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Becker’s Healthcare Podcast
Scott Becker - The Most Important Trends Happening in Healthcare Today 3-9-26
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This is Scott Becker with the Becker Healthcare Podcast. We're going to talk today about several of the most interesting thoughts and trends in healthcare. We'll talk about some of the most interesting and encouraging things. We'll talk about some of the most alarming developments. We'll then touch on some of the most important developments. We'll discuss artificial intelligence, and we'll talk a little bit about government and healthcare. For finally, we'll answer the question somebody asked me do I think as an outsider to healthcare, meaning not a physician, not a healthcare administrator, do I think the healthcare world is crazy or not? So let's try and go through these five or six subjects and I'll try and do so relatively quickly so I can get people in and out of this podcast in 15 minutes. So the first thing when I look at what's encouraging in healthcare, the first thing I see that's encouraging in healthcare is, is that over the last few years we've expedited tremendously as a nation the way in which we're developing nurses, advanced practitioners and physician assistants. We're now producing about 200,000 nurses a year. Just a couple of years ago, that seemed like an impossible number. That's done a great job to help fill the gap in the amount of nurses that we're creating a year. There could be some complaints about how quickly that's being done, about the lack of experience, some of the nurses. But all in all, I think this is a great thing that we've had that we've accelerated this. In Contrast, only about 23,000 doctors a year start med school a year. So we've got this huge daunting difference between the amount of nurses we're producing and the amount of doctors are producing. Second thing that's encouraging is cascading use cases with technology. More and more ways that AI is making a big dent on the administrative side, whether it's ambient listening, whether it's revenue cycle, whether it's or management, predictive analytics. Lots of places we're seeing cascading use cases with technology and artificial intelligence. Third, lots of improvements in pharmaceuticals in streamlining the way in which people get their pharmaceuticals. Again, still lots of challenges for very challenging rare diseases, pancreatic cancer, brain cancer, still not a lot of progress, but generally continuing to fund research. We need more and more support of the National Institute of Health and Research in the country, but still overall as a nation doing a tremendous job developing pharmaceuticals and solutions in personalized solutions and precision medicine. Fourth, and this may be a negative or a positive, but I'LL try to choose it as encouraging. I think there's greater recognition as a nation that we have a health care crisis coming and that we've got to deal with it. I hope that that gets more front and center. Washington still seems not focused on truly problem solving and fixing problems, but hopefully we've got more and more of that recognition that we've got a true health care crisis coming and we've got to find a way to solve it. Finally. Fifth, greater recognition that the money that is spent back and forth from government to massive insurance companies isn't helping. And in some ways it's just a massive money transfer that's leading essentially to greater healthcare, that we're putting more money through insurance companies, whether through Medicare Advantage, through Medicaid or other ways, and it's not really leading to reducing cost for improving health care. And that, quite frankly, we'll talk about this in a second, that we're moving in the wrong direction largely when it comes to the triple aim, quality, cost and access. And again, this is a complicated issue because we need subsidies so people can afford health insurance because it's so expensive. At the same time, the more that we subsidize things through the insurance companies, the more the costs continue to escalate and go up. So those are some of the most encouraging things that we see. And I know I've sort of hopped the line there a little bit with some discouraging and challenging issues as well. Here are several of the most alarming developments in health care. First, growing shortages of specialists and subspecialists. Only about 23,000 doctors start medical school each year. We find more and more that the bench of specialists in certain cancer certain areas is really, really short in our country, that even though it appears that we've got a lot of oncologists, they are overwhelmed. When you get into subspecialties, we are really, really short. Second, Washington, D.C. seems largely broke to me in terms of actually solving problems. You've got the left on one hand talks about coverage for all. We agree with coverage for all. The right talks about the free market in health care. The answer, of course, is somewhere in between. We already don't have a true free market. More than 50% of health care about that is being done through governmental pay. And coverage for all is great. But coverage without fixing the supply problem is like writing a check you cannot cash. We've got to do both. If you want to talk about coverage for all, I'm a big fan. But at the end of day, we got to Fix the supply problem in health care too. Third, problem, alarming situation. There's so much talk by academics, by others about the payment system and I think a lot of that is misguided. A lot of that discussion should be on the supply problem. How do we fix supply through technology and doctors and specialists versus focusing so much on the payment system. Yes, the payment system is its own quagmire, but at the end of the day, we have 350 million people in our country, only a million or so doctors. We've got to get that some progress made on that supply problem. Fourth, cost, quality and access, all going in the wrong direction. Used to be that people thought you can get two or three of these right or one of three of these. Right now it seems like cost is going up, quality is going down and access is really challenging. Fifth, the length of medical education in our country has become about a 12 year phenomenon. Four years of college, four years of med school, three to four years of residency, often one to two years of fellowship. They do it quicker in other countries and we're the beneficiaries of it. Medical education in our country, we produce great doctors, but we do so incredibly, inefficiently, inexpensively. Medical education was developed largely before the Internet in our country. We've got to figure out a way to expedite it to get people out of med school and residency and practicing by 28, 29, not 30, 32. Particularly as more and more doctors go part time by 40 to 50. The numbers just don't work. The number of doctors compared to our population. Sixth, rural healthcare is in a vicious cycle. Not enough doctors, not enough population. More and more of the population moving to the top metro areas, doctors and population. So we've got this vicious cycle of