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Managed Care's Next Act: When Docs Retire Early

Medical Device & Diagnostic Industry

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An MD&DI July 1998 Column

Whether developing new products or revamping current ones, think "consumer friendly."

Some people praise managed care's progress in curtailing the rising costs of health care, while others lament the loss of flexibility in choosing providers. Many also complain about a decline in the quality of care being delivered due to tighter schedules and the mandate for cost-containment. But yet even another effect of the managed-care revolution may still be in the offing: a mass early retirement of our nation's most skilled and experienced physicians.

Washington Post columnist Charles Krauthammer wrote about this possibility several months ago. As a medical school graduate himself, Krauthammer says that while doctors used to work into their late 60s and even beyond, "Three major pressures are driving these doctors to quit. The first is money. These doctors are at the peaks of their careers. As they watch similarly situated colleagues in law and business enjoying rising salaries and often exploding compensation, they are getting hammered by the new health-care economics. With Medicare decreeing ever-shrinking reimbursement—and insurance companies following suit—they find themselves losing ground even as they work harder."

Krauthammer also blames the high cost of malpractice insurance and a loss of independence (as insurance administrators veritably devoid of medical training attempt to prescribe care) as the drivers of this trend.

Krauthammer admits that his conclusions are based on unscientific conversations with medical professionals. Still, the trend seems real. As the daughter of a third-generation dentist, I toyed with the idea of entering dentistry. But, in the mid-1980s, when I was choosing a university
and field of study, my father discouraged me from doing so. Even then, he and his colleagues believed that the ability to provide proper care and to earn salaries competitive with other professions, was already being impaired by managed care. He and his peers are also in the midst of charting courses for early exits from medicine, confirming Krauthammer's belief that "they will work another 5 or 10 years to put away something for retirement, and then leave."

If this forecast does come true, how would it affect manufacturers? Already, there seems to be a trend toward more home health care, and devices that are easier to operate, often by personnel who do not have medical training. (Witness the defibrillators now placed on airplanes and in casinos to be used by nonmedical professionals in reviving victims of cardiac arrest.)

As manufacturers plan new product lines and revamp current offerings, they would do well to consider who will be using these devices—and how. Increasingly, consumers will need to take charge of their own care; as a result, user-friendly devices will be the market leaders in the years to come.

Further, educating consumers about how to use and care for devices will need to become a priority as well. Consumers have always figured prominently in the health care field as the recipients of health care. But they may soon figure prominently in care giving, too, whether for themselves or for others. This anticipated shift will provide new challenges and opportunities to manufacturers.

Stacey L. Bell

Copyright ©1998 Medical Device & Diagnostic Industry

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