Sessions and Themes
- Shifting the paradigm: Vikas Saini
- Magical thinking and Modern medicine: Harvey Fineberg
- What makes us do it?
- What will it take to get us there?: Don Berwick
- What are the knowledge gaps in avoiding avoidable care?
- Case discussions
- What are the ethical issues?
- Medical journals and the issue of avoidable care
- The schizophrenic life of the hospital CEO
- A reason to change: Shannon Brownlee
- Social responsibility of physicians: Bernard Lown
- Behavior-changing Best practices
- Global dimensions of unnecessary care: Julio Frenk
- Payment mechanisms and the Culture of medicine
- Choosing wisely and beyond: What are the next steps?
- How can patients help drive the needed change?
Proven, systemic solutions waiting to be found
Hi - I’m writing from the Yale Global Conference on Health. The questions of the survey reflect a lack of studying how other advanced countries have learned to control the rise in costs and services that zoomed in the 1960s, until the oil crisis recession of the 1970s. Why is there so much in-attention to how this problem of avoidable care as a SYMPTOM of mis-organization of financing and services? See my course on the answers: STANFORD 2011 Syllabus on Kaiser web:
In the US, Kaiser Permanente and a few other whole-system organizations have come up with similar solutions. Our own Veterans Health Administration showed how one can transform wasteful, 2nd-rate care into 1st-rate, efficient care in just ten years. Yet how they do this is not indicated in the choices offered for the survey questions.
In the area of prescribing, there is serious avoidable over-prescribing, which contributes to an epidemic of harmful side effects that cost even more to treat (often by prescribing yet another drug). See the INVERSE BENEFIT LAW on www.pharmamyths.net.
I guess I feel frustrated that most policy thinking about how to avoid unnecessary care and expenses today feels like discussions held in the US, Germany, and France in the early 1970s, after a series of articles at that time about excessive hospitalizations, investigations, operations, and prescriptions…