AI in Healthcare, 2025 Outlook, and Overcoming Physician Shortages & Burnout w/ Scott Becker

Erik Sunset: [00:00:00] All right. Hello and welcome back. I’m Erik Sunset, your host of the DocBuddy Journal. And today we’re joined by somebody who really needs no introduction. And that’s Scott Becker. Scott is the publisher of the Becker’s Healthcare Portfolio of Publications. He’s also a partner at McGuire Woods in Chicago, where he provides counsel to all types of healthcare organizations and a variety of healthcare industry entrepreneurs.

Erik Sunset: Scott, thanks so much for joining us.

Scott Becker: Erik, what a pleasure. Thank you for having me. I look forward to visiting with you and just to enjoying our time to discuss healthcare and business and everything together. Thank you very, very much.

Erik Sunset: It is absolutely our pleasure. And just, you know, as a quick programming note, it’s hard to believe that this year’s run of events is already behind us, but you’ll be able to see both Scott, the Becker’s Healthcare crew, as well as DocBuddy at some of the upcoming events in 2025 in Chicago, of course. Uh, so we’re looking forward to that.

Erik Sunset: And I know the, sort of the basis of our conversation today [00:01:00] revolves around healthcare, what’s hot in healthcare, the news, what are people talking about? Scott. And a recurring theme sort of about this time last year, it started to heat up and that’s around AI and healthcare. And that is for sure been the hottest topic.

Erik Sunset: Um, in the news and on your site. So Scott, from your vantage point, what are you seeing the evolution of AI and healthcare become

Scott Becker: Sure. No, I think it’s a great, great question. And we break it down into two different ways. Clinical versus administrative. Um, you know, the use cases where it’s most useful, where people are finding it useful. And then, of course, that will evolve greatly over the next several years. And if you think about the iPhone 15 years ago, no way in the world we would have thought we’d have all these different use cases and apps for it.

Scott Becker: I mean, almost, it may be predictable by some, but unpredictable by the rest of us. So, so what I’m sort of looking at is I break it down first into clinical versus administrative. The earlier [00:02:00] use cases, the most present use cases so far have been more along the administrative side than the clinical side.

Scott Becker: But some of those are sort of a very hybrid type of thing. So the biggest early use cases were in things like revenue cycle, predictive analytics. Managing of ORs, managing of revenue cycle in some place where you could, where you could replace repetitive tasks that were being done by humans that were very hard to even find or employ, particularly during the pandemic, where there’s just tremendous shortages of people.

Scott Becker: So you saw lots of movement quickly, you know, we’re on the 30 yard line. out of 100 yards in the administrative side, maybe the 20 yard line, but then on the clinical side, you’re just starting to see use cases where people, you talk to physicians, you talk to leaders, and they’re actually seeing real value.

Scott Becker: And one of the examples I hear about regularly, I don’t know if it’s a sponsor virus, I don’t think it is, I just don’t know, is GI Genius. And GI Genius is a [00:03:00] software that people use in AI that applies AI to to colonoscopies that improves the find rate for lack of a, for use of a simple term of polyps when people are doing colonoscopies.

Scott Becker: And I do hear from gastroenterologists that this is actually quite helpful, not everybody, but largely not replacing gastroenterologists, but improving their outcomes. And I think you’ll see, you know, there are so many different places where you’ll see some of this, whether it’s in surgery, that’s digitally assisted, robotically assisted, where a person just has.

Scott Becker: Not really AI, but better vision into what they’re doing, and so I break it down into two big ways. Clinical versus administrative, and then the second thing I break it down into is 2x versus 10x solutions. And when I talk about 2x technology solutions, I think about things that amplify and leverage our physicians time for or nurse’s time as they are.

Scott Becker: So, so, so very [00:04:00] helpful, but not what I think of as game changers. So, telehealth would be a great example. It, it, it doesn’t replace physicians, but allowed physician work to be done for multiple different locations without having to be in person. And, and sort of the earliest test cases or use cases for telehealth.

Scott Becker: Telehealth were in radiology going back a long time ago, just because you couldn’t get radiologists to lots of small communities. So radiology telehealth was the first first mover in sort of that area. When you see those types of things, they don’t eliminate the need for the physician, but they might make it more accessible, easier to access, you know, better able to manage and the great I’m going to give you a much longer answer, of course, than you wanted, Erik, so bear with me.

Scott Becker: The great challenge we’ve got is 1, 060, 000 physicians in our country, half of them going part time by 40, and 330 340 million people in that [00:05:00] aging, growing population. So the numbers are the worst ratio we’ve had, I think, in a very, very long time. and getting worse So the 2x solutions are good that free up physician time, the ambient listening types of things, the things that free up some of their time and maybe avoid some burnout and allow them to do a little bit more or take more breaks.

