The book covers several ways the physician-patient relationship has changed over the past five years, including:
1. Health insurance premiums increased significantly — some by around 45 percent — and patients are forced to switch insurers which may not cover their preferred providers. Insurers may have folded or dropped plans from the ACA exchanges due to rising costs as the insurance pool expands.
2. More patients are signing on to high deductible health plans, meaning their individual costs are more and physician offices are collecting a larger percentage of the entire bill from patients directly instead of insurance companies.
3. Physicians are focused on providing quality care and incentivized to meet new quality benchmarks and metrics instead of volume-based reimbursement. They are encouraged to work cooperatively with patients to achieve better outcomes, but it takes time to develop patters and trust between the patient and provider.
4. Physicians are seeing paperwork and documentation increase. The EHR and electronic data gathering requires physicians to enter data into the computer while talking with patients and families, putting a physical barrier between the patient and physician.
5. Reimbursement is decreasing for many procedures, so even with the focus on quality physicians must see more patients in less time. They are spending less time with each patient and sending their physician extenders to see some patients in the practice. Patients may not have consistent visits and follow-up care from their physicians.
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