How Physicians Can Change the Future of Health Care

Abstract

Today's preoccupation with cost shifting and cost reduction undermines physicians and patients. Instead, health care reform must focus on improving health and health care value for patients. We propose a strategy for reform that is market based but physician led. Physician leadership is essential. Improving the value of health care is something only medical teams can do. The right kind of competition--competition to improve results--will drive dramatic improvement. With such positive-sum competition, patients will receive better care, physicians will be rewarded for excellence, and costs will be contained. Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care. Three principles should guide this change: (1) the goal is value for patients, (2) medical practice should be organized around medical conditions and care cycles, and (3) results--risk-adjusted outcomes and costs--must be measured. Following these principles, professional satisfaction will increase and current pressures on physicians will decrease. If physicians fail to lead these changes, they will inevitably face ever-increasing administrative control of medicine. Improving health and health care value for patients is the only real solution. Value-based competition on results provides a path for reform that recognizes the role of health professionals at the heart of the system.

Optimal follow-up for melanoma

“…This can be done by creating hospitals within hospitals; units that excel in delivering one type of care [134]. For melanoma this implicates a need for creating integrated multidisciplinary practice units within focused (oncology) clinics [135]. So in the coming years these dedicated multidisciplinary clinics are the next step in melanoma patient care.…”

Money matters: exploiting the data from outcomes research for quality improvement initiatives

“…Having a customer, a provider and a market, the methods and the philosophy used in industry to improve quality can be applied in the health care setting and they can certainly be useful to obtain benefits both in terms of quality improvement and economic revenue. The growing preoccupation with cost shifting and cost reduction is also increasing awareness of the fact that health care should be moving toward market-based strategies to improve performance [23,[26][27][28][29]. The notion of health care as a market is often viewed by health operators with distaste.…”

“…Instead, however, it is poor quality that costs money, and the improvement of quality that hence allows costs to be reduced [30]. It has recently been advocated that only with a shift to valuebased competition, common in industry, will we be able to improve health and health-care value [29,31], where value is a function of satisfaction of needs/use of resources [3].…”

“…There is general consensus that an improvement in the quality of a service can be attained with the active cooperation of all the operators [23,29,45,64,65]. The need for a value-based competition market to improve quality will increase the necessity to incorporate industry-derived methods in health care.…”

Reducing Operating Room Costs Through Real-Time Cost Information Feedback: A Pilot Study

“…In order to ensure that healthcare professionals are driving these changes, it is important for physicians to understand how best to deliver healthcare value to patients 6 . In order for these cost savings to be instituted safely and effectively, it will be vital for surgeons to have access to realtime cost data, with the ability for quick implementation of changes.…”