That is a lot of uncertainty for a hospitalist. How can they prepare?
I don’t think one can prepare adequately for the changes that are going to take place. What hospitalists have to do first is to make sure that they fulfill their own roles in caring for patients, but they should also be thinking about innovative approaches and ways of delivering services that are good for patents but also good for the system.
Is that enough—being at the vanguard of care delivery?
No, and I can’t give people assurances that there is any specific thing they can do that will make things work, or work better, because we’re moving into an uncertain environment—an uncertain environment in the real world where we’re going to see health as a share of GDP probably continue to go up for a while, but there will be some pushback against that; uncertainty as we try to integrate the public and private halves of our healthcare system a little bit better than we have; uncertainty as we find that the fiscal realities of America mean that you’ve got to put even more of a squeeze on Medicare, Medicaid, and even veterans’ health. Those things don’t happen in isolation.
Should doctors see this as an exciting time?
I think there is a bright side to this, which is there really is an opportunity here for innovation in ways to fulfill their oaths. There is an opportunity to find ways to provide better healthcare for people, better services to make their lives better.
Richard Quinn is a freelance writer in New Jersey.
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