Vital Times 2014 - (Page 12)
ADAPT AND PROSPER
A Guide to Survival as
Fee-for-Service Payment
Crawls Toward Extinction
By Keith Chamberlin, MD, MBA
W
hen Charles Darwin wrote about "natural selection," he also used the
phrase "survival of the fittest." He didn't mean survival of the biggest
or the most ferocious. After all, T. rex didn't outlast the Cretaceous Period.
Darwin's work revealed the secret that those who survive are those who
learn to adapt. And that applies to anesthesiologists as much as to birds or
any other creatures.
We are being challenged at every turn with the need to adapt or perish. New
clinical techniques evolve all the time, requiring us to learn and improve:
*
There is another
change that will
challenge us
and physicians
everywhere:
the constantly
evolving change in
how we get paid
for what we do.
12 | CSA Vital Times
*
*
*
Advanced imaging - ultrasound, transesophageal
echocardiography (TEE), bedside transthoracic
echocardiography
Ultrasound-guided peripheral nerve blocks and catheters
Blood utilization protocols
Video and other indirect laryngoscopy techniques
The closer you are to your residency, the less stressful these new clinical
developments may be, but no one can afford to ignore them.
There is a different kind of change that will challenge us and physicians
everywhere: the constantly evolving change in how we get paid for what we
do. We have entered the realm of risk sharing and payment based on results.
Risking Your Pay on Patient Outcomes
Fee-for-service (FFS) payment, based on volume and production, has been
declared the evil at the root of most of our country's financial problems. If
you believe this line of argument, it proceeds like this: FFS leads to outof-control health care costs, which now consume 17 percent of the Gross
Domestic Product. These costs increase public debt service, and increase the
difficulty that U.S. industries have in competing internationally. Yes, your
fee-for-service billing is why we cannot compete with China.
Table of Contents for the Digital Edition of Vital Times 2014
AND NOW, A WORD FROM THE EDITOR
PRESIDENT’S PAGE
ON YOUR BEHALF: CSA Fights and Wins in 2014
ADAPT AND PROSPER: A Guide to Survival
POLITICS AND MEDICATION SAFETY: The CSA 2014 Annual Anesthesia Meeting
DR. CSA GOES TO WASHINGTON
CALIFORNIA ANESTHESIA RESIDENCY IN 2014
A NEW YEAR AND NEW LEADERSHIP IN THE CSA
CAUTIOUSLY OPTIMISTIC – CSA FINANCES IN OUR 2014-15 FISCAL YEAR
THE ASA ANNUAL BOARD OF DIRECTORS’ MEETING: Building for the Future
ANESTHESIOLOGY™ 2014
CONSOLIDATION IN THE HEALTHCARE MARKETPLACE: What’s in your Future?
IF I COULD SPEAK
PEERING OVER THE ETHER SCREEN: Germs and the Pseudoscience of Quality Improvement
THE ETHICAL CONSULTANT: Perioperative ‘Do Not Resuscitate’ Orders
THE VALUE OF CSA MEMBERSHIP
UPCOMING MEETINGS
MY WEEK ON HAWAII'S BIG ISLAND
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