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Top Challenges Number 3: Increased competition


Medical Economics counts down the top challenges facing physicians in 2020.

It has never been such a challenging time to be a physician. Every physician, whether they own their own practice or are employed by a hospital or larger health system, must navigate a host of obstacles each and every day: Payment hassles, staffing issues, patient communication obstacles, technology burdens, long hours and burnout, and much more. 

Each December, Medical Economics presents its list of the top challenges facing physicians going into the next year. This year we focused not only on the challenges, but also practical tips physicians can start using right away to make practicing easier.

Challenge 3: Increased competition

Will the quest for patient convenience kill the traditional medicine practice?

In the past, a handful of Saturday appointments was about the only convenience patients expected from a practice. But patients are now demanding the same conveniences from practices that they do from restaurants or retailers. If they don’t get these conveniences, they will find another doctor.

And there are an increasing number of options out there for patients. Hospitals and retail pharmacies are investing in convenient care clinics where patients can get seen even? for acute issues. There are more urgent care centers across the country and they are increasingly being used as primary care by younger and uninsured patients.

“If practices don’t adapt, they will see patients slowly migrate elsewhere,” says Susanne Madden, MBA, president and CEO of The Verden Group, a Nyack, NY-based healthcare consulting firm.

Madden says if practices want to survive, they need to cater to consumer behaviors, even if there are no other doctors in town. “Some rural doctors might get patients not because they are amazing doctors, but because there aren’t many options,” she says. “But the day a competitor moves into town with a higher level of care access and communication, they’ll be out of business. They need to take the time to up their game.”

Competition is coming from retail clinics and urgent care facilities as much as other medical practices, experts say. The corporations backing them often have the funds and expertise to give consumers exactly what they want and redefine what an appointment with a doctor looks like.

Take GoHealth Urgent Care, of Atlanta, for example. Backed by private equity, its mission is to “redefine the healthcare experience.” It has 125 centers and is opening 30 more in the next year.

GoHealth partners with local health systems and builds facilities they say are based on convenience. Patients can compare wait times for GoHealth facilities online, make an appointment at the one with the shortest wait, and upon arrival, check-in via kiosk. Office designs are bright and open, and patients enter exam rooms where high-tech electrostatic glass walls change from clear to frosted for privacy. All equipment is either in the room or brought to the patient, so no moving about the office if, say, an x-ray is needed. Wall-mounted screens show the patient what the doctor is looking at and entering into the health record, and there is no checkout when the patient is finished-they just leave.

“We compare ourselves to a restaurant, where consumers will not return after one or two poor experiences,” Dev Ashish, CIO of GoHealth, said at HIMSS19, an annual health IT convention. “The same rules apply to healthcare.”

Conveniences patients expect from today’s medical practices

Easy online appointment-setting.

Patients can order anything from a book to a mattress at any time with a few clicks on their smartphone. They don’t want to spend 15 minutes on hold to make an appointment. Practices need to offer online scheduling to patients to make it easier for them to book an appointment.

Streamlined paperwork.

Today’s patient expects a smooth and easy visit. The more forms that can be filled out electronically and in advance of an appointment, the better. No one wants to sit in a waiting room filling out forms on a clipboard that could easily have been done the night before. Checkout should be just as easy, with little to no time spent standing in line. Any prescriptions or follow-up appointments should be as automated as possible.

Minimized wait times.

Patients expect the doctor to see them within about 15 minutes of their appointment time. They have little tolerance in their own busy schedules for physicians who run late or overbook. To mitigate the issue, consider implementing a system that texts patients updates on wait times, allowing them to adjust their arrival to reflect the doctor’s current schedule.

Quick responses to questions.

Patients expect a response to questions posed via email or an EHR portal in 24 hours or less. This timeframe is basic business protocol established by the retail and service industry, and medical practices must embrace it as well. They also expect lab results to be posted online or emailed to them for easy viewing.

Updated waiting rooms.

Free Wi-Fi, coffee, and water are the minimum. A modern design with comfortable furniture and natural lighting will put patients at ease and make them feel valued. A dingy room plastered with warnings and payment notices isn’t exactly customer-friendly.

Transparent pricing.

Patients expect guidance on how much services will cost, what will be covered by their insurance and what will not. If a referral is made, the patient should be informed whether it will be in network or out of network. Any bill sent by the office (or better yet, presented online), should be easy to read and understand.


Patients don’t get sick only during business hours, and offering a few Saturday appointments no longer caters to their busy lifestyles. With urgent cares and retail clinics offering extended hours daily, if a practice doesn’t adapt its schedule to its patients, they’ll get their care from a place that does.

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