U.S. supplier shortage: Can digital healthcare revive our broken medical service system?
Have you ever wondered why it takes so long to schedule an appointment with your primary care provider? Or why the waiting time for specialists—from obstetricians and gynecologists to psychiatrists to gastroenterologists or dermatologists—can take weeks or even months in many cases. You are not alone. This system makes it difficult for Americans to get the care they need quickly.
Individuals across the country, from the most densely populated metropolis to the most sparsely populated rural towns, are facing the increasingly severe reality that an imminent systemic medical crisis has been brewing for decades.Today, consumers in the top 15 major cities The average waiting time for appointments with providers is 24 days. In some cities, the situation is much worse.For example, patients in Philadelphia are trying to schedule their first dermatology appointment, which is much better than traveling to neighboring cities It takes an average of 78 days to receive treatment by a dermatologist in his city. These shortages are worse in rural areas The ratio of primary care physicians to patients often exceeds 1:3,500.
What causes these insurmountable waiting times and prevents Americans from accessing healthcare services? The simple answer is that supplier shortages are widespread and rising. Unfortunately, as supplier supplies decrease further in the next ten years, the future looks bleak.By 2033, the American Association of Medical Colleges expects Supplier shortage will climb to 139Ks.
There are three fundamental reasons for the serious mismatch between supply and demand. First, Insufficient number of medical internship places for medical students To support the growing health needs of the American population. Fewer people enter urgently needed areas such as primary care, Instead, they choose to pursue a career with a high-paying profession to repay the ever-increasing medical school debt. Second, the country’s gray tsunami describes a large and growing aging population that requires its providers to provide more high-touch, intensive care, thereby increasing the demand for the providers’ already limited capabilities. The number of Americans over 65 years old will increase by about 50%, reaching 80 million by 2040. Nowadays, People over 65 see a doctor five times a year, almost twice the national averageFinally, exhausted doctors are exiting the labor market at an unprecedented rate Exceeded the expectations of experts.
Unfortunately, the imbalance between supply and demand is only expected to worsen, so millions of people across the country will face major obstacles in accessing basic care.The fact that complicates these challenges is Almost half of working doctors will reach retirement age In the next ten years, many people choose to retire early because of exhaustion. Therefore, people feel frustrated and hope to get an excellent experience from the healthcare system. Patients are transforming into healthy consumers and expect the same convenient, on-demand healthcare experience in other aspects of their lives. Some things must be transformed.
Accelerating innovation in virtual care, a glimmer of hope for the pandemic
The pandemic has had a huge impact on users’ adoption of virtual care, almost Two-thirds of consumers report using telemedicine in 2020, Which is a huge improvement from the level of only 11% before the pandemic. Driven by the ever-expanding user base, virtual care solutions are raising unprecedented funding to accelerate growth, thereby increasing the demand from providers. Not only do consumers need virtual care, but providers are also starting to use it. Nowadays, 70% of providers are motivated to provide care in a virtual way.
Although Covid-19 has severely exacerbated the shortage of suppliers, the pandemic has made digital health part of the solution.Digital health solutions can achieve provider scalability in the following ways Allow doctors to monitor and treat their patients more Efficient remotely, in many cases there is no need for face-to-face visits. Similarly, virtual care solutions can more equitably distribute supplier supplies across geographies and improve access to care in a market where shortages are increasing.
As consumers continue to expect excellence, the market requires digital health solutions to provide lower-cost care in a more seamless and integrated manner, forcing companies to think creatively or face outdated consequences.
Demand is overwhelmed, and virtual care solutions are forcing changes in the supply curve
The demand for virtual care solutions has skyrocketed, driving new supply demands on the market to serve the growing consumer user base. Therefore, mature virtual care companies, with the support of the new funding pool, are rapidly recruiting suppliers and further squeeze the shortage. However, some digital health solutions are implementing strategies to use their care supply creatively and lead to broader market changes in the supply curve.
Can virtual medical services alone solve the shortage of providers?Not exactly, but digital health will become a catalyst for transforming care, such as MD can focus on the most complex cases and practicesIn this shift in meeting demand with limited supply, digital healthcare companies can use a variety of levers to promote this shift.
Expand the geographic coverage of providers to serve areas where there is a shortage of care
In the early stages of the pandemic, some regulatory barriers were removed, including restrictions on cross-state practice. Although the durability of this change is unclear, Some states have begun to withdraw their temporary exemptions, This legislation has brought innovation because several virtual care companies have established clinical networks with providers licensed in multiple states. Expanding the geographic coverage of the network can balance the supply and demand of suppliers, especially in underserved areas such as rural communities.Company likes NOCDIt is a virtual behavioral health platform for consumers to fight against serious mental illnesses focusing on obsessive-compulsive disorder. A strong clinical network of experts has been developed to provide services to members in all 50 states.Similarly, companies like this Nacks with Sims Provide a strong network of suppliers to get prescriptions for contraceptives, anxiety drugs, and depression drugs on demand, and now primary care conditions can be accessed in multiple markets. Among these companies, many clinicians have obtained cross-licensing in multiple states, further expanding their ability to provide care to a wider geographic population.
