The Atlantic and Planning Accountable Care
CAL/AAEM News Service
calaaem.news.service1 at gmail.com
Tue Nov 9 08:05:04 PST 2010
November 2010
Lies, Damned Lies, and Medical Science
The Atlantic
Much of what medical researchers conclude in their studies is
misleading, exaggerated, or flat-out wrong. So why are doctors—to a
striking extent—still drawing upon misinformation in their everyday
practice? Dr. John Ioannidis has spent his career challenging his
peers by exposing their bad science.
IN 2001, rumors were circulating in Greek hospitals that surgery
residents, eager to rack up scalpel time, were falsely diagnosing
hapless Albanian immigrants with appendicitis. At the University of
Ioannina medical school’s teaching hospital, a newly minted doctor
named Athina Tatsioni was discussing the rumors with colleagues when a
professor who had overheard asked her if she’d like to try to prove
whether they were true—he seemed to be almost daring her. She accepted
the challenge and, with the professor’s and other colleagues’ help,
eventually produced a formal study showing that, for whatever reason,
the appendices removed from patients with Albanian names in six Greek
hospitals were more than three times as likely to be perfectly healthy
as those removed from patients with Greek names. “It was hard to find
a journal willing to publish it, but we did,” recalls Tatsioni. “I
also discovered that I really liked research.” Good thing, because the
study had actually been a sort of audition. The professor, it turned
out, had been putting together a team of exceptionally brash and
curious young clinicians and Ph.D.s to join him in tackling an unusual
and controversial agenda.
For the rest of the article, go to: http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269
November 1, 2010
Planning Accountable Care Organizations
Kaiser Health News
American Medical News: "The National Committee for Quality Assurance
is seeking input from the public on draft accountable care
organization standards," which "were drafted by the organization's
Accountable Care Organization Task Force comprising representatives
from large integrated health care systems, academia and the insurance
industry. ... Establishing ACOs for Medicare and Medicaid
beneficiaries is a key part of health system reform legislation" (11/1).
Modern Healthcare: California's experience with ACOs may help predict
whether accountable care organizations, which "bring together
providers and then reward them for taking responsibility for the
quality of care for their patients while controlling costs," will work
under the Affordable Care Act. "In California, many providers have
been working in ACOs for decades, and they say they can work well--
although there are pitfalls and limitations." Currently, around "half
of insured Californians receive their care through some type of ACO."
According to one expert, California's experience demonstrates that
"[a]ligning incentives and strong leadership are more important than
the actual institutions;" that "varied payment mechanisms, instead of
a one-size-fits-all approach, such as capitation" are important; and
that "ACOs must not be fixed to only one insurance type." A pressing
question is whether care coordination can "work in a PPO environment
where consumer choice reigns. ... Pilot projects are under way in
California that seek to collaborate among providers and payers across
business lines" (Vesely, 11/1).
Anna Parks &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine
Contact us at: calaaem.news.service1 at gmail.com
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