The healthcare disruptors scaring physicians 

Six healthcare leaders recently joined Becker's to discuss the biggest disruptors concerning physicians. 

Question: What healthcare disruptor is concerning you right now?

Editor's note: This response was edited lightly for brevity and clarity.

Luis Argueso. Partner at InHealth Advisors: The extraordinary rate of provider burnout is the most concerning healthcare disruptor to me. When combined with physician shortages, America's healthcare workforce is under enormous strain as the population ages and the demand for healthcare services increases. There are no quick solutions to this problem given the time to train new practitioners, although increases to the number of resident slots are a good start. Provider shortages will lead to delays in care and increased costs, at a time when healthcare is already hard to find and difficult to afford. This concern doesn't just impact patients; given the way healthcare is financed (through taxes for government payers or forgone compensation for employees), we all bear the financial cost.   

Brian Curtin, MD. Orthopedic Surgeon at OrthoCarolina (Charlotte, N.C.): Artificial intelligence has potential to completely disrupt the way healthcare is delivered in the foreseeable future with potential improvements in efficiencies as well as diagnostic accuracy.  However, the potential is also there for further erosion of the physician-patient relationship and overreliance on algorithm-based clinical decision-making that may in some instances result in worse patient care and outcomes. It's a very slippery slope that requires substantial oversight if it is to be implemented successfully.

Matt Mazurek, MD. Assistant Clinical Professor of Anesthesiology at St. Raphael's Campus of Yale New Haven (Conn.) Hospital: Artificial intelligence, bots and other novel technologies incorporating AI are already making an impact. My concern is the use of AI in healthcare needs to be evaluated and governed before unleashing its potential in clinical care. It is an unproven technology, and solving the problem of ownership of how it is used and to what extent it is used requires our systems to slow down and be very deliberate. For example, suppose AI is used in a diagnosis or treatment and the diagnosis or treatment is incorrect? Who will take responsibility for poor outcomes? Also, will patients trust and rely on AI for care and challenge a physician's diagnosis or treatment? There are legal and governance issues which need to be addressed first, and there are more questions than answers. The use of AI is the next revolutionary event not only in healthcare but in all aspects of our lives. I hope the technology is used properly and appropriately for the right reasons. Slowly incorporating the technology will assist us in addressing both ethical and legal issues. The potential for using AI in nefarious ways also needs to be appreciated.

Michael Meyers. President and CEO of Meyers & Gerard Medical (Manhasset, N.Y.): Optum, the large pharmaceutical distributor/pharmacy management company, also manages over 70,000 physicians in a variety of practice venues. They have other subsidiaries that are cloaked in other names that manage various specialties, i.e. Sound Anesthesia Services is owned by Optum, at least partially, which is of course owned by United Healthcare. Does it not strike you as a problem that the insurance company that insures so many of the patients also owns the doctor groups? Seems a bit counter intuitive to the checks and balances of good healthcare. This is the type of thing that bankrupted Envision, and it is only a matter of time before other physician management groups file as well. That way you can create a socialized medical system run by United Healthcare as a governmental surrogate. ... I'm sure they will be buying hospitals as well quite soon, those that are not bankrupt first. 

Smita Rouillard, MD. Associate Medical Director of The Permanente Medical Group (Oakland, Calif.): We've seen a huge number of physicians retiring at a time when the U.S. population will need more healthcare as they grow older and sicker. This is a concern as we were already facing a shortage of physicians, especially in primary care. Because of the pressures and challenges created by the pandemic, we're seeing more widespread adoption of types of changes we've been trying to drive for a long time — with a dramatic increase in virtual care options to increase the ease, convenience and accessibility of care.

Shlomit Schaal, MD, PhD. Executive Vice President and Chief Physician Executive at Houston Methodist: One significant disruptor in the healthcare industry is the use of AI and machine learning technologies. They are fundamentally changing the way healthcare is provided, with potential implications for the role of physicians and other healthcare providers. AI is entering all medical fields, specifically in ophthalmology and in retina, the field I specialize in. While AI can significantly enhance diagnostic accuracy, personalized treatment, and efficiency in healthcare, we must be mindful that we must find the balance between helping our patients and creating new problems.

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