While today’s stagnant economy and job scarcity has taken its toll on most of the country, it has also been a boon to entrepreneurs. The recession has given many people inspiration to learn from their previous mistakes and look for new opportunities. Now as these people bounce back from the recession they’re looking to a new booming sector – healthcare. Although there’s a lot of work to do, healthcare shows great potential.

Healthcare is always dismissed as bland and paper work orientated job, but new innovative ideas are changing this. In fact a Business Week article indicates new technologies are rapidly improving healthcare and putting it at the cutting edge of innovation. More specifically tools like E-CARE enable hospitals to reduce waste, safeguard privacy, and save lives. E-CARE can facilitate these goals because it allows people to share medical history and information.  The article further notes the advent of personalized care is leading to new innovations in medicine and technology. Currently, customized medicine is expensive, but can revolutionize healthcare quality and delivery. All together new discoveries and inventions in healthcare are vigorously sought after. This places the healthcare industry not only at the forefront of innovation but also at the perfect place to achieve sustainable growth.

Sustainable growth, as the 2008 credit crisis has proven, is very important. Investing in massive growth real-estate schemes and accepting sub-prime mortgages showed America that prioritizing short term growth could be deadly. So while other industries withered away in the credit crisis, healthcare stood resiliently. CNBC concurrently pointed out healthcare is a recession-proof industry – to some extent. The article extrapolates that healthcare industry’s ability to adopt market conditions and provide essential care precludes its complete downfall. Even better, one year after the credit crisis had begun medical and diagnostic labs saw 8.22% jump in growth from 2008. Moreover, new government funding will ensure consistent growth over the next few years. A Forbes article notes the new governmental emphasis on healthcare means the industry will have to increase its workforce by 30% by 2020. Likewise, a Georgetown University study adds that after all is said and done that amounts to three million new jobs. This would make the healthcare the fastest growing sector in the US. Although job security is great, healthcare, as the Forbes article points out, also boasts a competitive earning potential. The reason is simply there is a high demand for healthcare workers, so qualified people will be paid more than usual.

All in all, the healthcare industry boasts many advantages over many other sectors. Thus the Wall Street Journal rightly notes the industry’s potential has made the entrepreneurial spirit infectious. Seeing the possibilities, entrepreneurs are realizing healthcare shows a lot of promise; not just from what has been done but what can be achieved.

As the sequester looms closer everyone, including politicians, is looking to save money and to eliminate inefficiency. Furthermore if Congress fails to act by the end of the month, The Washington Post reports it will trigger $1.1 trillion in spending cuts. Spread across the board, these cuts will drastically affect everything from defense spending to Social Security. So the question is: where do we start? As shown the healthcare industry is rife with waste and inefficiency. Along with popular discontent with the industry, this sector is a perfect place start. However, instead of turning inwards to look for a solution, (which has failed countless other times) we’ll take a look at what other successful countries have been doing.

Switzerland – In terms of healthcare Switzerland has made much improvement over past two decades. Fareed Zakaria, editor of Time Magazine, points out about twenty years ago Switzerland had a healthcare system like that of America with similar problems. After intense debate Switzerland decided on an individual mandate system; a system where everyone is required to have healthcare. Although akin to Obamacare at its roots, this system gets Switzerland a better deal on healthcare by, as a NPR’s Julie Rovner reports, not allowing insurance companies to make a profit on basic healthcare. This saves Switzerland money because it now only has to spend 11% of its Gross Domestic Product (GDP) on healthcare, while America spends 17%. All the while, Switzerland’s quality of care remains high, costs have been reduced and satisfaction remains is high. In terms of Swiss healthcare, both Republicans and Democrats have something to agree. PBS contends while Republicans may not approve of the individual mandate, unlike Democrats, they’ll be happy find out citizens choose from a potpourri of private plans. The article goes on to say one of the major downsides is the relatively high cost which is pushed on to the consumers.

