This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (1)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Health Policy  • Prognosis/ Outcomes  • Alert me on articles by topic

Jennifer Dixon, MBChB, MSc, PhD; Cyril Chantler, MBChB; John Billings, JD

JAMA. 2007;298:1445-1447.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Society flies blind when it comes to health care. The value of treatments to patients, in particular with respect to health gain, is not routinely measured. As a result, reforms focus less on improving health and value to patients and more on cost minimization; consequently, such reforms are led by administrators, not physicians. Physicians are disgruntled and disenfranchised, and perversities result such as, in the United States, cost shifting and other forms of dysfunctional competition. The way forward is for physicians to seize the initiative, take as their goal improved value of care to patients, organize medical practice around medical conditions and care cycles, and measure risk-adjusted outcomes and costs, all within a competitive health system. Positive-sum competition for value to patients will result that only physicians can deliver. Tinkering with financial incentives in the system will never be . . . [Full Text of this Article]

Where Physician Leadership Has Been Lacking

Author Affiliations: King's Fund, London, England (Drs Dixon and Chantler); and Wagner School of Public Service, New York University, New York, and King's Fund (Mr Billings).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Competition and integration in the English National Health Service
Ham
BMJ 2008;336:805-807.
FULL TEXT