Optimize the use of intermediate clinicians
Although clinical training for MD is required in some cases, for some cases of low vision, intermediate providers such as physician assistants, RN and NP are particularly suitable for providing care.Therefore, some digital health companies like wheel The mid-level care team is being optimized as the first line of defense for screening, vaccination, and non-emergency emergency care cases.Other professional nursing companies, such as Bet Intermediate providers are being used to provide low-cost, high-quality care to solve more routine gastrointestinal cases, while only experts are used to handle the most complex cases.In addition, players such as Healthy mood with bright side Practicing nurses are being used to provide low-cost, high-quality longitudinal psychiatric care, from medication management to long-term care plan formulation. finally, The newly merged Ginger and Headspace organizations are now Headspace HealthAs another example, the company best evaluates and stratifies the level of consumer needs, and then matches consumers with coaches, therapists, psychiatrists, or self-management solutions (sleep, anxiety, stress management, etc.) .
The role of non-clinical care teams in reducing provider demand
In addition to using clinicians, the virtual care solution also uses certified health coaches and other non-clinical teams to motivate customers to comply with treatment plans and change lifestyles, thereby expanding the supply of providers. The integration of non-clinical care team members not only expands the capabilities of providers, but has also been shown to drive behavior changes and improve health outcomes.The darling of digital health Liongo, It is now part of Teladoc, a case study on the effective use of health coaches to manage the care of consumers with chronic diseases, including diabetes, hypertension, and behavioral health disorders.
Company likes Bright line, A virtual pediatric behavioral health platform, is enhancing provider-led virtual care services through health coaches, customized educational content and community resources.Digital Health Unicorn Marvin, A whole-person virtual care model for women and families, provides each member with a dedicated care advocate, praises them through active digital intervention, and guides members between on-demand visits with professional providers.Other companies such as oath Caring and wisdom, Is building social health platforms that rely on compassionate peer communities and certified health coaches who have experienced similar life experiences to help individuals experiencing major health events.
Use technology to expand provider capabilities and reshape nursing navigation
Finally, a new wave of virtual care companies is integrating technology solutions that can replace on-site clinical diagnosis and treatment, and ultimately expand the size of the provider group.For example, asynchronous care platform, such as Cirrus MD Using the chat-first model, individuals are connected to providers within 60 seconds, and most encounters on the platform can be resolved within minutes.In addition, AI-enabled workflow automation tools, such as Worth noting Enable providers to focus on providing high-quality clinical care and reduce the time spent on administrative tasks.
Digital health companies can not only integrate innovative technologies, but some companies are also building a digital ecosystem for medical navigation, such as transparent, When appropriate, classify consumers into the lowest-cost, high-quality care options or self-management. The company uses the non-clinical patient navigator to help consumers understand their coverage, schedule appointments and submit claims.Supplementary care navigation is a classification solution, such as buoy, To further expand the capabilities of providers by enabling consumers to self-manage conditions and attract consumers to virtual and/or face-to-face providers when necessary.
How will the market converge?
In the short term, increased demand for seamless and convenient digital health alternatives and over-tension of providers that provide face-to-face care will push consumers and suppliers to switch to virtual care. In the long run, virtual care can increasingly add MD-level care for less severe cases through non-clinical team members and intermediate providers. A new wave of enterprises—— What I thought before was Virtual Care 2.0 – Workforce scalability will be further realized, thereby reducing the provider’s group size and expanding their ability to treat patients. The market will tend to a new balance between supply and demand, and eventually a healthier balance will be reached.
The provider shortage is the result of damage to the care delivery system and cannot be resolved by simply injecting thousands of MD into the supply. Although digital health provides multiple benefits, given the complexity and systemic nature of the shortage, there is no single treatment that can cure this problem. A series of solutions are needed to attract stakeholders across the ecosystem to ensure that care services are not affected. Ultimately, digital health solutions are critical to enable informed connected healthcare consumers to proactively self-manage their care and become part of the solution to the growing shortage of supplier supplies.
Editor’s note: The author serves on the board of directors of NOCD, which is a portfolio company of the author’s employer, 7wireVentures. In addition, CirrusMD, Brightline, Transcarent and Livongo are all 7wireVentures portfolio companies.
Photo: hudiemm, Getty Images
