Its hardly a secret that the doctors and managers who run the nations biggest multispecialty group practicesplaces like the Mayo and Cleveland clinics, for instancefirmly believe that their model of integrated delivery is the very best way to provide patients with quality healthcare.
As always, that sentiment of superiority summed up the dominant theme last week when the Alexandria, Va.-based American Medical Group Association, the trade group for all those large medical groups, held its annual conference over four days at the luxurious Westin Kierland Resort & Spa in Scottsdale, Ariz.
But not every single conference attendee stood in total agreement with the notion that doctors are doing such a bang-up jobor, for that matter, that the big medical groups that compose the AMGA are really at the top of the healthcare pyramid. In fact, the self-satisfied attitude of many AMGA members took a bit of a beating from Charles Inlander, noted naysayer and the outspoken president of the Peoples Medical Society since the consumer-advocacy group was founded 24 years ago.
You folks have been losing the healthcare policy wars for years, he told an early morning audience that included those attendees who werent out on one of the three nine-hole golf courses that abut the hotel and conference center. And the reason youve been losing the war is because the focus hasnt been on the patient. Its been on the delivery system.
For some reasontoken balance, perhapsthe conference organizers invited the consumer gadfly to join a panel discussion entitled Brave New World of Healthcare, Part 2: Working with Stakeholders. The panel, all a bit more conventional than Inlander, included Francis Crosson, a physician who is executive director of the Permanente Federation; Peter Lee, chief executive officer of the Pacific Business Group on Health; Allan Korn, a physician who is senior vice president and chief medical officer of the Blue Cross and Blue Shield Association; and Paul Antony, a physician who is chief medical officer of the Pharmaceutical Research and Manufacturers of America, the drug industrys trade group. These panel participants, of course, were the button-down industry veterans to Inlanders version of a tie-dyed radical about to storm the gates and bring down the system.
Inlander wasnt done criticizing his hosts. After suggesting that universal healthcare is inevitable sometime in the next several years because the public will demand it, he reinforced his point about the industrys lack of sincere concern for patients by mentioning a keynote address one day earlier by Jacque Sokolov, a physician-turned-consultant whose speech was billed as the Brave New World of Healthcare, Part 1: Navigating the Waves of Change. Sokolov, an impressive speaker and a familiar presence at these events, talked about the big momentum in big group practices. He talked about the CMS payment system, hospital margins and just about everything else in the complex world of healthcare. But, according to Inlander, this highly regarded expert never mentioned the P-word.
Jacque never once mentioned the word patient in a 50-minute speechnot once, Inlander charged.
That revelation drew some murmurs of disbelief from the crowd. Don Fisher, the president and CEO of the AMGA, said later that I find it hard to believe that Sokolov failed to mention that particular noun during his lengthy address. Fisher vowed to review the tape.
And, upon further review, the call stands. In an e-mail exchange, Sokolov acknowledged the absence of the word, saying he took out some slides related to patient-centric care in an effort to keep the presentation within time limits. He said he would correct that oversight in future presentations.
Regardless, Fisher said, he disputed Inlanders remarks in two key areas.
The AMGA and other big healthcare trade groups are not losing the policy wars, Fisher said. In fact, theyve won quite a few battles in recent years. Whats more, he said, the multispecialty group-practice model represented at the meeting is all about the patient. And without mentioning any nameshe is, after all, a diplomatFisher added, We are one of the few organizations that arent out there (lobbying lawmakers) just trying to get something for us.
Permanentes Crosson gently dismissed Inlanders comments as posturing, though he admitted that everyone who takes the stage in front of hundreds of people tends to do that to some degree. Nevertheless, he said, Ive spent my life focusing on patients and multispecialty practices are the best way for patient-centric care to proceed in the future.