• We’re seeing huge changes in healthcare.

•  About 25% of patients used telehealth last year, far exceeding the 5% who accessed care this way before the pandemic.

• Pharmacies with physicians present (like pet stores with vets present)

• Physicians in private practice greatly reduced.

• The share of doctors who worked in practices wholly owned by physicians fell from 60.1% to 46.7% from 2012 to 2022.

• More people seeing nurse practitioners

• From 2016 to 2021, the number of primary care physicians billing Medicare declined each year, from 142,000 physicians in 2016 to 135,000 physicians in 2021. 

• Physicians tell me that the paperwork, reimbursement bureaucracy, and corporate demands are terrible. Example: 5-8 minutes allowed for patient questions during visits.

• Some exceptions: dermatologists have modestly increased. There are no midnight emergencies for dermatologists.

• Faith in the medical establishment has been undermined by the conflicting medical and political decisions during and after COVID.

• Religious institutions, education, and medicine have all suffered damage to their integrity.

• Patient costs are rising in terms of copays and over coverage denied by insurers.

• The limited government data available suggests that, overall, insurers deny between 10% and 20% of the claims they receiver

• When I consulted with RI Hospital it started every year in the red by $14 million because they were required to provide care to indigents.

• Recent studies of medical errors have estimated errors may account for as many as 251,000 deaths annually in the United States, making medical errors the third leading cause of death.

• Sepsis is a leading cause of death in hospitals.

• Emergency room waits can be 12 hours and worse.

• It wasn’t all that long ago that doctors were not washing their hands between seeing patients!