 |
|
CLINICIAN'S CORNER
How Physicians Can Change the Future of Health Care
Michael E. Porter, PhD, MBA;
Elizabeth Olmsted Teisberg, PhD, MEngr, MS
JAMA. 2007;297:1103-1111.
Today's preoccupation with cost shifting and cost reduction undermines physicians and patients. Instead, health care reform must focus on improving health and health care value for patients. We propose a strategy for reform that is market based but physician led. Physician leadership is essential. Improving the value of health care is something only medical teams can do. The right kind of competition—competition to improve results—will drive dramatic improvement. With such positive-sum competition, patients will receive better care, physicians will be rewarded for excellence, and costs will be contained. Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care. Three principles should guide this change: (1) the goal is value for patients, (2) medical practice should be organized around medical conditions and care cycles, and (3) results—risk-adjusted outcomes and costs—must be measured. Following these principles, professional satisfaction will increase and current pressures on physicians will decrease. If physicians fail to lead these changes, they will inevitably face ever-increasing administrative control of medicine. Improving health and health care value for patients is the only real solution. Value-based competition on results provides a path for reform that recognizes the role of health professionals at the heart of the system.
Author Affiliations: Harvard University, Cambridge, Mass (Dr Porter); Darden Graduate School of Business, University of Virginia, Charlottesville (Dr Teisberg).
RELATED LETTERS
Changing the Organization of Health Care
Afschin Gandjour
JAMA. 2007;298(3):286.
EXTRACT
| FULL TEXT
Changing the Organization of Health Care
Truls Østbye and Lloyd Michener
JAMA. 2007;298(3):286-287.
EXTRACT
| FULL TEXT
Changing the Organization of Health Care—Reply
Michael E. Porter and Elizabeth Olmsted Teisberg
JAMA. 2007;298(3):287-288.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Perspectives on Medical Outsourcing and Telemedicine -- Rough Edges in a Flat World?
Singh and Wachter
NEJM 2008;358:1622-1627.
FULL TEXT
The GAAP in Quality Measurement and Reporting
Pronovost et al.
JAMA 2007;298:1800-1802.
FULL TEXT
Competition on Outcomes and Physician Leadership Are Not Enough to Reform Health Care
Dixon et al.
JAMA 2007;298:1445-1447.
FULL TEXT
Changing the Organization of Health Care
Gandjour
JAMA 2007;298:286-286.
FULL TEXT
Changing the Organization of Health Care
Ostbye and Michener
JAMA 2007;298:286-287.
FULL TEXT
Chronic Kidney Disease and the Public Health: Gaps in Evidence From Interventional Trials
Himmelfarb
JAMA 2007;297:2630-2633.
FULL TEXT
Access to Care as a Component of Health System Reform
Fontanarosa et al.
JAMA 2007;297:1128-1130.
FULL TEXT
|
