Texas' medical execs comment on the future of cash-only medical practices
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The current change in the healthcare industry, coupled with the resentment from current insurance reform has led to the creation of new-and-improved healthcare clinics. Dr. Gustavo Villarreal, of the state of Texas, is one of these revolutionary doctors who are steering away from traditional medicine:
“It had always been affordable and possible to maintain a practice with what insurance and patients paid, but about 10 or 15 years ago, you started seeing a decline” in revenue, said Villarreal, who switched his traditional family practice to its current business model in 2012.
Texas is not the only state who has jumped on this trendy debate; it was recently surveyed that one of every four doctors in Florida was considering the move out of traditional medicine as well. However, Texas has reported extremely high-levels of uninsured residents, so both the federal and state governments are at work to get a handle of this seemingly ever-increasing number.
Executives from the TMA, THA, Texas Academy or Physicians, have all recently commented on this issue, in order to set the records straight.
“We have to find ways of stretching the current number of primary care doctors to meet that demand,” said Dr. Clare Hawkins, president of the Texas Academy of Family Physicians. “Direct primary care goes in the other direction.”
Not only is the doctor-shortage still a rampant problem throughout the healthcare industry, but with the current insurance-based or cash-based debate, what will be the next step towards healthcare reform?
One opinion is that patients need to anticipate their healthcare needs, and not abandon the traditional service, which has worked for over 100 years.
"Consumers should anticipate their medical needs," said David Gonzales, executive director of the Texas Association of Health Plans. "However, when that is not possible, consumers should have financial protection from the unexpected."
Lee Spangler, vice president of medical economics with the TMA, said “Texas is seeing an increase in practices like these because they give doctors more flexibility to determine the services they provide and to cut costs for their practices.”
“A physician has very little ability to negotiate all policies and procedures that come with insurance contracts,” Spangler said, adding that some insurance companies can even dictate the business hours during which doctors can be paid. “Basically you get rid of all those shackles in terms of having a carrier dictate to the practice how to deliver medical services.”
Moreover, it seems unclear if there really is an imbalance in the success of private cash-only practices. On the one hand, these practices allow residents the opportunity to abandon the healthcare insurance based system in lieu of a cheaper, last-minute form or care; and on the other, traditional medicine provides constant, more expensive care.
For doctors like Villarreal the answer is clear; he has more time to spend with his patients, is able to see close to 40-60 patients daily and has a new pool of clients. With pros like these, it would not be surprising to see where this trend of cash-only practices will spring up next.
Dexcom: changing the lives of people with type 1 diabetes
It is estimated that 9.3% of adults around the world are living with type 1 diabetes, which amounts to a total of 463 million people. A further 1.1 million children and adolescents under the age of 20 are living with the condition.
Unlike the more prevalent type 2 diabetes, where the body still produces insulin and symptoms develop slowly, people with type 1 diabetes need regular insulin injections or pumps, and must monitor their sugar levels frequently.
In recent years a number of remote glucose monitoring systems have become available that patients can use at home. These work with a sensor, usually placed under the skin, that measures glucose levels every few minutes. This information is then transmitted wirelessly to a device like a smartphone or tablet, which can then be shared with their clinician.
British actress Nina Wadia's son Aidan, 14, has type 1 diabetes, and has been managing his condition using Dexcom, a glucose monitoring system used by patients all over the world. Here Wadia explains how Dexcom has improved their lives.
As a parent of someone with type 1 diabetes, what is your day-to-day life like?
Being able to take a breath, think and pivot constantly without getting frustrated becomes an essential mindset because sometimes it feels like each day is determined to be different from the day before. Whatever worked yesterday is going to misfire today.
Which areas of yours and Aidan’s life are most impacted by diabetes?
The one thing that you have to fight hard to reclaim is spontaneity, especially when it comes to food and exercise. It’s only when this is taken do you realise how essential each one is. You can be flexible and there are no real limits, but only in the sense that a great athlete can be flexible without limits because they’ve trained super hard to be that way. So we’ve all had to become athletes when it comes to being spontaneous.
How has Dexcom helped you and Aidan?
Dexcom has brought future science fiction to real life today. The continuous glucose monitoring system is tiny, sits discreetly on his body and gives him a ten-day breather between sensor changes, so it's goodbye finger-pricking seven times daily.
Dexcom is totally active at a grass roots level and for Diabetes Awareness has pledged to donate £2,000 if #DexcomDiabetesStories and/or #DexcomWarriorStories is shared 200 times! I’ll be sharing more on social media and would love to hear how other families are winning their fights.
Maybe most importantly Dexcom is trying to introduce a reimbursement programme for type 1 diabetes patients which will give greater access to modern, life changing hi-tech. I want to spread the word on the importance of accessing it through this campaign.
If you compared your life today with how it was before Aidan was using Dexcom, what has changed?
It's always working, which lets him take his mind off diabetes for longer stretches. It also lets me get off his back. We both receive alerts so I no longer have to pester him by asking him what his number is, and especially importantly, I don’t have to wake him at night to prick his finger if I’m worried. Dexcom gave us back our sleep!