Myths, Realities & Possibilities Myths, Realities & - PDF document

Myths, Realities & Possibilities Myths, Realities & Possibilities Charlotte Jefferies Horty, Springer & Mattern The U.S. has the best The U.S. has the best health EMERGENCY CARE care system in the world! system in the world! In 2006, the U.S. ranked: • 37 th in performance U.S. medical technology has • 39 th for infant mortality not translated into better • 43 rd for adult female mortality • 42 nd for adult male mortality health statistics. • 36 th for life expectancy • #1 for health care spending 1

Myths, Realities & Possibilities “20% to 30% of spending is waste that yields no Spending more does not benefit to patients.” make us healthier. Donald Berwick Physicians control over 80% of Areas of Waste health spending: • Overtreatment of patients • Hospital care • Failure to coordinate care • Prescription orders • Administrative complexities • Nursing home orders • Burdensome rules • Fraud • Testing • Physician services It is impossible to become Being the best requires more efficient and cut costs cooperation and sacrifice on without the input and everyone’s part. assistance of physicians. 2

Myths, Realities & Possibilities Making sick people pay more for health care will cut unneeded care! “The only thing worse than a high-priced policy High patient payments you can’t afford is a low- will do nothing but deter cost policy you can’t use.” essential and needed care. Massachusetts State Senator Mark Montigny Physicians should decide what is vital to diagnose and treat patients while respecting both effectiveness and cost of care. 3

Myths, Realities & Possibilities Patients don’t get better because of their lifestyles! Lifestyle issues are difficult For every complex problem, and complex. You can’t solve there is a solution that is this problem alone! simple, neat, and WRONG! Socioeconomic More information does not circumstances, residence and necessarily result in more work strongly influence compliance. health status. 4

Myths, Realities & Possibilities Listen for the patient’s values: Four groups of patients: • Physicians value compliance • Patients value convenience, money, • Cruise Control cultural beliefs, habits, body image, • Taking Charge attitude • Overwhelmed • Speak the language of feelings • Disengaged My patients care more about our personal relationship than convenience or cost! Retail clinics rose to 11.2% in 2011 (up from 3% in 2010). 5

Myths, Realities & Possibilities Retail clinics are 40% cheaper than similar care at a Convenience and price physician’s office and 80% key factors. less expensive than an emergency room visit. WEDNESDAY, NOVEMBER 30, 2011 Emory Healthcare Joins CVS Walk-In Clinics The Atlanta Journal-Constitution (11/30, Williams) reports, “The Clinic on North Highland Avenue is one of 31 such CVS Caremark MinuteClinics in metro Atlanta teaming up with Emory Healthcare.” The new partnership “means patients see nurse practitioners as they did before, but now the nurse practitioners can turn to Emory doctors for help with diagnosis and treatment.” William Custer, a healthcare expert at Georgia State University, said, “This is the latest in an increasing number of partnerships between health systems and other types of medical providers that aims to keep people = Well Visits Preventive care is too expensive! 6

Myths, Realities & Possibilities Preventive care has the Chronic disease is the potential to control risk dominant source of mortality factors, thereby reducing the in the U.S. and the most costly. prevalence of costly chronic disease conditions. Focus on improving Could the cost to reduce health in a fiscally risks offset any savings? sustainable manner. But for the malpractice crisis! 7

Myths, Realities & Possibilities Very few hospital medical What malpractice crisis? injuries ever become tort claims. Insurance business practices Doctors still face harsh rather than malpractice payouts medical liability realities. are primary source of volatility. Malpractice fears and abuses drive: A very small number of • “Defensive Medicine” practice physicians appear to be responsible for most of the • Physicians to leave medical field malpractice that occurs. 8

Myths, Realities & Possibilities The failure to self-regulate through peer review and disciplinary processes creates malpractice and litigation risks. ANY doctor is better than NO doctor! Hospital has a corporate legal duty to: • Appoint and privilege only those who are safe, competent and professional What happened to the “best • Monitor the performance of those who they appoint during the term of interest of the patient”? appointment • Renew and reappoint only those who have demonstrated that they are competent, safe and professional 9

Myths, Realities & Possibilities Legal duty requires action when care is not competent, safe and professional. 10