Perhaps one of the most important shifts in the medical world over the last decade or so is the coordination of care and the way medical teams need to work together to drive outcomes. The days when physicians set up solo practices, individualized the way they treated patients and just “did their own thing” are long gone. In the past physicians merely needed to match community standards to remain out of trouble. Today they are being asked to significantly lift the standards. If they do they will be financially rewarded, but if they don’t they will be punished. This requires a completely different mindset that forces physicians to learn from each other and work with others in healthcare to constantly coordinate and improve care.
This drive for improvement is seen most vividly today in the accountable care organizations that are being set up with unbelievable speed across the country. These groups are making massive financial commitments with the view that they can improve the quality of care and outcomes and when they do they will be handsomely rewarded for their investment and execution. These organizations, that are strategically blending science and business, are significantly changing medical care in both the government and commercial markets. Success requires a different type of healthcare provider. Adaptation is demanded for survival.
Take a look at this article that discusses what hospitals with an ACO emphasis are looking for when they hire physicians. Note how important it is that the physician be willing and able to work as part of a team. This includes not just working with other physicians but also mid-level providers such as NPs and PAs. The new physicians must have a strong understanding of technology and quality measures. The underlying message is that physicians must contribute to and become part of a system of delivering care that is evidence based and outcomes driven. The system is much more important than the individual performer.
It is important to look at these changes through the lens of the pharmaceutical marketer. When physicians were working alone or in small groups, the pharmaceutical representative often provided and was relied on to give insight as to what is going on in the rest of the community. They called on all of the offices and coordinated educational events that connected the community together. As physicians were making their independent decisions on which products to use the representative had a much greater influence on the drug decisions. As formularies became more prevalent there was pushback and “prior approval” and “outside of formulary” drug usage was encouraged. This even became part of the culture for awhile. Today that has changed dramatically. Now when a physician breaks away from the system they are both reprimanded and hurt financially. The pharmaceutical model needs to consider this huge shift.
Drug companies today must win by working within the system. They must recognize what is trying to be accomplished by the overall organization and then position their products in the middle of the care plan rather than trying to upset things. Yes, this may require a more aggressive pricing plan but if successful it opens huge opportunities that can be pulled through much more efficiently. The pharmaceutical world has truly become more business to business than ever before. Internally this requires a greater team approach as well. Sales, Marketing, Finance and Managed Markets need to work together seamlessly in order to put together a coordinated offer for our customers. Success for the industry will depend on how quickly we join our customers’ teams and demonstrate that we too are team players rather than unpredictable individuals.