Scott Becker: Very helpful. What we ultimately need is the 10x solutions. Like what you’re doing in AI with revenue cycle. A. I. Is replacing in a lot of places what a person was doing, and we’re sometime away from in different specialties or primary care having a I truly either replace or leverage the physician’s time a million times better.

Scott Becker: So we don’t need to have 2, 000, 000 physicians. which we’re only producing 25, 000 a year, so we’ll never get there. So we got to figure out a way on the clinical side to get from these 2x solutions to 10x solutions. And I think we’re a long time away from it, and it [00:06:00] doesn’t mean that we’ll be replacing physicians.

Scott Becker: Every time we’ve improved technology, we’ve never really replaced anybody, but it provides different opportunities and need to figure that out. But we’re we’re some time away from having the impact. We really need to solve the biggest problem we have, which is not enough providers, specialists, primary care physicians.

Scott Becker: The AI use case for primary care is abundantly clear in getting close, where you could use a PA to do a lot that a primary care used to do. You know, you could use a CRNA to do a lot that a anesthesiologist should do. There’s lots of places where the AI can help a great deal, and the intelligence, the analytics can help a great deal, but we’re still far away away from that in a lot of specialties, but that’s the.

Scott Becker: That’s the frontier that we either have to get to or we’ll get crushed as a country in terms of these physician and, and staff shortages.

Erik Sunset: you, you hit on a topic that’s near and dear to me. And that’s on these physician shortages driven by burnout, obviously healthcare centric sites like yours. They’re reporting on this [00:07:00] precipice. We’re on the precipice of a cataclysm with, having the right number or even nearly the right number of providers to treat patients in the U.

Erik Sunset: S. But that is not something that’s being talked about on your cable news networks, at least not that I’ve seen. So I, I wholeheartedly back the sentiment that these 10x solutions, whether they they’re AI or not, something needs to be done because the amount of administrative tasks that we’re burying providers under is killing the job.

Scott Becker: Right. And what you’re talking about, what you, you mentioned that was, that’s exactly the right on point is that people have talked about for years, this political football of Medicare Advantage, Medicare for All, coverage, needing coverage for everybody. And I think most of us agree at this point, whether you’re a Republican or Democrat, that we, that we want to have coverage for everybody.

Scott Becker: Exactly. I think most people don’t have a huge argument over that. It’s really how we do that. But then coverage is very different than access. And getting access is the great challenge that’s evolving. You know, particularly outside of the top 10 to [00:08:00] 20 big metro areas, the access problems are just incredible.

Scott Becker: They’re very challenging in the big metro areas too. Like you, if you want to get to the right person, You know, you need to know somebody and that’s obviously a horrible statement for health equity. It’s just a horrible statement for where we’re at. And we’ve got multiple different trends going on. There was 4, 000 additional residency spots, which again is a drop in the bucket that we’re going to be funded in one of these different bills that was on Capitol Hill.

Scott Becker: But of course, it gets packaged in like everything does into huge, huge, gigantic bills that don’t, that didn’t get passed. So you got, you got the shortage of residency spots. You’ve got a situation where growing populations. You’ve got a mismatch of specialties to needs. You’ve got enough people going into orthopedics, uh, not nearly enough people going into a ton of other subspecialties where you really need really, really bright people and, and so forth and so on.

Scott Becker: We’ve got, for the first time that I remember, we’re working towards a serious shortage in GI, which I didn’t, didn’t realize. think was going to happen. [00:09:00] Got about gastroenterologists in the country, and now we’re looking at shortages there. You know, a lot of different places. We, you know, I recently had a horrendous summer for my own health.

Scott Becker: The beauty of healthcare is we’re all consumers. I had a detached retina. I’d have that replaced, and I’d have a cataract done, you know, which is a, a, a, a direct follow up to having You know, uh, the attached retina. And what I find amazing is how hard these physicians are working to take care of their patient base.

Scott Becker: I mean, you know, it did this cataract on Friday. The doctor comes in by himself on Friday, on Saturday morning. to have a follow up visit with the seven patients he saw the day after Thanksgiving, and just like the guy is working his butt off and bright, bright guy. But I can’t imagine that’s not a prescription for burnout.

Scott Becker: No staff in the office, nobody helping, just him taking care of six, seven patients to work through the follow up from the day before. And it’s amazing that he’s got that yeoman’s effort to do it. But that just is, that’s a hardcore, that’s hard, hard work. And that’s just a very, you know, the beauty [00:10:00] of healthcare is effort.

Scott Becker: Every single one of us is a consumer. So you go in an ER today, they’re swamped. I mean, they’re just swamped. I mean, wait times are 3 hours and 45 minutes. Just 10 years ago, people were advertising, we’ll get you into our ER in 30 minutes. Now it’s, those advertisements are all gone. But just a tremendous shortage throughout the system.

