doctors blame ACA for rising costs, the fact is, costs are not rising, but pressures are. But perception is reality. Now that the entire healthcare system shares one metric — “patient outcomes” — this brings a host of challenges to a model that always focused on new diagnosis and treatment but was abysmal with adherence, which of course has a direct impact on outcomes. Doctors will become deeply involved in adherence through EHR’s and other digital tools.
6. Mobile-Society: this seems like a technology challenge/issue but it isn’t. Mobile is about communication, it is our fastest form of satisfying our information needs. Doctors are incredibly adept now at moving between devices and are using them to squeeze in research time. Meanwhile. more and more patients are using mobile as a platform to search for health information, track their own health and seek peer influence from Social Media.
Unlike my typical blog post, I have avoided making my usual number of insights, judgments and recommendations. This was a context post. Letting the visualized data tell the story of a doctor’s struggles in a time of tumult is important if we are to understand the new stresses on doctor’s and how we still need to give them time to actually practice their craft.
We are in the middle of “turn-healthcare-on-its-head” time. To that end, I finish with a future-forward infographic that shows what lies ahead for patients and doctor’s and how the challenges the patient-doctor partnership face in the future will force a new — and hopefully better — dynamic relationship between the two: