To many analysts, administrators, physicians and anyone with the rare ability to read, these trends may be easy to see and foresee but they were interesting to hear nonetheless. Here's a rundown of the top trends in US medical practice directly from the mouth of the practitioners themselves.
 

  1. Independent practice is dying. This was immediately evident when the pannelists asked the audience, by a show of hands, who was independent and who was affiliated with a hospital. Let me put it this way, if the two groups were having a tug of war, the independent practitioner-end of the rope would be dangling on the floor.
  2. No more playing with the latest and greatest devices. With more scrutiny over efficiency and costs, physicians no longer have free rein on what devices they choose and have to consider a great many factors before deciding what to use.
  3. Data! Pay will eventually be aligned with performance and many institutions are investing in detailed data collection systems so that when their reimbursement rates are reviewed, there are no surprises. Additionally, ratings will eventually end up in the public domain so institutions need to be able to track their performance so they can improve it and along with it, their bottom line. It's about time!
  4. Away from institutions being jacks-of-all-trades and towards centralization of complex procedures. When the presenter mentioned that anecdotal evidence suggests that 80% of AF ablations are done in centers that do less than 55 in a year, one physician sitting beside me exclaimed "Dear God"! Both quality of care and cost effectiveness would be better served by focusing efforts in a few high volume centers and it seems to already be happening.

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