Glasgow Daily Times, Glasgow, KY

August 16, 2012

GUEST EDITORIAL: Change in healthcare business requires adaptation

Special report
Glasgow Daily Times

GLASGOW — Oh, these times of change. I have been troubled for quite some time about the rapidly changing life in which we live. Things have become so complex and complicated. We all know what I am talking about. Think about your days now and how complicated what used to be the simplest tasks have now become. It’s all around us in every aspect of life. No more simple handshake. We have strayed from the basics. Things move too fast and again have become very complicated. Well, our healthcare system has not been immune to this; it has been a prime example of it all. Our healthcare system and its delivery has become nearly impossible for us to all understand, much less carry out in a successful way. But, as has always been the case, we Americans will pull together and succeed. I am writing some of my thoughts now in an effort to help. I have been very troubled not only trying to deliver the best healthcare I can, but also trying to comply with all the ever-changing rules and regulations and trying to succeed as well as a small business owner. I am not alone which is why there is talk going around town. All of us as people tend to fear change. We resist it and it makes us uncomfortable. It even makes us paranoid. When that happens we just don’t succeed. We get angry, we lash out, we place blame, we just don’t get along.

It really bothered me to pick up our weekend newspaper and see not one but two articles divided on the front page and referencing what has been perceived as a problem between the hospital and the doctors in this community. Two articles opposite one another as if standing on opposite sides of a battle line. Well, that is just not the case. This is not about a battle between the doctors and the hospital. In fact, it is very naive to think that it is all that simple. This is a case of a rapidly ever-changing healthcare system and us living in it. We doctors not only provide care to our patients, but we have been running small businesses as well. And oh yes, that has always been true, but now the aspect of running the actual business has become far too complicated. We are experiencing the same poor economy that all businesses are.  Many patients have no healthcare insurance, and for those who do, their insurance companies don’t reimburse the way they once did. Even all of us with insurance are expected to actually pay much more out of our pocket than in times past and we all know the government (Medicare and Medicaid) funds are inadequate. We are experiencing rising costs of running the business as well, just like all business people. But also in healthcare it gets more complicated. We are talking about providing a service that we as American people feel is an inherent right of us all. We all feel we deserve it and that we deserve the best care right away. And, you know, as doctors that’s what we feel we should provide as well, but it has become very difficult and very frustrating to do that with all the new regulations and laws and forms to fill out and claims to process and re-process and, oh by the way, I forgot to mention the ever-threatening lawsuit lurking, which is usually filed not because of the occurrence of a truly negligent act but rather due to a bad outcome that this society, misled by malpractice lawyers, often can’t accept. So, we are all frustrated.

Well you know what? We can tackle this problem as American citizens and as fellow neighbors in Glasgow just like we have always tackled problems. You see, sometimes we get spoiled living here because even when there is change inevitable we still move slowly compared to faster-paced areas of this country and thus it doesn’t seem as painful. Unfortunately, these changes seem to be coming more quickly and part of that is actually because of our hospital system, T.J. Samson Regional Health including the T.J. Samson Community Hospital and its doctor group T.J. Health Partners. Our hospital is acting in a visionary way. They have recognized that we doctors are no longer going to be able to make it on our own in the “business” of healthcare. Because of that, they are paving a way for us to survive and you know what that means? We get to be “doctors” again. I can’t tell you what a strain it has been to be in charge of “running the business.” I have to be so in tune to so many things besides simply caring for my fellow man. It really has weighed heavy on my mind that I have begun picking up a patient’s chart and somewhat naturally started looking first to see what kind of insurance they have or whether they even have insurance at all. That’s not being a doctor, that’s being the “businessman.”

For months I have sensed this frustration, but couldn’t put a finger on how to fix it. In fact, I have even been in meetings with our hospital administration and had differing opinions, but once I realized we are all experiencing these same things and approached them in a way to allow us both to bring our strengths together in this effort, I found the hospital to have open arms. They want me to succeed and us to succeed as a team because that will mean that you, the local public, will benefit and be comfortable within this healthcare system. This is just one example of a huge benefit we will see here in Glasgow as doctors join a group such as T.J. Health Partners. Not only does that organization have more professional know-how in participating in today’s ever-changing healthcare system, they have the resources to do it and do it well. Another example of a successful approach in tackling the healthcare issues of today is the infrastructure and technologies that the hospital is able and willing to provide us as doctors so we can in turn use them on you as patients. The soon-to-be open T.J. Health Pavilion is such an exciting advancement for the delivery of healthcare here in our community and to look at it in any other way is only self-serving. Those who are resistant to all this change need to wake up and put their own self interests to the side and stand shoulder to shoulder with the hospital.

You know, when my dad started practicing medicine here in 1946 all doctors basically provided total care. They delivered your babies, they administered vaccines, they managed your blood pressure and diabetes and heart disease, they set your broken bones, met you in the emergency room and sewed you up or even took out your appendix or gall bladder. Well, imagine how they and the community felt when that first “specialist” came to town and announced “I am here to take care of just your heart.” Or “I am here to take care of just your bones.” Or “I am here to take care of just delivering babies and female needs.” That was change. Big change. I am sure it was met with resistance. Much like the advent of “hospitalists,” I am sure patients of my dad who still came to him for their other medical problems were a little leery of going over to see Dr. Bravo to have a baby or to Dr. N. Reddy to have their broken arm fixed. I am even sure that some of the doctors themselves were a little resistant to letting them go. But look now, there is a specialist for every problem you can imagine and we welcome that because we know that the concept of focusing on a narrower scope of problems is a better way of providing healthcare. Well then I would tell you not to be so afraid of some of the changes that are taking place. This is a rapidly changing healthcare environment that we are in and we must play the game to succeed and I believe we all have good things to offer so we should maximize our chances for success by getting along as fellow experts in the field and bring what we all do best to the table, share it, do it together and we will all be better off because of it.

M. Todd Marion, M.D., F.A.C.S.

Glasgow Surgical Associates —

Soon-to-be Affiliate, T.J. Health Partners