Healthcare

• We’re seeing huge changes in healthcare. •  About 25% of patients used telehealth last year, far exceeding the 5% who accessed care this way before the pandemic. • Pharmacies with physicians present (like pet stores with vets present) • Physicians in private practice greatly reduced. • The share of doctors who worked in practices wholly owned by physicians fell from 60.1% to 46.7% from 2012 to 2022. • More people seeing nurse practitioners • From 2016 to 2021, the number of primary care physicians billing Medicare declined each year, from 142,000 physicians in 2016 to 135,000 physicians in 2021.  • Physicians tell me that the paperwork, reimbursement bureaucracy, and corporate demands are terrible. Example: 5-8 minutes allowed for patient questions during visits. • Some exceptions: dermatologists have modestly increased. There are no midnight emergencies for dermatologists. • Faith in the medical establishment has been undermined by the conflicting medical and political decisions during and after COVID. • Religious institutions, education, and medicine have all suffered damage to their integrity. • Patient costs are rising in terms of copays and over coverage denied by insurers. • The limited government data available suggests that, overall, insurers deny between 10% and 20% of the claims they receiver • When I consulted with RI Hospital it started every year in the red by $14 million because they were required to provide care to indigents. • Recent studies of medical errors have estimated errors may account for as many as 251,000 deaths annually in the United States, making medical errors the third leading cause of death. • Sepsis is a leading cause of death in hospitals. • Emergency room waits can be 12 hours and worse. • It wasn’t all that long ago that doctors were not washing their hands between seeing patients!

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