Luis Manuel Tumialán, MD, Professor of Neurological Surgery, Director-American Board of Neurological Surgery, Chair of the Council of State Neurosurgical Societies, who practices at Barrow Brain and Spine, discusses workforce issues and solutions within the medical field. He addresses challenges faced by physicians and calls for meaningful change to strengthen the healthcare industry and support those on the front lines of care.
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(00:00):
This is Scott Becker with the Beckers Healthcare
Podcast.
We're thrilled today to be joined by a
brilliant surgeon, a brilliant physician.
We're joined today by Luis Manuel Tumi Allen.
And doctor Allen's gonna talk to us a
little bit about
physician owned hospitals, the prohibition of physician owned
hospitals, and a lot more. Doctor Toomey Allen,
(00:21):
can you take a moment to introduce yourself
and tell us about your practice
and and your your history?
Yeah.
Thank you for having me on this podcast,
Scott, and and helping me build awareness for
these issues that are challenging the ability to
practice medicine in 2025
and moving forward. My name is Luke Chamealyn.
As you mentioned, I'm a a private practice
(00:42):
physician
with Barrel Brain and Spine. We are the,
27,
neurosurgery
group,
that services,
several hospital systems in the Phoenix area. I
am a minimally invasive spine surgeon. I
have a very,
strong focus on on motion preservation in the
cervical and lumbar spine and developing technologies
(01:03):
that will allow us to preserve motion, not
stop that motion, but at times, you do
need to do that.
I, I I I trained,
in Atlanta, Georgia at Emory, and then I
had a stint in I I spent eleven
years in the world's finest navy,
and,
of those, eleven years, six active fiber reserve.
(01:23):
I spent time as an operational physician, and
then I was able to practice medicine and
I guess what would could only be considered,
the what would be a capitated system.
And I,
felt the frustrations
of working in that type of environment at
the end of my naval career and was
very happy to,
join a private practice
and be,
(01:44):
untethered from those things. And those are the
and that's, I have a strong interest in
socioeconomics,
so much so that I I ventured into
a the socio economic arm of neurosurgery, which
is a council of state neurosurgical societies.
And,
and over the span of fifteen years,
now I I currently reside as the chair
of that organization, and that chair or that
(02:06):
the council of state neurosurgical societies is dedicated
to one thing,
increasing the value of the neurosurgeon, increasing the
value of the of the physician. And so
that that's, in a nutshell what, my journey.
I I
do not
want to, become a an employed neurosurgeon,
and I continue to fight that battle and
(02:28):
create an ideal environment for the next generation
of spine surgeons to be able to do
what it is that,
I I get to, do and have fulfillment
and career and control over to a certain
extent of my life.
So what an amazing practice. And for people
that don't know,
Bureau Spine, Bureau Neuro is one of the
the great, great practices in the country. Tremendous,
(02:48):
tremendous reputation as just a great, great, highest
quality practice.
And and talk about some of your advocacy
work, and then also tell us if you're
still a Georgetown Hoya fan,
or both. Tell us about the advocacy work
and what you're most focused on there, and
also tell us if you're a Georgetown fan.
Well, I'll start with the Georgetown fan. I
I'm I'm a huge Hoya fan,
(03:11):
and,
big,
what my
fondest memories are gonna be,
spent in over the Potomac and then,
with the judge on the Jesuit campus there
at Georgetown. What a great environment to to
start a medical career.
Advocacy work is just you know, one of
the things that we do is we we
we build awareness.
(03:32):
We we do small things, which are actually
not that small, but not how about this,
they're not as noticeable. For example, we advocate
for,
a,
a a surgeon who does a decompression with
a fusion at one point. There was a
defacto bundle.
It's around the same area, and we read
this article in this one piece. And so
(03:52):
what we're gonna do is we're gonna go
ahead and bundle it. And we go, no.
No. No. No. No. No. If we go
back to the history of these codes and
everything everything stems from understanding the history of
how we got here.
Because we're we're in a very Byzantine arcane
system with the RBU system, which is how
all physicians get paid, which is one of
the things that they should teach
physicians the first day of medical school because
you need to know how it is that
(04:13):
you are gonna make it in this world.
But, of course, talking to a medical student
about remuneration is like talking to your children
about procreation.
No one wants to do it. It's a
it's a it's a bad thing to do
apparently when I think it's,
essential, that we need to increase the socioeconomic
IQ of our,
of our burgeoning physicians. But for, you know,
one of the, advocacy,
(04:34):
elements that we did was we said, look.
We we believe that the history of the
code used to be that an orthopedic surgeon
did the arthrodesis, a neurosurgeon
did the decompression. These are two separate pieces
of work as
as,
difficult as that sounds to untether. That's the
history of the code. One's muscular skeletal, one's
nervous system. And, therefore,
(04:55):
these, the work was already parceled out, and
so you have to preserve the value of
that work. And so a physician should be
remunerated for that, that additional work for decompression
with lumbar fusion. As as as small as
that may be, that little nuance,
that resulted in since the development of the
six three zero five two and six three
zero five three codes, the decompression codes with
(05:16):
lumbar fusions is part of the advocacy
that we collaborated with, the the spine section,
double a n s, CNS, NASS,
and, ISAS.
All of that results in
over a $100,000,000
that are being paid out to physicians over
the span of a year, work that was
not being remunerated before. So that's an example
(05:37):
of advocacy. Another example is making, surgeons aware.
Hey. Do you realize
that you are not being paid
for work that you've had
prior authorized?
We are the only industry,
Scott, that that would tolerate this.
If you have a contractor, do work on
your house,
(05:58):
and they give you a,
an estimate. Here here, Scott, this is what
we're gonna do to your this is what
you you you want this. You want your
kitchen redone. Here here's our estimate. And guess
what? The estimate is is it always goes
over.
And and then they when the work is
done, they go, okay. Here here's what you
owe us. If you don't pay that bill,
they'll put a lien on your house. We
(06:19):
get a prior authorization.
Physicians listening to this podcast will be surprised.
I some won't, but some may,
that they will get a prior authorization to
do a procedure where the approved codes were
XYZ.
They do a procedure on such and such
a date that cover x y z. They
submit the charges for x y z.
And
twelve to fifteen percent of the time,
(06:40):
that will be denied even though they did
everything to a t. Do we put a
lien on that patient? Of course not. We
can't. What do we do? We knock on
the door, introduce ourselves to the next patient
that's gonna, that needs care, and we just
keep going on. No other industry tolerates what
we tolerate as physicians. But that's to increase
the awareness all of a sudden builds a
(07:00):
groundswell of support. Wait a second.
Why do we tolerate this? And, hopefully, it'll
lead to,
a legislation
where, a because you you we all get
this. We get the the prior authorization is
not a guarantee of payment. That sentence needs
to go away.
Legislation federal legislation needs to be. If we're
if we're advocating for position, we're trying to
(07:21):
deal with the physician work shortage, should be
that
prior authorization
is a guarantee of payment on a clean
claim. If I do exactly what I said
I was gonna do,
and anyone's
mind of what is fair, you should be
paid. 12 to 15%,
that doesn't happen.
(07:41):
And how do we change that? How does
that get changed? That does seem incredibly
unfair. You know? So tell us, how does
that get changed or or what can be
done?
Well, I mean, it's it's it's, you know,
one of the we are involved with our
political action committee. We have a neuro pack.
Our wash committee is very involved, and they
they they set up, meetings with our, elected
(08:03):
officials. And I was fortunate to be able
to meet with senator Cassidy from Louisiana who's
a, an OB GYN. No. He's a gastroenterologist.
Senator Marshall from Kansas whom I also was
able to meet through this
PAC, and and they said the same thing.
You know, reach out. Reach out to your
elected official. Reach out to your congressman. Reach
out to your senator. As lofty as that
(08:24):
may seem, I mentioned that to my wife.
The next thing you know,
she sets up meetings, and I have a
Zoom meeting with senator Kelly's,
legislative assistant, and then I and then senator
Gallegos. So and then, congressman Schweickart, who as
it turns out go his sister goes to
my church.
Cassidy made the point to say, you'll be
surprised
that how close you actually are to your
(08:46):
elected officials. There there's not that many degrees
of separation.
And so we begin that dialogue.
You you you you it's not a ranting
and raving, but rather data. Here's the data.
Here here's the data on our workforce.
Here here's the here's the shortage that we
foresee happening. Here's what here's what's happening with
(09:06):
medical students that are graduating. They're being around
a bunch of physicians who appear to be
burned out or complaining about their jobs. And
guess what? After they graduate medical school, they
don't go into practice. So even though you
may increase the three throughput from medical school,
you're not having enough physicians enter the workforce
because of the rate of burnout, because of
(09:28):
the rate of of,
of the the the job fulfillment not being
what they thought it was. What we need
to do is create an environment where medical
students are around, physicians are saying, hey. I'm
being treated fairly. I have great fulfillment in
my job,
and I've got a long, fulfilling career in
front of me. And and what we need
to do is also keep positions in the
workforce. We have I I have colleagues of
(09:50):
mine who are in, I would consider myself
mid career, and they are already looking for
the exit.
I think if we create an environment that
that allows us to take advantage of it.
Talk about that because the stats are alarming.
There's about, you know, a 100,000
practicing physicians at most.
And something like 40%
are going part time by 40 to 50,
(10:12):
and and we're losing a lot. And and
how do we how do we make
Dalton work better for physicians
So so they stay excited and enthused and
treated well because we are such in dire
need, particularly in many, many specialties.
Well and, I mean, there's there's gonna be
several opinions on that I have in mind.
One of the things that we need to
bring back is the physician entrepreneur.
(10:34):
And one of the topics that we had,
broached broached at the beginning is the ban
on physician
owned hospitals. So section six zero zero one
was a little
recognized
section that was I wouldn't say it was
snuck in, but it it certainly
did not get a lot of attention when
it went in. And that is the only
(10:57):
piece of legislation that exists in the books
where one
type of profession
has been singled out
and precluded from a business enterprise.
No. There's there's no legislation that says a
lawyer cannot own their law firm. There's no
legislation that says bakers can't own their ovens.
(11:19):
But a physician cannot own the means of
production of their enterprise, of their of their,
in their professional
environment.
And once you've done that, what that allowed
is eliminated the competition. Once you eliminate competition,
you have vertical integration. When you have vertical
integration, you have you have physician practices that
are struggling.
They get acquired. You lose control, and now
(11:41):
all of a sudden, the cycle happens.
A simple because this is it would be
ludicrous with and then I think someone you
know, I I I had a post.
I'm a social media neophyte. I don't know.
I I rely on other people to do
this. But, I posted something with regards to
the, repeal on a piece that I wrote
for,
our our one of our,
(12:02):
society,
publications
where it was said, oh, so you wanna
repeal the Affordable Care Act. No. No. I
don't wanna repeal the Affordable Care Act. You
you completely that's a huge 1,100
page bill that that only Nancy Pelosi read.
I don't wanna repeal that. The only thing
I want is to take I wanna fix
what's broken. I wanna take one section out,
(12:22):
allow for physician ownership of hospitals
because we see when we look at the
grandfathered physician owned hospitals, there's 250
of them that remain in our country. There's
5,000
non physician owned hospitals.
Somehow, 48
of four the top 48 or 48 out
of a 100,
the top 48 for cost, quality of care,
(12:45):
and access to care physician owned.
And nine of the top 10 are physician
owned. So there's something about a physician being
involved. And so that so for quality,
for access to care,
and, to for the cost of care, you
want physicians involved.
And so from and also it allows for
(13:05):
physicians to have fulfillment, to be part of
the ownership process, and also to be remunerated
for success that they have in achieving metrics.
And that is the realization of the Affordable
Care Act. Right? We're supposed to increase quality.
We're supposed to increase access and decrease cost.
So the the experiment that we ran with
section six zero zero one
has
(13:25):
now been realized.
It doesn't it it didn't materialize that. Time
to try something new.
We and like I said, what senator Cassidy
told me, you'd be surprised how close you
are. You ask what the solution is or
how a solution
a pathway is.
