Trends that Will Shape a New Decade in Healthcare

March 17, 2023
March 17, 2023

The world of healthcare provider management and services can be characterized by constant change. Some long-standing trends continue to affect this area and are becoming more extreme, while others are moderating over time. There are ways in which one can see this functional sector of the healthcare industry adapting to changes in overall population demographics and altered payor relationships as well as technology. Other process innovations are emerging as healthcare catches up to more advanced areas of the economy in how it uses technology to improve outcomes and operations. As a leading provider of provider management solutions in healthcare, VerityStream would like to share and call attention to the following significant trends that clients and providers should anticipate and factor into their plans for the coming year and near future

Physicians Will Be in Short Supply

The existing physician shortage will continue and become an even larger problem across many areas of healthcare. According to a 2019 infographic from the Association of American Medical Colleges, the United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply. The high end of the number of doctors we could lack includes more than 55,000 primary care physicians, nearly 66,000 specialists, and more than 23,000 surgical specialists. Two factors are contributing to this problem—the U.S. “population is estimated to grow by more than 10% by 2032, with those over age 65 increasing by 48%. Additionally, the aging population will similarly affect the physician supply, since one-third of all currently active doctors will be older than 65 at some time during the next decade. When these physicians decide to retire could have the greatest impact on supply” (AAMC, 2019). Rural and innercity areas will feel the shortage most acutely, as those are places physicians are less likely to want to practice. It is probable that the industry will see states and hospitals going to great lengths to retain the doctors they have trained and hired. There are already examples of financial incentives, such as loan forgiveness and bonuses, being used in some areas to hold on to physicians.

Physician Burnout Is Moderating

Many healthcare organizations have long been worried about physician burnout, a long-term stress reaction in doctors marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. The AHRQ shares that in 2019, up to 50% of physicians are experiencing some level of burnout, which can lead them to leave the profession, provide care that threatens patient safety and care quality, or suffer disastrously from impaired attention, memory, and executive function (AHRQ, 2019). The American Medical Association shares good news in 2019 that or the first time since 2011, the physician burnout rate has dropped below 50 percent among doctors in the United States (Berg, 2019). For comparison, the overall prevalence of burnout among U.S. workers was 28.1 percent in 2017. The specialties with the lowest levels of burnout are plastic surgery, dermatology, pathology, ophthalmology, and orthopedics. There’s good news about the effectiveness of what the industry is doing to make headway against burnout, from staffing changes and reducing workloads to lengthening patient visit length (AHRQ, 2019). With significant impacts for physician burnout like medical errors, physician suicides, and a cost estimated as $4.6 billion annually (Oaklander, 2019), reduction in the prevalence of this problem is very good news for healthcare.

Concierge Medicine Is on the Rise

Concierge medicine is a popular emerging alternative to how healthcare is traditionally provided. This subscription-based, membership medicine business model occurs primarily in family medicine and internal medicine and has proven to be ideal for patients with chronic conditions that require more time and attention from their doctor. Practitioners choosing this route tend to be more entrepreneurial and forward thinking than their colleagues while garnering prestige from their peers (Concierge Medicine Today, 2019). Currently there are approximately 20,000 concierge medicine physicians practicing nationally, with their ranks growing 3-6% annually. According to the Advisory Board (2019), concierge medicine can offer patients some combination of attractive care options. These may include same-day appointments, more appointment time with providers, email and telephone consultations, personal health coaching, nurse guidance, and robust patient portals. This mode of practice appears to improve physician satisfaction, with 95% of doctors responding they are more satisfied in the profession ten years after making this change. An important patient benefit that has already been identified is the reduction of medication use among patients of concierge practices. Interestingly, though 44% of U.S. physicians practicing concierge medicine have opted out of Medicare, their 2017-2018 median annual salary is still more than $260,000.

