gp today & tomorrow

DR. AVINASH BHONDWE

WHAT ARE ESSENTIAL THINGS?

• STETHOSCOPE

• PAPER

• PEN

• BRAIN

THE DIFFERENCE OF INTERIORS

STORY OF YESTER YEARS

THE DIFFERENCE OF INTERIORS

TODAY

THE DIFFERENCE OF INTERIORS

TOMORROW

YOUR AREA……MAY BE A MARKET PLACE LIE THIS

OR A MOHOLLA LIKE THIS

OR THE RICHEST PLACE

WHAT I GET FROM PRACTICE?

• IS MONEY YOUR GOAL?

DO YOU WANT TOBECOMEAPROFESSIONA

LLIKE A FRUIT SELLER?

COMPETITIONThis rapidly expanding population of

physicians is already increasing the competitive pressure on practitioners to generate more income by using marginal or new unproven procedures, tests, and technology. As the number of physicians continues to increase, and as competition from outside the profession from nurse practitioners, chiropractors, and other kinds of health practitioners also expands, the pressure is bound to grow.

MEDICINES YESTERDAY

DISPENSING THE MIXTURES, POWDERS & COMPOUNDS

MEDICINES TODAY

• DISPENSING READYMADE COMMERCIALLY

PREPARED TABLETS &

PREFILLED BOTTLES

MEDICINES TOMORROW

EMAILING & DOOR DELIVERY

MEDICINES

• PURCHASE

• DISTRIBUTORS

• ONLINE STORES

GADGETS

• LABORATORY

GADGETS

• SPECIAL TESTS- STRIPS

GADGETS

• ECG

• HOLTER

• SPIROMETER

GADGETS

• USG

• 2D-ECHO

• CD

GADGETS

• STRESS TESTS

SURGICAL

• MINOR O.T.

SURGICAL

LASERS

PHYSIOTHERAPY EQUIPMENTS

COMPUTERISATION IS THE KEY

COMPUTERS

• REGISTERS

• RECORDS

• ACCOUNTS

COMPUTERS

• INFORMATION- DISEASE/DRUGS

• DIAGNOSTICS

• Telemedicine: Emergence of the Virtual Doctor January 26, 2001 was a significant day for India in

more ways than one. Apart from being the country’s Republic Day, the day was also marked by the devastating earthquake in Gujarat. Some 40,000 lives were lost, and over one lakh people were badly injured. The need at that point in time was to immediately treat the injured and provide healthcare facilities to prevent further deaths. But given the magnitude of the calamity, the number of available medical personnel proved inadequate. To make matters worse, many hospitals and other medical facilities were destroyed by the earthquake.

Telemedicine:• In this gloomy scenario one promising

technology made its impact: Telemedicine. The day after the earthquake, the Ahmedabad-based Online Telemedicine Research Institute (OTRI) came to the rescue and established the first communication link from Bhuj, which was close to the epicentre of the quake. Within the next four days, OTRI established a disaster management system with online transmission from places like Rapar, Bhachau, Gandhidham, Anjar and Ahmedabad, with the control room based at Gandhinagar.

•Specialists were able to provide consultations from far-off places, thanks to the established telemedicine links. For example, after the telemedicine centre was set up at Bhuj hospital, an X-ray facility was provided to the people whereby a specialist provided online consultation from Ahmedabad. During the subsequent days, quake victims could get medical advice from other doctors based at Ahmedabad and Bangalore. Over 750 sessions were established in a period of 30 days, thus saving many lives.

Telemedicine:

• Telemedicine :-A method by which patients can be examined, monitored and treated, while the patient and doctor are located in different places. The patient’s reports can be sent via text, voice, images or even video, and medical advice offered from a remote location.

COMPUTERS

• EMAILS

• WEBSITE

• CONFERENCING

Email is a great tool to communicate with patients

•As appointment and preventive health reminders •To communicate small, discrete packets of information. •The asynchronous nature of email can afford efficiency to patients and providers that other forms of communication cannot. •Email has value beyond patient communication. Providers can use email to communicate with specialist or other members of the care team.

TYPE OF PRACTICE

TYPE OF PRACTICE

• HOSPITALS OF GPS- CALLING SPECIALISTS

• MULTISPECIALITY HOSPITALS

• INVESTORS HOSPITALS

The Investor-Owned Hospital industry,

INSURANCE FACTOR

• The third-party reimbursement system

also had an important effect on the behavior

of patients. They became claimants for medical care to which they felt entitled because the insurance premiums had been paid, and they had no personal interest in what things cost, since there were no out-of-pocket expenses.

A nationwide network of over 45 medical equipment distributors can place and service the system you purchase with otherdoctors in hospitals that actually use the equipment. The doctor or hospitalusing your equipment then pays you for each ECG they run, with a minimal monthly guarantee.” The ad goes on to explain how the purchase and subsequent lease of this equipment provides a physicianwith depreciation,

NEWER INVESTIGATIONS

“Dear Dr.: You probably recognize thevalue treadmill exercise testing and Holter monitoring/ INSULINS have in helpingyou deal more effectively with the epidemic incidence of coronary heart/ DIABETES & disease . . . but may have questions about the procedures and how they will fit into your setting. What better way to evaluate the role of either or both of these valuable procedures than to take advantage of this SpecialOffer. . . . ”

SPONSOR FACTOR….

The ad then explains that the company will pay the doctor’s travel and lodging expenses to attend a two-day professional educational seminar on exercise testing and Holter monitoring, which is to be held in Taj Goa/ XYZ.

For those who purchase equipment, the company offers to pay all expenses for two, for a week in a luxury hotel in Goa/

SPONSOR FACTOR

They further offer to train the doctor’s office staff and provide a sixty-day period to evaluate the procedure on a lease or rental basis. They also offer to reimburse the doctor the difference between billings, and the rental during those sixty days. This kind of appeal evidently does not fall on deaf ears because the ad concludes this way: “We have assisted literally thousands of Physicians to evaluate the role of these procedures in their setting. Let us send you referrals in your area.

SPONSOR FACTOR

FINANCIALS

LEGAL & NEW ACTS

• SHOP ACT

• BIO MEDICAL WASTE

• CLINICAL ESTABLISHMENT ACT

• ETHICAL REGULATIONS

• LAW AGAINST MOB VIOLENCE

KNOWLEDGE

• BOOKS• MAGAZINES• WEBSITES• SEMINARS & CME & WORKSHOPS• CONFERENCES• MEDICAL ASSOCIATIONS• STUDY GROUPS/ PEER GROUPS• EXAMINATIONS

• In the long run, physicians must be in charge of medical care, but they must live within budgets and be accountable to payers and to their patients. The only solution that makes sense to me is one based on multiple local physician networks, organized on a not-for-profit basis. In short, I predict that staff and group model HMOs, with salaried physicians, will be the mainstay of the medical care delivery system within a few decades.

• Personal medical home

• Commitment to provide a defined basket of services

• Advanced information systems, including electronic health records

• Elimination of barriers to access; open access by patients

• Team approach to care

• Whole-person orientation

• Focus on quality and safety

• Enhanced practice finance

• Redesigned, more functional offices

• Care provided in a community context

DOCTOR PATIENT RELATIONSHIP