Taiwan – As Taiwan began its ascent into economic prosperity in the 90’s the Taiwanese government realized reforming healthcare was imperative.. Fareed Zakaria notes the outcome was also the individual mandate system, but a bit different from the Swiss system. Instead of choosing between a selection of private insurers Taiwan created one big insurer (similar in concept to Medicare). The article further states the end result was unprecedented low costs with Taiwan only spending percent 7% of its GDP on healthcare. Moreover, the same PBS article points out Taiwan significantly cut costs after expanding health insurance to 40% of its citizens. And in terms of coverage, NPR’s T.R Reid states that Taiwan has created a consolidated system with no “gatekeepers”. For instance if someone woke up with shoulder pain he or she could go and visit an orthopedic specialist the same day. The idea behind that is people are smart enough to choose their doctors; consequently this system boosts efficiency by removing an unnecessary intermediary. The article goes on to say that the creation of the “Smart Card” (a card which has the patient’s entire medical history encoded on to it) has reduced administrative costs because providers no longer have to bill the government. All together the time, money, and frustrations saved results in great efficiency.

France – In 2000, The World Health Organization ranked France number one in healthcare out of 191 countries. France also has universal healthcare provided by the government, and as NPR’s Joseph Shapiro says most of the funds come from income tax. This allows to the French government to reimburse nearly 70% of medical costs. The Boston Globe adds like Taiwan, France gives its citizens the option to the doctor or provider of their choice. Moreover on top of government required health insurance Time Magazine finds most citizens have supplemental insurance to cover other expenditures. With all this, the French barely pay anything out of pocket. Consequently the results are positive on all levels. The Time article goes on to say France has the lowest death rate, the best early care, and best survival rates among people with expensive and life-threatening illnesses. Unfortunately there is a downside. The French still spend a lot on healthcare compared to its European counterparts, but still less than half of what America spends.

While an individual healthcare mandate has shown promise in the listed countries, it also has disadvantages. A CATO study points out several reasons. Firstly, most supporters of universal healthcare assert that an individual mandate would eliminate free riders (people who pass on their bills to the government). However, the article notes that most “free riders” pay 25% out of pocket, have insurance which pays 33% of their bills, and do not pass on costs to taxpayers. In other words, an individual healthcare wouldn’t drastically improve the situation. Secondly there’s the problem of noncompliance. In most states like California auto insurance is mandatory. In spite of that 25% of them are still uninsured while national average is near 12%. The point made is we should convince consumers pick the most efficient option not coerce them. Thirdly, an individual mandate shields providers and consumers from costs making both of them less cost-conscious. This in turn discourages cost saving innovative ideas because everyone is covered by the government. Thus the consumers will blame the resulting rise in cost on insurance companies thereby justifying further governmental intervention.

All in all, there’s a lot good ideas from all of these countries and many more. Although throwing arbitrary ideas at America’s healthcare problem won’t solve anything. A properly planned system will go a long way to solve the healthcare dilemma.

The inefficiencies in the US health care are the talk of the moment these days. And though healthcare is the center of many debates across America the situation on the ground doesn’t seem to be improving fast enough. With increased focus on use of technology to solve some these inefficiencies, the question is, Can health IT really make a difference?
The Health Information Technology is loosely defined as this overarching umbrella of technology connecting everyone. In essence, people, from consumers, to doctors, to health systems, to insurance companies, can now securely exchange health information. Overall this increases safety, quality, and the efficiency.

Let’s start off with some facts. The Atlantic points out the healthcare industry wastes $750 billion annually, a price comparable to the eight yearlong Iraq War. In fact, the article reports the majority of this waste comes from unnecessary services, excess administrative costs, and inefficient care delivery. Secondly, the Institute of Medicine, reports that if doctors would take a few extra steps (e.g., order fewer procedures and consolidate records) it would drastically reduce waste. And thirdly, The New England Journal of Medicine states patients also exacerbate the problem. The fact of the matter is when people are slightly sick and don’t receive proper medical attention they go straight to the ICU. This increases cost in two main ways. First, when there’s more demand and less supply prices for a service will go up – simple supply and demand economics. Second, the majority of people who go to the ICU for any treatment are unable to pay back their debt. Thus the hospital pushes these costs to the insurance companies and with so many cases increase everyone’s premium so they can continue to make the same profit margin.