Scott Becker: They’re getting worse and worse. Medical education is broken. I mean, we’re still educating physicians by the sort of method that was built 100 years ago before the internet. Uh, it just is literally with lots of rote memory, lots of everything. It’s an insane situation and we’ve got to fix it.

Erik Sunset: We, we definitely need to fix it. There’s some macro items that we can potentially tackle. There’s some more micro items that, uh, things like health systems and medical schools can help to tackle, but go to that macro layer. You know, some of the other big news that really just happened is unless you’re living under a rock, you’ll know, we just had a pretty major presidential election.

Erik Sunset: Uh, we get Trump too. We have a GOP house and GOP Senate. What are you hearing that might be different [00:11:00] or really different going into January 20th, 2025, when

Erik Sunset: this all

Scott Becker: Yeah, this is, this is a great question and it’s, it’s, it’s bifurcated. When I look at the Trump administration, the first one, I think that they and a lot of other people got it wrong on placing such big bets on Medicare Advantage. I am not a fan thus far. I think it’s been a huge boon to the payers.

Scott Becker: Patient satisfaction is lower with it. It’s costing the government a lot more than expected. Appreciate it. It’s like everything else. All we did was add a middle man, a middle person to the, to the Medicare program, which is one of the most beloved programs in America. So I think Trump one got that wrong.

Scott Becker: Biden came into office against it, but then of course, got talking to you by the insurance industry, became a fan of it and sort of, they, Both ended up down the path of being very pro Medicare Advantage. And to me that is just a, [00:12:00] it’s, it’s a horrendous program and I know people disagree with that. There’s people, the idea of it may make sense, but you have to take out reality to, to get to that point.

Scott Becker: The perspective is there, there’s a canon of thought. That’s become almost like religion, that fee for service is bad, that it leads to some abuses, and no question it leads to some. But the same kind of thought and narrative should be applied to managed care. The idea of it, that we’re going to manage people’s care in a value based way, of course that sounds good.

Scott Becker: The reality is that it is not. You have just as much abuse on that side as you have on the other side. Net abuse was horrific during COVID. Medical operations went way down. Insurance companies, Medicare Advantage providers got rich, but for all the wrong reasons. Not because they were managing care well, because procedures and screenings weren’t being done, because people couldn’t do them.

Scott Becker: So, Everybody cleaned up. Uh, but you know, you have abuse on either side. I’m not a believer that it’s the payment system. [00:13:00] I’m a believer at the end of the day, it’s a supply and demand issue, which we’ve talked about some already. So the one thing I think the Trump administration got very wrong the first time was their buying into the, you know, The insurance companies love of Medicare Advantage.

Scott Becker: The thing that they got right the first time around was expediting and streamlining so many processes at the FDA and other places. They just got that very, very right. I don’t know if they’ll get it right this time. I mean, obviously, like, um, you know, you know, I don’t, I don’t, um, I’m not one of these people that’s an anti Trump or an anti Kloss by any means at all.

Scott Becker: I do believe he got some of his picks so far right, like Marco Rubio’s fine, Elise Stefanik’s fine, a lot of people that he’s appointing are fine, uh, Dr. Oz. You know, to me, and I don’t know Dr. Oz, I’ve not met him, I’ve watched his career, of course, like all of us have, he became like a healthcare hustler. I mean, he became like an embarrassment to healthcare over the course of [00:14:00] his career.

Scott Becker: And there’s things to like about him. I mean, he’s a driven guy, he’s a charismatic guy, but at some point he crossed the line from being a true doctor to being sort of like almost a joke of sorts. And he’s a huge Medicare Advantage proponent. And one of these people are Medicare Advantage proponents.

Scott Becker: It’s not that it’s, you know, the truth on all these things is always somewhere in between. So, but, but I’m not a fan of, um, you know, some of his perspectives as to Medicare Advantage. I just think it’s, it’s, it, all these things sound good in theory, but they don’t necessarily work. All they end up really doing is they added another layer of tax to our system, which is just a whoosh to the insurance company.

Scott Becker: So I’ve not been a fan of it. I don’t like Dr. Oz’s views on it. I don’t have great regard for Dr. Oz, but I don’t know him that well or that deeply to really have a great feel for it. Uh, Robert F. Kennedy, I don’t know enough. You know, I always thought he was such a quack, and then of course he’s now going to be in charge of something big, and it’s fascinating.

Scott Becker: It’s not like, and he’s not like, he’s not wrong on some of these thoughts, not right on some of his thoughts, but I’m not, [00:15:00] at least from this perspective, I’m not fans of some of those picks. Now, but to be, to be fair, I also thought Joe Biden in certain areas had some horrendous picks for his leadership.

