Conference Agenda

Organized by the Lown Cardiovascular Research Foundation and the New America Foundation, and co-hosted by the Institute of Medicine, the Conference will bring together experienced, practicing clinicians from a broad range of medical specialties as well as thought leaders in policy and medicine to discuss the scope of avoidable care, its causes and consequences, and its implications for medical professionalism.

The Conference program will consist of a mixture of short keynote speeches from prominent and proactive speakers, audience Q & A, and panel discussions organized into debate formats. A key deliverable from this conference will be a toolkit including talking points, white papers, and instructions for organizing meetings and events at participants’ affiliated institutions. We strongly encourage participants to stay for both days.

To read about our featured speakers, click here.

To read about our moderators and panelists, click here.

 

DAY 1: The problem and its contours

7:30 – 8:00 AM
Registration and continental breakfast

8:00 – 8:30 AM
Welcome, housekeeping, and background
Vikas Saini
, MD, President, Lown Cardiovascular Research Foundation

8:30 – 9:00 AM
Keynote address: Magical Thinking and Modern Medicine
Harvey Fineberg, MD, PhD, President, Institute of Medicine

9:00 – 10:15 AM
What makes us do it? Myths and realities about the drivers of unnecessary care
Moderator:
Chuck Kilo, MD, MPH, Chief Medical Officer, Oregon Health & Science University
Panelists:
• David C. Goodman, MD, MS, Director, Center for Health Policy Research, Dartmouth
• Amitabh Chandra, PhD, Kennedy School, Harvard University
• David Newman, MD, Dept. of Emergency Medicine, Mt. Sinai School of Medicine

10:15 – 10:30 AM
Break

10:30 – 11:00 AM
Keynote address: What will it take to get us there?
Don Berwick, MD, MPP, Former Administrator, Centers for Medicare and Medicaid Services

11:00 – 12:00 PM
What are the knowledge gaps in avoiding avoidable care?
Moderator:
Rita Redberg, MD, MSc, Chief Editor, Archives of Internal Medicine; Professor of Medicine, University of California, San Francisco Medical Center
Panelists:
• Eric B. Larson, MD, MPH, Executive Director, Group Health Research Institute
• Salomeh Keyhani, MD, MPH, Assistant Professor, University of California; VA Medical Center
• Al Mulley, Jr., MD, MPP, Director, The Dartmouth Center for Health Care Delivery Science

12:00 – 2:00 PM
Working Lunch: Case Discussions
Detailed assessment of process through case vignettes with analysis and discussion and debate about decisions providers make about what care to deliver. Each case has 30 minutes allotted.

Case 1: Surgical Case
Case 2: Cardiology case
Case 3: End of life case

Green Room
Moderator:
Rob Janett, MD, Medical Director, Mount Auburn Cambridge IPA

Surgery Case
Presenter –
Rob Janett, MD
Discussant –
James Rickert, MD, Orthopedic surgeon; Asst. Clinical Prof. Orthopedic Surgery, Indiana University School of Medicine

Cardiology Case
Presenter –
Vikas Saini, MD, President, Lown Foundation
Discussant – Shmuel Ravid, MD, MPH, Lown Cardiovascular Center

End of Life Case
Presenter –
Rob Janett, MD
Discussant – Angelo Volandes, MD, MGH, Harvard Medical School

Red Room
Moderator:
Ted Herwig, MD, FAAFP, Chairman, New England Quality Care Alliance

Surgery Case
Presenter – Ted Herwig, MD, FAAFP
Discussant –
Martin Makary, MD, MPH, Dept. of Surgery, Johns Hopkins Hospital

Cardiology Case
Presenter –
Charles M. Blatt, MD, Lown Cardiovascular Center
Discussant – Frederick Welt, MD, Director, Cardiac Catheterization Laboratory, Brigham and Women’s Hospital

End of Life Case
Presenter – Ted Herwig, MD, FAAFP
Discussant – Dennis McCullough, MD, Associate Professor, Community & Family Medicine, Dartmouth Medical School

2:00 – 3:30 PM
What are the ethical issues? Do we need a new Hippocratic Oath, or just a new interpretation of the original?
Moderator:
Shannon Brownlee, MS, Acting Director, New America Health Policy Program
Panelists:
• Diane Meier, MD, FACP, Director, Center to Advance Palliative Care; Vice Chair, Public Policy, Geriatrics and Adult Medicine, Mount Sinai
• Howard Brody, MD, PhD, Director, Institute for the Medical Humanities, Univ. of Texas Medical Branch
• Jerome R. Hoffman, MA, MD, Professor of Medicine Emeritus, UCLA; Professor of Emergency Medicine, USC