Luckily newly integrated technologies have given some hope to this sector. After much research the Annals of Internal Medicine concluded the functions of Health IT can enable the industry to tap unprecedented levels of efficiency. The study reports that new technologies can specifically affect administrative capabilities, electronic documentation, and other factors that cause inefficiency (as identified by the institute of medicine). As for the results they have been remarkable too. Early results show that in terms of quality, patients received better care due to easy access electronic records. As for efficiency and cost: patients were using fewer health services because the system provided one clear cut prognosis. The list goes on and on.

We at DocASAP are proud to be a part of the solution here. Easy access to doctors anytime and simplified referrals not only minimize everyone’s frustration but also enable reducing some of the key inefficiencies plaguing the system.

We are pleased to announce that DocASAP is now live in New York. From primary care physicians to orthopedic surgeons we have hundreds of doctors now live with comprehensive profiles and ability for consumers to book appointments online. New Yorkers now have a choice of using a care provider scheduling service that looks at healthcare and access holistically.

We are also very proud to announce the launch of our partnership with prominent regional health network, MagnaCare. MagnaCare covers more than 1.2 million lives with about 60,000 providers in their network. DocASAP is used to power the provider searches on the MagnaCare website to ensure patients find their perfect doctor for whatever the visit reason may be. Not to mention patients have accessibility to book appointments right on the provider directory website on MagnaCare.com. MagnaCare CEO Joe Berardo says, “This partnership exemplifies MagnaCare’s focus on the patient, as well as our commitment to meeting evolving healthcare needs and adopting the latest advances to optimize every level of care coordination.” For DocASAP this is a step in the right direction and allows us to display our optimistic outlook towards value creating alliances in the ecosystem.

Simplifying healthcare access is our core focus. And so, we are not just solving the patient scheduling but also comprehensively handling the whole care coordination process across specialties and diagnostic centers.  Further, features like patient check -in and filling the practice forms beforehand are standard since the very beginning

We are excited and look forward to exciting times here in The City That Never Sleeps while providing ways to access care 24×7.

It seems every summer we arrive at the month of August with feelings excitement and sadness. “Summer just started! Where did the time go?”  The beach lowers on our priority list and mixed feelings begin to stir as fall preparations are in order.

The DocASAP intern team faces a very bittersweet day as we quickly approach the end of our amazing experience. The seven of us worked with such fluency. There was never a question unanswered or help offered when needed. It was important for each individual to walk away with knowing something they hadn’t known before.

So now that the London 2012 Olympics are over, our internship is ending and those mid-July back to school commercials continue to bombard our televisions, we seem to think, now what? Instead of dwelling on summer’s end, we are thinking positive. Each the interns are excited to use our experience with DocASAP and apply it to our lives. Intrapersonal skills were gained, not to mention sustainable relationships. We look forward to see how DocASAP grows over the next few years and happy to be a part of this great company.

As many of you already know, this week is Shark Week on the Discovery Channel. Curiosity brought us to research Shark Bites on WedMD (pretty gruesome, I know) to see if there were any informational points about shark attacks that are not already common knowledge.

The ones that stood out:

-  Many people do not immediately know if the sea creature that bit them was actually a shark or another sea animal, such as a barracuda.

-  Most species of sharks are not documented attackers of humans (360 out of 400 species.)

-  Though sharks are most notorious for causing bite injuries, shark skin can also cause injury (scrapes) when it comes in contact with human skin because of its coarse texture.

-  According to WebMD, most shark bites do not cause significant deep wounds that result in blood vessel or nerve injury.

-  A significant factor for shark attack victims to consider is wound infection, since many bacteria exist in seawater that are not prevalent on land.

To treat a shark bite, apply pressure to any bleeding source. Provide warmth to the victim when out of water and take the person to a hospital for a doctor to treat life-threatening injuries.

