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Politics : Formerly About Advanced Micro Devices
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To: i-node who wrote (704562)3/16/2013 6:40:41 PM
From: Alighieri  Read Replies (1) of 1573227
 
The Dean of Harvard Medical School -- no right wing ideologue, but one who has pointed out the stifling effect on innovation, co-authored an opinion piece in the WSJ on ACOs and what a disaster they are in the making:


This opinion piece is an example of your incredible bias beacon...this piece is an indictment of today's health care system, not ACA...read the excerpt below for instance. The second paragraph in particular implies best practices boards...do you remember what republicans used to campaign against ACA ... boards that come between you and your doctor...in the last sentence this fellow is advocating precisely what you stand against...a decline in quality by referring patients to NPs and PAs....there are no untwisted facts that support your extreme proclamations...give us a break.

Al

The first untenable assumption is that ACOs can be successful without major changes in doctors' behavior. Many proponents of ACOs believe that doctors automatically will begin to provide care different from what they have offered in the past. Doctors are expected to adopt new behavior that reduces the cost of care while retaining the ability to do what's medically appropriate. But the behavior of doctors today has been shaped by decades of complicated interdependencies with other medical practices, hospitals and insurance plans. Such a profound behavior shift would likely require re-education and training, and even then the result would be uncertain.

To give one example, if ACOs are to achieve their cost-saving goals and improve medical care, most doctors will need to change some of their approaches to treating patients. They'll need to employ evidence-based protocols more often to determine optimal treatment—for instance, in prescribing medication or deciding whether certain kinds of surgery are necessary. Doctors will also have to find ways to move some care to lower-cost sites of service, such as more surgery in ambulatory clinics instead of a hospital. ACOs aren't designed or equipped to transform physician behaviors on the scale that will be needed.
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