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Scott Becker - The Most Important Trends Happening in Healthcare Today 3-9-26 · Becker’s Healthcare Podcast

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  This is Scott Becker with the Beckers HealthCare
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  podcast.
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  We're gonna talk today about several of the
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  most interesting thoughts and trends in health care.
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  We'll talk about some of the most interesting
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  and encouraging things. We'll talk about some of
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  the most alarming developments.
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  We'll then touch on some of the most
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  important developments.
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  We'll discuss
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  artificial intelligence,
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  and we'll talk a little bit about government
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  and health care. Finally,
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  we'll answer the question somebody asked me, Do
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  I think as an outsider in health care,
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  meaning not a physician,
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  not not a not a health care administrator,
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  do I think the health care world is
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  crazy or not? So so let's try and
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  go through these five or six subjects, and
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  I'll try and do so relatively quickly so
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  I can get people in and out of
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  this podcast in fifteen minutes.
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  So the first thing, when I look at
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  what's encouraging in health care,
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  the first thing I see that's encouraging in
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  health care is that over the last few
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  years, we've expedited tremendously as a nation
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  the way in which we're developing nurses, advanced
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  practitioners,
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  and physician assistants. We're now producing about 200,000
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  nurses a year.
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  Just a couple years ago, that seemed like
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  an impossible number. That's done a great job
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  to help fill the gap in the amount
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  of nurses that we're creating a year.
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  There could be some complaints about how quickly
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  that's being done about the lack of experience
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  some of the nurses, but all in all,
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  I think this is a great thing that
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  we've asked that we've accelerated this. In contrast,
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  only about 23,000
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  doctors a year start med school a year,
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  so we've got this huge daunting difference between
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  the amount of nurses we're producing and the
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  amount of doctors we're producing.
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  Second thing that's encouraging
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  is cascading use cases
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  with technology.
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  More and more ways the AI is making
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  a big dent on the administrative side, whether
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  it's MBA and listening,
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  whether it's revenue cycle,
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  whether it's OR management,
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  predictive analytics,
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  lots of places we're seeing cascading use cases
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  with technology and artificial intelligence.
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  Third, lots of improvements in pharmaceuticals,
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  in in streamlining the way in which people
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  get their pharmaceuticals.
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  Again, still lots of challenges for very challenging
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  rare diseases,
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  pancreatic cancer, brain cancer, still not a lot
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  of progress, but, generally,
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  continuing to fund research, we need more and
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  more support of the National Institute of Health
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  and research in the country, but still overall
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  as a nation doing a tremendous job developing
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  pharmaceuticals
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  and solutions
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  and and personalized
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  solutions and precision medicine.
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  Fourth, and and this may be a negative
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  or a positive,
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  but I'll try to choose it as encouraging.
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  I think there's greater recognition as a nation
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  that we have a health care crisis coming,
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  and that we've gotta deal with it. I
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  hope that that gets more front and center.
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  Washington still seems not focused on truly problem
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  solving and fixing problems, but, hopefully, we've got
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  more and more of that recognition
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  that we've got a true health care crisis
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  coming, and we've gotta find a way to
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  solve it.
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  Finally, fifth,
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  greater recognition
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  that the money that is spent back and
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  forth from government
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  to massive insurance companies
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  isn't helping. And in some ways, it's just
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  a massive money transfer that that's leading essentially
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  to greater health care inflation,
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  that that we're putting more money through insurance
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  companies, whether through Medicare Advantage, through Medicaid, or
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  other ways, and it's not really leading
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  to reducing cost for improving health care. And
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  that quite frankly, we'll talk about this in
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  a second, that we're moving in the wrong
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  direction largely
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  when it comes to the AAAIM,
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  quality, cost, and access.
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  And, again, this is a complicated issue because
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  we need subsidies so people can afford health
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  insurance because it's so expensive. At the same
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  time, the more that we subsidize things through
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  the insurance companies, the more the cost continue
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  to escalate and go up. So so those
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  are some of the most encouraging things that
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  we see, and I know I've I've sort
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  of hopped the line there a little bit
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  with some discouraging and challenging issues as well.
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  Here are several of the most alarming developments
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  in health
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  care. First,
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  growing shortages of specialists and subspecialists.
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  Only about 23,000
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  doctors start medical school each year. We find
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  more and more that the bench of specialists
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  in certain cancer, certain areas
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  is really, really short in our country. But
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  even though it appears that we've got a
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  lot of oncologists, they are overwhelmed when we
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  get into subspecialties. We are really, really short.