Scott Becker: You know, some horrendous political hacks that ended up in charge in the Biden administration. I’m a huge fan. I think Anthony Blinken’s done a great job in the Secretary of State role. And then Janet Yellen, Department of Treasury. was a well respected person who over the course of her career became a total political hack.

Scott Becker: So I mean, you know, I don’t, you know, like saying, Oh, the inflation is transitory. It’s not going to be a real problem. It’s not going to be a real issue. It’s just talking points out of the, out of the DNC at that point. So I think, you know, some of the Trump picks, I don’t love the Oz pick. I don’t love the Robert F.

Scott Becker: Kennedy pick. Some people do love him. I don’t, I don’t, I doesn’t, I don’t, I don’t, I don’t know him well enough to really have a feel for it, you know, but, you know, enough what I see gives me concern. And we’ll see how it goes. I mean, we’ll see how it goes, but I’m not, uh, you know, so I think they’ll probably get the FDA maybe a little bit better than the Biden administration got back to being really slow on it and [00:16:00] horrendous.

Scott Becker: The Trump administration was pretty good on the FDA. The Trump one, FDA, good. Medicare, not so good. Um, free market, somewhat positive, but so much of that free market is not really a free market anymore. You know, so I, I think it’s a mixed bag, but I, I’m not, I’m not a fan so far of the member Oz pick or the, uh, you know, the, uh, you know, the, uh, I am a fan of the Elise Stefanik pick.

Scott Becker: I am a fan of, uh, Marco Rubio’s fine. You know, it reminds me of a modern day John Kerry. He’s fine. Um, you know, but, uh, but, um, I’m certainly not a, you know, and I don’t, I don’t start I’m loving RFK’s views on a lot of stuff. Um, I do, um, and Dr. Oz, I think, has become sort of a drugstore husk where I don’t, I don’t really know how to describe Dr.

Scott Becker: Oz today compared to what he had built years ago his reputation.

Erik Sunset: Yeah, well, a lot remains to be seen, particularly with the folks you identified. Well, one thing that I’m hearing will be slightly different from Trump 1 is that Obamacare, you know, the Affordable Care Act, maybe won’t be [00:17:00] so much in the crosshairs this time around, for the point that you made. You know, getting coverage to people I think is a more reasonable stance and it’s not just coming from the other party that installed Obamacare, created the Affordable Care Act.

Erik Sunset: So it seems like there’ll be maybe some fine tuning there, a little restructuring there, but not, certainly not taking a chainsaw to it.

Scott Becker: I think the bigger issue, and this is something that Trump has in his favor, in his favor, that there’s some head, there’s some tailwinds he has on that that are, um, negative and positive. So the big tailwinds are Joe Biden. know, both of these, both Biden and Trump were horrendous presidents for the federal deficit, and I’m a, I’m a federal deficit watcher.

Scott Becker: I view it with great concern. So they were both horrendous on the federal deficit and this year deficits a trillion eight, which is horrendous. By anybody’s measure, it’s horrendous. It’s eight, nine [00:18:00] percent of the economy. We’re getting two, three percent growth. That means we’re throwing away five to six percent someplace.

Scott Becker: It’s literally having that kind of deficit. It’s horrendous. Trump is going to be the beneficiary of some of the things that were added into the America Rescue Plan, the ARP, fade away by themselves in the next year or two. And a lot of those are affordable CARES Act subsidies that helped us. Make the Affordable Care Act continue to have pretty good coverage and get our uninsured rate down to about 10 percent but also cost the government a fortune.

Scott Becker: So Trump, without taking the chainsaw to it, without having to do anything affirmatively, those subsidies are going to wear off. And I’m sure that he and Vance’s team are going to largely let them wear off unless they get so much lobbying from the insurance company that they don’t. Companies that they don’t so that is gonna that’s gonna bring the deficit down Some couple hundred billion dollars a year without him doing anything and getting what [00:19:00] some of the far right Republicans wanted Which is less of this Obamacare Affordable Care Act, you know, so it’s it’s a fasting situation I mean, I think the you know, the Affordable Care Act.

Scott Becker: I don’t start off originally as a proponent of it Partly because how it got passed, but at the same time, I’m a huge fan of the fact that we’re able to move down our uninsured from 20 to 10%. And now we’ve got to deal with the real problem, which is access and enough providers, enough supply. So, so we’ll see how it goes.

Scott Becker: But I think it’s a fascinating set of subjects.

Erik Sunset: Yeah, it really is. I’ll be, I’ll be tuned into that. I’m a federal, uh, budget deficit watcher as well. Um, not at any cost. Do we want to reduce that? Um, and with the affordable care act, you’re going to be right back sort of where you were on day two of it. Yeah, we had a lot more people coverage. They can’t use it, but they’re covered.

