Navigation Links
Cost containment focus could have consequences for health care delivery
Date:1/7/2009

BOSTON The drive toward containing health care costs could have the unintended consequence of reducing physician productivity, impairing quality and perhaps even increasing costs, two Beth Israel Deaconess Medical Center physicians suggest in a New England Journal of Medicine "Perspective."

Citing studies in behavioral economics and psychology, Pamela Hartzband, MD and Jerome Groopman MD, express the fear that assigning a monetary value to every aspect of a physician's time could prove to be self-defeating.

"There is also a communal relationship, an expectation and obligation to help when assistance is needed," Hartzband and Groopman write in NEJM's Jan. 8, 2009 edition. "We believe that in the current environment, the balance has tipped toward market exchanges at the expense of medicine's communal or social dimensions."

The physicians, an endocrinologist and hematologist-oncologist respectively, note the environment in which they work has long been one where a colleague would not hesitate to stop in a corridor and offer a colleague his or her thoughts on a complex case.

"Now imagine that they had just left a departmental meeting where a divisional budget was reviewed and goals for individual relative value units (RVUs, the monetary metric of physicians' time and effort) were presented. Would their interaction be different?"

The physicians cite studies that suggest the answer is yes. Experiments found money-primed subjects were consistently less willing to extend themselves to those who needed help.

In one study, a control group asked to do a favor without compensation was significantly more willing to help move a sofa than those offered a token payment.

These experiments have a greater meaning in a profession where marketplace and communal relationships live side by side.

"Many physicians we know are so alienated and angered by the relentless pricing of their day that they wind up having no desire to do more than the minimum required for the financial 'bottom line,'" they write. "In our view, this cultural shift risks destroying some essential aspects of the medical profession that contribute to high quality health care, including pride of profession, sense of duty, altruism and collegiality.

"Extending oneself to patients, families, trainees and colleagues not only is a traditional element of care, but translates into more effective care."

Hartzband and Groopman suggest that new trends in primary care may offer an opportunity to restore balance. The "patient-centered medical home" is being envisioned as a "compassionate partnership" between caregivers and patients, with compensation for what is now unreimbursed time.

"Caregivers should be appropriately reimbursed but should not be constantly primed by money. Success in such a model will require collegiality, cooperation and teamwork precisely the behaviors that are predictably eroded by a marketplace environment."


'/>"/>

Contact: Jerry Berger
jberger@bidmc.harvard.edu
617-667-7308
Beth Israel Deaconess Medical Center
Source:Eurekalert

Related medicine news :

1. Governor Rendell Revises Executive Order; Extends Operation of PA Health Care Cost Containment Council
2. Louisiana Department of Health and Hospitals Announces Intent to Award Cost Containment Services Contract to HMS
3. Governor Rendell Issues Executive Order Regarding Pennsylvania Health Care Cost Containment Council
4. Patient Advocacy Is the Focus of Decembers Current Clinical Practice
5. Stem Cell Product Commercialization Focus of Summit
6. TeleTracking Technologies to Focus on Growth
7. SpectraScience Awarded U.S. Patent 7,469,160 for Its Unique Methods and Apparatus for Evaluating Image Focus
8. DiFUSION Technologies Announces Company Launch Focused on Surgical Site Infections (SSIs)
9. Lumension Security's Audiocast Focuses on Evolving Threats and Countermeasures: Achilles Heel of Data Loss and Theft
10. Karate For Your Body Announces Release of Volume One in Martial Arts DVD Training Series, Focusing On Fundamentals
11. Nutrigenomics - Developing Personalized Diets for Disease Prevention - Is the Focus of a Special Issue of OMICS
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/21/2017)... PA (PRWEB) , ... May 21, 2017 , ... Following ... 2012, New York became the first state to require that hospitals follow a protocol ... controversy in the medical community as to whether such steps would have saved Rory ...
(Date:5/19/2017)... ... 19, 2017 , ... DMG Productions is proud to announce ... Ed Begley, Jr., airing fourth quarter 2017 on FOX Business. , Based in ... supplement made from naturally occurring ingredients. Innovations will enlighten viewers on RawTrition’s all-in-one ...
(Date:5/19/2017)... ... May 19, 2017 , ... The Miller Agency, ... to families and business owners in the region, is embarking on a cooperative ... and their families. , Multiple sclerosis (MS) is a demyelinating disease that affects ...
(Date:5/19/2017)... ... May 18, 2017 , ... ML Billing, 2016 ... specialties and sizes and specializes in large group practices, is pleased to announce their ... it has also set the standard in all aspects of full-service medical billing. This ...
(Date:5/18/2017)... ... 18, 2017 , ... Dr. Kim Ross supports Stroke Awareness Month by now ... link between this condition and serious systemic health conditions including heart disease and stroke. ... in Annapolis, MD, and seeking treatment with Dr. Ross immediately may prevent bacteria from ...
Breaking Medicine News(10 mins):
(Date:5/4/2017)... 2017  A new tight-tolerance microextrusion medical tubing ... materials, is being launched by Natvar, a Tekni-Plex ... in recent years to service a wide variety ... More expensive materials such as glass and fluoropolymers ... to their ability to consistently hold tolerances. This ...
(Date:5/3/2017)... Calif. , May 3, 2017 ... of any hospital or healthcare facility. Commonly referred ... room is equipped with diagnostic imaging technology to ... of the heart. In these spaces, a team ... catheterization, balloon angioplasty, percutaneous coronary intervention, congenital heart ...
(Date:5/3/2017)... , May 3, 2017  Getinge, a ... contribute to quality enhancement and cost efficiency within ... a study of contemporary practice demonstrating that intra-aortic ... therapy for critically ill patients. The single-center, retrospective, ... newer large volume MEGA ® 50cc intra-aortic ...
Breaking Medicine Technology: