Thread by @DrZuhdiJasser

THREAD- Reality check on American Medicine and YOUR doctor:

While the American economy, especially small businesses, are savaged in this mandated shutdown it bears noting that your small business doctors (who in many states can be 50% of care provided) from primary care to 1/6

specialties completely depend, like any business, upon throughput and are essentially fee-for-service. They’ve been telling us for years to make up for fixed payments “with volume”?! OK as irrational and as much as it stimulated worsening quality now with #COVID19, 2/6

our volume is cut in half if not more overnight and like any business our payrolls and rent didn’t change.

Yet hospital and insurance companies buoyed by Obamacare population health payments and now additionally the cancellations of “elective” surgeries and procedures and 3/6

visits are still essentially seeing very little to no change in cash inflow with a huge profitable decrease in cash outflow expenses by providing less care.

It is not an exaggeration to say that this may be the end of private small business medicine unless something is done 4/6

to our fee payment structures. The urgent SBA loans, televisits, and other bandaided loss leaders are a start but really only a drop in the bucket.

Yes. your doctor is busier than ever in this crisis, but if your doctor is in private practice, your doctor may not be 5/6

around in a few months just like your other small businesses in this crisis. #CoronavirusPandemic 6/6 END

M Zuhdi Jasser, MD FACP
Private Practice of Internal Medicine

@ArizonaMedicine @ArizonaACP @AIFDemocracy @JordanSchachtel @davereaboi @SethLeibsohn