Actions by the Trump Administration and Congress are creating uncertainty across the spectrum of health care, from the largest health system to individual patients, according to Fay Rozovsky, JD, MPH, of The Rozovsky Group, Inc. Rozovsky, a health care risk management consultant and attorney, works with clients along the continuum of care, providing health care professionals, and organizations with practical risk management and patient safety solutions. She spoke with Wolters Kluwer about changes and challenges in the health care industry. Rozovsky is the author (along with Jane L. Conley), of Health Care Organizations Risk Management: Forms, Checklists and Guidelines .
What do you think were the most significant developments in health care over the past year?
The attempt to retool a number of regulatory requirements in the ramp up to the new Trump Administration and thereafter, the determination by the new Administration to overturn many of these reform measures. Add to the mix the attempt to repeal and replace the Affordable Care Act.
What do you expect will be the biggest pain point for your clients over the coming year?
It can be summarized in one word: uncertainty. Much of my work is in health care risk management and, in particular, enterprise risk management or "ERM" as it is known in the field. One of the goals of ERM is to smooth out the variabilities in health care processes and systems. Such measures help to eliminate wasteful spending, enhance patient safety, and utilize savings for investment in staffing, technology, etc. Signals coming from the new Administration and Congress reflect the antithesis of such an approach. The uncertainty is impacting all aspects of the health care industry, from the "brick and mortar" facilities, to health care providers, health plans, and, of course, patients.
How has the day-to-day practice of health care changed since you started?
When I started working in the field, the focus was very much on hospitals and physicians. Medical malpractice was a major focal point along with some legal-regulatory and transactional considerations such as antitrust. The "tools" were a far cry from today’s technology such as instant, online access to laws, regulations, and case law. Data analytics were not part of the equation as it is today. The number of specialty publications in health law were far fewer as compared to contemporary resources. With such ready access to information, a practitioner is obliged to digest and apply much more data for the benefit of clients. It has also created a shift in client expectations from "will I have the memo in the next few days?" to "Please send that memo to me electronically today!"
What do you find most enjoyable about the practice of health care?
The fact that no two days are alike. There are a host of issues, challenges and health care professionals with whom to interact. There is also a willingness among health care leadership to listen to health care risk management professionals and health lawyers often before and not after a final decision has been made on a project or problem.
What continues to surprise you about your clients?
Their resiliency and willingness to ride the waves of change. Certainly, those who found change difficult to accept have moved on to other endeavors. Those who have remained steadfast have learned to absorb and even thrive in the vortex of change called contemporary health care. It is refreshing and surprising in many ways to see these innovators move ahead to reshape health care.
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