How to thrive in the Medapocalypse

Sickcare spending continues to spiral out of control. Patients are becoming impatient voters. Hospitals are folding or consolidating and rural hospitals are disappearing. bringing the number of rural hospital closures up to 98 since 2010. Hundreds more are likely to follow. Currently, 46% of rural hospitals operate at a loss, compared to 44% in 2018 and 40% in 2017. Due to financial strains, nearly 700 rural hospitals are financially vulnerable and at high risk of closure.

Politicians and policy makers see the answer as insuring more patients by spending more taxpayer and employee dollars increasing the present national debt of $23.25 trillion. You cannot possibly get your head around that much money. If you spent one dollar per second, in a day you would spend $86,400. Over the course of a year, your spending would come to more than $31.5 million. At that rate of spending, it would take you over 32,000 years to spend one trillion dollars. (A trillion = 1000 billion.)

Some think that there will be little, if any, substantive change in the US Sickcare system of systems in the near future. But, maybe, instead, we are in the midst of a medapocalypse.

US Sickcare Inc (USI on Nasdaq). a system of systems, including many others around the world, is simply unsustainable. There is an increasing likelihood that we will face the medical meltdown, the Medapocalype, much like the retail apocalypse has devoured retailed businesses and malls. Digital health won’t save us and big box medicine, income inequality and Marie Kondo are three of the culprits impacting USI as well .

Now is the time to prepare for the “de-growth” of USI. Start doing these things today:

1. Prepare for the medical school bubble
2. Become data literate to transform sick care to healthcare
3. Learn how to practice retail medicine
4. Don’t let your babies grow up to be primary care doctors
5. Create and deploy new business models
6. Change the coverage and reimbursement rules
7. Save more, spend less
8. Care about the planet
9. Raise your health and insurance IQ
10. Invest in closing hospitals and make them into condos, senior living facilities, medical department stores or specialized mini-care facilities
11. Create medical devices and drugs that actually work for most patients at less cost and that do not have planned obsolescence built into them. Have the guts to take on the biomedical industrial complex and all the rest who refuse to say no because they feed at a $3.6T trough. That includes doctors who are both part of the problem and the solution.
12. Create substitute technologies, not supplemental technologies, that create a Moore’s law for medical technology, not drive up the cost of care
13. Get rid of single use items and rethink medical packaging and sterilization techniques
14. Don’t allow medical students to take out more loans to get MBAs Will graduate school really teach you how to be a physician entrepreneur or just a way to get your manager ticket punched so you can go to meetings all day long?
15. Separate the sickcare system of systems from the healthcare system system of systems
16. Eliminate the 30% of medical services that are unnecessary

17. Focus on the 5% who account for 50% of spending

18. Get rid of wasteful admininistrivia

19. Replace expensive, ineffective EMR systems.

20. Work with social determinant partners and stop cost shifting the costs to the sickcare system.

Surviving the Medapocalypse will take more than hiding under your desk. Just do these things even if you don’t have $31M dollars to spend each day.

Arlen Meyers, MD, MBA is the President and CEO of the Sociaety of Physician Entrepreneurs on Twitter@SoPEOfficial and Facebook.