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Penn Medicine physician: Emphasis on 'value' in health care reform sends mixed messages
Date:3/6/2013

nts derive from undergoing such tests; but a physician-centered approach would caution against administering costly tests that have little or no data to support their efficacy. Further complicating this dichotomy are studies showing that, for instance, patients who receive medical imaging, regardless of whether it is truly indicated, are generally more satisfied with their care.

Likening the present-day situation to a psychological phenomenon called inattentional blindness -- the tendency to become immersed in specific stimuli at the cost of missing other things that are right before one's eyes -- Rosenbaum calls for a view that encompasses the perspectives of both patients and physicians. "Patients and physicians are on the same team and the patientphysician dynamic remains central to medical care, decisions about resource use, and our evolving definition of quality," she said. "If we focus on physicians and patients separately, we lose sense of how their goals may or may not match up."

Offering a solution, Rosenbaum offers an example from her own training experience. "A cardiac patient I was seeing had had a number of tests already. But he was still concerned about his condition and asked, 'Isn't there some other test you could do?' My preceptor spent a long time explaining to the patient and his wife the implications of his previous tests, why all the tests he had found on the Internet would probably be of no further value, why he needed to take an additional blood-pressure medication and begin exercising, and how he should change his diet. At the end of the conversation, he and his wife exchanged a look of relief. 'No one has ever explained any of this to me before,' he said."


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Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
Source:Eurekalert

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