Let's everyone listening to this podcast
should just say, hey. I need to reach
out to my elected official. Talk to their
(13:47):
legislative system, provide them the data, and recognize
we are facing a huge physician shortage. We
need to do something about it. What are
the things that we can do? Obviously, we
can increase throughput, but, also, let's let's return
the physician entrepreneur.
The private practice physician
is an endangered species.
We're on a trajectory that everyone's either gonna
(14:07):
be academic or hospital employed. That's not a
that's not a healthy,
environment,
for the next generation. We want balance amongst
all of them. I'm not criticizing
academics.
I'm not criticizing
hospital employee. I am criticizing an imbalance
by not empowering private practitioners. We need a
healthy balance of all three of those demographic
(14:29):
practices.
We
we we could not agree with you more.
Doctor Tomia Allen, you've had a great career.
Any advice for emerging physicians?
I I would say that our socioeconomic
IQ is our weak point. It certainly was
mine. I I had no idea how to
code. I had no idea where money was
(14:51):
coming from. Doctor Glaukenfleck who does all of
these,
spooks on on YouTube as a great example
of where he's, he's he's asking hey. Someone's
studying for the boards,
all of these, maple syrup disease, things like
that, but the kid has no idea how
he's gonna get paid. He goes, well, I
I do medicine, and then I get paid
by the money people.
(15:14):
That that's about as sophisticated as I was
when I graduated medical school when I finished
residency. We need to increase our socioeconomic IQ.
We need to be part of the process.
We need to advocate for ourselves.
Look.
Practicing your trade is is very important. Having
people will say, look. I I do this.
I do that. They're they're swelled with the
importance of the job that they do. But
(15:34):
in order if they truly believe that,
they need to empower themselves
to be able to practice at that level,
which means they need to advocate for themselves,
which means that they need to understand the
issues and get involved. The more of us
that get involved,
we will create a huge groundswell.
We build awareness.
Change becomes an inevitability.
(15:59):
Doctor Toomey Allen, what a pleasure to visit
with you. Brilliant. I could not agree with
your sentiments more. Thank you for joining us
today on the Becker's Healthcare podcast. We look
forward to having you back on. Thank you
very much for joining us. It's my privilege
to be here, Scott. Thank you for giving
me,
an outlet to to communicate with my colleagues.
Thank you very, very much.
This is Scott Becker with the Beckers Healthcare
Podcast.
We're thrilled today to be joined by a
brilliant surgeon, a brilliant physician.
We're joined today by Luis Manuel Tumi Allen.
And doctor Allen's gonna talk to us a
little bit about
physician owned hospitals, the prohibition of physician owned
hospitals, and a lot more. Doctor Toomey Allen,
(00:21):
can you take a moment to introduce yourself
and tell us about your practice
and and your your history?
Yeah.
Thank you for having me on this podcast,
Scott, and and helping me build awareness for
these issues that are challenging the ability to
practice medicine in 2025
and moving forward. My name is Luke Chamealyn.
As you mentioned, I'm a a private practice
(00:42):
physician
with Barrel Brain and Spine. We are the,
27,
neurosurgery
group,
that services,
several hospital systems in the Phoenix area. I
am a minimally invasive spine surgeon. I
have a very,
strong focus on on motion preservation in the
cervical and lumbar spine and developing technologies
(01:03):
that will allow us to preserve motion, not
stop that motion, but at times, you do
need to do that.
I, I I I trained,
in Atlanta, Georgia at Emory, and then I
had a stint in I I spent eleven
years in the world's finest navy,
and,
of those, eleven years, six active fiber reserve.
(01:23):
I spent time as an operational physician, and
then I was able to practice medicine and
I guess what would could only be considered,
the what would be a capitated system.
And I,
felt the frustrations
of working in that type of environment at
the end of my naval career and was
very happy to,
join a private practice
and be,
(01:44):
untethered from those things. And those are the
and that's, I have a strong interest in
socioeconomics,
so much so that I I ventured into
a the socio economic arm of neurosurgery, which
is a council of state neurosurgical societies.
