Every day in the U.S. countless experts discuss plans and policies to contain the cost of health care using words and concepts that run counter to our (the public’s) experiences with finding and using care. Most of us ignore the steady stream of proposals until one political party or the other crafts an inflammatory meme that resonates with our fears of not getting what we need. At which point, we leap into action online, in town meetings and in the voting booth. As Uwe Reinhardt noted in his Kimball Lecture at the recent 2011 ABIM Foundation Forum, researchers and policy makers “cannot even discuss the cost-effectiveness of health care without being called Nazi(s).”
Our discomfort with the array of private and public sector proposals to improve health care quality while holding down costs should not be surprising. Most of us hold long-standing, well-documented beliefs about health care that powerfully influence our responses to such plans. For example, many of us believe that:
… if the doctor ordered it or wants to do it, we must need it.
… talking about less expensive treatments makes us feel that others are trying to bargain-shop our care and that scares us.
… clinical care does not vary much among our own doctors and hospitals.
… when we talk about the “quality” of health care we are referring to Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
There is discontent in the house of medicine. So many physicians struggle. They seem to wade through uncertainty every day — uncertain about diagnoses, about pain, about disposition. We find ourselves uncertain about our jobs, our futures, our finances.
The consultants we call are uncertain about their practices and whether they can remain viable in the coming years as medicine evolves into something we may find unrecognizable.
Some days, as I enter my 17th year of practice, I don’t know if I can bear to walk around our little department for 10 or 20 more years, like some gerbil on an exercise wheel. I am uncertain if I can bear the weight of more entitlements, more confabulated stories, more regulations, and manufactured drama. I wonder if I can endure decades more of circadian assaults on my brain. Read more »
*This blog post was originally published at edwinleap.com*
I just got back from a wonderful week in Toronto, Canada. No, I wasn’t up there to take tips on how to impose socialized medicine on an unsuspecting public, notwithstanding what some of you may incorrectly-surmise about my political leanings.
Rather, I was there to attend ACP’s annual scientific meeting, during which I had the opportunity to serve as faculty for three separate scientific sessions that discussed the impact of the new Patient Protection and Affordable Care Act (PPACPA) of 2010 on internists and their patients. Several hundred ACP members attended these sessions.
And guess what? Rather than encountering doctors who were angry at the new law and ACP’s support for it, I instead found an engaged and curious group of internists who are looking at health reform in a reasoned, measured and open-minded way. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*