Effective change in the health care system must begin with adjustments in physician behavior rather than legislation, despite the recent health care reform debate that has raged in Washington, D.C., according to a panel of health care experts from local medical facilities and non-profit physician groups.
The panel discussion held Thursday, "Current Challenges, Future Solutions," included four medical professionals seeking to address issues of inequality and injustice in health care and to help promote dialogue about the hotly-debated issue of health care reform.
"As a society, we are no better off than the least cared for," said Eugene Lindsey, president and CEO of Atrius Health, a non-profit alliance of five medical groups in Massachusetts. "In the long run, there are a lot of people who look at the realities of what we're spending now and it is an unsustainable system the responsibilities lie in the medical community."
Lindsey stressed that in order for the health care system to see positive changes from reform, physicians must first accept that they may face cuts in their future paychecks.
"There have been concessions from pharmaceutical companies, but not any revenue concessions from physicians," Lindsey said. "We still ask for a steady income stream."
John Butterly, executive director of Dartmouth-Hitchcock Medical Center, echoed Lindsey's sentiment, emphasizing that patient care must always remain the primary responsibility of any physician.
"We're paying attention to the wrong thing about getting paid and not how we're taking care of people," Butterly said. "Let's design a system to achieve our mission and we'll do well financially as well."
Lindsey said that one of the largest problems plaguing the health care field is that doctors employ "inappropriate use of the pen," prescribing unnecessary tests and procedures in order to make up for the high costs of buying and maintaining equipment.
Health care providers' unwillingness to change current practices is a leading contributor to the unnecessarily high costs of care, Butterly said.
"A lot of provider groups have the argument that we're still in the fee-for-service mode,'" Butterly said. "They think, If we change too quickly, we wont get reimbursed for what we're doing. Maybe we should maximize our reimbursement now, wait until people figure out what they're doing and then catch up'. Such a mentality is not patient-centered."
The United States spends the highest percentage of its gross domestic product on health care 15.3 percent, compared to the international median of about 9 percent, a trend that is "unconscionable and unnecessary," according to Harry Dorman, president and CEO of Alice Peck Day Memorial Hospital in Lebanon.
"I don't think that we have completely factored in the impact on our current practice of medicine on the economy," Lindsey said.
The United States is paying the most of any country for an inferior product, measured by consumer experience, Lindsey said.
The problematic role of money in the health care system is not one that is easily overcome, he added.
"It takes a lot of energy for our society to overcome the power of property," he said.
One way of cutting costs is to transition towards a more outpatient-based system, Bruce King, president and CEO of New London Hospital, said.
New London Hospital is a critical access hospital a small hospital mostly used for outpatient treatments. By reducing the time a patient spends in the facility, costs can be cut, King said.
"There needs to be a more efficient utilization of hospital resources," Lindsey said. "At the same time, growth of resources has to match the growth of the economy."
Currently, medical costs in the United States are higher than the Consumer Price Index, an index used to measure inflation, according to Lindsey.
Lindsey said that hospitals must be the ones to reevaluate how they provide care and must become more cost and time-effective, because consumers cannot indefinitely increase their spending on health care.
"The best health care is the least amount needed," Dorman said
The panel discussion was held on Thursday in Chilcott Auditorium as part of Dartmouth Medical School's Martin Luther King, Jr. panel series.
