Physicians are scientists. Trained to be scientific, logical diagnosticians of health issues. But they are also humans, subject to all the foilbles that brings upon us — like uncertainty, pack-behavior, allure to the latest new thing, and, yes, even to greed. They perform is a world where potential solutions to individual health conditions are complex and the way they treat these condiditions pose variables that cause one doctor to perform one way and another doctor working on a similar DRG to perform differently. That’s one side of the argument.
Sharon Begley, senior editor of Newsweek and accalimed for her ability to write about complex topics so that they are clear and understandable, has another point of view, expressed in this week’s issue of Newsweek Magazine. She sees doctors as having long resisted using science to guide their practice, thus leading to a chronic pattern of overtreatment and using more expensive techniques than are necessary.
Begley writes: It’s hard not to scream when you see how many physicians, pharmaceutical companies, medical-device makers and, lately, hysterical conservatives seem to hate science, or at best ignore it. These days the science that inspires fear and loathing is “comparative-effectiveness research” (CER), which is receiving $1 billion under the stimulus bill President Obama signed. CER means studies to determine which treatments, including drugs, are more medically and cost-effective for a given ailment than others.”
Spending a billion dollars to determine effectiveness of one treatment over another will shine a spotlight on some of the issues. Then it becomes policy-making time. Does Washington through its power behind Medicare payments dictate to doctors and hospitals how to treat patients? Or do we prefer as patients selecting our own physicians and hospitals based on they go about healing us? And who will pay for the difference? In the end, no one wants overtreatment, we just want the right treatment. Who is to say who is right?
Filed Under: Clinical Improvement • Featured Articles
Tags: defensive medicine, Medical overtreatment
About the Author
Cary understands what it takes to make, “Better American Hospitals.” In addition to being a seasoned consultant, Cary has worked as interim hospital CMO in three different organizations, as well as served as medical director for two multi-specialty medical groups and several HMOs. Cary has a solid history of leading medical staff through improvements in utilization management, changes in peer review practices, and corrective action procedures. As President and Chief Operating Officer, Cary is armed with a diverse background in hospital, medical group, and managed care settings, and has immersed himself in developing the strong knowledge base and extraordinary skill set needed to successfully improve today’s hospitals.
While serving as a member of the American College of Physician Executives, Cary has used his deep knowledge of the complex structures of the healthcare field and applied it toward implementing quality improvement initiatives and developing governance structures, strong compensation plans, productivity reporting models, and effective physician management training programs. Prior to joining Compass Group, Cary provided a number of successful consultant services resulting in projects that included the effective merging of medical staff of two hospitals, reducing the length of stay at hospitals, decreasing inpatient utilization for managed care organizations in several markets, the successful turnaround of the financial performance of a Medicare PHO with full capitation, mentoring Chief Medical Officers, evaluating medical group capability for managing capitation, and improving operating room utilization. Cary continues to use his compelling interpersonal skills to maintain a strong focus on improving clinical operations, developing medical staff leadership, and strengthening physician relationships.
While Cary served on active duty in the U.S. Navy, he was Head of the Quality Assurance Department of the Navy Medical Command, National Capital Region, in Bethesda, Maryland. Cary is board certified and completed a laboratory medicine residency and an immunohematology fellowship at Washington University in St. Louis. In addition to his numerous national speaking engagements, he has authored a number of publications including, Hospital Service Recovery, Journal of Hospital Marketing and Public Relations.
Case studies to learn more about ways in which Compass Clinical has worked to create better American hospitals.