HealthLeaders asked one of the top chief medical officers in the country to gauge trends for clinical care next year.
HealthCareLeadersMedia
CHRISTOPHER CHENEY
DECEMBER 29, 2021
KEY TAKEAWAYS
- Nursing has been a flashpoint for workforce shortages in 2021, but physician shortages will also likely become acute in 2022.
- Keeping up with coronavirus variants in 2022 will likely become an exercise in “whack-a-mole” at healthcare organizations.
- The growth of artificial intelligence in healthcare is expected to accelerate in the next year.
Workforce shortages will be the most significant clinical care trend in 2022, according to the chief medical and scientific officer of Novant Health.
In addition to serving as chief medical and scientific officer at Novant, Eric Eskioglu, MD, is an executive vice president at the Winston-Salem, North Carolina-based health system.
His background also includes practicing as a neurosurgeon and working as a former aerospace engineer at Allied-Signal Aerospace and Boeing.
In a recent interview, HealthLeaders asked Eskioglu about the top clinical care trends for 2022. The following is a lightly edited transcript of his comments.
- Workforce shortages
- Coronavirus variants
- Data technology
- Disruptors
- Payers blending with providers
- Burnout and well-being
1.Workforce shortages:
The Number One trend in healthcare for 2022 is staffing. We all know about the nursing issues-nursing staffing and the nursing shortage. We are in one crisis with the coronavirus pandemic, but we have also lurched into another crisis in the workforce in healthcare. The workforce crisis is a big challenge for us, and nursing is a top concern.
Health systems are trying to bring in international nurses to address the nurse staffing shortage. First of all, I have a moral issue with this strategy because we are robbing the countries that can barely afford these nurses. So, we are creating a healthcare crisis abroad; and when you talk about COVID-19, it must be a global effort. You cannot just put yourself in isolation in the United States and hope that the pandemic goes away.
By bringing in international nurses, we are robbing Third World countries of a precious resource to fight diseases, including COVID-19. We are accelerating that problem. Secondly, you are going to be seeing some resentment from the nursing staff that is native in this country. As a result, you may see a greater push for unionization.
Medicare has cemented 9.75% cuts for physician pay starting in January 2022. I suspect that the physician workforce is going to go the same way as nursing to the gig economy. We are starting to see that already. You are going to see a lot more physicians moving to locum tenens work. Just like nursing workforce issues came suddenly upon us, I suspect 2022 is the year when we are going to have an even bigger challenge with the physician workforce.
Another workforce issue is the millennial generation. This generation is looking for different experiences. They are on the move. They do not like to be tied down. They like to do things on their own timing and choosing. That is leading to a workforce mentality shift in general. This affects us because we have a lot of millennial physicians coming in. It used to be a Norman Rockwell kind of thought process, where you set down roots in a community, stayed there for 30 years, practiced taking care of patients, then you retired. Those days are gone. The millennial generation is looking for different experiences.
2. Coronavirus variants:
A trend is going to be continuing to watch the mutations of COVID-19. As a scientist, with almost 80% certainty I believe the current vaccines that we have, which are based on the original Wuhan strain, are not going to be as effective against the omicron variant when it has 30 different mutations. The antibody that we formed was for the spiked protein that came out of Wuhan. It is an antibody that fits on top of the spiked protein, then your white blood cells come in to destroy the spiked protein.
Right now, our antibodies are probably not going to fit omicron-it is not going to be a good fit. This is going to be like whack-a-mole. Infections by a variant will start to go down, then infections by a new variant are going to start going up. It is going to be a never-ending process.
3. Data technology:
Artificial intelligence is going to be accelerated in 2022. It already has taken off. AI is not going to be a choice anymore. It is going to be an imperative. If we do not adopt AI, we stand to lose hundreds of thousands of lives because of the complexity of the medical field.
The medical field is getting very complex, and we have seen this during the pandemic. There have been many discoveries and millions of lives depend on us making the right diagnosis with the right treatment modalities-if we cannot do that with AI, we will start losing more people.
In 2022, AI is going to continue to take off in radiology and pathology.
Augmented reality and virtual reality are going to be applied to our psychiatry patients. When they leave the doctor’s office, I can see the doctor prescribing them a video from a library of videos with a hololens.
The doctor will say, “I want you to put your hololens on once a day and the video is going to stream into your hololens.” It is going to be catalogued for bipolar disease, major depression, and obsessive-compulsive disorder. Behavioral health patients will have constant touch points without requiring physicians.
4. Disruptors
There is going to be further push by tech companies into healthcare. I would not be surprised if tech companies took either majority or minority equity interest in some of the for-profit or even not-for-profit healthcare organizations.
When I say tech companies, I think it will be Amazon, Microsoft, Apple, and possibly Google. They are going to go deeper into healthcare because their growth has stalled in the environments they are currently in. How many people can sign up for Facebook or Amazon Prime before it plateaus?
Do not forget, healthcare is about 20% of the gross domestic product. So, tech companies are looking at healthcare as a growth avenue. You are going to see speedy, continued integration of tech companies into traditional areas of healthcare that they have not gotten into before.
Companies such as Amazon are going to go after everything.
- They have gotten licensing for pharmacy in all 50 states.
- They have one of the best supply chain and distribution operations in the world
- They are already in telemedicine with Amazon Care-they are likely to expand to go after the Fortune 500 companies to provide them healthcare.
5. Payers blending with providers:
Another trend is that the boundaries between payers and providers are starting to blur.
You are going to see more of the payers such as UnitedHealthcare, Blue Cross Blue Shield, Aetna, and Humana getting into the provider space.
I read recently that UnitedHealth Group’s Optum arm now employs 60,000 physicians, and that is a significant percentage of the U.S. physician workforce.
You are going to see a trend where there is more vertical integration from the payers into areas where they traditionally have not been involved.
The payers are going to go after primary care because primary care is the quarterback of the patient.
Optum is going to go after more primary care and specialties such as family practice, internal medicine, pediatrics, and possibly obstetrics.
You are going to see more of the payers such as UnitedHealthcare, Blue Cross Blue Shield, Aetna, and Humana getting into the provider space.
6. Burnout and well-being:
The last trend is that physician and nursing burnout is going to accelerate, unfortunately. With each successive wave of the pandemic, morale gets knocked further down. Right now, there is no end in sight. So, you are going to see even further deterioration of physician and nursing morale.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Originally published at https://www.healthleadersmedia.com.
Names cited
scientific officer at Novant, Eric Eskioglu, MD, is an executive vice president at the Winston-Salem, North Carolina-based health system.
