As one of the Y2K army of programmers, I can assure you there would have been major outages and errors…
Curbside Consult with Dr. Jayne 12/30/24
The end of the year is within striking distance. I was fortunate to have a nice break since nearly everyone who I work with was taking time off.
Running your own business can be labor intensive, so now it’s time to finish up those end of year accounting reports and get ready to open the books on a new one. I enjoy opening a nice, clean spreadsheet, probably a holdover from the heady days of picking out school supplies and having brand new Pink Pearl erasers at your disposal. Maybe I should start the new year with some brand new shoes as well. I’m sure there will be something sparkly in the post-New Year’s sales that would be suitable for HIMSS.
Plenty of people ask me what I predict will happen in healthcare and healthcare IT in the coming year. I think we are going to see a lot more conversation about the role of insurance in the healthcare system and how it needs to change. Unfortunately, I think it’s going to be all talk and little action, as powerful lobbying forces work to prevent any kind of substantive change. Profit is a powerful motivator, and shareholders aren’t going to stand for lower returns when more dollars are spent on patient care.
There will also continue to be resistance to any kind of universal healthcare, despite the fact that other developed nations do a pretty good job at it, with better clinical outcomes at a lower overall cost. Anecdotal stories about people who had to wait for care in Canada will continue to sway opinions, despite the fact that care rationing and delays have been the norm in the US for years if you don’t have “good” insurance that comes at a hefty price.
One prediction that I think many of us would agree with is that Epic will continue to grow market share. Given the uncertainties at Oracle Health, Epic is a safe bet when you’re about to open your wallet to the tune of tens or hundreds of millions of dollars. Small to mid-sized practices might continue to select niche EHR vendors for a particular specialty, especially if they have a low need to integrate with the local health system, but everyone else is gravitating towards the folks in Wisconsin.
Hopefully, this leads to more patients demanding full use of the Epic solutions, including self-scheduling or the lower-key ticket scheduling option, which would allow patients to have greater control over the services they receive without having to make inconvenient phone calls to try to book appointments. I still marvel at the number of organizations that haven’t implemented these features and am always happy to have a conversation with the physicians who are typically blocking their implementation.
Another prediction: physicians will continue to leave medicine earlier than they planned, particularly if they are in primary care. I hear from a number of former colleagues who are trying to find non-patient-care roles and who think that informatics is a logical jump. I advise them that it takes more than being an EHR user to be a successful informaticist and recommend that they do some formal coursework before they decide that it’s the next phase of their career.
It feels like the majority of physicians I know have some kind of side hustle (including real estate, life coaching, crafting, baking, and photography) that they are hoping to grow to a point where it can generate income if they are too burned out to practice. I’ve already received notice of three retirements this year, along with one offer to buy a practice for an insanely low price that I gently declined.
As for non-physician workers, I think we’ll continue to see more of the so-called “quiet quitting” and “coffee badging” phenomena. People are continuing to realize that employer loyalty is a thing of the past in many areas. They will work the amount that they feel is appropriate for what they are being paid.
I think we’ll see this more in people who feel they have been forced to be physically present in the office when it does nothing for their productivity. It’s hard to build culture when you demand that people interact just because they receive a paycheck from a common employer even though they don’t even work in the same sector as others who are also forced into the office. I have a couple of friends that drive 20 to 30 minutes to their offices every day to engage in back-to-back Zoom meetings with team members who are located in other states. One goes to an office that is a non health-related division of a large corporation, but it has the same logo as their paycheck and is within 60 miles, so it’s required. Based on our conversations it’s not making for a happy work environment and employees will do the bare minimum in person so as to not be penalized.
My final prediction is that we’ll continue to see companies try to enter the health sector because they think that they are smarter than everyone else who has been there before, which positions them uniquely to solve problems that are significantly more complex than they think. They will raise a fair amount of money along the way by convincing people that they are unique or have special skills, but I think we’ll see the majority of these companies fizzle out in the same way as their predecessors. I’m hoping that they’ll be smarter about how they operate than the last crop of startups, but I guarantee that we’ll see plenty of them blowing through cash and parading around at the trade shows. It’s what makes the industry interesting at times, and even though you want to look away, you can’t, because it’s just such a spectacle.
I’d be remiss if I didn’t end 2025 with a mention of the passing of former US President Jimmy Carter, who reached age 100 and died at home after choosing hospice care over more invasive treatments. His desire to pass with grace and dignity is admirable and resonates in a particular way with those of us who have had to perform so-called heroic measures on patients who most likely would not have wanted them had they fully understood what was involved. Carter is remarkable less for his presidency than for what he did following it, working to advance the democratic process around the world and to demonstrate a culture of service at home. He embodied service throughout his life, from his time with the US Navy to the White House to Habitat for Humanity and beyond. There’s a lot of talk about servant leadership out there, but he embodied it. Today’s leaders could learn a lot from his example. My condolences to his family and loved ones.
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The insurance industry is ‘under the gun’ right now, and this allows the provider sector to avoid the fundamental issue that it costs too much. The AHA and other trade organizations lobby like crazy against everyone except themselves, and avoid every effort to prod them to greater efficiency. The health plans may earn a healthy margin, but that margin is some percentage of the underlying and overblown costs of health services.
After reading your comments about employees “forced to be physically present in the office when it does nothing for their productivity” reminded me of my own experience decades ago when I was in my first sales role in healthcare. I was very organized with my time and started working from home until I needed to hit the road for face to face appointments. I was the #1 salesperson the entire time I worked for this organization. One day my manager decided everyone needed to start/end their day from the office. It took me 30 min. to drive to the office. Once there, I observed that the first hour of the day was essentially chatter with colleagues about what TV shows they’d watched the night before, etc. The end of the day was similar. So I essentially lost 1-2 hours of productivity (i.e. a sales appointment) each day which led to reduced sales each week. It became very clear to me that my manager did not know how to manage individuals and needed a ‘one size fits all’ approach even though my productivity was higher than other teammates. When I complained, she stated ‘I can’t let one person do something different than the rest of the team’. Sigh. So sometimes rules are made because the organization has ineffective managers and no one is holding THEM accountable. 🤦♀️
Re: “…forced to be physically present in the office when it does nothing for their productivity…”
For most of my career, it made no difference, at all, what was productive. Or cheapest, or improved morale, or helped competitiveness, or reduced legal liability, or … If the boss laid down an edict, that was it. We routinely heard some reason for the edict, so the reasoning seemed important, but we could always come up with some counter-argument, that would be dismissed immediately.
My Father had a saying, “the boss may not always be right, but they’re always boss.”
The difference now, it seems to me? The workforce is much less deferential to authority now.
I am reminded of a sub-national politician here. There was an issue that concerned governmental policy towards disabled people. The issue blew up when presented in the legislature, leading to a major course reversal. The government leader was incredulous, saying, “but we had agreement in Cabinet!”
Decisions made behind closed doors, have the weakness of being made behind closed doors.