Both doctors and patients have a strong bias to “do something” rather than nothing, even when “something” ends up being unnecessary, risky and incredibly costly. Death rates from thyroid cancer have remained virtually the same since the introduction of high-tech screening methods. Is the increased volume of detection and treatment actually saving lives – or is it subjecting patients to unnecessary care, risk and expense? For instance, my wife had thyroid surgery a few years ago and ended up with nerve injury that made it difficult to sing. In her case, the surgery was necessary, but imagine how badly we would feel if it had not been.
Gawande provides additional examples of how our current system tends to compensate doctors for “more” care, but not necessarily better care. There is hope: alternative payment models, such as accountable care organizations (ACOs) that reward providers for overall results and quality – instead of just volume – are taking hold and generating significant savings along with improving patients’ lives.
Blue Shield is a nationally-recognized leader in establishing innovative provider partnerships, like ACOs, and we are continually looking for ways to drive better health outcomes through coaching and educational programs. Gawande believes that approaches such as these – which provide the right level of care and necessary support for patients with a complex chronic condition – can make a substantial difference in helping them avoid unnecessary treatment, complications and expense.
Watch for future blogs from me and other Blue Shield leaders to learn more about how Blue Shield is working with providers to deliver quality health care.
Marcus Thygeson, M.D., M.P.H., is senior vice president and chief health officer at Blue Shield of California