By Tom Schramski, PhD, CM&AA 

Volume 3 Issue 9 April 26, 2016

Last month I was scheduled for my third colonoscopy, not unusual at the age of 64.  The night before, I reserved a local taxi for a specified pick-up time to take me to the appointment.  Ten minutes before the scheduled arrival I called to confirm and was told that “due to demand” they “could not guarantee” that I would be transported on time for the procedure.  At this point, I immediately pinged a local Uber driver who arrived in less than five minutes and cheerfully drove me to Desert Sun Gastroenterology Surgical Center.  Everything went well at Desert Sun and I was in and out in one hour and 45 minutes.  The service was first class, I reviewed the results with Dr. Tsai before I left (no polyps) and, as I departed, I told the nurse that I was shocked the process was so easy.

Why was I shocked?  Because my last colonoscopy was at a local hospital where I was asked my Social Security number four times, waited forever between intubations (which failed twice) and anesthesia, struggled for more than one hour to recover from the anesthesia, and I had to return another time for the physician’s review of my results.  Total procedure time?  Six hours plus the follow-up visit.

The juxtaposition of Uber (transportation) and a colonoscopy (healthcare) illustrates the dramatic and positive opportunities that are emerging in our world of disruptive innovation.  We are less constrained than ever in our choices, and physician providers are paying more attention to what we want as consumers.

The implications for healthcare and related investments could include the following:

• The continuing emergence of the entrepreneurial physician will fuel the accelerating proliferation of outpatient, non-acute care facilities, ranging from endoscopy centers to office-based vascular labs (OBLs), given the strong value proposition and consumer preference. Another great example can be found in The Laser Spine Institute, which utilizes a minimally invasive alternative to open neck and back surgery. Post-procedure care can be provided in your own home with no inpatient exposure to infections or unnecessary expenses.

• Hospitals that have embraced massive consolidation efforts may intensify their rethinking of what they have created (many have) in the face of what they are learning.  They are being trumped (sorry) on value and choice, with many patient surveys also suggesting most physician-operated clinics are safer, friendlier and more customer-oriented than hospitals.

• The outpatient approach will increase across all healthcare vehicles, from urgent care centers to intensive outpatient (IOP) models of substance abuse treatment, especially as research supports their efficacy and payers endorse their reimbursement.  Certainly, some interactions require in-patient treatment, but 10 years ago did we believe that effective Type 2 diabetes management would ever take place in a Minute Clinic?

• Investors in healthcare are becoming increasingly sophisticated. They will continue to lead much of the innovation while putting their “dry powder” to work in the growth of new post-acute outpatient healthcare models (check out Honor and Healthloop as investor-driven examples). This will further encourage progress.

There will be more turns in this physician practice evolution and we are all fortunate to be experiencing it.  Whether you believe in the current attempts at healthcare reform or not, it has helped to force a change in perspective.  The real revolution is more significant and not that far into our future. In the mean time, try Uber when it’s available.