As Shark Week reminds us of the potential (but admittedly improbable) dangers of beach-going, the DocAsap intern team is rather happy learning about these fascinating animals on our desktops instead of finding out firsthand (yikes.) Happy Shark Week!

It’s that time of year. Kids are getting ready to head back to school…and school nurses are getting ready to see the seven most common school-borne illnesses. Seeing as many DocASAP users are family-oriented individuals (with young ones dearly holding onto the last month of the summer), we figured we’d give families the heads up to remind their kids how to stay healthy in school.

So Here’s The List: (some of these are looking pretty familiar…)

Colds. Stomach flu. Strep throat. Chicken pox. Mononucleosis. Pink eye. Head lice.

We’re no doctors, but there are a couple tips out there that should be common knowledge to every parent (and child!) to avoid catching these illnesses. Here are a couple of points to reiterate to your child:

1. Wash your hands! After using the restroom, after recess, after arts and crafts…you get the idea.

2. Don’t share food and drink. Many illnesses (such as mono) are spread by saliva, and it’s just not sanitary to share food in general.

3. Cover your mouth when sneezing and coughing – and try not to use your hands. Sneezing or coughing into the crease of your elbow, although not entirely effective, does curb the amount of germs spread to others and especially curbs the amount spread by hands.

Here’s to a happy and healthy rest of the summer and school year!

http://www.rexhealth.com/school-borne-sicknesses

Photo Credit: http://www.insuranceproviders.com/what-is-a-copay/

Physician visits in the US are much more costly than in other countries. Take this statistic into consideration: the average physician visit costs $89 in US, $30 in Canada and $16 in India. Corrected for price parity, the average cost of a physician visit is five times as expensive in the US compared to Canada and twice as expensive compared to India.

Why? Let’s look at a breakdown of the overhead expenses doctors have to consider in pricing a patient visit:

• Medical licensing fees
• Medical malpractice fees
• Compensation for the uninsured
• Medical equipment/supply costs
• High tech advancements in the office
• Compensation for the work of receptionists, office managers, nurses and others
• Rent, utility and janitorial expenses

Which factors listed above pose significant differences for the US compared to other countries?

Medical malpractice fees. Generally speaking, the practice of defensive medicine in the US is widespread, which exists in other countries but only to a limited degree. In many other countries, lawyers do not render services on a contingency basis and instead are exclusively paid for their services in malpractice cases by the hour. This can make the cost of hiring a lawyer extremely expensive and dissuade wronged patients from initiating lawsuits. Some hospitals in other countries even create their own medical malpractice policies to set compensation rates, which are meager in comparison with US malpractice settlement rates. If there is less of a chance of being sued for malpractice in other countries (because of higher expenses and lesser rewards for those suing), the demand and cost for malpractice insurance in those countries will decrease.

The uninsured. The price of a patient visit may increase according to the amount of uninsured patients a doctor treats free of charge or at a reduced rate. Dr. Manoj Jain, a writer for the Washington Post, inflates the cost of a visit for all patients in his practice to make up for the cost of treating uninsured patients, which comprise about 10% of his patient base. This practice may differ from countries that have universalized healthcare systems in place to provide a base level of care for all citizens.

Medical equipment costs. According to the New York Times, the use of high tech medical equipment is more widespread in the United States compared to other countries. These devices are expensive to purchase and maintain, which results in increased patient fees to compensate for the cost. This may derive from the increased amount of specialist referrals in the US, which nearly doubled from 2001 to 2011 and is higher than the referral rate of any other country. Since specialists order the tests that involve the use of these machines, more specialist referrals means more machine-related costs.

Other high tech advancements. Other forms of high tech advancements that the United States dominates in terms of market share are electronic billing services and medical records, both of which bill users monthly. According to Accenture, the US EMR market share in 2010 was $7.4 billion, compared with Asia Pacific’s 2.3 billion, and Europe, Africa and Latin America’s collective $5.8 billion.

