Comments on: Seven Policy Recommendations for Healthcare’s New Era

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By: Dr. Rick Lippin

Dr. Rick Lippin — Wed, 05 Jun 2013 15:34:06 +0000

Sandra_Raup is correct- Patients clearly have other legitimate values/goals besides maximizing their own biological health. As providers we need to cease the paternalistic practice of assuming that our patients’ values are the same as ours.

Dr. Rick Lippin
Southampton,Pa

By: Sandra_Raup

Sandra_Raup — Fri, 31 May 2013 22:31:56 +0000

A thoughtful and practical appoach – thanks for an important jump start to a conversation about what could really impact care. I would also like to see more effort at determining what goals (quality measures) patients value. They may be the same as those of their clinicians, but at least outside the hospital (where hopefully most spend almost all their time), they are the ones that have to do most of the work to reach those goals. Do they value the same goals? If not, is it because they perceive the effort as being too great, too inconvenient or too expensive? I think we could come up with far better approaches to getting patients to reach OUR goals for them if we better understood what they value and what made it easier/harder for them to incorporate suggested interventions into their lives.

By: Mighty Casey

Mighty Casey — Fri, 31 May 2013 22:20:05 +0000

From my years in engineering, I still hear “we’re faithfully reproducing the problem” ringing in my ears when I read #1. Making that one simple shift – to outcomes rather than process – would revolutionize the entire healthcare system. It would go a long way toward weeding out the resistance to price transparency, too, since I feel like the same cohort that’s resisting full disclosure on cost data is the same bunch that’s determined to follow a checklist to a bloody fault.

Reading this give me hope. Unfortunately, I don’t run a large health system or hospital. I’ve got my fingers crossed that those who do are reading it, and seeing its simple power.

By: Doolittle

Doolittle — Fri, 31 May 2013 18:27:36 +0000

# 3 will help more than you can imagine ..

Instead of vaguely Orwellian sounding “quality” measures which are truth be told largely negative marks assigned to an individual perp who is unlucky enough to be in the wrong place at the wrong time in the wrong hospital, you’ll get more constructive and genuinely useful data with an emphasis on team performance …

“Measure quality at the level of the organization, rather than the clinician.
Historically, the physician has been viewed as the leader of medicine, with responsibility for the care and outcomes of patients; in iconic photographs and paintings, the physician is seen as a lone, heroic figure. Such a view has led to natural interest in the measurement of individual physicians’ performance. It is therefore not surprising that some information brokers, including the U.S. News and World Report and many city magazines like the Washingtonian, provide ratings of “top doctors,” often based mostly on reputation, warranted or not.”