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Integrated delivery systems continue to support primary care practices, despite a history of rising administrative responsibility and increasing losses on a per physician basis, according to a cost survey from MGMA. Obviously, the benefits of having an integrated primary care practice are not entirely reflected in the financial revenue shown per physician, the system or hospital often benefits from referrals from ancillary services.
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Hospitals plan to boost capital spending by 14% annually over the next five years, according to a new survey. Roughly three quarters of the 460 US hospitals surveyed said they expect to increase capital investment over the next several years. The big spending plans mark a turnaround from prior times when money borrowing troubles in the late 1990’s saw hospitals increase capital spending by just 1% a year between 1997 and 2001. The graph below shows where hospitals anticipate spending their money.
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Global pharmaceutical sales grew 9% in 2003 to $466.3 billion. North America, Europe and Japan accounted for 88% of the consumption, according to IMS Health. North American drug sales set the pace, growing 11% to $229.5 billion. European sales rose 8% to $115.4 billion. The ten best selling drugs accounted for $48.3 billion in sales in 2003, a 14% increase from the previous year. Pfizer’s cholesterol lowering drug Lipitor was the top selling drug with $10.3 billion in global sales, 2% more than the previous year’s sales. The most commonly prescribed drugs are used to address high cholesterol and triglycerides levels.
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Insurance costs keep rising. Many employers still pick up a large amount of the health insurance premiums, according to a national survey by the Kaiser Family Foundation. Even so, last year workers paid an average of $2,412 towards their premiums, an amount equal to 5.6% of the median household income. The percentage of premiums workers pay is expected to rise. Workers are also being requested to pay for annual deductibles and out of pocket costs such as routine doctor visits and prescription drugs.
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Recently there has been considerable literature focused on the shortage of certain specialists. For example, despite the growth in supply of cardiovascular specialists as shown in the graph below, the demand for certain skills has continued to exceed the supply. It is important to remember that more of the physicians between the ages of 50–65 are planning to retire, seek non-clinical jobs or significantly reduce the number of patients they see within the next three years according to a recent survey by Merritt Hawkins and Associations, a national physician search and consulting firm. Traditionally, physicians in their fifties and early sixties have been viewed as being at the peak of their careers. The survey results indicate that within three years, 17% of the physicians between ages 50–65 plan to close their practices to new patients or significantly reduce their workload, 10% plan to seek medical positions in which they would not be involved with patient care, 8% plan to retire, 7% plan to seek other non-clinical career alternatives, 6% plan to work on a temporary basis and 3% plan to seek jobs outside of medicine. Obviously, each of these options limits patient access to physicians and shows that the shortage of doctors may actually be magnified by “physician flight”. Also of note was that more than 50% of physicians surveyed indicated that they would not choose medicine as a career if they were starting out today. Only 36% of the physicians indicated that they would recommend medicine as a career to their children or to other young persons.
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