( continued from page 23 ) clear how the recent change in the political climate in Washington will affect MACRA . Congress , through MACRA , has once and for all finally put an end to fee-for-service health care delivery . Physicians and their assistants will be going from their present setting of seeing more patients for less , to one of working more while also being at considerable financial risk . They will both have the required “ skin in the game ” with health systems , MCO ’ s and other provider based health care organizations . All the financial elasticity will be gone from the health care delivery system . Physicians and health care providers may not be able work more hours or any harder . However , this new environment created by MACRA health care funding requires that all physicians and physician assistants will need to learn to work much smarter .
Poverty and other health care disparities have always been prime indicators of health . Employment improves health without any specific medical care cost and does not generally require the provision of health care . The unemployed enjoy better health when looking for work or taking job training . There is also some suggestion that community involvement improves health . Training programs should be designed to teach our physician assistants how to help patients deal with all these important health related issues . Physician assistants must be educated and skilled in dealing with the social issues of addiction , obesity , stress and the environment . Mid-level health care providers will need to understand how science-based medicine should be applied to all health care . Physicians and physician assistants should also understand that the health plan of the future must be designed to target all unengaged health care consumers . A “ big box store greeter ” may be needed to become part of the health care delivery team to triage patients in order to meet this need . Physician assistants as health care providers must learn how to document care and to understand the importance of the electronic health and medical record . They must be system thinkers who do not view performance reporting as just another example of “ processing ” irritants / grief . Physician assistants and their sponsoring responsible physicians must also be proactive when providing a value-added medical home for all of their panel of patients . A medical home should have a positive impact on the reduction of low quality and high cost unscheduled clinic visits , emergency room visits and hospital readmissions .
The future as a health care provider looks bright for physician assistants and all other physician extenders . There should be many open positions for the employment of trained , certified and licensed individuals interested and willing to do clinical practice as part of a health care delivery team . Health care management positions will be available to physician assistants who have other advanced degrees , training , people skills and leadership experiences . There will also be more opportunities coming available for interested physicians presently in practice to become chairpersons , program directors , professors and medical directors at universities and colleges offering a master ’ s degree program in physician assistant studies . The future manpower issue that some health care planners are working on is the concept of a six year medical school . It may be that the velocity of change will demand that the nearly 200 accredited physician assistant schools that are already in place be utilized to meet this projected manpower need .
Dr . Henderson is a clinical professor at the University of Louisville School of Medicine , Department of Pediatrics .
PROFESSIONAL ANNOUNCEMENT PACKAGE
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Are you opening a new satellite office ?
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The GLMS Professional Announcement Package provides mailings and printed announcements in the monthly publications to let your colleagues know about changes in your practice .
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CONTACT Cheri McGuire , Director of Marketing 502.736.6336 cheri . mcguire @ glms . org
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