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Why Amazon’s hiring of a doctor for senior Americans is noteworthy

If Amazon is looking to disrupt the healthcare industry, why start with geriatrics -— a specialty that hardly seems cutting-edge?

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We have seen a lot of news recently about major technology companies diving into healthcare – from Alphabet company Verily moving into health insurance and Apple launching health clinics for its employees, to Amazon’s announcement that it will launch a new health care company with JP Morgan and Berkshire Hathaway. As a doctor who treats seniors, one announcement particularly caught my eye – Amazon hiring a Seattle-based geriatrician.

The hire left many in the tech industry puzzled.

If Amazon is looking to disrupt the healthcare industry, why start with geriatrics -— a specialty that hardly seems cutting-edge? But what tech experts don’t know, and what Amazon has figured out, is that to provide high-quality health care for seniors, physicians must be innovative — and disruptive.

Seniors are some of the most challenging patients in the healthcare industry. Many are facing multiple chronic conditions, experiencing an increasing number of hospital stays, and have new or worsening physical challenges, making it harder for them to adopt healthy behaviors. All of these problems are magnified for seniors who are low-income, lack access to transportation or deal with mental health conditions.

In a health care system that was built for fee-for-service models of care, all of this adds up to either tremendous costs or worsening outcomes. For example, a patient once came to me who traditionally saw her primary care provider only twice a year for her five chronic health problems, including heart failure, diabetes, high blood pressure, and high cholesterol. Over the previous year, she had made multiple visits to an emergency room due to acute exacerbations of her heart failure and uncontrolled diabetes. She had significant challenges accessing her prior primary care provider, no transportation, trouble affording the 10 medications needed to manage her conditions, and she was suffering from side effects of being on so many medications. She found her health was spiraling downward.

To break this cycle, we have to disrupt the old ways of running a practice.

Physicians need to throw out what they think they know about how a primary care practice works. Instead of limiting one-on-one time with doctors to increase the volume of patients we can see in a day, doctors need to actually spend more time with them. Instead of maximizing our physicians’ panel sizes to get the most out of them, we need to dramatically reduce them. Instead of prescribing more medications to manage a condition like diabetes, doctors should work on the basics – diet, exercise, and healthy habits.

We also have to have the technology to back that up. Most EHR systems were built to support fee-for-service medicine, so it works great for accountants, but not for doctors. I would encourage those with the ability to build our own system to support what doctors actually need when they are with a patient – ability to spend time face to face, not clicking through screens.

By doing this, patients will have fewer hospital visits, more healthy days, and spend less on health care costs. The patient I mentioned earlier is a great example of someone whose health was failing in a fee-for-service world but is now thriving within the value-based care world. She’s now on fewer medications, controlling her diet, and has not visited the hospital in nearly a year.

But, as I’m sure doctors reading this are thinking, this is easier said than done. In fact, it’s not possible unless physicians’ incentives are not only aligned with patients but also with payers.

This is why the Medicare Advantage program is working so well today. Physicians get paid a flat fee, adjusted based on the overall health condition of the patient, and they are responsible for the total cost of care for the patient. We have skin in the game. If our patients are not actually getting healthier, we are not only failing on our core mission as doctors, but we could be destroying our business.

This is how other great industry disruptions have happened – a new way of operating becomes the norm when the old way is not benefitting providers and customers. Take ride-sharing, for example. Drivers needed flexibility and easier entry points into the industry, and riders needed lower prices and better access. Despite ongoing regulatory challenges, it’s changed the way many of us get around.

Health care — especially for seniors — is at its breaking point and is ripe for disruption. The old ways of doing things have not been working for patients or providers. That’s why the geriatricians who have been on the front lines are actually some of the most innovative minds who could shift the paradigm. We are excited to be part of the senior health care revolution and we look forward to seeing what comes next from Amazon and others in the industry.


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Susan Schayes

Susan Schayes is the National Director of Primary Care, and Regional Chief Medical Officer for ChenMed, a physician run privately held company that has created a unique care delivery model focused on the needs of low to moderate income Medicare eligible patients with multiple chronic conditions. The group accepts full global risk from Medicare Advantage plans and has created a unique “one-stop” approach to preventive care and medical risk management that incorporates a spectrum of innovations ranging from on-site physician prescription dispensing to a customized electronic medical record designed for capitated practices.
Susan Schayes formerly was a faculty member for 16 years at Emory University School of Medicine, where she was the Division Chief of Family Medicine, as well as the Residency Program Director for the Emory Family Medicine Residency Program. Prior to joining Emory, Susan worked for the University of Toronto, and was in private practice. As the Georgia Academy of Family Physicians educator of the year in 2012, Susan has been a champion of educating and training medical students, residents and other allied healthcare learners for more than two decades in two countries.
She received a M.D. from the University of Alberta, Edmonton, Alberta, and a M.P.H. from Emory University in Atlanta, Georgia. She did her Family Medicine Residency at Queen’s University in Kingston, Ontario. She is board certified in Family Medicine in both Canada and the United States, and actively practices medicine.

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