what happens in rural areas in terms of health care is more and more of a country moves away from rural areas, really trying to take care of those areas and have them be growth spots versus dying healthcare spots. Really challenging. Seventh, we've got this increased tiering of healthcare. You used to have commercial and governmental and indigent. Now you've got a whole build of concierge medicine which Only the top 5 to 10% of wealthy or affluent people can afford. Then you've got commercial insurance, then you've got governmental insurance, then you got indigence insurance. You've got more and more multiple tiers of health care. This long term is a disaster from a health equity perspective. Again, I don't blame the doctors or the systems one bit, but we got to fix the Supply problems. Eighth, we have a massive aging of America. More older people than younger people. And this creates a real challenge. When so many of our safety nets, Social Security, Medicare, other things have been built on the concept that a lot of people will be working compared to the people not working compared to now you've got this massive aging of America economically, the amount of cure that's needed creates real challenges, real problems. Finally, ninth, 40% of hospitals are losing money. So that is a real challenge. Hospitals are the safety net of our healthcare system, plus doctors. We've got to get those two things situated better while we also produce more nurses and PAs and pursue technological solutions. Third, we'll talk about some of the most important developments that we see and that we need and I'll go through five or six of them. First, the need to get the best and brightest into med school and into specialties, to keep on trying to make it really attractive to get the best and brightest to go to med school versus law school, accounting, finance, all these other areas. Technology. We need both. We need a lot of the best and brightest going to med school too. Second, we need to figure out a way to get our doctors out of school sooner and practicing sooner. We need to update medical education. We produce great doctors, but we do so in a very lengthy period of time. Third, you've got to find a way to increase the amount of specialists and subspecialists. And part of my sense of this is we're going to move a lot of primary care over time to PAs and advanced practitioners. So in the meantime, we've got to figure out how to increase the number of specialists and subspecialists. Fourth, we're going to have constant improvements in technology. And my belief is it's technology plus doctors and nurses that will solve the problem. It's not one or the other. Fifth, many of the solutions and technology are 2X solutions. They help leverage our population better, they leverage our doctors and nurses better. They don't replace our nurses and doctors. It's sort of both. You need great technology and great doctors. Sixth, great developments in medicines, GLP1s, other types of things that could really help people. We're still struggling in many types of cancer in the precision medicine and so forth is really helpful, but still not there for a lot of different areas. Finally, seventh, there's this need for any system to be great at something that whatever you're doing, you've got to be great at it. So that's sort of the most, some of the most important developments that we're watching technology, pharmaceuticals technology plus people solutions, and trying to expedite and accelerate medical education. In terms of artificial intelligence, it's almost like there's a spot when the apple, the iPhone was developed. There will be so many different use cases that we can't even imagine right now. We're already seeing a ton of use cases around ambient listening, revenue cycle, predictive analytics, a lot of other areas. And we're seeing this cascading evolution of clinical use cases cases, and we'll see how that evolves, where it gets to Finally, I'll talk for a second about the government and healthcare from my perspective. In terms of actual problem solving versus sloganeering. The government is largely broken. They don't seem to want to figure out health care. They want to figure out getting reelected. Again, the left often says coverage for all. We totally agree with that. But coverage without supply and access is a disaster. The second the right often says get the government out of our health care. That again, is ridiculous because the government's already half of health care or something like that. Neither seems to be really focused on solving supply demand challenges. I think that's a real problem. We've got to get more government focused on really problem solving versus sloganeering. Finally, most health care economists that talk about health care are often agenda driven, narrative driven, often misfocused. You could talk about all you want about economics and payment systems. There's problems with fear for service, there's problems with decapitation, whichever payment system you use. But if we don't solve supply and demand, we've got real, real challenges. One of the things I think about is in health care, and this goes back to the question, as an outsider, I think it's crazy. I don't at all. I think the beauty of healthcare is we're taking care of 350 million people. It is the third largest country in the world after China and India. We do it in many ways very well, but it is challenging and getting harder and harder. The other thing that I love about health care is every single one of us is a consumer. So no one can really pull the wool over your eyes as to what's going on in health care because we all are consumers and in some ways all of a front row seat at it because we have the same access problems that others have and see it very clearly. So some of us might have better access than others, but at the end of the day, we really are in a spot where all of us are consumers and all of us face different health care challenges, different health care problems and see the system in different ways, but we all have our own lens on what healthcare looks like. We end up in the ER for good reason because we can't find access elsewhere elsewhere. And that's why, you know, there's so many different discussions about this. But I love the fact that we're all consumers, all see it. Finally, we do do this far better than a lot of the other largest countries in the world. There's a lot to be thankful for, but we've got to make some serious improvements as well. I hope people find this helpful. I hope you listen to it all the way through. There's obviously so much more we could talk about. We've got all the shortages of behavioral health resources. So much we can talk about. Health equity is challenging. There is so much to talk about in healthcare. These are just some of our thoughts, some of the things we want people to think about. Again, feel free if you listen to this all the way through, if you enjoy it or you hate it. If you're the first person to text me at 773-766-5322, I'll go ahead and send you a $100Amazon gift certificate to thank you for listening again. Scott Becker, founder, publisher of Becker's Healthcare. Thank you so much for joining us.