I’d like to begin today’s post by admitting to the world at large of a personal habit that can at the very least be viewed as politically incorrect and at worst terribly insulting and possibly bigoted.

I like making fun of old people.

There are a number of reasons for this, but when I try to get to the root of my mocking attitude towards the elderly, it comes down to two influences on my psyche that are the most extreme examples of poor behavior in one’s twilight years: Abe Simpson from the now-iconic TV show The Simpsons and my own father.

In Abe Simpson, we have an extreme study of a stereotypical senile old man who spends his time watching Matlock, falling asleep mid-sentence while trying to verbalize a flight of ideas and yelling at clouds. In my father, I see a man so internally and ideologically consumed by resistance to change that when he begins to verbalize his belief system in horrifying detail, I begin to look around me to make certain that no one who may have any small control over my human fate isn’t around to hear the man with whom I share DNA spouting such abominable and atavistic nonsense. It is in the general – if not exact – example of my father where today’s journey begins. 

“Set in their ways” is one of the most common terms I hear from others in describing older people. We’re often told that the 18-54 age group is “the money demographic” in advertising terms, as the belief goes that this age range hasn’t found one particular product, lifestyle or set-in-stone place in society to the point where they can’t be convinced to change their mind about something. By extension, people beyond this age range are seen as having made up their minds about everything and are less able to be convinced to try something new or make a switch to a different product.

For better or worse, we all reach different definitions of “comfort zone”, from the cars we select to drive to the music we choose to hear. If you’re a provider of medical services, the way in which you practice medicine is developed after years of study and one-to-one patient interactions. While you’ve weathered the dozens of adverse changes in the reimbursement for your services, the fundamentals of your practice may not have seen such a drastic overhaul to the point where the root of your profession is adversely affected.

Over the next roughly 42 months, a paradigm shift is going to occur within the walls of the comfort zone that is your medical practice. From the moment a patient enters your sphere of treatment, your well-honed approach must be modified. I wish I could tell you that this is mere opinion, but the volume of changes about to sweep over the landscape moves this into the realm of impending fact.

The mandatory conversion to an electronic health record (if you haven’t already) will change the way your information is stored and shared. What is documented in that record will need to change to accommodate the long-delayed conversion to ICD-10 for diagnostic reporting. With quality reporting and patient outcome indicators moving from its current voluntary model to one of compulsory permanence, the patient record will need to include a level of detail that will require you to go through a period of adjustment.

Many providers should begin a short period of assessment immediately to decide how these changes will be handled on the practice level. The first uncomfortable idea I’d like to bring forward is this one; nothing is off the table. Many providers have no doubt begun to enter a self-examination phase, questioning the changes and the effect these will have on them as doctors. My advice is to expand that analysis to every aspect of your practice as it currently stands. Perhaps you have a front desk staff that has been with you for many years, but are these trusted people savvy enough to handle the coming environment? Do your billing agents have the expertise to seize every reimbursement opportunity for your practice? Are the documentation habits of any ancillary staff such that they could pose a risk in the days to come?

3 1/2 years seems like a long time, but one by one, the changes in our industry will transform from ideas and initiatives to possibly uncomfortable new realities. Channel the mental anguish you may be feeling about the future into a vision for a pliable yet compliant medical practice.

As a postscript, I know that some of you who may be older are saying, “just wait, sonny. Your time to be mocked is coming”. In answer to that, I approach age in this way. As long as there’s one person on the Earth who’s older than I am, I’m still a young man. Recently, a 130-year-old woman was discovered in Russia. I figure I’ve got a lot of young living to do, so go get in your Buick and get ready for bed.

12:26 pm, July 9th, 2010 |