Beauty Health for Life

Investors just ponied up well over $100 billion for a piece of the social media giant Facebook. While Mr. Zuckerberg and his co-founders deserve a hearty congratulations, the Disease Management Care Blog finds some eerie parallels between Facebook and accountable care organizations.  The similarity does not bode well for either business model.

1. The users are not the customers: Facebook sells its users to marketeers.  ACOs sells its patients health care utilization to insurers. 

2. Its the data and its not yours: Facebooks targeted ads are constructed off of prior usage patterns. ACOs shared savings calculations are built off off actuarially determined health care utilization patterns.

3. Sovereign hostility: Washington DC views information technology and health care as distractions from the true task at hand: restoring the U.S. manufacturing base.

4. Do you care, really? Now that the wunderkids in charge of Facebook have made their millions, it remains to be seen if theyll work as hard in delivering value to its users.  Ditto for all the salaried docs working for ACOs, who no longer have to arrive early, skip lunch and stay late.

5. The long term: Yahoo once was the darling of internet investors.  Even if ACOs have initial success, is a better care model being developed as you are reading this?

Since the Disease Management Care Blog not only wants to be informative but also helpful to its readers, it has developed a seven point generic physician employment inquiry response and recruitment letter.  It is available below. 

The DMCB is confident that those smaller physician-owned private practices that remain independent will find this form letter very helpful in the coming years.  The DMCB releases this to the public domain and its colleagues are welcome to copy, paste, distribute, share, alter, modify or adapt all or some of the document as it becomes necessary.

Dear [insert name of physician here]:

Thank you for your recent [select: tweet, email, Facebook posting or VM] inquiry about leaving your current salaried position and joining our practice.  Thanks to widespread patient dissatisfaction with the institutions that were spawned by "health orm," our small business has experienced tremendous growth. We are constantly on the lookout for new talent that complements our projected demand.  Maybe you can join our team!

As you are undoubtedly aware, many of our colleagues nationwide have been lured into full time employed positions involving large complicated corporate practice arrangements, many of which were set up to be ACOs. Savings havent materialized and many of these organizations have responded by demanding more patient "throughput" from their employed physicians and imposing cutbacks in vital support services.

In contrast to those organizations, our practice offers you:

1) a completely transparent compensation arrangement that equitably divides our net revenue income among the owner-physicians.   No more having to deal with an unwieldy administration that allocates salary amounts based on some opaque budget of anticipated revenues and upside savings minus overhead and capital allocations that you have no say in.

2) a team-based environment that not only relies on your expertise but knows whos boss.  Unlike those other complicated practice settings with layers of middle management, our office personnel report directly to you, period.

3) a patient population that is not only grateful for our high "same day" service standards and efficient and compassionate practice style, but who also recognize that unnecessarily calling at the end of the business day or repeatedly while were on night call is reason to be assisted in finding another physician.  We have caully cultivated a very loyal following of patients who genuinely partner with us.

4) a highly trained and motivated administrative support and care management staff that not only uses state-of-the-art approaches to deal with private managed care commercial insurers, but uses a "3A" approach of Anticipating, Automating and Appealing any service that requires prior authorization from you.  Youll only get involved in these matters when its necessary.

5) a stable practice environment. Speaking of managed care insurers, they comprise the bulk of our business. While they are far from perfect, Medicare and Medicaid they are not.  They dont threaten us with arbitrary fee schedule cuts, audits, and payment delays.  We firmly believe patients and taxpayers should get what they pay for.  Its not our fault if they havent paid for our level of clinical and consumer excellence. 

6) an EHR system is not only low cost and user-friendly, its modular and cloud-based.  Our vendor has agreed to performance guarantees, there are no one-sided "hold-harmless" clauses and its seamlessly compatible with any hand held device of your choice any time and any where.

7) a unique market niche that sits in that "sweet spot" between a local employer community that likes us, insurers that respect us, specialist physicians work with us and a multispecialty ACO close by that welcomes our errals.

Once again, thank you for contacting us.  Please send your CV to [insert P.O Box address here] where we will store it in strictest confidence along with dozens of your colleaques CVs.  We promise you that when we get to it in the coming months, we will contact you. 

Best regards,