New health care trends that can be good for physicians and patients alike. Like it or not, the healthcare system has a caste system built into it by certain medical specialties, keeping costs for some services unreasonably high, while other services that should be widely available are not. This lack of competition, is leaving room for a disruption of the status quo. It is time for more effective and less expensive services such as chiropractic to get the respect and attention they deserve, which is slowly happening, even with the protectionist activities of medical specialties. Evidence of these activities includes when ophthalmologists prevented optometrists from using Lasix in NJ even though the machine does most of the procedure, or when nurse practitioners have tried to practice independently. There are of course many other examples as well. There are technological disruptors as well, to the status quo in medicine, not unlike how Uber is disrupting the taxi industry. Examples of this include apps that can do an EKG, more cost effectively and a new company that can do most standard blood tests for less than $10, as compared to todays expensive labs. Kevin MD has a wonderful article discussing how these changes will affect healthcare. Read about this here 5 health care trends that should give physicians hope MICHEL ACCAD, MD | PHYSICIAN | NOVEMBER 18, 2015 I feel that I have been spending way too much time as a "œchronicler of the decline," to use von Mises"™ phrase. The secular trend in health care (literally spanning the last 100 years) is one of increasing centralization, consolidation, and reduced choice. Nevertheless, there are some promising developments that give me hope for a better future. Here are five notable trends, in no particular order: 1. Direct patient care. Direct care encompasses all models of health care where physicians and patients have said goodbye in part or in toto to the third-party payer. Those include the booming direct primary care models, concierge practices, and specialty outpatient surgical centers. Other arrangements will undoubtedly emerge. Doctors in increasing numbers are "œopting out" of the insurance system to try to regain professional autonomy and satisfaction. There is no question that these models, limited in scope as they are for now, are providing perfectly good care and, in many cases, much lower prices as well. Anyone unfamiliar with this trend, or anyone with doubts about its benefits, should check out the work of Dr. Keith Smith at the Oklahoma Surgery Center, listen to this podcast interview of Dr. Josh Umbehr at the AtlasMD clinic, read the Direct Primary Care online journal, or follow the #directprimarycare hashtag. Read more