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  Second,
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  Washington DC
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  seems largely broke to me in terms of
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  actually solving problems.
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  We've got the left on one hand, talks
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  about coverage for all. We agree with coverage
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  for all. The right talks about the free
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  market in health care. The answer, of course,
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  is somewhere in between. We already don't have
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  a true free market. More than 50% of
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  health care or about that is being done
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  through governmental pay.
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  And coverage for all is great, but coverage
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  without fixing the supply problem is like writing
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  a check you cannot cash. We've gotta do
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  both. If you wanna talk about coverage for
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  all, I'm a big fan.
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  But at the end of the day, we
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  gotta fix the supply problem in health care
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  too.
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  Third problem, alarming situation. There's so much talk
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  by academics,
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  by others
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  about the payment system,
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  and I think a lot of that is
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  misguided. A lot of that discussion should be
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  on the
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  payment system? Yes. The payment system is its
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  own quagmire, but at the end of the
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  day, we have 350,000,000
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  people in our country, only a million or
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  so doctors. We've gotta get that some some
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  progress made on that supply problem.
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  Fourth,
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  cost, quality, and access all going in the
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  wrong direction.
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  Used to be that people thought you can
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  get two or three of these right or
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  one or three of these right. Now it
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  seems like cost is going up, quota is
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  going down, and access is really challenging.
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  Fifth, the length of medical education in our
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  country has become about a twelve year phenomenon,
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  four years of college, four years of med
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  school, three to four years of residency, often
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  one to two years of fellowship.
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  They do it quicker in other countries, and
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  we're the beneficiaries of it. Medical education in
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  our country, we produce great doctors, but we
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  do so incredibly, inefficiently,
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  and expensively.
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  Medical education was developed largely before the Internet
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  in our country. We've gotta figure a way
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  to expedite it to get people out of
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  med school and residency and practicing by '28,
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  '29, not 3032,
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  particularly as more and more doctors go part
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  time by 40 to 50.
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  The numbers just don't work. The number of
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  doctors compared to our population.
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  Sixth, rural health care is in a vicious
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  cycle. Not enough doctors,
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  not enough population,
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  more and more of the population moving to
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  the top metro areas, doctors and population. So
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  we've got this vicious cycle of what happens
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  in rural areas in terms of health care
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  as more and more our country moves away
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  from rural areas, really trying to take care
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  of those areas and have them be growth
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  spots versus
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  dying health care spots, really challenging.
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  Seventh, we've got this increased tearing of health
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  care. You used to have commercial and governmental
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  and indigent.
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  Now you've got a whole
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  build of concierge medicine,
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  which only the top five to 10%
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  of wealthy or affluent people could afford. Then
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  you've got commercial
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  insurance, then you got governmental insurance, then you
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  got indigent insurance.
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  You've got more and more multiple tiers of
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  health care. And this long term is a
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  disaster from a health equity perspective. Again, I
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  don't blame the doctors or the systems one
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  bit, but we gotta fix the supply problems.
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  Eighth, we have a massive aging of America,
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  more older people than younger people, and this
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  creates a real challenge when so many of
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  our safety nets, Social Security, Medicare, other things
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  have been built on the concept that a
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  lot of people will be working compared to
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  the people not working. Now you've got this
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  massive aging of America
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  economically.
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  The amount of care that's needed creates real
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  challenges, real problems. Finally, ninth, 40% of hospitals
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  are losing money. So that is a, real
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  challenge. Hospitals are the safe net of our
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  health care system plus doctors. We've gotta get
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  those two things
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  situated better,
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  while we also produce more nurses and PAs
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  in in in pursuit technological
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  solutions.
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  Third, we'll talk about some of the most
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  important developments that we see and that we
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  need.
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  And I'll go through five or six of
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  them.
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  First, the need to get the best and
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  brightest into med school and into specialties to
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  keep on trying to make it really attractive,
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  get the best and brightest to go to
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  med school versus law school,
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  accounting, finance, all these other areas, technology.
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  We need both. We need a lot of
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  the best and brightest going to med school
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  too. Second, we need to figure out a
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  way to get our doctors out of school
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  sooner and practicing sooner. We need to update
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  medical
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  education. We produce great doctors, but we do
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  so in a very lengthy period of time.
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  Third, we've gotta find a way to increase
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  the amount of specialists and subspecialists.
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  And part of my sense of this is
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  we're gonna move a lot of primary care
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  over time to PAs and advanced practitioners. So
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  in the meantime, we've gotta figure out how
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  to increase the number of specialists and subspecialists.
