Healthcare is changing rapidly. Patients are mostly seen by an ARNP or a PA, not their physician. I know this is not always true, but it is becoming the norm. This norm is catching steam and soon will be accepted medical practice. Why? Because reimbursement rates are being cut by insurance companies and the federal government – both trying to increase profitability, decrease costs or both.

The problem I have with this concept is that patients are getting less and paying more. Insurance premiums are increasing, while reimbursement rates are decreasing. This seems like a recipe for increased profits for the insurers. So, to stay profitable with less income, physicians are hiring multiple non-physician providers in their practice to see more patients – a viable business strategy to counter the declining income trend. 

Pharmacy is also being subjected to the same reimbursement pressures as medical practices. Technicians are being registered in multiple states to do more in the pharmacy with prescriptions, while pharmacists are slowly being replaced by technology. Soon, instead of an onsite pharmacist to make sure your medication is correct, you will have pre-filled dispensing vending machines from which you will get your medications. If you think this is a dream, I will have you know that this is already a reality in some emergency rooms across the country. These changes will come in the name of “progress” and profit for the pharmacy. After all, a technician and a prescription vending machine are lower payroll expenses than a pharmacist, just as an ARNP or PA is a lower expense to a physician than adding a partner to the practice.

So, what is the patient to do? My answer is to seek out providers who put you, the patient, first. Medical providers are already taking a stand by rejecting some insurance plans and by forming concierge practices, while independent pharmacy practice is going through a booming growth by providing their patients individualized attention through personalized services. While technology and lower payroll expenses can reduce operating costs, longterm business sustainability is all about the personal interaction between the patient and the provider. And the more “walls” built between the two players, the worse it gets for the practice. It was, is, and always will be about people.

I welcome your feedback on this topic. And, as always, stay well.

Dion