Services provided by other staff in medical practices. Medical transcriptionists, receptionists and office managers are an integral part of medical offices around the globe. What set US practices apart are the responsibilities these positions take on with respect to insurance companies: patient coverage checks to determine co-pays, calls to get approval for future referrals and tests, and paperwork resubmission in instances where insurance won’t pay a bill, among others. Countries with single payer systems spend significantly less time and money performing similar functions, which is reflected in lower patient visit costs.

Though many other considerations exist that are presumed to affect the going rate for patient visits (such as med school costs), overhead expenses are a major reason why patient visits are more costly in the US. It’s an uphill battle to practice cost containment and maintain patient satisfaction, and the argument as to whether increased cost means increased quality continues.  What do you think?

Cindy J. Chang, MD, Team USA’s Chief Medical Officer in London with US Athletes (Photo credit: http://www.newswise.com)

The Olympics are all about competition, and that doesn’t just apply to the athletes. According to New York orthopedic surgeon Dr. Scott Rodeo, US team physicians for the 2012 London Summer Olympic Games underwent a rigorous testing process to earn a spot to work alongside the best physicians, coaches and trainers the nation has to offer to ensure athletes’ health at the Games.

Candidates needed to apply almost two years in advance to fill only 80 spots on the 2012 US physician team. Apart from their work as practicing physicians, candidates needed to prove their extensive experience in sports medicine by having volunteered at one of the nation’s three Olympic Training Centers and working through the ranks to advance from domestic to international competitions.

Testing for candidates’ eligibility to work at these competitions usually entails a two week testing process at one of the training centers, where US Olympic Committee members judge doctors on criteria such as how well doctors work under pressure and how effective they are in communicating with athletes and coaches. Once they received the go-ahead from Committee members, doctors had to be licensed by the UK’s General Medical Council to be considered volunteers for the London Organising Committee of the Olympic and Paralympic Games. After all that, it was on to London.

But it doesn’t stop there. Doctors are on call throughout the duration of the games jumping from venue to venue as needed, and 16-plus hour work days are not uncommon. Doctors also have to make tough calls about whether injured athletes can compete.  It’s a lot of pressure. But the docs are enjoying the experience immensely, citing the sense of community and honor they feel in being able to volunteer for such a special event.  According to Dr. Peter Donaldson, one of the US team doctors alongside Dr. Rodeo, “There are few opportunities that come up in life that are as unique as this.”

The DocAsap team applauds all the athletes and doctors in the London Olympics for working their hardest and making us proud. We’d love to hear if any of our own docs are part of the team!

According to the American Medical Association, older doctors are a lot more technologically advanced than we might think. It’s not that these doctors are opposed to change. Being more experienced in the field (which means many fads have come and gone since their days as rookie MDs) has made older doctors more wary of following the trends, including the use of the internet or electronic devices to care for their patients, simply because “everyone else is doing it.”

However, if technological advancements are presented to doctors to make them believe these devices and services will make them more efficient, better satisfy patients and enhance the quality of care, they will be more inclined to take them up.

And it doesn’t matter how long the doctors have been in practice. The use of tablet computers, according to a study by QuanitaMD that surveyed more than 3500 physicians, was almost equal between doctors who have been practicing medicine for 31 or more years and recent medical school graduates. According to the researchers, doctors started using tablet computers to have better access to information. This study really shows that doctors young and old are benefiting from technologies that offer timely and up-to-date services – and older doctors are among the new trendsetters (despite what we might suppose.)

What’s my take on it, you ask? As a DocAsap representative, it’s exciting to see who is up for trying a service that is on the forefront of the new age of medicine. To hear that doctors want to get on board with us for the sake of being cool is great (I swear that some doctors really feel it’s a status upgrade to have an increasing internet presence), but it’s even more exciting to hear that they are up for it because they are adventurous and believe it holds long term value for all involved – and that is irrespective of the experience and age level of the providers we reach out to on a daily basis.

It’s no longer an argument about what age group is more willing to try new technologies. The bottom line is, it’s an argument about who has the attitude to try new things and who doesn’t. As long as new tech devices and services are believed to hold long term value at a reasonable cost, the technology implementation game is an even race between doctors new and old.