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A Transparent Healthcare System: What’s More Clear?

Congressional democrats want more transparency in healthcare, believing it would further drive down the cost of care, reports Politico.

Hoping to drive competition, some lawmakers are grumbling to force doctors to reveal business negotiations between them and drug and device makers. Opponents worry that manipulating economics would backfire. If everyone knows their competitor’s business, why bother negotiating lower prices?

But transparency worked for Wisconsin’s hospitals, not in business dealings but in reporting outcomes, reports The Fiscal Times. By voluntarily revealing clinical outcomes on the Web, the Wisconsin Collaborative for Healthcare Quality was able to spur low-performing hospitals to improve, high-performing facilities to eliminate tests that didn’t improve outcomes, and create an informed healthcare consumer with choices where to receive care.

*This blog post was originally published at ACP Hospitalist*

Cutting Healthcare Costs Means Saying “No” To Patients

Let’s face it, the best way to cut healthcare costs is to say “no.” That means denying unnecessary tests that most patients in the United States are accustomed to having.

The New York Times‘ David Leonhardt has the best take on this issue that I’ve read. He acknowledges the difficulty of telling the American public “no,” and cites examples ranging from the breast cancer screening controversy to the managed care backlash in the 1990s:

This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given in just a single year — and that there was “significant overuse” of such scans. Read more »

*This blog post was originally published at KevinMD.com*

How To Micro-Tweak Diagnosis And Treatment

A common problem in healthcare is the number of times that small adjustments are needed in a person’s care. Often for these little changes, a physical exam and face-to-face time have nothing to do with good medical decision making.

Yet the patient and doctor are locked in a legacy-industrialized business model that requires the patient to pay a co-pay and waste at least half of their day driving to and from the office, logging time in a waiting room, and then visiting five minutes with their practitioner for the needed medical information or advice.

Today I’d like to visit the case of a patient I’ll call “DD,” who I easily diagnosed with temporal arteritis (TA) through a 15-minute phone call after she’d spent four weeks as the healthcare system fumbled her time with delays and misdirection via several doctors without establishing a firm diagnosis. Read more »

Why Creating Healthcare “Consumers” Won’t Work

I [recently] gave a speech at the Midwest Business Group on Health’s (MBGH) 30th Annual Conference. The MBGH is one of the country’s leading organizations on healthcare, and its members include the leading innovators and thought leaders on healthcare in America. It was a privilege to present to them.

I spoke about why healthcare just isn’t a consumer business in spite of all of the effort to turn people into healthcare “consumers.”

At Best Doctors, we have a closeup view of what happens to people when they try to find their way through the healthcare system. It’s not a pleasant picture. Healthcare consumers –- if you can call them that –- are often lost, confused, frustrated, alone. Read more »

*This blog post was originally published at See First Blog*

Does Group Health’s “Medical Home” Leave The Poor Behind?

Group Health has published two papers recently, one in Health Affairs and the other in JAMA, both extolling the virtues of its Medical Home. These follow their brief report last fall in the NEJM and the lengthy description of their model in the American Journal of Managed Care. Their model has been promoted by the Commonwealth Fund, and it is cited in the currrent issue of Lancet.

The big news is that costs were a full 2% lower than conventional care, hardly a great success –- it wasn’t even statistically significant. But was even this small difference due to the Medical Home, or was it because the Medical Home patients were less likely to consume care? Read more »

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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