Toward a Virtuous Quality and Savings Loop

Tom Emerick

Posted 2/1/12 on Cracking Health Costs

If doctors in the US followed the prevailing medical ethic in most of our peer countries, quality of care would improve and hundreds of billions of dollars could be saved.

The prevailing medical ethic in the US is this.  If a treatment may help a patient, let’s do it.  That doesn’t sound bad, does it?  Problem is, that is a deeply flawed ethic.

A higher ethic is this. Let’s first get the patient’s diagnosis right. Then determine the desired patient outcome, one with which an informed patient would agree.  Next develop the safest and least invasive treatment plan to achieve the desired patient outcome. Further, under this higher ethical standard, doctors do not do unnecessary or redundant testing, especially those which can cause cancer in patients, e.g., CT scans.

Those two ethics are worlds apart.  Most specialists follow the first ethical model, which leads to excessive surgery, unproven care modalities, etc.  If the US could fully embrace the higher ethical standard, the result would be higher quality care, fewer deaths, and savings of hundreds of billions of dollars.

The higher ethic is the norm in Canada, UK, and other English speaking countries, as well as most of Western Europe, the Veterans Administration, Mayo Clinic, Cleveland Clinic, Kaiser, and a number of other like institutions of care.

Doctors in other countries are bewildered that we pay for unproven care and contraindicated surgery in the US.  Obamacare’s ACO notion is an attempt to spark the higher ethical model in more clinical settings in the US.

When and if we can begin transfering large numbers of patients to clinics which follow the higher ethical model, a highly virtuous quality and savings loop will commence.

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