And,
and over the span of fifteen years,
now I I currently reside as the chair
of that organization, and that chair or that
(02:06):
the council of state neurosurgical societies is dedicated
to one thing,
increasing the value of the neurosurgeon, increasing the
value of the of the physician. And so
that that's, in a nutshell what, my journey.
I I
do not
want to, become a an employed neurosurgeon,
and I continue to fight that battle and
(02:28):
create an ideal environment for the next generation
of spine surgeons to be able to do
what it is that,
I I get to, do and have fulfillment
and career and control over to a certain
extent of my life.
So what an amazing practice. And for people
that don't know,
Bureau Spine, Bureau Neuro is one of the
the great, great practices in the country. Tremendous,
(02:48):
tremendous reputation as just a great, great, highest
quality practice.
And and talk about some of your advocacy
work, and then also tell us if you're
still a Georgetown Hoya fan,
or both. Tell us about the advocacy work
and what you're most focused on there, and
also tell us if you're a Georgetown fan.
Well, I'll start with the Georgetown fan. I
I'm I'm a huge Hoya fan,
(03:11):
and,
big,
what my
fondest memories are gonna be,
spent in over the Potomac and then,
with the judge on the Jesuit campus there
at Georgetown. What a great environment to to
start a medical career.
Advocacy work is just you know, one of
the things that we do is we we
we build awareness.
(03:32):
We we do small things, which are actually
not that small, but not how about this,
they're not as noticeable. For example, we advocate
for,
a,
a a surgeon who does a decompression with
a fusion at one point. There was a
defacto bundle.
It's around the same area, and we read
this article in this one piece. And so
(03:52):
what we're gonna do is we're gonna go
ahead and bundle it. And we go, no.
No. No. No. No. No. If we go
back to the history of these codes and
everything everything stems from understanding the history of
how we got here.
Because we're we're in a very Byzantine arcane
system with the RBU system, which is how
all physicians get paid, which is one of
the things that they should teach
physicians the first day of medical school because
you need to know how it is that
(04:13):
you are gonna make it in this world.
But, of course, talking to a medical student
about remuneration is like talking to your children
about procreation.
No one wants to do it. It's a
it's a it's a bad thing to do
apparently when I think it's,
essential, that we need to increase the socioeconomic
IQ of our,
of our burgeoning physicians. But for, you know,
one of the, advocacy,
(04:34):
elements that we did was we said, look.
We we believe that the history of the
code used to be that an orthopedic surgeon
did the arthrodesis, a neurosurgeon
did the decompression. These are two separate pieces
of work as
as,
difficult as that sounds to untether. That's the
history of the code. One's muscular skeletal, one's
nervous system. And, therefore,
(04:55):
these, the work was already parceled out, and
so you have to preserve the value of
that work. And so a physician should be
remunerated for that, that additional work for decompression
with lumbar fusion. As as as small as
that may be, that little nuance,
that resulted in since the development of the
six three zero five two and six three
zero five three codes, the decompression codes with
(05:16):
lumbar fusions is part of the advocacy
that we collaborated with, the the spine section,
double a n s, CNS, NASS,
and, ISAS.
All of that results in
over a $100,000,000
that are being paid out to physicians over
the span of a year, work that was
not being remunerated before. So that's an example
(05:37):
of advocacy. Another example is making, surgeons aware.
Hey. Do you realize
that you are not being paid
for work that you've had
prior authorized?
We are the only industry,
Scott, that that would tolerate this.
If you have a contractor, do work on
your house,
(05:58):
and they give you a,
an estimate. Here here, Scott, this is what
we're gonna do to your this is what
you you you want this. You want your
kitchen redone. Here here's our estimate. And guess
what? The estimate is is it always goes
over.
And and then they when the work is
done, they go, okay. Here here's what you
owe us. If you don't pay that bill,
they'll put a lien on your house. We
(06:19):
get a prior authorization.
Physicians listening to this podcast will be surprised.
I some won't, but some may,
that they will get a prior authorization to
do a procedure where the approved codes were
XYZ.
They do a procedure on such and such
a date that cover x y z. They
submit the charges for x y z.
