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Patient Outcomes Measures: A Key to Preserving Quality of Care

Posted in Practice Management Solutions | Aug 2010 | Comments (0)

Tags: health insurancehealthcare costsevidence based medicinevalidated patient outcomes measurescomparative effectivenesshealthcare cost containmentmedical outcomes data collectionelectronic medical records

Introduction

The world is changing rapidly. The Internet has revolutionized information exchange in a short period of time. This is a revolution similar to the Gutenberg press of the 15th century. Social media and the complete reshaping of human communication have simultaneously created a similar transformation, allowing individuals to interact in new and powerful ways, potentially influencing the common good.1

The computerization of medical records may have similar consequences. Perhaps the real revolution in the field, however, will derive from the collection and use of medical outcomes data and comparative effectiveness. Medical evidence enables us to quickly determine the effectiveness or lack of effectiveness of individual treatments.2 With this information, practice standards can be based on hard evidence relating the comparative effectiveness of various treatments. This information ultimately affects the cost of care, and our efficacy as physicians.

I believe that Evidence Based Medicine may transform the practice of clinical medicine in a profoundly positive way. Yet, this transformation can only occur with vision and cooperation among health care providers. Moreover, it can only occur with and because of us, the physician. In a rapidly changing healthcare landscape, we can sit back and watch as we lose control, or we can be the driving force for improvement, transforming the care of patients in ways that only we can.

Insurance

Medicine was once a noble profession, when its practice was controlled by science and its practitioners. This is not the case today; a paradigm shift has occurred which places doctors and patients at the mercy of the “marketplace” and those who control that market.

Insurance companies operate entirely in the absence of the antitrust controls that protect and preserve market competition in the rest of our capitalistic society. They dictate reimbursement to physicians, the cost of insurance and co-pays for patients. In other words, they practice medicine without a license. They dictate care, telling us “what is allowed” for our patients. Insurers are not driven by the principles and standards to which doctors hold themselves. They are not guided by the charge that they are to do what is right or even that they “do no harm.” Instead, they are driven by simple and pure economics; our “do no harm” is their “show me the money.” Their driving principle is to give back as little of the hard-earned premiums as possible to the patients and to the doctors who provide them with lifesaving care. This places insurers at odds with doctors who are attempting to do the right thing. What is worse, it places the insurer between us and our patients and us between the patient and the insurer. The result is that we are unable to fulfill the most basic and fundamental of our charges as doctors. We have lost our jobs.



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