Writer: Max Crampton-Thomas
2 min read July 2021 — Dickson Medical Associates (DMA) is one of the largest multispecialty physician-owned medical groups in Tennessee. Executive Director Christie Strong spoke with Invest: and discussed Nashville’s reputation as the healthcare capital of the world, the need for greater healthcare access in rural communities and the issues with healthcare technology in the United States.
What makes Nashville a great market for a healthcare firm?
Nashville is the healthcare hub of the world. One of the perks of the healthcare industry in Nashville is the sheer amount of innovation and collaboration. Nashville is the home to one of the nation’s largest healthcare information technology companies and home to the nation’s largest health system of doctors. In addition, Nashville is home of the Jack Massey Graduate School of Business at Belmont University, where I obtained my MBA. Jack Massey was one of the founders of our nation’s largest health system of doctors, Hospital Corporations of America (HCA). Then there is Vanderbilt Medical School that is currently ranked 13th among our nation’s medical school programs, and Vanderbilt School of Nursing which is ranked 6th best nursing school in the nation. We also have an entity called the Group Practice Coalition, which is composed of large outpatient groups throughout Tennessee that have come together to share industry best practices.. The Group Practice Coalition was formed to advocate on behalf of outpatient groups on the regional and national level.
Why is Dickson Medical Associates focused on rural communities?
We have nine clinics, three of which are established as rural health clinics. Rural communities have become a strategic initiative for our organization because of the healthcare disparities and lack of access to quality care in these communities. Individuals in rural areas typically don’t have access to quality opportunities in the job market, so they’re uninsured or underinsured. This leads to an extremely high Medicaid population. It’s difficult to find physicians who want to serve this population because practitioners know that Medicaid reimbursements are too low for them to be able to make a satisfactory living. So, the low reimbursement in rural health is the culprit for these disparities. We really focus on making sure that people in rural Tennessee, especially in the western part of Middle Tennessee, have access to high quality healthcare.
How has the pandemic impacted your use of new technologies?
I would consider the healthcare industry to be laggards in the adoption of technology, mainly due to clinical resistance from older practicing physicians. The Meaningful Use program, which was implemented in 2009, incentivized healthcare organizations to move to electronic medical records (EMR). So only in the last 12 years have we seen significant adoption of technology in the healthcare service industry. COVID has really pushed us to adapt to new technology. For example, I began proposing telehealth services for our organization in 2014. At the time, many of our physicians believed that we could not deliver quality care through telehealth services. Fast forward to 2020, we were forced to adopt telehealth services, and we were forced to implement them quickly. We have now found ways to implement telehealth in areas where it really adds value to patients and providers. Since the pandemic, we have implemented new technology platforms including a new population health module, an EMR rules engine to ensure coding compliance, and reengineering of our systems and network.
How has demand for your services shifted over the past year?
During the state mandated shutdowns of the pandemic, our organization experienced a 30% decrease in demand for healthcare services. This was mainly due to the flexibility of our organization that allowed us to start a COVID initiative of mass testing at our main site. We were able to test and treat a significant number of patients with the goal of keeping them out of the hospital. Our No. 1 area of decline was in general health, in addition to elective surgeries. Around November, general health started to increase as people realized delaying healthcare could cause poor outcomes of COVID related illnesses. If COVID has had any positive impacts, one would be highlighting the importance of maintaining good health. Now, our general health visits have increased substantially, exceeding 2019 numbers. We have a provider that has recently branded a weight and wellness clinic that focuses on addressing our communities most significant comorbidity of obesity. With our increasing demand, we have recruited more physicians in 2021, then we have ever recruited in a single year.
Overall, Nashville is experiencing a massive influx of new residents from Washington and California, and Dickson specifically has been an attractive place for those people who have lived in big cities during COVID and are now looking for a change of lifestyle. This has contributed to our growth, and our goal is to continue to meet the healthcare needs of our community.
What is driving high healthcare costs in the United States?
There are many factors that play into the high healthcare costs in the U.S. One thing that I am a huge proponent of is a universal electronic health record (EMR). There is so much redundancy of testing because our EMRs are not integrated and do not communicate with each other; this really drives up the cost. The United States has more modalities of high tech imaging than any other country in the world, which contributes to the overuse of imaging. When you compare our health outcomes to other countries that do not have the same level of technology, we don’t have superior outcomes.
What is your outlook for the next 18 months?
We are very excited for the future, especially with our ASC (ambulatory surgery center) project. We have been working on this project since before the pandemic, and we are hoping to start construction before the end of 2021. Ambulatory surgery centers provide an excellent alternative for lower-cost outpatient surgery compared to hospital-based outpatient surgeries. We have recently added multiple new physicians including an allergist, a pulmonologist, an orthopedist, and a podiatrist. By the end of 2021, we plan on recruiting another pulmonologist, a second urologist, and an otolaryngologist. We also have plans to expand one of our rural health clinics to offer pediatrics and specialty care. With all the new services we are now providing, and our current strategic initiatives of expanding into other service areas, we are excited to continue to serve our community and the surrounding communities by providing high quality, convenient and comprehensive care.
For more information, visit: https://dicksonmd.com/