Issue link: https://viewer.e-digitaledition.com/i/1029344
The Business-acumen Imperative P H Y S I C I A N S W I D E LY P E R C E I V E the employed-physician model as one that largely frees them from operating a business. In a Medscape survey, nearly three in fi ve employed physicians cited avoiding the hassles of running a practice as a key benefi t. But employment is no get-out-of-the-business-of-medicine- free card, according to Robert M. Pearl, MD, former CEO of The Permanente Medical Group, and Alexander L. Fogel, MBA, an MD candidate at Stanford University School of Medicine. Writing in NEJM Catalyst, produced by a division of the Massachusetts Medical Society, they argue that understanding business is crucial to enhancing care quality and lowering costs. "Regardless of whether future physicians decide to work in a large healthcare system or solo practice, they will need fundamental knowledge and skills in three key business disciplines: leadership, teamwork and data analytics," Dr. Pearl and Fogel write. They see signs that medical education is meeting the chal- lenge. For example, students can now pursue joint MD/MBA degrees at almost half of U.S. allopathic medical schools. ■ — Steve Barrett I N A D D I T I O N T O the incalculable benefi ts of promoting healing and averting suffering, the approximately 737,000 physicians in the United States who provide patient care have a staggeringly positive effect on the economy, the "2018 AMA Economic Impact Study" reports. The study estimates that U.S. physicians: + Support $1 trillion in direct and indirect wages and benefi ts — roughly $1.4 million per physician + Generate $2.3 trillion in direct and indirect economic activity — about $3.2 million per physician + Directly or indirectly support 12.6 million jobs — 17 jobs per physician + Produce almost $93 billion in state and local tax revenue + Pay on average more than $126,000 each in total taxes "Physicians' impact is felt far beyond the exam room, reaching through local communities, producing a network of jobs and spurring local investment," the report states. ■ — Steve Barrett PER— CA PITA E X PENDIT URE S ON end-of-life care have been dropping since 2008, according to a study by The Dartmouth Institute for Health Policy and Clinical Practice and Dartmouth-Hitchcock Medical Center. The decrease helped moderate Medicare spending, the study finds. Spending declines occurred in areas such as inpatient care and home health. "Potential explanations include changes in supply — meaning doctors' efforts may have been redistributed from end-of-life care to care of patients newly insured under the ACA — or decreased demand for end-of-life care: Patients and their families may have adapted a more conservative approach in end-of-life decision-making," William Weeks, MD, PhD, MBA, lead author and Dartmouth Institute Professor, states in a release about the fi ndings. The recession may have played a role as well. It is important to assess how decreased spending is affecting the quality of end-of-life care, Dr. Weeks adds. The study appears in JAMA Internal Medicine. ■ — Steve Barrett Not a Cost Bogeyman After All? End-of-life Care: Physicians' Trillion-dollar-plus Impact 2 2❱❱❱❱❱ B U S I N E S S O F M E D I C I N E