While the US grapples with the challenge of health care costs that contribute to high rates of poor-quality care, burdens to business competitiveness, and looming government deficits, clearly there ...are areas in which health care spending does not add to the health of individuals and communities. The polarizing political environment makes it difficult to conduct rational public discussions about this issue, but clinicians and consumers can change the nature of this debate to the potential benefit of patients, the medical profession, and the nation. The initial focus should be on overuse of medical resources, which not only is a leading factor in the high level of spending on health care but also places patients at risk of harm. In fact, some estimates suggest that as much as 30% of all health care spending is wasted. Cassel and Guest discuss Choosing Wisely campaign that will help physicians and patients make smart decisions about their care.
Can Retail Clinics Transform Health Care? Cassel, Christine K
JAMA : the journal of the American Medical Association,
05/2018, Letnik:
319, Številka:
18
Journal Article
Recenzirano
The landscape of the US health care system continues to undergo change. As market forces are invoked to drive lower cost, better access, and improved quality, the entities in the health care market ...continue to diversify. For instance, Apple (with personal electronic health records). Amazon/JPMorgan and Chase/Buffett (with the promise of an affordable nonprofit employer health care system). CVS/Aetna (combining a health plan with retail clinics), emerging Walgreens-ExpressScripts-Cigna relationships, and Walmart (in discussion to acquire Humana) represent major relatively recent developments. CVS/Aetna is the most well-developed of these changes. Nearly 6 years ago. the growth of retail clinics was described as a potentially positive disruptor, especially in the expansion of access and convenience.' Many clinicians were concerned about lack of continuity and delegation of care to nonphysicians, yet these clinics seemed to offer a more accessible and less costly point of care compared with emergency department visits or even physicians' office visits.
This Viewpoint proposes principles of security, transparency, and privacy to guide data-sharing agreements between clinical organizations and digital technology companies as both seek electronic ...health record (EHR) data to grow their business and improve health care delivery and outcomes.
Rotenstein discusses how the coronavirus pandemic has highlighted the burnout felt by the entire health care workforce, including nursing assistants, transport personnel, and clerical staff, and how ...this can be addressed through a blended approach that improves workforce well-being, the health care system, and patients' health. Much of the clinician well-being movement has focused on physicians and nurses. But as the May 2022 Surgeon General's Advisory Addressing Health Worker Burnout and ongoing deliberations of the National Academy of Medicine's Action Collaborative on Clinician Well-Being and Resilience highlight, the coronavirus pandemic has underscored the need to attend to the well-being of the entire health care workforce, including nursing assistants, transport personnel, clerical staff, and others.
We Need to Talk: Advancing Open Inquiry Cassel, Christine K; Maurana, Cheryl A
Academic medicine,
2024-Mar-01, 2024-3-00, 20240301, Letnik:
99, Številka:
3
Journal Article
Recenzirano
Odprti dostop
In this article, the authors explore the current state of divisiveness in U.S. society and its impact on medical schools. Higher education institutions are increasingly faced with challenges in ...supporting freedom of speech while respecting marginalized groups who may feel attacked by certain kinds of speech. "Cancel culture" has resulted in misunderstandings, job loss, and a growing fear of expressing ideas that may offend someone. These dynamics are particularly relevant in medicine, where issues of racial justice, reproductive health, gender identity, and end-of-life care, occurring in the context of personal and religious differences, affect patient care.Despite these challenges, there must be ways to talk and listen respectfully to each other and bridge sociopolitical divides. Open inquiry and discussion are essential to medical education and patient care. There needs to be a common language and a setting where open engagement is encouraged and supported. This requires expertise and practice. The authors describe several models that offer constructive approaches toward this goal. Organizations including Braver Angels, Constructive Dialogue Institute, Essential Partners, and Greater Good Science Center are working to advance open inquiry and discussion, as are psychology leaders whose methods encourage empathy and learning from one another before engaging in a charged, polarized discussion topic. These and others are using methods that can benefit medical education in supporting diversity of ideas and deliberative discussions to equip students with skills to overcome divisiveness in their training and clinical practice.Promoting civil discourse is critical to society's well-being, and respectful engagement and open inquiry are essential to medical education and patient care. Despite the challenges posed by current societal divides, there are ways to talk with each other respectfully and constructively. The authors assert that this requires ongoing effort and practice, which are crucial for the health care enterprise to flourish.
In 1999 and 2001, the Institute of Medicine published two landmark documents on health care quality and serious quality problems. Two decades later, focal progress in quality improvement is ...undeniable, but wholesale, systemic improvement has been hard to bring to scale.
Nearly all patients will experience a diagnostic error in their lifetime, sometimes with devastating consequences. That conclusion by the Institute of Medicine (IOM) of the National Academies of ...Sciences, Engineering, and Medicine in a recently released report, "Improving Diagnosis in Health Care," should mobilize collaboration among patients, health care professionals and organizations, government, and the private sector to improve the diagnostic process. Diagnostic errors have received less attention than other medical errors, even though correct diagnosis is fundamental to subsequent choices. Diagnostic errors occur in every health care setting and clinical area. Here, McGlynn et al discuss the newly released IOM report about diagnostic error and the most effective strategies for improving the diagnostic process.
Over the past 75 years, many medical and surgical specialties have emerged. In this Sounding Board article, the authors outline the history of medical and surgical specialization and ...subspecialization and frame the issues faced by the public and the profession.
At a time when most authorities believe that the country desperately needs more generalists, the American Board of Internal Medicine (ABIM) is adding new subspecialties. Specifically, in the past 2 years the ABIM has launched certification in the fields of hospice and palliative care and advanced heart failure and has begun a process for internal-medicine certification with a focused practice in hospital medicine. The ABIM has also approved the subspecialty of adult congenital heart disease to move forward to the American Board of Medical Specialties (ABMS) for final approval. In addition, the ABIM has received requests from specialty societies to . . .
Retail Clinics and Drugstore Medicine Cassel, Christine K
JAMA : the journal of the American Medical Association,
05/2012, Letnik:
307, Številka:
20
Journal Article
Recenzirano
Easy access to medical clinics in retail settings is gaining momentum in the US. While criticized in some quarters, these clinics are successful as measured by patient satisfaction and quality ...scores. Retail clinics hold potential for a uniquely US solution to the problem of access to primary care. Although questions remain about their future, evidence suggests that retail clinics may have an important role in US health care. Here, Cassel highlights the importance of retail clinics and drugstore medicine.
