A few weeks ago, I suggested that — love it or hate it — physicians need to prepare themselves for the likely advent of health reform by getting a handle on internal costs and processes, and by strategically organizing into stronger bodies able to negotiate more effectively with payors across a range of new approaches to payment for health care services.  While the landscape has changed dramatically in the past week, my advice still holds.  Some physicians may believe that reform in any form similar to the bills that are now derailed must be stopped in its tracks, and that entertaining any notion of negotiating with payors under a new regime is insane.  In fact, one commented on my earlier post, saying: "I feel like a Pole with Molotov on one side and Ribbentrop on the other, a map of Poland on the table, and this lawyer counseling me to 'get a seat at the table.' "  

Strong words, huh?

So now here we are, with Ted Kennedy's former seat soon to be occupied by Scott Brown, the self-proclaimed 41st vote against health reform in its present incarnation … likely voted in (in Alice In Wonderland fashion) because folks in Massachusetts thought the health reform bills weren't progressive enough.

It seems clear that no matter what, there will be significant change to the landscape in the relatively near future: it could be during the current Congress, or it could be that nothing happens this year or next, we slide closer to the brink and have to face a more draconian solution five or ten years down the road

In any event, my earlier advice to physicians stands: better to get organized sooner rather than later — before you're under the gun.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting