FTC’s proposed ban on noncompete agreements could be a game changer for some physicians
The past twenty years have been a period of declining political and economic influence for physicians. As many as a third of all physicians are now hospital employees, and as many as a hundred thousand more are employed by corporations, many private equity backed. However, as COVID scythed through the practicing physician community and the baby boom generation of physicians head for retirement, scarcity of physicians will increase their economic leverage and political power. How will physicians use this increased power? Read Jeff Goldsmith’s Op-Ed in STAT First Opinion Oct 14, 2022 Plus, a recent Federal Trade Commission proposed rule would outlaw non-compete clauses in employment contracts. Hundreds of thousands of employed physicians have non-compete provisions in their contracts. How likely is this prohibition to become effective, and how will carve outs effect the freedom of physicians to practice in the communities?
The future for practicing physicians in a corporate world
The Future of Practicing Physicians in a Corporate World The past two decades have seen a marked decline in physicians’ economic and political power. Private medical practice has withered, and as many as one-third of physicians are now employed by hospitals in the US. More than a hundred thousand more physicians are employed by corporations, health insurers and private equity firms. As the baby boom generation retires, however, physicians will become increasingly scarce, driving up not only their incomes but also their professional power. How will they use their increasing power?
Disruption: A Burned Out Meme?
In 1997, Harvard Business School’s Clayton Christiansen published an influential treatise on industry economics entitled The Innovator’s Dilemma. In it, he discussed how technical and business model innovation works to overthrow entire industries. Released at the peak of the late 1990’s Internet boom, Christiansen’s book had widespread influence and enshrined the notion of “disruptive innovation” at the core of business strategy in healthcare. Twenty-five years on, the “disruption” meme is showing signs of aging, and decreasing usefulness in guiding investment in healthcare. Read Has “Disruption” Reached its Sell-By Date?
United Healthcare: Anatomy of a Behemoth
United Healthcare Anatomy of a Behemoth On May 25, Jeff Goldsmith posted on Medium a detailed analysis of the business model and strategy of UnitedHealth Group, a $300 billion integrated health insurer. In addition to being the US largest health insurance enterprise, United has greater assets and earnings than Exxon Mobil. It is the also largest employer of physicians in the US, and second only to the British National Health Service in the world. Yet this vast enterprise, which is within reach of being 10% of total US health spending, is poorly understood and appreciated in the industry.
The Reckoning: What Happens to Digital Health After COVID?
The Reckoning: What Happens to Digital Health After COVIDWith Advisory Board President Eric Larsen, Jeff Goldsmith laid out the root causes of the crash in digital health company valuations in 2021-22 and explored how customer needs will determine the size and shape of this promising field. It is wrong to think of digital health in isolation from the existing care system; it is not a new care system, but rather a force multiplier of the core relationships that are at the heart of medicine. What forces will govern the consolidation of the digital heatlh sector?
Hospital Systems: A Framework for Maximizing Social Benefit
Health Systems: a Framework for Maximizing Social Benefit. Health systems have been under more or less continuous attack during the past decade by academics and health policy experts for driving up healthcare costs. Yet they proved indispensable in the fight against COVID. This essay, written with fellow futurist and policy wonk Ian Morrison, explores how to maximize the social benefits health systems provide society.
Trusting relationships are the core of medicine. Can telehealth support them?
After the Crash. After an astonishing run during COVID, digital health and tech stocks withered in a broader collapse of NASDAQ companies in early 2022. What do past industry cycles teach us about how important innovations recover from initial challenges and become essential to our lives? How will health tech recover from the crash and what do innovative companies have to do to power through the downturn?
Trust is the Core of Medicine
Jeff Goldsmith argued in STAT First Opinion that the explosion in digital health offerings since COVID began has not altered one key aspect of US healthcare: the central role of trust in healthcare provision. Despite a proliferation of “virtual first” offerings by insurers and employers, trusted relationships between care providers and patients remains the core of the health system. The market for anonymous, “right now” transactions between patients and their cell phones/PCs is limited, and many “virtual first” care and health insurance offerings will founder on this reality. Digital health’s key potential is that of a “force multiplier” for the trusted relations that are the heart of medicine.
Cost Effectiveness in Healthcare
Jeff Goldsmith talked about the role of cost effectiveness in the management of health systems in an interview with Eric Reese of HFM, the lead publication of the Healthcare Financial Management Association. How should health care finance leaders factor cost effectiveness into their strategies?
Health Systems Made A Big Difference In The COVID Fight: Time To Reconsider Their Social Impact
Health Systems Saved Lives During COVID Large multi-hospital health systems have been in the political/regulatory doghouse for the past decade. However, they made a huge difference in the fight against COVID. They were able to mobilize caregivers and facilities at scale across regions to fill gaps left by crumbling public health infrastructure, and stood up testing, vaccination and telehealth offerings rapidly to respond to the pandemic. Policymakers should reconsider the social benefits created by these large complex organizations. With colleague Ian Morrison in Health Affairs blog