Physician Trends, Vaccine Oversight, and AI in EHR with Laura Dyrda

In this episode, Laura Dyrda, Editor-in-Chief at Becker's Healthcare, discusses the latest healthcare stories, including changes to the CDC’s vaccine advisory committee, shifts in physician employment trends, and Stanford’s pilot of a new AI-powered EHR tool designed to streamline clinician workflows.

Episode Transcript

(00:00):
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This is Scott Becker with the Beckers Healthcare
Podcast.

(00:42):
I am thrilled today to be joined by
brilliant leader, Laura Dirda.
Laura is at Becker's Healthcare editor chief, and
joins us regularly to talk about stories that
she's watching in healthcare. Laura, let me let
you take it away. What are a handful
of the key stories you're watching currently and
keeping an eye on?
Thank you so much, Scott. And, you know,
truly, a lot happening in health care as

(01:04):
always. One of the really big stories that
we have our eye on right now is
coming out of Washington DC.
Yesterday, June 9, HHS removed 17 members of
the CDC's advisory committee for immunization practices
and is evaluating candidates for replacement.
Members of the committee, which provide vaccine guidance
to the CDC,
serve up to four years typically, and 13

(01:24):
of those members were appointed last year.
HHS said the decision to reconstitute the committee
stems from erosion and public trust in vaccines.
And in a Wall Street Journal op ed,
HHS secretary Robert f Kennedy junior said the
new advisory committee would be
free from financial conflicts of interest with pharmaceutical
companies.
So, really, he'd said he'd be looking for

(01:46):
folks that were not tied to the pharmaceutical
companies and didn't have
agenda on the pro or anti vaccine side.
Critics of the move say that it could
undermine public trust in vaccines, which then may
lead to harmful or deadly outbreaks of the
preventable diseases.
And hospitals and clinician offices are typically dispensing
these vaccines or keeping a close eye on

(02:07):
this so they can understand what will likely
happen with some of the,
recommendations,
rules, and regulations going forward, how that could
impact their current processes and systems and access
to vaccines for people who want them, as
well as what that might do for their
larger communities and and thinking about,
disease prevention overall. So it's definitely a huge

(02:29):
issue that I know stems,
you know, in many different ways, but certainly
for health care providers to, you know, who
have been used to,
one set of rules in in providing these
vaccines.
It could definitely
be a big difference depending on who joins
this committee for the CDC. So we're keeping
a very close eye on that. It will
definitely,
provide updates as new members are appointed.

(02:52):
Thank you. And and so many fascinating pieces
to this. Obviously, this concept that Robert f
Kennedy leads with, RK Jr leads with, that
people on the committee should be freed from
conflicts
as American as apple pie,
and it's hard not to agree with that.
The flip side is, for those of us
that grew up of a certain era, and
I don't know, maybe that's maybe it's just

(03:13):
not me, but so many of us.
We viewed vaccines as such a godsend to
the world
where the polio vaccine and again, I'm younger
than that to have been a polio vaccine
person,
but, the MMR vaccines, all these other vaccines,
we've grown up thinking they're so vital and
essential to what we do.
So so, I mean, what an interesting and

(03:34):
brutally charged issue. And I and I I
I he has to to get too engaged
in this discussion negatively about the anti vax
move movement,
but but it sure is, a frightening
concept,
from my perspective. And I know that's not
not a lot of people don't agree with
that. A lot of people think that we
do too many vaccines and so And so

(03:54):
it just came to the forefront
forefront
in a much more aggressive way
during
the COVID period,
but this anti vax movement for those of
my age, Jenna and and I don't and
that sounds so selfish to say my age,
Jenna. So I know so many people agree
with this concept. This anti vax concept
seems so crazy to so many of us.
I know some people disagree.

(04:16):
Anyways, thank you, Laura, for covering that.
Give us the next story you're following closely.
Yeah. Absolutely. You know, I I think, another
story that we're following closely certainly is, you
know, always looking at kind of the trend
with physicians and
where they're at, how they're moving within the
health care space. And recently, the American Medical
Association

(04:36):
came out with a report saying that more
physicians are joining hospital
owned or private equity owned practices instead of
the independent groups, which isn't surprising. That's been
a trend that we've seen over several years.
But, you know, to see current numbers are
are certainly continue to move away from that
independent
space.
The report found that 42.2

(04:57):
of physicians were in private practice last year,
which was about 18 percentage point drop, since
2012.
And then over that same period, hospital and
practices became more popular accounting for about 23.4%
of physicians
in 2012 to now around 34.5.
The number of
physicians directly employed by hospitals doubled in that