Erik Sunset: They have insurance.

Erik Sunset: So we’ll see

Erik Sunset: lots of lot remains to be seen there.

Scott Becker: That’s exactly right.

Erik Sunset: And one of the other pieces of news sort of heads and tails of that run up to the election week was [00:20:00] the CMS 2025 final payment schedule. I know across your sites, you’ve collected a lot of reactions from individuals in the front lines of health care.

Erik Sunset: I haven’t seen a whole lot positive, uh, on what was published by CMS. What’s the, what’s the silver lining, Scott, um, if there is one?

Scott Becker: Yeah, I don’t know. It’s so much a silver lining. It’s um, you know, the great challenge Physicians and health systems are caught sort of in this very in between spot Where they used to be so reliant on commercial payers to subsidize what they made in Medicare and Medicaid And now we’re in a spot where They no longer get that subsidy from commercial payers because, you know, a larger percentage of the population is through Medicare and Medicaid than it’s ever been.

Scott Becker: So not only is half of Medicare Medicare Advantage, it basically half of everything is governmental pay. So you’re in a spot where government pays a bigger and bigger part of it. What happens is providers at the end of the day [00:21:00] gravitates towards liking the fee for service, Medicare and Medicaid pay. not necessarily the reimbursement amounts, but they’ve grown to understand the system and they get paid and they don’t have all the pre auth and denial types of situations.

Scott Becker: So the, the, the, if there’s a silver lining to it, they’re going to go up less than inflationary worth of inflation, which is bad, but it’s a, it still is a stable program and people don’t get screwed with under the Medicare and Medicaid programs. As much as they get screwed with meaning providers and health systems as they do under Medicare Advantage.

Scott Becker: So, if you want a silver lining, that’s a silver lining. The challenge is we’ve got a horrendous federal deficit problem and it’s, it’s, it’s going to get And Medicare Advantage feeds more into that versus less. So it’s a debacle. Um, yeah, I don’t have a silver lining. I think it’s sort of like at the end of the day, we’ve [00:22:00] just got to continue to strengthen the health care workforce and make sure we’ve got enough of a health care workforce.

Scott Becker: Well, adding technological sort of advances to, but there’s no, no real silver lining. It’s like, well, health systems, you know, out there, 50, 50, half the health systems are making money. Half of them are losing money. Uh, you’ve got closures again going on, you know, you, you know, and that’s outside of sort of the, the private equity funded stuff that got messed up through too much debt.

Scott Becker: Just in the general healthcare community, you’ve got big systems struggling, you know, still, and, and some systems doing fine.

Erik Sunset: Well, one thing that I’m really interested to watch, you know, we have a lot to be watching for next year, and I’m certainly not a part of the, uh, the RFK Jr. cult, uh, cautiously optimistic about what maybe he can do around the ownership of an individual’s health. Because we’ve talked about value based care a little bit.

Erik Sunset: Let’s keep healthy people healthy. Let’s keep them out of the emergency room. Let’s keep them out of the hospital. So his [00:23:00] whole make America healthy again, sort of mantra, we’ll see what happens. We’ll see what takes, I know there is a subset of society that is really bought in and really excited.

Erik Sunset: And, you know, maybe

Erik Sunset: doesn’t need that encouragement because they’re already,

Scott Becker: yeah, no, I think that I think the challenge is, of course, you know, I, I am getting older, of course. And so, of course, you know, you spend as you get older, you spend more and more time on your physical and mental health. You have no way around that if, you know, there’s this great concept, uh, you know, Peter Tia writes about it a lot.

Scott Becker: The health span versus lifespan concept. That you live to 84, you want to be as healthy as possible to 79, 82. So your last few years aren’t just horrible, you know? And so, I mean, I, the, the, the problem with the RFK thinking on this stuff is China and India both had to gravitate towards preventive care models because they’re just so understaffed in terms of physicians to population.

Scott Becker: This is the fallacy. I’m going to go through this R. F. K. Thinking of make America healthy. I mean, [00:24:00] all of us are believers that if, on average, our country lost 10 apiece, we would cut down heart disease, cancers, orthopedic issues, joint issues. Probably inflammation issues and everything. So it’s like on average, if we all lost 10 pounds, that would be a win.

Scott Becker: What China and Russia taught us during the pandemic, both those countries are heavily reliant on preventive care models by necessity. They don’t have enough doctors, healthcare workers, and labor force. China, because they’re so short of people to take care of people, had to close down entire swaths of their economy.