Artificial Intelligence Will Transform Healthcare

Artificial intelligence (AI) research and application within medicine is growing rapidly. In 2016, healthcare AI projects attracted more investment than AI projects within any other sector of the global economy. According to the British Journal of General Practice (2018), investment banking giant Morgan Stanley estimates that the global market for AI in healthcare could surge from $1.3 billion today to $10 billion by 2024, growing at an annual compound rate of 40% (Buch et al, 2018). Harvard University tells us why—advances in computational power paired with massive amounts of data generated in healthcare systems make many clinical problems ripe for AI applications. In Forbes, Accenture reports that the ten most promising AI applications for healthcare, led by robot-assisted surgery, virtual nursing assistants, and administrative workflow assistance, could create up to $150 billion in annual savings for U.S. healthcare by 2026. Just a few examples show that AI-informed healthcare can significantly improve outcomes, from outperforming physicians’ ability to detect cancer (Harvard, 2019) and increasing the time that doctors can spend with patients to screening medications for effectiveness against the Ebola virus (Amisha, 2019).

New Physician Specialties Are Emerging

As medicine evolves, new types of doctors are emerging to meet the changing needs. In some cases, these clinicians are in new specialties that didn’t exist until recently, and demand for some of these physicians is already high. The Association of American Medical Colleges (2019) identified these five new specialties that match where healthcare is headed:

  • Cancer immunologist - This doctor will be adept at harnessing a patient’s individual immune system to fight cancer while avoiding or treating immune system overreactions and treatment-triggered diseases.
  • Nocturnist - Increasingly medically complex patients need the care continuity of doctors who practice hospital medicine primarily at night, a key addition to the level of safety and service offered.
  • Lifestyle medicine physician - 80% of healthcare costs are connected to care for chronic diseases, and 80% of chronic disease is related to lifestyle choice. A lifestyle medicine specialist oversees a patient’s food choices, exercise, sleep, stress levels, and ability to connect with others, whether in a primary care environment, lifestyle medicine clinic, or residential care facility. Demand to sit for this certification exam is exploding.
  • Clinical informatics – This specialist collects and analyzes patients’ health information and applies those insights to improve patient health. Growth in this area is related to provisions of the Affordable Care Act (ACA) and the proliferation of electronic health records (EHRs). The goal is to use the volumes of medical data now being generated to make better clinical decisions and guide research efforts.
  • Medical Virtualist – This physician provides telehealth services, a sector of healthcare delivery that is expected to rise 30% each year between 2017 and 2022. Early uses include second-opinion consults, as well as telepsychiatry and telestroke services. Health systems are just beginning to add telehealth to their service mix, for primary care triage, specialty consults, and virtual rounding. The ability to create a successful telehealth experience for patients will be a key competency for this specialty (AAMC, 2019).

Provider Credentialing Will Change Significantly

With their constant attention on patient safety, Medical Services Professionals (MSPs) are taking on more complex roles as the healthcare industry continues to shift to value-based care rather than a volume-based model. The National Association Medical Staff Services (NAMSS) says in its 2018 State of the Medical Services Profession Report that standardization, consolidation, and the increasing importance of quality metrics will redefine the role of MSPs play in organizations in the coming years (Barajas, 2018). Electronic and software solutions for credentialing and related services are growing rapidly as the industry moves to digitize records and operations to support automation. The volume for credentialing functions is predicted to increase as more nurse practitioners (NPs) and physician assistants (PAs) begin working in a hospital environment.

Physician Employment Is Slowing

According to the American Medical Association (AMA), physicians are close to evenly spit between those who are employed (47.4%) and those who own their own practices (45.9%) (Henry, 2019). While this is a milestone achievement, and the culmination of a long trend towards physician employment, HealthLeaders reported in 2019 that the momentum of increasing employment has slowed. From July 2016 to January 2018, the number of hospital-employed physicians increased 6%, much less than the staggering increase from July 2012 to July 2015 of 49% (Cheney, 2019). Nevertheless, the growth in employed physicians continues, albeit far more slowly. The AMA also explains that when talking about “employed physicians,” it isn’t just limited to hospitals or healthcare systems acting as employers. In some cases, the employer is actually a practice wholely owned by another physician. Private practice, it needs to be acknowledged, does seem to be holding its own. This structure is more prevalent with older physicians (54.3% among physicians 55 and older vs. 25.5% of those under 40), especially among surgical subspecialists (Henry, 2019).

