Although the top of Modern Healthcare's recent list of the 100 Most Influential People in Healthcare was dominated by government types wielding political power, the bulk of the list—77% to be exact—was made up of individuals with private-sector jobs working to improve the nation's troubled healthcare system without—or despite—government involvement.
It's not just politicos working for change
Political clashes and the weak economy are combining to make change inevitable, and many physician executives are determined, as Chicago Mayor Rahm Emanuel is known to say, to not let this crisis go to waste.
"I see lots of aligning forces," says Dr. Gary Kaplan, the president and CEO of Seattle's Virginia Mason Hospital and Medical Center. "We have to do something about the lack of value."
Kaplan tells how Virginia Mason is working with employers on low-profile but high-cost problems like headaches and back, knee and shoulder pain that contribute heavily to worker absenteeism and for which treatments have been expensive and largely ineffective. Using evidence-based guidelines, Virginia Mason has reduced its use of magnetic-resonance imaging tests while concentrating on getting people back to work with full function.
While the reduction in MRIs had a short-term negative economic impact, Kaplan says there were long-term benefits such as improved patient satisfaction, longer life for expensive equipment and getting patients into effective treatment regimens quicker. Under the current dominant care model in which every ache requires an MRI, Kaplan says, "You're waiting in line for studies you don't need instead of getting better through therapy.”
Summarizing, Kaplan says the healthcare system can reform itself by stopping the rewarding of quantity "and create an environment where quality and stewardship of resources is rewarded."
Dr. Robert Wah, new chairman of the American Medial Association board of trustees, offers similar sentiments.
"I think the opportunity is before us to improve the care of our patients through reform of the care process," says Wah, who is the chief medical officer of Computer Sciences Corp. "It's critical that physicians have input on that."
While physicians can drive system reform and the development of accountable care, he says the government needs to find a different formula for paying doctors who provide Medicare services. He rejects the troubled sustainable growth rate now being used, which requires Congress to pass temporary "patches" every few months to avoid deep payment cuts.
"We have been very consistent in our message to Congress: The SGR is not sustainable," Wah says. "They need to get rid of it completely."
Follow Andis Robeznieks on Twitter: @MHARobeznieks.
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