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MED3OOO Clinical Newsletter - April 2012

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Newsletter for Physicians and Clinical Staff
"Who Will Rise To The Top?"
By Paul McLeod, M.D., MED3OOO Chief Medical Executive
 

Paul McLeodWhat can I do?

We hear almost daily of a broken system of healthcare in this country. Inherent in that statement is a sense of helplessness on the part of the individual physician. The system is big. My practice, by comparison, is very small. I did not make the rules. I cannot change the rules or force others to change their behavior. Let’s be realistic, what can I really do that will make a difference? Good question.

Revamping health care will involve a multitude of changes. The proposed rules for accountable care organizations lead us to focus on changes to “the system.” It is easy to look outside ourselves in this situation. The system has failed us and our patients in many ways. But some of the most important needed changes will have to result from self-evaluation. As physicians, we have the duty and privilege to monitor ourselves. This is one of the qualities that distinguish us as a profession. Daily we use the best information available to us in the context of our training, experience, and the patient’s wishes. There are things we can all do that will help. This time, I suggest we look in the mirror. We can start by examining our routines.

A November 14, 2011, article in the Archives of Internal Medicine did just that. The authors looked at several services that have become incorporated into patient visits for a general medical exam. By distinction, they were not orders based on the suspicion that the patient had any illness. These “routine tests” were compared against evidence-based preventive care guidelines and analyzed for their cost and diagnostic value. To no one’s surprise, the results were disappointing.

We spent an estimated $32.7 million on Complete Blood Counts. Millions were spent on metabolic profiles and millions more on screening Dexa Scans for women less than 65 and PAP smears for women younger than 21. The biggest potential opportunity identified in this article for value-based savings centers around “routine” use of branded statin drugs for treatment of lipid disorders. We could save an impressive $5.8 billion per year simply by making the switch to generic statin drugs.

More and more information like this will become available to us in the coming years. We may find ourselves facing the mirror on a daily basis. MED3OOO is committed to providing our clients the decision support and reporting tools necessary to facilitate good decision-making in the care of patient populations and individuals. Like you, we face the challenge to examine what we do and our outcomes. We would be privileged to partner with you in this journey.

For a printable version of this newsletter click here: April Clinical 2012


The Clinical Advisory is a clinical publication from MED3OOO dedicated to informing physicians and clinical staff about tools and information to improve the quality of patient care.
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