The big trends this physician is keeping an eye on

Healthcare is full of excitement and ripe for change. 

James Stone, MD, CEO and chief consultant/investigator at Stonaire Consulting, connected with Becker's to discuss the healthcare trends he is excited about. 

Editor's note: This response has been lightly edited for length and clarity.

Dr. James Stone: 1. Rural surgeons. Rural surgical care is in crisis. Multiple professional organizations are addressing the issue. This has brought discussion to many areas of rural care, such as access to specialty care, levels of critical care, surgical resident curricula and emergency transport. All these topics are extremely pertinent to the future of medical services and care in rural areas.

2. Access to primary care and emergency department boarding. A common scenario is for patients to say they could not get an appointment with their primary care provider for weeks to months. Which appears to be contradicting the term "primary care." As a result, patients are using the emergency department as their primary care access point, which is causing accelerated emergency department waiting times and overcrowding. The result is patients being boarded in the emergency department for extended periods due to lack of available patient beds. A cyclic problem. These critical results are drawing attention from multiple divisions of healthcare. This will hopefully result in innovative and appropriate revisions as well as new processes.

3. Laparoscopic vs. robotic procedures. Studies are demonstrating variable advantages to robotic procedures when compared to laparoscopic procedures. Given the cost variances, many facilities are hesitant to develop robotics. Many recently trained surgeons are advocating robotic capabilities. But unlike laparoscopic cholecystectomy, valid confirmatory data comparing the two procedures needs to be obtained. That is beginning to happen, which will benefit the patients and surgical care in general.

4. Uninsured care. A good portion [of uninsured Americans] are employed but earn too much to qualify for Medicaid yet too little to pay premiums for a healthcare policy. And there is extreme variability between states. The result has been thus far for states to address or revise their Medicaid criteria and for insurance companies to create low-cost policies. The small business owner continues to be burdened with providing his employees healthcare coverage. While the discussion and innovation has just begun, it will need to continue and accelerate. 

These topics excite me because they are early in the discussion but, I believe, will have a significant impact on the future and quality of healthcare.

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