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  Fourth,
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  we're gonna have constant improvements in technology,
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  and my belief is it's technology plus doctors
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  and nurses that will solve the problem. It's
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  not one or the other.
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  Fifth, many of the solutions in technology are
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  two x solutions. They help leverage our population
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  better. They help leverage our doctors and nurses
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  better. They don't replace our nurses and doctors.
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  It's sort of both. You need great technology
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  and great doctors.
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  Sixth,
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  great developments in medicines, GLP ones, other types
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  of things that could really help people.
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  We're still struggling in many types of cancer
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  in in the precision medicine, and so it
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  is really helpful, but still not there for
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  a lot of different areas. Finally, seventh, there's
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  this need for any system to be great
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  at something that whatever you're doing, you've gotta
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  be great at. So that's sort of the
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  most some of the most important developments that
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  we're watching,
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  technology,
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  pharmaceuticals,
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  technology plus people solutions, and and trying to
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  expedite and accelerate medical education.
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  In terms of artificial intelligence,
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  it's almost like with their spot when the
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  Apple, the iPhone was developed.
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  There will be so many different use cases
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  that we can't even imagine. Right now, we're
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  already seeing a ton of use cases around
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  ambient listening, revenue cycle predictive analytics,
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  lot of other areas, and we're seeing this
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  cascading evolution of clinical use cases, and we'll
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  see how that evolves and where it gets
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  to.
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  Finally, I'll talk for a second about the
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  government and health care from my perspective in
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  terms of actual problem solving
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  versus sloganeering.
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  The government is largely broken. They don't seem
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  to wanna figure out health care. They wanna
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  figure out getting reelected. Again,
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  the left often says coverage for all. We
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  totally agree with that. But coverage without supply
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  and access is a disaster.
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  The second, the right often says get the
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  government out of our health care. That, again,
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  is ridiculous because we the government's already half
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  of health care or something like that.
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  Neither seems to be really focused on solving
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  supply demand challenges.
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  I think that's a real problem. We've gotta
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  get more government focused on really problem solving
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  versus sloganeering.
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  Finally,
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  most health care economists that talk about health
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  care are often agenda driven, narrative driven, and
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  often misfocused.
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  You could talk about all you want about
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  economics
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  and payment systems. There's problems with fear for
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  service. There's problems with capitation,
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  whichever payment system you use. But if we
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  don't solve supply and demand,
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  we've got real, real challenges.
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  One of the things I think about is
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  in health care, and this goes back to
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  the question, as an outsider, I think it's
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  crazy. I I don't at all. I think
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  the beauty of health care is we're taking
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  care of 350,000,000
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  people.
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  It is the third largest country in the
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  world after China and India. We do it
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  in many ways very well, but it is
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  challenging and getting harder and harder.
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  The other thing that I love about health
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  care is every single one of us is
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  a consumer, so so no one can really
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  pull the wool over your eyes as to
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  what's going on in health care because we
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  all our consumers, and in some ways, all
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  the front row seat at it, because we
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  have the same access problems that others have
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  and and see it very clearly. So I
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  I some of us might have better access
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  than others, but at the end of the
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  day, we we really are in a spot
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  where all of us are consumers and almost
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  face different health care challenges, different health care
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  problems, and see the system in in different
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  ways, but we all have our own lens
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  on what health care looks like. We end
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  up at the ER for good reason because
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  we can't find access elsewhere
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  elsewhere,
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  and that's why you know, and there's so
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  many different discussions about this, but I love
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  the fact that we're all consumers and I'll
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  see it.
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  Finally,
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  we do do this far better than a
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  lot of the other largest countries in the
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  world. There's a lot to be thankful for,
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  but we've gotta make some serious improvements as
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  well. I hope people find this helpful. I
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  hope you listen to it all the way
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  through. There's obviously so much more we could
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  talk about. We've got all the shortages of
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  behavioral health resources. So much we could talk
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  about. Health equity is challenging. There was so
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  much to talk about in health care. These
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  are just some of our thoughts, some of
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  the things we want people to think about.
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  Again, feel free if you listen to this
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  all the way through, if you enjoy it
• 13:01
  or you hate it, if you're the first
• 13:03
  person to text me at (773)
• 13:05
  766-5322,
• 13:07
  I'll go ahead and send you a one
• 13:08
  hundred hour Amazon gift certificate to thank you
• 13:10
  for listening. Again, Scott Becker, founder, publisher of
• 13:14
  Becker's HealthCare. Thank you so much for joining
• 13:16
  us.