Since the introduction of Obamacare, a growing number of physicians are part of what are called Accountable Care Organizations, where physicians, nurses and other providers are responsible for the health of their patients and the costs of that care.
The shifting landscape is rearranging incentives, and leading doctors into corners of their work they’ve rarely visited.
On a late Friday afternoon last month, the Family Health Associates practice in Charleston, West Virginia is empty.
Empty except for Dr. Julie DeTemple and her staff.
“I should be home and I’m here typing away doing my notes, charting,” DeTemple said.
The primary care doctor has had to adjust from examining patients – why she got into the business – to examining data.
Her quality time with spreadsheets has ramped up this year, now that’s she’s co-founded the Aledade West Virginia ACO, made up of 11 physician practices in the state.
The physicians constantly meet, looking for ways to improve care and cut out wasteful spending.
HENRY KOTULA 
Very interesting. I think it’s healthy for doctors to take a hard-nosed business attitude toward their work. But it also makes me reflective. I knew the father of HMO’s Paul Ellwood. He said the great thing about shared risk was, “Doctors will be so busy fighting each other, they’ll never have time to fight the suits.” Let’s hope as the pie shrinks further , physicians don’t eat their own..