And
twelve to fifteen percent of the time,
(06:40):
that will be denied even though they did
everything to a t. Do we put a
lien on that patient? Of course not. We
can't. What do we do? We knock on
the door, introduce ourselves to the next patient
that's gonna, that needs care, and we just
keep going on. No other industry tolerates what
we tolerate as physicians. But that's to increase
the awareness all of a sudden builds a
(07:00):
groundswell of support. Wait a second.
Why do we tolerate this? And, hopefully, it'll
lead to,
a legislation
where, a because you you we all get
this. We get the the prior authorization is
not a guarantee of payment. That sentence needs
to go away.
Legislation federal legislation needs to be. If we're
if we're advocating for position, we're trying to
(07:21):
deal with the physician work shortage, should be
that
prior authorization
is a guarantee of payment on a clean
claim. If I do exactly what I said
I was gonna do,
and anyone's
mind of what is fair, you should be
paid. 12 to 15%,
that doesn't happen.
(07:41):
And how do we change that? How does
that get changed? That does seem incredibly
unfair. You know? So tell us, how does
that get changed or or what can be
done?
Well, I mean, it's it's it's, you know,
one of the we are involved with our
political action committee. We have a neuro pack.
Our wash committee is very involved, and they
they they set up, meetings with our, elected
(08:03):
officials. And I was fortunate to be able
to meet with senator Cassidy from Louisiana who's
a, an OB GYN. No. He's a gastroenterologist.
Senator Marshall from Kansas whom I also was
able to meet through this
PAC, and and they said the same thing.
You know, reach out. Reach out to your
elected official. Reach out to your congressman. Reach
out to your senator. As lofty as that
(08:24):
may seem, I mentioned that to my wife.
The next thing you know,
she sets up meetings, and I have a
Zoom meeting with senator Kelly's,
legislative assistant, and then I and then senator
Gallegos. So and then, congressman Schweickart, who as
it turns out go his sister goes to
my church.
Cassidy made the point to say, you'll be
surprised
that how close you actually are to your
(08:46):
elected officials. There there's not that many degrees
of separation.
And so we begin that dialogue.
You you you you it's not a ranting
and raving, but rather data. Here's the data.
Here here's the data on our workforce.
Here here's the here's the shortage that we
foresee happening. Here's what here's what's happening with
(09:06):
medical students that are graduating. They're being around
a bunch of physicians who appear to be
burned out or complaining about their jobs. And
guess what? After they graduate medical school, they
don't go into practice. So even though you
may increase the three throughput from medical school,
you're not having enough physicians enter the workforce
because of the rate of burnout, because of
(09:28):
the rate of of,
of the the the job fulfillment not being
what they thought it was. What we need
to do is create an environment where medical
students are around, physicians are saying, hey. I'm
being treated fairly. I have great fulfillment in
my job,
and I've got a long, fulfilling career in
front of me. And and what we need
to do is also keep positions in the
workforce. We have I I have colleagues of
(09:50):
mine who are in, I would consider myself
mid career, and they are already looking for
the exit.
I think if we create an environment that
that allows us to take advantage of it.
Talk about that because the stats are alarming.
There's about, you know, a 100,000
practicing physicians at most.
And something like 40%
are going part time by 40 to 50,
(10:12):
and and we're losing a lot. And and
how do we how do we make
Dalton work better for physicians
So so they stay excited and enthused and
treated well because we are such in dire
need, particularly in many, many specialties.
Well and, I mean, there's there's gonna be
several opinions on that I have in mind.
One of the things that we need to
bring back is the physician entrepreneur.
(10:34):
And one of the topics that we had,
broached broached at the beginning is the ban
on physician
owned hospitals. So section six zero zero one
was a little
recognized
section that was I wouldn't say it was
snuck in, but it it certainly
did not get a lot of attention when
it went in. And that is the only
(10:57):
piece of legislation that exists in the books
where one
type of profession
has been singled out
and precluded from a business enterprise.
No. There's there's no legislation that says a
lawyer cannot own their law firm. There's no
legislation that says bakers can't own their ovens.
(11:19):
But a physician cannot own the means of
production of their enterprise, of their of their,
in their professional
environment.
And once you've done that, what that allowed
is eliminated the competition. Once you eliminate competition,
you have vertical integration. When you have vertical
integration, you have you have physician practices that
are struggling.
