Medical News: Looking back on the past year, how has the healthcare system changed and what is the physician community doing to adapt to the changing environment?
Stephen Toadvine, MD: Over the past year, we have seen an ever-increasing pressure to reduce the cost of providing healthcare; continued progression to providing care outside of the inpatient setting; rapid advance of new technologies including telehealth; a focus on consumerism; a growing realization that we’re not simply competing to be the provider of choice within our local markets but that we’re competing against nationally prominent healthcare organizations on a multi-state level; and all of this within an environment of uncertainty regarding upcoming major policy decisions on both the state and federal levels.
MN: How has the practice of medicine changed over your career? How would you like to see it continue to change?
ST: Our physicians have been responding to on-going change in healthcare the way, I believe, that the medical profession throughout history continuously has—by keeping current with the latest and best medical evidence to provide optimal care for patients in a way that avoids unnecessary and ineffective care. Physicians are always adapting to new technology, and many of our physicians at Baptist are participating in telehealth technology. Our physicians are working hard to provide preventive care and effective chronic care management, all while being accountable to new requirements placed on us by governmental and private insurance payors.
Also, here in Kentucky, over the last year, I have seen much interest on the part of physicians in contributing input to the legislative process. As a group we have been encouraged by the exemplary work of State Senator Dr. Ralph Alvarado on behalf of the practice of medicine in ways that will benefit our patients.
MN: What are the biggest challenges to practicing medicine in Kentucky? What are the benefits?
ST: Over my career in Kentucky, the transition of large numbers of physicians from private practice to employment relationships with health systems has been a remarkable change. As this transition began, I think many physicians actually took a step back as leaders in their healthcare communities, but now I see that returning. Physicians understand that they must lead for healthcare to advance in positive ways. I am encouraged to see increased involvement of physicians within their own health systems, and also within state and national medical societies. The importance of physicians meeting together in-person in medical society settings is making a comeback, and must continue to do so.
Challenges in Kentucky include reimbursement issues, the need for continued tort reform, opportunity for better coordination of care between rural and urban communities and the need to change unhealthy lifestyle habits across the commonwealth. That being said, Kentucky is a wonderful place to practice–full of communities with rich heritage, and a place where physicians can make a great impact, and have truly rewarding and professionally-fulfilling careers.
MN: What can Kentucky do to create a better environment for physicians?
ST: Changes to make Kentucky an even better environment for physicians would include continued tort reform, enhancing “speed of entry” by physicians into Kentucky in terms of the licensure process (perhaps including participation in multi-state compacts), funding of additional residency positions in Kentucky, and facilitation of reimbursement for expanded telehealth services.