What scares doctors about technology
I think I know what most frightens physicians about technology.
It's the fear of becoming part of a roll-up, like Esse Health, profiled recently by the St. Louis Post-Dispatch.
On the surface Esse is simply a collection of doctors' offices. But when new CEO Mike Castellano talks about it, he's describing something that sounds a lot more like McDonald's:
Mike Castellano, the company's new chief executive, said he wants to promote Esse's name throughout the community and he hopes to create a brand that links the name to the practice's philosophy on medicine.
"The organization, in my view, has matured to a point where it is a large small company on the verge of becoming a small large company," said Castellano, who is a certified public accountant by trade.
The key to all this is technology. Esse uses computers and networks not only to automate billing, but to actually deliver better care, with simple things like e-mailing blood sugar and blood pressure results to patients.
In fact, technology is now a profit center. The company's original EMR platform, called Wellinx, merged with a Canadian company in 2005 to create Purkinje, which sells practice automation systems at prices as low as $399 per month.
Because it makes effective use of technology, Esse is also able to run its own Medicare Advantage program, which it calls Essence. This brings in patients and cash flow. Careful management is needed to make a profit in this kind of business, but if it can be done it gives a practice a big advantage.
You can easily see the fear. You're no longer a sole practitioner, with your own office and your own credibility. You're an employee. The face to your patients may be CEO Charles Willey.
And when hard decisions are being made, whether financial or medical decisions, you're no longer the one making them. Would you like fries with that heart screening?
The answer, if you're afraid this is going to happen to you, is to beat the roll-ups to the punch. Do your own automation, and do it right. Easier said than done I know, but what choice do you have, really?