Myles Riner, MD, FACEP
The nice folks at Perspectives on the Acute Care Continuum asked The Fickle Finger to take another shot at gazing into the crystal ball of healthcare trends and events for 2014. Looking back at last year's effort, I think these predictions were reasonably accurate, except perhaps for this one: Obama will use his Constitutional authority to raise the debt ceiling without Congressional approval. Never happened, because Republicans in Congress eventually chickened out.
I think my predictions specific to emergency medicine (EM) were nearly spot-on:
- There will be more emergency department (ED) visits in 2013 than in prior years.
- Emergency physicians will make less money in 2013 than in prior years.
- More ED patients (and sicker ones) will be treated by nurse practitioners (NPs) in the ED.
- Commercial and government payers will push back on emergency physicians (EPs) even harder in 2013 through RAC and commercial claims audits and recoupment demands.
- Single ED groups will continue to be swallowed up by hospitals and larger ED groups.
- The popularity of EM residencies, relative to other specialty training programs, will begin to peak in 2013.
- ED boarding of admitted patients will continue to plague the practice of EM.
Not surprisingly, most politicians won't give a damn.
I can't prove #2, but I still think it is true, in part because EPs are working fewer hours per month, but EP incomes may have been (temporarily) sustained by significantly rising charges throughout the industry.
In any case, here is The Fickle Finger's set of predictions for 2014. I am trying not to be too pessimistic, but this last year was dismal, except for the stock market; and this year will likely be just as bad, except for the stock market.