They get acquired. You lose control, and now
(11:41):
all of a sudden, the cycle happens.
A simple because this is it would be
ludicrous with and then I think someone you
know, I I I had a post.
I'm a social media neophyte. I don't know.
I I rely on other people to do
this. But, I posted something with regards to
the, repeal on a piece that I wrote
for,
our our one of our,
(12:02):
society,
publications
where it was said, oh, so you wanna
repeal the Affordable Care Act. No. No. I
don't wanna repeal the Affordable Care Act. You
you completely that's a huge 1,100
page bill that that only Nancy Pelosi read.
I don't wanna repeal that. The only thing
I want is to take I wanna fix
what's broken. I wanna take one section out,
(12:22):
allow for physician ownership of hospitals
because we see when we look at the
grandfathered physician owned hospitals, there's 250
of them that remain in our country. There's
5,000
non physician owned hospitals.
Somehow, 48
of four the top 48 or 48 out
of a 100,
the top 48 for cost, quality of care,
(12:45):
and access to care physician owned.
And nine of the top 10 are physician
owned. So there's something about a physician being
involved. And so that so for quality,
for access to care,
and, to for the cost of care, you
want physicians involved.
And so from and also it allows for
(13:05):
physicians to have fulfillment, to be part of
the ownership process, and also to be remunerated
for success that they have in achieving metrics.
And that is the realization of the Affordable
Care Act. Right? We're supposed to increase quality.
We're supposed to increase access and decrease cost.
So the the experiment that we ran with
section six zero zero one
has
(13:25):
now been realized.
It doesn't it it didn't materialize that. Time
to try something new.
We and like I said, what senator Cassidy
told me, you'd be surprised how close you
are. You ask what the solution is or
how a solution
a pathway is.
Let's everyone listening to this podcast
should just say, hey. I need to reach
out to my elected official. Talk to their
(13:47):
legislative system, provide them the data, and recognize
we are facing a huge physician shortage. We
need to do something about it. What are
the things that we can do? Obviously, we
can increase throughput, but, also, let's let's return
the physician entrepreneur.
The private practice physician
is an endangered species.
We're on a trajectory that everyone's either gonna
(14:07):
be academic or hospital employed. That's not a
that's not a healthy,
environment,
for the next generation. We want balance amongst
all of them. I'm not criticizing
academics.
I'm not criticizing
hospital employee. I am criticizing an imbalance
by not empowering private practitioners. We need a
healthy balance of all three of those demographic
(14:29):
practices.
We
we we could not agree with you more.
Doctor Tomia Allen, you've had a great career.
Any advice for emerging physicians?
I I would say that our socioeconomic
IQ is our weak point. It certainly was
mine. I I had no idea how to
code. I had no idea where money was
(14:51):
coming from. Doctor Glaukenfleck who does all of
these,
spooks on on YouTube as a great example
of where he's, he's he's asking hey. Someone's
studying for the boards,
all of these, maple syrup disease, things like
that, but the kid has no idea how
he's gonna get paid. He goes, well, I
I do medicine, and then I get paid
by the money people.
(15:14):
That that's about as sophisticated as I was
when I graduated medical school when I finished
residency. We need to increase our socioeconomic IQ.
We need to be part of the process.
We need to advocate for ourselves.
Look.
Practicing your trade is is very important. Having
people will say, look. I I do this.
I do that. They're they're swelled with the
importance of the job that they do. But
(15:34):
in order if they truly believe that,
they need to empower themselves
to be able to practice at that level,
which means they need to advocate for themselves,
which means that they need to understand the
issues and get involved. The more of us
that get involved,
we will create a huge groundswell.
We build awareness.
Change becomes an inevitability.
(15:59):
Doctor Toomey Allen, what a pleasure to visit
with you. Brilliant. I could not agree with
your sentiments more. Thank you for joining us
today on the Becker's Healthcare podcast. We look
forward to having you back on. Thank you
very much for joining us. It's my privilege
to be here, Scott. Thank you for giving
me,
an outlet to to communicate with my colleagues.
Thank you very, very much.
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