Scott Becker: during covid because they had no one to take care of people. India ended up in periods of time in the same exact issue and I don’t blame them. They have a trillion five, they have a billion five people in those countries, a billion three to billion five in each country. I don’t blame them. They don’t have nearly enough providers.

Scott Becker: So India just Over overrun during the worst parts of COVID just overrun with people that couldn’t be cared [00:25:00] for. So what I’d say to RFK Oh my goodness is is like it’s the same thing when people talk about value based care. It’s all nice in theory You better trust and verify in the backend. It all sounds good.

Scott Becker: Like RFK is maybe done a good job of getting this associated. God bless him. But the reality is for most Americans, the willpower it takes with the food around us, the amount of, the amount of sort of like the amount of where we’re at as a culture, where we’re at as a community, it would be great if we were all healthier.

Scott Becker: I believe that like when JFK had the fitness Medal of awards and we made it. part of the bully puppet? Absolutely. Do I think that bully puppets can really move us towards better health as a nation? I don’t. It might move a few percent. I mean, you and I can get as many motivational videos as we want on YouTube, on any place we want to look at, on how to keep healthy.

Scott Becker: It’s a war for me every day. every day to keep my weight under control and be where I want to be. It just is. And it is for most people. You know, I mean, you might be fortunate. You look taller and thinner than I am. God [00:26:00] bless you. I wish I was that, but it is what it is. It is a war every day. So when people say they’re going to use their bully pulpit to fix our health, I would say, if we weren’t on a public podcast, I would say, I would say go blank yourself because it’s a great idea, but we better have enough doctors and nurses and people to take care of our people in case the experiment doesn’t work.

Scott Becker: You follow me? India and China ended up trying to go that experiment and no choice by necessity. And they got screwed because they don’t have enough workforce to take care of their people. It just is like we’re getting to have 300, 400 million people. We’re the third largest populated country in the world.

Scott Becker: We don’t want to be those countries in terms of our health care system. And people talk about, well, we don’t need as many doctors. You know, we had this, you know, and I, I, I, I’ve had Hillary Clinton in our conferences a number of times. I, I, I, I like her in person very, very much, but they were predicting what was When they were [00:27:00] trying to move everything towards the insurance companies, and I guess it was the 80s or 90s, that we’re going to need a ton less doctors because everybody’s going to manage care better.

Scott Becker: But they were just wrong. They were completely wrong that managed care would lead us to needing less doctors and nurses and people. This is the experiment that when I hear these guys talk about, well, preventive care is going to solve things. It’s the same people that say technology is going to solve all of our problems.

Scott Becker: Technology is great, but trust and verify. We better get more doctors, we better get more nurses, better get more RTs, more technicians, more everything. To go with the technology, to go with the preventive care, I don’t believe the preventive care is going to solve it. We all ought to be on a GLP 1. I don’t disagree with that, but even that’s not going to get us where we need to be.

Scott Becker: I mean, we better actually take care of, uh, we better make sure we have nurses and doctors and providers take care of our people.

Scott Becker: So I, I, I spent a lot of time in the supply and demand of healthcare. The top 1020 metro areas. It’s not nearly as bad as in the rest of the country, but even their subspecialist specialists were in horrible trouble. So what are [00:28:00] we going to be the big issues going forward? It’s very hard to tell. So a couple of years ago, the big concern for hospitals and health systems was the disruptors, the retail disruptors.

Scott Becker: And then, of course, the CVS is the Walgreens. Uh, the Walmarts all got out of the business because it, not because it’s such a hard business, health systems would like to tell you, well, they got out of it because it’s such a hard business. It’s not such a hard business. It’s a simple business, but to staff what they need to staff, they need enough people and bodies to take care of it.

Scott Becker: They, they can’t, you can’t have 5, 000 drugstores and there’s only a, Uh, uh, a million 60, 000 doctors in our country and staff 5, 000 drugstores, whatever amount of Walmart outlets are, whatever amount of CVS and Walgreens out, so they just can’t do it. So at some point, supply and demand is going to hit a boiling point.

Scott Becker: If it’s not already there, you know, you go to right now, like when my elderly parents need to go to the doctor. Half the time they can’t get it out, they need to see, so they end up in the ER. When our younger daughter, who’s healthy and in great shape, you know, half the time when she’s in trouble, we end up at the, at the ER.

Scott Becker: [00:29:00] Everybody’s getting up at the ER. You’ve got three and a half hour wait, waiting times at the ER now. And I think at some point you’ll hit this crisis point where people start to see, like you talked about, you hit it exactly right. Nobody talked about cable news this year, about health care, because there’s so many other, I mean, reproductive rights, yes, but general health care, no.

