Medical Guild to Collectivist Wallet: Pay Us More and We’ll Care More About Patients

That’s essentially the message—delivered through Medicratese and Newspeak, of course—from the American College of Physicians in recent testimony to Congress [PDF]. I spotted the press release at EurekAlert.

Some relevant whines quotes:

Many physicians would like to redesign their own practices to become a patient-centered medical home, but are discouraged by doing so by Medicare payment policies that reward physicians for the volume of services rendered on an episodic basis, rather than for comprehensive, longitudinal, preventive, multi-disciplinary and coordinated care for the whole person. The authors of a recent survey found that “a gap exists between knowledge and practice—between physicians' endorsement of patient-centered care and their adoption of practices to promote it. Physicians reported several barriers to their adoption of patient-centered care practices, including lack of training and knowledge (63 percent) and costs (84 percent). Education, professional and technical assistance, and financial incentives might facilitate broader adoption of patient-centered care practices. With the right knowledge, tools, and practice environment, and in partnership with their patients, physicians should be well positioned to provide the services and care that their patients want and have the right to expect.” (5) ....

Medicare should create payment incentives to encourage physicians to acquire specific structural enhancements and tools that are directly related to care management in the ambulatory setting, such as patient registry systems, secure email, and evidence based clinical decision support, which can be measured and reported on. (That is, paying doctors for acquiring the systems needed to become medical homes). This recommendation would be implemented by the National Health Information Incentive Act of 2007, H.R. 1952, introduced on April 19, 2007 by Representatives Charles Gonzalez and Phil Gingrey.


(5) Commonwealth Fund study, "Adoption of Patient-Centered Care Practices by Physicians: Results from a National Survey" (Archives of Internal Medicine, Apr. 10, 2006)

Funny, but nothing in there sounds to me like it would help doctors actually care for patients better. It’s all bureaucracy-centered. What a shocking development.

Oh, and are you wondering that a “medical home” is? Here you go [emphasis switched from underlining to bold]:

As described in the joint principles, a patient-centered health care medical home is a physician practice that has gone through a voluntary qualification process to demonstrate that it:

• Provides continuous access to a personal primary or principal care physician who accepts responsibility for treating and managing care for the whole patient through an a [sic] patient-centered medical home, rather than limiting practice to a single disease condition, organ system, or procedure,
• Supports the specific characteristics of care that the evidence shows result in the best possible outcomes for patients.
• Recognizes the importance of implementing systems-based approaches that will enable physicians and other clinicians to manage care, in partnership with their patients, and to engage in continuous quality improvement,
• Introduces transparency in consumer decision-making and accountability for getting better results by reporting on evidence-based quality, cost and patient experience measures of care.

Sounds like nothing more than a clinic or hospital that has at least one primary care or general practice physician.

Guess I can’t call this extortion since the Medicare program’s purse is held by Congress. Needless to say, my faith in socialized medicine has been completely restored.