With the Affordable Care Act and pressure from millions of Americans for comprehensive and accessible care, the fundamentals of the healthcare industry are going through drastic changes. But are physicians being trained to navigate healthcare’s changing landscape? Are doctors being educated on medical science and business fundamentals to cope with new legislation and policies. Doctor and Bench to Bedside program founder Noah Minskoff believes that changes to medical instruction could make a huge difference.
In a recent Forbes article, Kathleen L. Brown, a specialist in healthcare and regulatory manners, discusses the changes from the Affordable Care Act’s implementation during the policy’s first year in place.
Brown says, “On both local and national levels the old pay-for-service framework is giving way to a pay-for-performance model — creating new revenue streams for companies that previously weren’t directly involved in care delivery.”
Citing the expansion of the UCLA health system in the Los Angeles metropolitan area, Brown says the increase of primary care clinics established in conjunction with CVS Caremark are a direct result of Obamacare’s primary care incentives. She says, “It now pays to keep patients healthy.”
Physician Noah Minskoff advocates these priority shifts within the medical community.
“Physicians walk around all day and see tons of problems with the current standard of care that were delivering to patients, and we have an idea of how to make it better, but we don’t know what to do with the idea,” he says. “The process of taking an idea and translating into a meaningful change in healthcare practices is so daunting that these ideas seldom emerge as innovations.”
He says physicians need to understand the business aspect of healthcare in order to comprehend the Affordable Care Act’s effect on patient care procedures.
Minskoff’s program, Bench to Bedside, is a synergy of medical, engineering, and business students in partnership with one another. Its goal is to create new medical treatment products while teaching students the values of multidisciplinary thinking.
“Whats novel about the program is how it creates a collaborative team between these students with really different backgrounds and basis in their education,” Noah Minskoff says. “It creates a synergistic overlap so they can all bring their experience together and develop technologies that can really have an impact on the lives of patients and the healthcare ecosystem.”
Minskoff, the program’s founder, says Bench to Bedside was developed as a beta-test for the BioInnovate program.
In the program, student teams form “start-up” companies, and are given the task of identifying unmet clinical needs. They have access to over 100 University physicians from various specialties. These physicians serve as consultants.
“Through the education process, medical students are not taught anything about business or engineering. However, in order to solve many of the critical issues in medicine it requires that all of these disciplines collaborate and contribute in order to successfully bring innovative technologies to market,” Minskoff says.
Each team has six months and a $500.00 development fund to develop medical device concepts. During this time, students evaluate the IP landscape, prototype their design, and construct a business plan.
This type of innovation in healthcare may ultimately be the one thing that pulls American healthcare into the 21st century.
In another Forbes article detailing the changes in the healthcare industry’s priorities, contributor John C. Goodman compares care in the United States versus systems in other countries including the United Kingdom and Canada.
He says that patient spending in the US has actually decreased over the past 50 years, and that government spending has risen steadily.
“Over the past 50 years the share of medical bills paid by patients has steadily decreased. Over the same period the role of government has steadily risen – to the point where government spending now accounts for almost half of all health care spending,” Goodman says.
He attributes this anomaly to several factors including the incentive for a third-party payer that “naturally pits providers against insurance bureaucracies,” along with economic incentives to keep doctors from doing anything that costs insurers money.
Goodman says the government’s role in healthcare has become so pervasive that its procedures are dominating the market.
“For example, the vast majority of private payers use Medicare’s billing codes. That means that Medicare in many ways is in a position to determine how medicine is practiced,” he writes.
Given this disconnect between the fundamentals of patient care and the financial aspects, a shift in American healthcare’s priorities also requires a drastic analysis of the industry’s perspectives as well.
“The education system is so stove-piped, the fields of medicine, engineering, and business never interact in their training, and then you get out into the workplace and you have a lot of talented people who have no idea how to talk to each other,” Noah Minskoff says. “They don’t speak the same language, have no familiarity with how each discipline needs to contribute in the process of new technology development, and it creates this invisible wall where a lot of ideas don’t come to fruition because you can’t easily interact within those different disciplines.”