Thursday, December 24, 2009

Pharma... Heal Thy Doctor!

No one would argue that Doctors, or more aptly put their patient care decisions, play the central roll in the cost and performance of the American healthcare system and it's reform.  But in Healthcare Reform's media blitz there is a huge issue that has been largely overlooked.  Healthcare reform will drive millions of previously uninsured into their offices.  Healthcare reform legislation will ask doctors and their staff to do  more for their patients, a lot more,  particularly for the Medicare beneficiary.

But today, there is a huge shortage of doctors.  Many are already overworked.
The shortage is particularly acute in primary care... targeted as the battle front for healthcare reform.  Doctor's are still pharma's primary customer. This presents a huge opportunity for the savvy pharma company to establish a new and long lasting relationship with it's customer which will confer much better Doctor access and better business than the next company knocking at the Doctor's office door.

Observations regarding the Doctor shortage starts with the fact that the US has fewer Doctors per 1000 than many other Western Countries.  Although we also don't visit our Doctors nearly as much as other countries.  See Table to the left.

The shortage is very acute in primary care.  The number of new primary  care doctors each year has fallen 50% since 1997.  Some estimate the shortfall by 2020 to be close to 200,000 MDs.  The problem is widely know to be exacerbated in rural areas. 

While healthcare reform legislation is taking steps to remedy the situation, aspects of the legislation are likely to overwhelm currently practicing doctors before the "fixes"are implemented.  First, insuring the uninsured will swell average MD patient volume.  The uninsured rate is close to 15% of the population.  But in some states the increase will be much greater. California's uninsured population is 18.5% and Florida's is over 20%.  In addition to insuring the insured there are a number of areas, where the legislation removes co-pays for wellness and prevention visits (Medicare).  Insurance companies long ago learned the value of a co-pay to depress "nuisance" MD visits so their removal will increase the number of currently insured into doctor's offices.  Lastly, there are provisions in the bill which will force MDs to prepare detailed health assessments.  One such provision is the Senate's version of the Legislation Section 4103 titled "Personalized Plan Services" which will ask MDs to prepare a detailed wellness and treatment plan for Medicare beneficiaries.  In the final 358 page amendment to the Senate plan also calls out mandatory patient medication plans and services to improve Medicare beneficiary Rx compliance and management.  Indeed preparation of these plans will take even more time out of an already MDs overloaded day.

The overloaded physician as an opportunity won't be missed by savvy Pharma Cos.   The MD is their customer and what ails their customer is an opportunity to build back eroded relationships and gain enhanced access.  What can companies do?  Well.... strategies and tactics are only limited by imagination and of course regulation.

Let me provoke a few neurons in the gray matter.  One idea would help MDs adopt productivity enhancing IT which will help MDs save time.  Smart phone apps might be the way to go as 64% of MDs now have smart phones.  Another idea might be to consider the use of nurse educators as an adjunct to Rx therapy helping to improve patient outcomes and preserve MD and staff time.  This approach is used very successfully in the MS and Diabetes markets by Pharma.  Better yet, it has been strongly endorsed by satisfied doctors and patients alike. 

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