Obamacare’s effects on private medical enterprise…

See on Scoop.itObamacare’s effects on private medical enterprise…
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Dr. Michael J. O’Connell, PainCare, New Hampshire‘s insight:

Many folks ask for my thoughts on the effect Obamacare will have on the healthcare industry’s private medical enterprise in particular.  My answer is complex, and just like anyone else’s, uncertain.  Even the survival of Obamacare as healthcare law is very much in doubt.  Regardless, it is evident that Obamacare has set in motion may concepts, actions, and reactions that have made the future of private medical business a Risky Business at best.  Here are four key examples, all direct products of Obamacare that we have observed in my business environs that I feel are critical determinants of our success in the future:

Evidence based medicine – This concept received its nascent energies during the G. W. Bush era, and is heavily embraced by the Obamacare doctrine. The intent is to stimulate the use of treatment that is supported by solid scientific evidence, and discard treatment that is not well supported.  This sounds wonderful in theory, but breaks down miserably under analysis and application.

“First, we could debate the definition of “solid scientific evidence.”  Practically every scientific article ever written has an element of bias or has inherent weaknesses; many articles are not and some cannot be double blinded/randomized controlled in format; and all articles are products of humans treating humans.  The latter is possibly the more contributory to the difficulty in pursuit of “solid scientific evidence.”

“Second, our society promotes the concept of treatment for a malady, and a pill for a cure.  This notion conflicts dramatically with the lack of solid medical evidence for benefit of many thousands of “standard treatments,” antibiotic and statin therapy among them.  Will our society even tolerate the “no treatment option?”

¨Third, all the science in the world, even if solid and tangible, cannot be assumed to be applicable to end of life situations.  We spend a ghastly inordinate amount of healthcare dollars during the last year of life, suggesting wastefulness of an astounding order.”

2.   Treatment guidelines – These are products of the insurance industry.  They purportedly guide physicians in how best to treat patients, yet insurance companies take no responsibility for the outcomes.  What they arguably do is restrict treatment options, not for the benefit of the patient or the practitioner, but for the financial reward of the insurance company.  TGs have been developed not out of concern for the welfare of the patient, as much as for the solvency of the payors.  The future will undoubtedly contain more restrictive guidelines, based on “solid scientific evidence,” which as I addressed in #1 is elusive at best.

3.   Precertification hurdles – These are also products of the insurance industry, and also have a primary goal of saving money for the insurance company in anticipation of possible reduced profits as Obamacare takes hold.  Insurances require phone calls to pre certify, often letters of medical necessity, and of course make the process as difficult as possible, through understaffing, queuing up callers for sometimes an hour at a time, and then feeling free to not follow through and pay for the treatment authorized.  This process has the intended humiliating and demoralizing effect on the practice, and patients are thwarted in getting the care prescribed them.

4.   Cut-throat attitudes – Medicine has always been a somewhat competitive environment, but we are certainly not experiencing the “kinder/gentler” society envisioned by President Bush senior in the 1990s in his inaugural address.  The pressures of Obamacare have turned various specialties into adversaries in pursuit of patients.  Primary care practices, the majority owned by hospitals, are not as quick to refer to non-hospital employed specialists and tend to hold on to patients and treat them instead.  Specialties have vastly expanded their array of treatments so as to recapture lost business, but in the process overlapping treatments with different specialties.  Patients are caught in the middle, and dissatisfaction is mounting among physicians and patients alike.

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About Dr. Michael J. O'Connell, New Hampshire
Dr. Michael J. O'Connell of Barrington, New Hampshire, has forged a distinguished career spanning over three decades, as entrepreneur, physician, businessman, philanthropist and healthcare consultant. As former owner, administrator and CEO of a 225+ employee multi-specialty medical practice, Dr. O'Connell has dedicated his entire professional life to helping patients with family medicine and especially those experiencing chronic pain and all aspects of addiction. Since selling his family of healthcare businesses, he has never once contemplated retirement despite his rich and fulfilling journey, but instead has turned his focus to consulting in an industry starved for courage and creativity. Having weathered many political, technological and legal challenges, there is hardly a storm he has not confronted, a tempest he has not quelled, an urgent need he has not met. While the talking heads and self-proclaimed experts in the field have assumed the conventions and standards of the times, Dr. O'Connell does not believe in merely reflecting the herd mentality, but rather in leading the charge. Eschewing political correctness, Dr. O'Connell says and does what needs saying and doing, and not what the mindless masses expect. In addition to the continual education afforded by his variegated life experiences, Dr O'Connell earned his BS in Biochemistry at the University of NH in 1975, his Medical Degree from Dartmouth College in 1981, interned at Walter Reed Medical Center in 1982, Residency/Fellowship at UCSF in1986, and finished his Masters in Healthcare Administration at UNH in 1995. Dr. O’Connell enjoys many outdoor activities, including rock climbing, snowboarding, hiking, and golf. Through the decades Dr. O'Connell has supported many non-profit charities to include the St. Charles Home in Rochester NH, the Tri City VNA and Hospice, Hyder House, and Cocheco Valley Humane Society. To the latter organization alone Dr. O'Connell has donated over $180,000 and pledged another $250,000 in the “Bring-Us-Home” campaign for a new building. His “Matching Donations Christmas drive” has generated over $175,000 in charitable giving from the community. In addition Dr. O'Connell has participated in many dozens of other volunteer and donation efforts locally as well as in Africa and the Dominican Republic. For a listing of how I gave back to the community during my career and continue to do see: https://michaeloconnellmdnh.wordpress.com/

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