(05:19):
time period as well to 12%. And so,
you know, it's just been interesting to see
some of those trends.
We heard from, you know, those physicians who
were surveyed in the AMA report that
inflation on private practices as well as the
Medicaid,
you know, pay drops,
33%
in the last twenty five years really impacted
a lot of those decisions as well as

(05:40):
the increase
in expenses,
what it takes to, you know, have run
a practice, have employees,
and really, you know, just inadequate ability
to find funds to modernize the practices with
the technology that they need
in in the infrastructure that is, you know,
necessary in order to have a competitive practice

(06:00):
today. And so,
it's just been, you know, a couple of
things that we have have noted in the
report. Now there are some exceptions,
in terms of, you know, positions in in
different specialties.
Still ophthalmology, 70%
are independent.
Around 54% of orthopedic surgeons are independent. In
in other specialties,
about half of them, you know, if you

(06:22):
look at all of the specialties are are
independent. So it's just fascinating to see in
a trend that will,
you know, continue to keep an eye on
as the dynamics change within the broader health
health care ecosystem.
Thank you very, very much. It seems like
the percentage of physicians employed by hospital or
hospital related groups would be higher than the
34%

(06:42):
cited employed by insurance companies. Because I know
United itself United Optum itself employs 8% or
so. Any sense there?
Yeah. Yeah. Definitely.
And so, you know,
it's hard to say exactly. Optum is definitely
the largest physician group in the country, and
so, you know, they've got large base. I
I know a few others, employ quite a

(07:03):
few physicians as well. And so we didn't
see the breakout necessarily there for Optum or
for some of those other payer organizations.
But it you know, I I think it's
just another area where,
the physicians an option to sell their practices
if they don't wanna sell to their hospital
or or it's not
in a community where that makes sense. They
certainly have that option. And it seems every

(07:25):
day more and more are taking that or
have been selling to one of the insurance
companies or another non traditional health health care
provider space. So it's it's really interesting to
see.
No. Thank you so much, Laura. So so
we've talked about sort of vaccines.
We've talked about where physician employment lies. And
again, getting really dauntingly short of physicians.

(07:46):
What else are you watching closely or or
any other stories you're watching closely currently?
Absolutely. So the last thing I had kinda
prepared to talk about today is actually
pretty exciting,
from the health care technology side. We often
talk about some of those organizations that are
at the forefront of technology development, interesting partnerships,

(08:07):
and spaces where, you know,
especially artificial intelligence is coming into play. And
in the last week, Stanford Health Care out
in California
announced that it was piloting an internally developed
AI batch software that's designed to revolutionize the
way clinicians interact with the EHR. I know
this is something that,
Oracle Health has been trying to do for

(08:28):
a while with their EHR, and so to
see it come out of Stanford is really
interesting. The project is being led by Nigam
Shah, who is the chief data science officer
at Stanford, and he's developing,
the software which they have called chat EHR.
It allows clinicians to ask questions or request
summaries and pull specific information from patient medical
records.

(08:48):
That chat EHR is built directly into that
EHR system to maximize clinical workflows.
Currently, they're just in the pilot phase. So
it's available to about 33 physicians, nurses, and
physician assistants.
But as they continue to develop and and
gather information,
they'll aim to refine it and and roll
it out to the broader health system.

(09:09):
The technology really is secure and is designed
for information gathering, not providing medical advice. So
it's not telling,
the clinicians what they should do or giving
advice there, but really, you know, having them
directed to to give them information where the
human can make the decision on medical,
the next steps in the the medical journey.
That chat EHR project began development in 2023,

(09:31):
and,
you know, it is really an interesting way
for clinicians to interact with patient records. They'd
be able to interact more like a,
conversation or or like they would with some
of their Internet search engines or, an AI
bot. And so it's really a unique way
to integrate large language capabilities
directly into the clinician workflow,

(09:52):
and bring that into what those day to
day conversations are with patients about what the
next steps are in their journeys.
So that's something that is kind of cool
on that front.
And I know in the future, they're working
to make sure it's accurate, has great performance,
and then can also use it for educational
resources as well.

(10:13):
And and so just another example of ways
health systems are,
using AI, using technology, and and really innovating,
in a at a very fast and efficient
clip.
Laura, thank you as always for joining us.
Amazing what's going on the on the technology
side. Let's hope it keeps on making in
inroads.
There are so many challenges and shortages of

(10:34):
caregivers that hoping this could leverage or help
our caregivers some as well.
Laura and Derrida, thank you for all the
work that you do.
You and I are both Chicago sports fans.
So as always,
we'll pray for a few more Chicago White
Sox victories. They've been few and far between
again in the last couple years. Thank you
for joining us today on the Better Self
Care podcast.

(10:54):
Thank you, Scott. I appreciate it.