Cool Technology Is on the Horizon

As in recent years, technology promises to transform more areas of healthcare, in the near and more distant future. A 2019 Forbes article offers multiple examples where great changes and advances are expected. A starting point is robotics, whose potential extends far beyond the application for surgery, which is already well-known. Tremendous growth is expected in the use of robotics for healthcare, from a telepresence in rural areas where doctors are scarce and for the transport of medical supplies within an organization to disinfecting hospital rooms, to helping patients with rehabilitation and micro-bots involving specific patient therapies. Another example, the wearable device, has potential uses that go far beyond the fitness tracking and counting steps that we all know. Wearables can be put into service to monitor heart rhythm, ECG, blood pressure, temperature, etc. Technology is driving the rise of genomic medicine, where a person’s genomic info is used to determine personalized treatment plans and clinical care. Computer analysis of genes and gene mutations will facilitate personalized medical treatment for such situations as organ transplant rejection, cystic fibrosis, and especially cancer. Some of the uses that healthcare will find for 3D printing will include patient-specific practice organs to be used by surgeons, on-demand device and tool manufacturing, customized prostheses, and transplantable tissues and organs. Look for enormous growth in virtual and augmented reality for healthcare—Forbes estimates its market will be $5.1 billion by 2025. Not only is this technology extremely beneficial for training and surgery simulation, but it’s also playing an important part in patient care and treatment, from treating patients with visual impairment, depression, cancer, and autism, to an augmented reality environment that supports healthcare practitioners during brain surgery and reconnecting blood vessels. Two other developments with promise are the development of digital twins to enable doctors to explore outcomes, as well as the 5G wireless network that will allow better data transfer, telemedicine advances, and remote monitoring, among many other benefits (Marr, 2019).

TeleHealth Is Becoming Easier to Practice

Telehealth promises to be an important solution to some big challenges in healthcare, from the shortage of clinicians and lack of rural providers to skyrocketing care costs. An impediment to telehealth has been the need for physicians to be able to practice beyond the limited geographic area of one to a few states that has been typical. The Federation of State Medical Boards offers that this is beginning to change, with the launch of the Interstate Medical Licensure Compact (IMLC) in 2015. Not only does it offer a new, expedited pathway to licensure for qualified physicians who wish to practice in multiple states, but it also allows states to work together to address shared needs or issues. As of late 2018, 24 states, the District of Columbia and one U.S. territory are participating members (FSMB, 2018). The number of annual IMLCs has mostly risen every quarter since it was established, leading many experts to believe that telemedicine will soon be available across a large part of the United States.

Retail Competition Is Heating Up

Expectations about the convenience of healthcare are changing, exemplified by the embrace of healthcare within a retail environment. The New York Times reported in 2018 that people are now flocking to clinics and urgent care centers located in strip malls or shopping centers. Some 12,000 are already scattered across the country in these kinds of more accessible locations. At the same time, office visits to primary care doctors declined 18 percent from 2012 to 2016, even as visits to specialists increased (Abelson & Creswell, 2018). Patients are more interested as well in appointment hours that work better with a working schedule, including evenings and weekends. Another development with larger implications involves the merger of retail drugstore chains like CVS with insurance providers like Aetna. The impact on provider networks, advertising, etc. could be significant. In addition, much of healthcare is waiting to see what Amazon and other big players in the digital economy may do to disrupt the traditional ways that healthcare is provided, supplied, and scheduled.