Happy Birthday to Us

Quick, name the most important thing that happened in 1990.

The invasion of Kuwait by Saddam Hussein’s troops, setting the stage for the first Gulf War? The reunification of East and West Germany?

These are mere blips of history when compared to the birth of this magazine, which that fall offered Vol. 1, No. 1, under its original title, Physicians Practice Digest.

Twenty years seems like a long time. Yet what strikes me most is how little things have changed in healthcare.

Consider some of our earliest cover stories: “A Prescription for the Recession.” “National Healthcare Reform: Band-Aid or Solution?” “Physician-Hospital Gamble: Will New Relationships Mean Better Care?” Sound familiar?

Some things have changed, of course. No one had ever heard of an EHR in 1990. Our first technology story, in fact, offered advice about this strange new thing called “computerization.” And you’re now able to offer patients a host of advanced diagnostics and treatments that didn’t exist 20 years ago. And we’re paying more, too: Americans spent $1 trillion on healthcare in 1990, and about $2.5 trillion in 2009.

The quality of healthcare services for those who can access and pay for them has gotten better these last 20 years. But the overall efficiency of the healthcare system - its ability to deliver high-quality care to everyone who needs it - has gotten worse. And its long-term economic viability is more imperiled than ever before.

Healthcare’s problems are fundamentally the same because the perverse economic incentives that drive those problems are unchanged. Physicians are not correctly reimbursed for the services they perform in a system that emphasizes procedures over prevention. Doctors don’t have enough time with patients because they’re too busy justifying themselves to insurers. Physicians have every reason to shun low-paying, high-hassle primary care in favor of other specialties, so patients are struggling to gain timely access to primary-care physicians.

A cynic might ask: Why do we bother, if the problems identified 20 years ago (and earlier), remain? But our objective is to empower American physicians to deal constructively with the world as it is. Sure, we’d love a more functional healthcare system. But we see little value in advising you to sit around and wait for things to get better. Instead, we hope to help you understand your own practices and the forces affecting them, so you can craft the practice that meets your needs, and your patients’.

It’s been 20 frenetic, passionate, fantastic years at Physicians Practice. For that, we have you to thank.

Bob Keaveney is editorial director for Physicians Practice. He can be contacted via e-mail at bob.keaveney@cmpmedica.com.
This article originally appeared in the January 2010 issue of Physicians Practice.