Scott Becker: But we all know we’ve got this access problem. You have to be like. Out of it, not to see it, or just really sort of like, or you’ve always been in an impoverished area. And so healthcare has always been horribly impoverished. So you’re like, well, it’s always sucked for us because our health equity is so bad, but, but for the, for, and we need to fix that.

Scott Becker: But if you don’t fix supply and demand, Health equity gets crushed, and sooner or later, we all get crushed. So I assume that even though we’ll be talking a lot about technological advancements, we’re going to be talking about shortages for a long time because we’re not really doing anything yet to address them in any serious way.

Scott Becker: So I think, I don’t know when that’s going to be the big issue. It’s like a broken glass right twice a day. At some point, that’s got to be the big issue because everybody, you know, I have access, I [00:30:00] donate to health systems, they still have trouble getting, you know, The people, my family and extended family, and when we need to get in, I can’t even imagine a bill that don’t donate to households or something like that.

Scott Becker: And I, that’s so obnoxious, but it’s, but it’s, it’s, it’s, it’s an amplification of what a horrible health equity problem we’ve got. And that, that’s coming in part, largely due to the supply and demand issues. And I think at some point that’s got to become the big issue. Cause you could, you could move the dollars around all you want.

Scott Becker: I mean, this managed care, this Medicare disadvantage, Medicare advantage, this, that, the other, you can move it all around. It’s not the payment system. It’s as, as I think James Carville or Bill Clinton used to say, it’s not the, it’s the economy stupid, it’s not the payment system stupid, it’s, it’s the supply and demand issue.

Scott Becker: It’s, it’s very simple economics, we don’t have enough people to take care of our people.

Scott Becker: You need a concierge physician. And, and if you want to talk about, and a concierge physician means you’re paying a couple thousand up front a year to have a concierge physician.

Scott Becker: If you want to talk about something that’s horrendous for health equity, that’s it. And it’s not, that’s not a knock on the physicians. I don’t blame them one bit. That’s, that’s it. That’s it. That’s it. That’s at all. I don’t blame them at all. They’re working their butts [00:31:00] off. It’s a knock on what we’re doing from an education producing physician standpoint.

Scott Becker: The CVS thing. So many CVSs have a minute clinic, but no doctors or providers in them. I mean, exactly. You know, they’re just there. And so they’re not really minute clinics. They’re real estate. But yeah, I think, I think you, I think I, the Florida is a perfect example of it. Growing population to get a primary care doctor, you need a concierge physician.

Scott Becker: Is that what you’re hearing in Florida a lot? Do you hear a lot about needing concierge physicians in Florida?

Erik Sunset: Oh, a hundred percent. Many, many friends and family for their children. They have a concierge pediatrician because number one, they don’t want to wait. You know, you have a sick kid. What do you expect to do with a sick kid? You got to take them to the doctor. And if you can’t just walk into a medic clinic, you know, you look at the, the morning available appointments.

Erik Sunset: There’s like one appointment available at 6 PM tomorrow. That doesn’t help my kid. You try to get to one of the big pediatric groups in Miami. Maybe they can see you today, maybe not.

Scott Becker: I am very cautious like we have relations with lots of systems. We’re trying to never jump the line We try to never get special care, you know We do try and make sure if we have to [00:32:00] like, oh Can you figure out which specialist to call who to get to you know, which your ERs is more open right now But we try to never jump the line You But you are going to want to make sure that you can actually get care for your family.

Scott Becker: And it’s a real, uh, It’s a disaster already if you’re, if you’re impoverished and not, you know, and can’t afford it. And you talk about a two tier system, it’s going to get a lot worse and you can talk about all the Medicare advantage you want, the different ways of managing it and stuff like that. But that’s not really a solution.

Scott Becker: The solution is, you know, if doctors and caregivers and providers and leveraging care and people working at the top of their license and all kinds of other solutions to it and technology, but it’s people and tech.

Erik Sunset: Well, I want to be greedy with your time. Just one more point that I have physicians on this show. Just like I have ASC administrators, experts like you, all types of folks come on the DocBuddy journal and the recurring theme with physicians. I bring up burnout. I bring up the precipice that we’re on a physician shortage.

Erik Sunset: The physicians with kids tell them, tell their kids, I don’t want you to follow my footsteps. Don’t go into medicine. It’s too much of a beating. It’s not [00:33:00] worth it. You’re abused up and down. It’s not rewarding work anymore. You know, for me, I’m not a provider. I don’t work in a health care organization. So

Scott Becker: one of the children in our blended family is in medical school. Um, and I think it’s a very complicated issue because you’ve got this, you’ve got that 100%. But we’ve also got this situation now. 50, 000 people apply to med school each year.

