Future of Medicine 2021

In 2021, MSMS spoke with about 60 health care leaders to update its original 2005 study of the future of medicine. This new study, The Future of Medicine: 2021, emphasizes the voice of physicians—both those who currently treat patients as well as those who hold leadership positions.

These leaders were asked where medicine should be in five years, both generally and related to specific issues. Even during the COVID-19 pandemic—and, in many cases, informed by the pandemic—interviewees offered ideas for strengthening patient care.

Team-based and integrated care models

Participants expressed broad support for these physician-led models, which promote patient-centered care and allow practices to address their patients’ needs more holistically and allow all team members to practice at the top of their license.

"We will continue to be in the business of treating patients; medicine may be pulled in different directions– public health, advocacy—but it all comes back to treating patients. This is the key to addressing physician burnout, so much of their time is spent not treating patients. We need to recapture the fundamental nature of what medicine is about and for—treating people and staying patient centered.”

Value-based and risk-based contracting

Participants often described the need for more aggressive evolution toward value-based and risk-based contracting. Many noted that these types of contracts would help decrease variability in care (e.g., by encouraging evidence-based practices and guidelines) and promote good patient outcomes. 

“The payment model has to move. If we build one that benefits patients, it will support physicians too. As it relates to equity, one that is more focused on value and not on volume. The more we drive and push towards this, it is where medicine needs to be. And it needs to incentivize value and addressing the social needs of patients and have the infrastructure to do so.”

Social determinants of health (SDOH) and health equity

Health care leaders often pointed to the ways proposed advancements to practice models, payment models, and technology would also enable medicine to better identify and address SDOH and health disparities. Many interviewees noted that more work is needed to address these issues. 

“We need a more personalized approach to medical care that is individualized for patients, where patients and providers work together with patients as the driver of their medical care, including in addressing SDOH and behavioral health needs.”

Physician leadership

Participants articulated a call to action for physicians to lead in multiple areas of the health care system (e.g., health systems, physician organizations [POs], payers) and to actively lead at the practice level in team-based care settings as well as at the community and state level (e.g., policy discussions).

“No one understand the needs of the patients and the resources available to meet those needs as well as physicians. I don’t think anyone understand the opportunities for waste and waste reduction and cost reduction as well as physicians. No one has a leadership perspective both within health care and in politics like physicians have. It is a unique perspective.”

Multidisciplinary and cross-sector collaboration

Participants frequently noted that no single sector or discipline can transform health care. Physicians and other health care providers need to work directly with payers, purchasers, businesses, and patients to move health care forward over the next five years.

“With a more collaborative approach to care, we could potentially end up with less sick patients and greater wellness.”

Electronic health record (EHR) improvements

Respondents emphasized the need for EHRs that support clinical decision-making regarding diagnoses and evidence-based treatments. They also said EHRs must be interoperable so health care information can be shared across providers and health systems. 

“Everything already exists for the universal EHR and marrying that with artificial intelligence–enhanced decision support. It’s already out there, we just have to implement it. If we really move toward leveraging AI to hardwire best practices and evidence-based guidelines, it will immediately improve quality."