The Value Tension

I spent this past weekend discussing internal medicine’s future with colleagues.  We spent our time forecasting, predicting and prioritizing.  During those discussions the concept of the value tension evolved. So why is the definition of value so important to internal medicine (and all other medical fields).  The MACRA website: The MACRA will help us to move more quickly toward our goal of paying for value and better care. It also makes it easier for more health care providers to successfully take part in our quality programs … One might assume that value is easy to define.  Congress must believe that we can measure value.  But many physicians believe that value has different meanings to various stakeholders.  Insurance companies (and we should include CMS here) adopt performance measurement as their definition of value.  Yesterday’s post reflects on the folly of that definition. Patients do not have one definition.  Patients are not homogeneous, rather their desires vary rather widely.  Here are some criteria that I have heard from friends: Accessibility Visible evidence of caring (looking at the patient, appropriate touching, listening carefully) Shared decision making Making a correct diagnosis After a correct diagnosis, knowing the most current treatment approaches Clear explanations Physicians also view value in various ways.  Most internists want sufficient time to address all the patient’s needs.  We want to make correct diagnoses....
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs