Doc: Specialize Or Die

It’s not the end of days for medicine if you don’t want it to be. Quite the opposite, in fact.

It’s been a long time coming
But I know a change is gonna come, oh yes it will
-Sam Cooke (A Change Is Gonna Come)

We are in the midst of a massive transformation of the way healthcare is delivered in United States. Across the board, every aspect of the market is being impacted by technology, policy, or both. Telemedicine and value-based care in particular are going to strike a massive blow to the traditional general practitioner model. The much-hated office checkup is on its way out. The current projection is that by 2020, 33% of all doctor consultations will happen virtually. We are going to need fewer general practitioners, fewer exam rooms, and less staff.

This is great for patients, for good doctors, and for our nation as a whole as we wrestle a healthcare system that is delivering poor quality care at an exorbitant relative price.

Doctors keep asking “what can we do to embrace technology and maintain relevance as the market changes?” The answer is surprisingly simple: specialize and use technology to deliver exceptional customer service. Let’s unpack this in 4 distinct recommendations:

1 — Identify all of your activities that can be done virtually or by someone with less training, then reduce or outsource those activities. Think about exams where no physical examination is performed, think about dermatology tests where no specialized tools are used, think about vision exams where you are just doing refractions. The list is seemingly endless and all of it will end up happening virtually. Slowly let that business go by focusing your efforts on building other areas and not trying to protect that dying business with regulation. Spend your time focusing on specialized areas of practice with procedures that cannot be done remotely. Distinguish yourself with your skills and experience.

2 — Be ultra-responsive to your patients and deliver an exceptional level of quality customer service that treats patients as partners. As geography no longer determines provider availability, switching costs fall, data gets shared more easily throughout the system and patients will have more choice in who delivers their care. Quality of service will become essential to differentiating your practice.

3 — Embrace telemedicine and deliver care through that medium! You’ll get paid during your downtime, have a chance to bring in new customers to your office, and get a front row seat to technology that will engage millions of new patients at the moment they need help the most.

4 — You can target communities that want to pay extra to see you in person. Geriatric patients, boomers, and the super wealthy are all good examples. Most of these groups will not be around forever, but if you are in the twilight of your own career then this could be a good option.

Some providers are already embracing these lessons. In the urgent care space, CityMD has leveraged technology and telemedicine to create an innovative care coordination system. Patients come at their most vulnerable when they need someone in person. Afterwards, CityMD uses customized phone and online systems to keep them as clients. In the classic primary care setting, One Medical Group has mastered customer service. It costs a bit more to be a member, but they’ve made an app for communicating with the facility and booking appointments, built beautiful offices and eliminated paper forms. It’s a real treat to see a doctor in that context.

There are many others trying to prevent telemedicine and spreading lies about what it will do instead of embracing change. It’s just fear. It’s not the end of days for good doctors, quite the opposite, in fact. If we embrace this change, we will return to doctors practicing at the top of their licenses with fewer “assembly line” medical visits and more time for thoughtful and high-quality care.