Scott Becker: 20, 000 get in. So 20, 000 go each year, something like that, around those numbers, you know, we end up between that and medical school, DL school, 20 25, 000 a year, um, out of 50, 000 plus applicants, of those 50, 000 applicants, there’s probably at least another 5 10, 000 that don’t get into any medical school, that the difference between them and that The five to 10,000 that get in at, at the, at the bottom end is probably almost nothing.

Scott Becker: You, you could, you know it. So if you, if you look at the 20,000 that got in versus 21st thousand [00:34:00] that didn’t get in, 25th thousand didn’t get in, probably the differences are probably minute. Now, I’m not saying that person that was number 45,000 should get in, but there’s still a lot of people that would like to be doctors.

Scott Becker: What we’ve done is we’ve, we have a medical school system. It is antiquated, and we could let in more doctors if we had more residency spots. That 20, 000 would go to 24, 000, 26, 000 if those residency spots got approved. Obviously, 4, 000 more residents that create 3, 700 more doctors in four years. It’s something that across a nation of 330 million doesn’t really solve a problem.

Scott Becker: It’s still a drop in the bucket, but it is, there are still enough people that do want to go to med school and we need more of them. But it’s, yeah, it’s different than it was when we were growing up. Of course, you went into specialty. You knew you’d both do great work and make a great living. Yeah. You’d be a bit of a kingpin in your community or a queenpin in your community.

Scott Becker: It was sort of a very esteemed life. And [00:35:00] now it’s like, you know, you know, you know, it’s a very different world. It’s like you’re, you’re just another type of professional. And it’s, it’s great. And it’s fantastic. But it’s not like, uh, it’s not sort of the, um, the, the wife and the lifestyle and things that sort of came with it.

Scott Becker: You know, when, when we were growing up, perhaps, you know, and so it’s, it’s a complicated thing. I mean, it’s all over the board. So, yeah, it’s a great profession. It’s fantastic what people do. I mean, there are a lot of physicians that are thrilled their kids are going to med school. I’m thrilled that ours is going to med school, but it’s not like it was.

Scott Becker: 30 years ago, where if you became this specialty, you did this, you had a great living, you also did that. It’s not like, you know, certainly not the Premier Cure guys that used to golf on Wednesday afternoon. I mean, those days are, you know, that used to be golf day for Premier. Those days are long gone. It’s just a different world, so.

Scott Becker: Yeah, I know. I know what the answer is to it, but there’s so many workflow shortages in health care that we gotta, we gotta figure out a way to turn around. We gotta, we gotta make it easy for people to become doctors and [00:36:00] not like without, I mean, it’s not so much. And I don’t mean this like we have a great medical education.

Scott Becker: It just is. It’s um, it’s antiquated. They’re creating doctors in other countries. that we’re bringing to this country that finish it all in six years versus eight or nine years and those doctors are wonderful. So it’s very doable. They’re doing it in India, they’re doing it in Brazil, they’re doing it in other places.

Scott Becker: They’re creating fantastic doctors in two to three years less time. So it’s, it’s, it’s not like it’s not doable. It’s, it’s being done

Erik Sunset: You know, there’s something to be said for that. We can’t lose sight of the fact that. Physicians go into medicine or providers of any type go into medicine because they care. They want to help people. And I have the utmost respect for a physician.

Scott Becker: I mean, both. And it’s, uh, you know, when it gets sort of like whipsawed, you know, there’s physicians that want to be entrepreneurs, there’s physicians that just want to work for people, and it’s constantly getting whipsawed.

Scott Becker: And it’s, it’s a changing demographic, a changing world.

 

Erik Sunset: Well, on that note, Scott, you’ve been really

Erik Sunset: generous

Erik Sunset: there anything else we didn’t cover that you want

Erik Sunset: to?

Scott Becker: but what a pleasure to visit with you. Thank you so much for having me on.[00:37:00]

Erik Sunset: Oh, absolutely. We loved it.

Scott Becker: sure. Yeah, no, 100%. You

Scott Becker: could

Scott Becker: find Becker’s

Erik Sunset: go, tell our listeners where they can

Scott Becker: you know, you know, online wherever you

Scott Becker: could

Scott Becker: find me on

Erik Sunset: will know

Erik Sunset: exactly where they can

Scott Becker: You could always email me, you could message me, 773 766 5322. We love to interact with people and hear people’s different thoughts. So, anytime is great, but LinkedIn is easy.

Scott Becker: different email addresses you could find for me pretty easy, Becker’s Healthcare, and then the text number 773 766 5322. Uh, thank you so much, Erik. What a great pleasure to visit with you.

Erik Sunset: We’ll be sure [00:38:00] all those links in that text number are in the show notes. And on behalf of the entire DocBuddy team, I want to thank you for listening. Be sure you’re subscribed on Apple podcasts, Spotify, and YouTube. And until next time, your host, Erik, we’ll talk to you soon.