On a recent road trip, my wife and I stopped to fill up, both the gas tank and my belly. Walking into the convenience store was like turning a dog loose in butcher shop. This place was huge and bright and upscale. If the developer who just opened the 3,000,000 square foot American Dream Meadowland mall in New Jersey built roadside convenience stores, this is what they would build.
I wandered around aimlessly for too long trying to decide on a drink and a snack. Too many alternatives gave me a serious case of decidiphobia. My wife told me to get some almonds (regular, smoky, bold, sriracha, habanero or wasabi?) and iced tea (sweet, unsweet, a little sweet, with cranberry, with motor oil?) and get to the car.
I have written before about product proliferation being one of the large mega-trends of the past 30-50 years, a clear marker of the march toward consumerism. We’ve flipped from Henry Ford’s ‘sure you can pick your color…and hey, you want black!) to the customer being in charge. Just walk the beverage aisle of your supermarket if you need evidence.
Yes, that is coming to healthcare, big time. We’ve discussed that frequently as well, so today is not about rehashing that, though we absolutely reserve the right to recycle old ideas when we don’t have a new thought to share. Blogger laziness.
What has me intrigued today is how this trend is backing upstream into the nature and structure of physician practices. It makes sense. If you have a lot of different types of beverages, you must have a lot of different types of production facilities to produce those different products.
If we are going to deliver a lot of different types of healthcare, we’re going to have a lot of different types of physician practices that can produce that variety.
We have practices closely tied to a hospital and other practices that never darken the door of the place.
We have practices that live and die on value-based reimbursement and some that can’t even spell that.
We have practices that exist to feed their downstream ancillary services and those that are just about the exam room.
We have practices geared to ride the Medicaid growth wave and practices whose payer mix is Visa, Mastercard and American Express.
We have practices getting small and focused and practices that are trying to gobble up everything in sight.
Never before has the idea of ‘the physician practice’ as a generic thing had less meaning. It will mean even less tomorrow.
You are now fighting for shelf space in the big convenience store. You better be a really good version of who you are trying to be because there are a million other options.
Just ‘being a good doctor’ is as anachronistic as just being a good potato chip.