3:30 – 4:00 PM
Break

4:00- 5:00 PM
Medical journals and the issue of avoidable care
Moderator:
George Lundberg, MD, Editor at Large, MedPage Today
Panelists:
Rita Redberg, MD, MSc, Chief Editor, Archives of Internal Medicine
• Phil Fontanarosa, MD, Executive Editor, JAMA
• Gregory Curfman, MD, Executive Editor, NEJM
• Elizabeth W. Loder, MD, MPH, Clinical Epidemiology Editor, BMJ

5:00- 6:00 PM
Cocktail Hour

6:00- 7:30 PM
The schizophrenic life of the hospital CEO
Moderator:
David Wennberg, MD, MPH, CEO, Northern New England Accountable Care Collaborative
Panelists:
• Nancy Howell Agee, President and CEO, Carilion Clinic
• Jeanette Clough, President and CEO, Mt Auburn Hospital
• Peter Slavin, MD, President, MGH

7:30 PM
Dinner

 

DAY 2: Growing a culture of change

7:30 – 8:00 AM
Registration and Continental breakfast

8:00 – 8:30 AM
Welcome and introduction
Shannon Brownlee, MS, Acting Director, New America, Health Policy Program

8:30 – 9:00 AM
Keynote address: The social responsibility of physicians
Bernard Lown, MD, Professor Emeritus, Harvard School of Public Health; Senior Physician (ret.), Brigham and Women’s Hospital, Boston

9:00 – 10:00 AM
Behavior-changing Best practices
Moderator:
Philip Madveg, MD, Associate Executive Director, The Permanente Medical Group
Presenters:
• Daniel Hoefer, MD, CMO, Outpatient Palliative Care and Hospice, Sharp HospiceCare
• Tom Denberg, MD, PhD, FACP, Vice President, Quality and Patient Safety, Harvard Vanguard, Atrius Health
• Robert S. Mecklenburg, MD, Medical Director, Center for Health Care Solutions, Virginia Mason

10:00- 10:15 AM
Break

10:15 – 10:30 AM
Keynote address: The global dimensions and implications of unnecessary care
Julio Frenk, MD, PhD, Dean, Harvard School of Public Health; Former Minister of Health, Mexico

10:30- 11:00 AM
Keynote address: Update on Massachusetts Payment Reform and Implications for Avoidable Care
Judy Ann Bigby, MD, Secretary of Health and Human Services, Commonwealth of Massachusetts

11:00 – 12:00 PM
Payment mechanisms and and the Culture of Medicine
Moderator:
Richard Lopez, MD, Chief Medical Officer, Atrius Health
Panelists:
• David Himmelstein, MD, Professor of Public Health, City University of New York
• Dolores Mitchell, Executive Director, Group Insurance Commission
• Allan H. Gorroll, MD, Professor of Medicine, Harvard Medical School

12:00 – 1:30 PM
Working Lunch
Small group sessions for brainstorming

Steps toward reducing avoidable care:

1:30 – 3:15 PM
Part 1. Choosing Wisely and Beyond: What are the next steps? What are the hurdles and roadblocks?
Moderator:
Susan Dentzer, Editor in Chief, Health Affairs
Panelists:
• Christine Cassel, MD, MACP, President and CEO, American Board of Internal Medicine
• Stephen R. Smith, MD, MPH, Brown Medical School; National Physicians Alliance
• Steve Weinberger, MD, FACP, American College of Physicians
• Allen Lichter, MD, CEO, American Society of Clinical Oncology

3:15 – 4:15 PM
Part 2. How can consumers and purchasers help drive the needed change?
Moderator:
David Lansky, PhD, President and CEO, Pacific Business Group on Health
Panelists:
• Patty Skolnik, Patient representative, Citizens For Patient Safety
• Jessie Gruman, PhD, President, Center for Advancing Health
• Elizabeth B. Gilbertson, MA, Chief of Strategy, UNITE HERE HEALTH
• Ben Moulton, JD, MPH, Foundation for Informed Medical Decision Making

4:15 – 4:45 PM
Reflections on conversations of the last two days
Vikas Saini, MD, Shannon Brownlee, MS, and Christine Cassel, MD, MACP

4:45 – 5:00 PM
Adjourn
Vikas Saini, MD and Shannon Brownlee, MS

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