Category Archives: treatment options

Does Insurance oversight of clinical practice improve either quality of care, or patient outcomes?

When outside oversight, based solely on published guidelines, interferes with clinical care there are potentially multiple adverse outcomes, including physician and patient frustration, waste of time and interference with delivery of optimal care. There should be ways for insurers to use their databases to mitigate inefficient and intrusive oversight. Continue reading

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Diagnosis may be the Achilles Heel of Incentive Based Payment.

“Diagnosis is the mental act of selecting the one explanation most compatible with all the facts of clinical observation”.  – Raymond Adams in Harrison’s Principles of Internal Medicine – 4th edition In almost all instances, Government and other third party … Continue reading

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What is Evidence Based Medicine?

One definition would be: Delivery of Medical Care based on results of best available evidence. This usually means finding or relying upon data, some of which will be from outside one’s immediate memory to help answer a clinical question. EBM … Continue reading

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Why do Physicians Behave the Way They Do?

I believe that the vast majority of physicians do “the right thing” for their patients. I don’t think I’m being a Pollyanna. On the other hand, the “The Tragedy of the Commons”, which describes behavior in many cultures, doesn’t bypass … Continue reading

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Registry Participation will help Develop Alignment and Improve Quality

Many hospitals and hospital systems are trying to ensure that they are satisfying quality metrics to help with accreditation, and to confirm that they are satisfying their mission and providing community benefit. Superior performance in achieving clinical quality may allow … Continue reading

Posted in Competition, CV, effectiveness/efficacy, Quality, treatment options | Tagged , , | 2 Comments

We should work to Identify Problems rather than try to Fix Blame in Medical Service delivery.

Recently there have been stories of inappropriate cardiac procedures being. There are at least four glaring examples of instances in which cardiologists have acted in a way that was not consistent with what others would have considered optimal patient care. … Continue reading

Posted in CV, Peer Review, Policy, Quality, treatment options | 3 Comments

Medical Ethics should address more than the individual patient encounter

George Lundberg, reviewed what he called the Principles of medical ethics in his blog on  MedPageToday.com on December 20, 2010. He’s done us a service by bringing this up as the season for reflection is upon us. The AMA’s Code … Continue reading

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What is “CE Research/Analysis”? Who should be responsible for it’s implementation?

CE research/analysis is clearly one technique to help gain insight into relative efficacy of several treatments for a specific clinical condition. If the private sector (industry, professional organizations) won’t do it in an unbiased manner, then perhaps an agency such as AHRQ should have our support, counsel and thought. Continue reading

Posted in effectiveness/efficacy, Policy, treatment options | Tagged , , | 3 Comments