The EHR vendor (and many other services), Kareo, has put out a practice model guide which they call “Practice Models: The ABCs from ACOs to Concierge and Everything in Between.” With this guide they shared this picture that includes various practice models:
When I see an image like this I’m torn on if this is an extremely exciting time for physicians or if it’s a miserable time to be a physician. One thing is clear, times are a changing. The medical practice models of the past are going to be blown up by new models.
Take for example Telemedicine. Can you imagine any healthcare future where telemedicine is not part of that future? I can’t.
I’m still personally torn on concierge practices. I can see why they’re appealing to so many. I love the idea of unlimited primary care and getting insurance out of primary care. However, it’s not clear to me that this idea can scale across the entire healthcare system. Certainly the rich can do it no problem. Can the concierge model work for the middle and lower class? Many fans of concierge tell me it can. I’m still not so sure.
I know a lot of doctors that are part of ACOs. I don’t know very many that are excited by the work ACOs are doing. Most of them just feel like they need to be part of it to understand the future of medicine. They’re not joining ACOs because they think it’s something that shows a lot of promise for their patients.
I’m probably coming off a little more cynical than I am about these shifts. A number of these changes are really exciting to see happening. However, I’m also not blind to the challenges that many of these medical practice models face.
Needless to say, it’s an exciting and challenging time to be in medicine. The structure of how we pay for healthcare is being questioned and new models are being explored. This can be really exciting if you find yourself tracking the right wave. However, if you miss the wave, then you can be stuck out in the middle of the ocean wondering how you missed out.