30 years ago, in order to practice law on a sophisticated level, you needed to be part of a firm with its relatively large support staff. You dictated and your secretary either took shorthand or transcribed the tape, typing away at a typewriter.
Flash forward to today — I’m dictating this post into Evernote on my iPhone from home, will polish it on my notebook computer in an hour or two and then upload it to the web. Gone is the need for a large support staff. Gone is the need to be in the same location.
In even more striking technological fashion, the microchip revolution that took place in medicine over that same time period enables physicians in independent practices and far-flung locations to share healthcare information and deliver technologically advanced treatment. This technological revolution enables the coordination of care across locations, providers, and facilities.
This, in fact, was the entire underpinning of the need for HIPAA: Information was going to be shared electronically among various providers and entities; therefore, standards for sharing the data were required and data security and privacy protections were adopted to make sure that sharing would be secure.
Yet over the past several years the pressure’s been to amalgamate physicians, under the control of hospitals, purportedly to coordinate care. That flies in the face of the technological advancement that has rendered superfluous the need for common ownership and close financial relationship.
So then why “physician alignment,” and “healthcare collaboration” in the form of hospital-centric healthcare?
The answer is clear: money and control.