Much of the shortage of primary care physicians expected over the next decade could be eliminated if the nation increases use of new models of medical care that expand the role of nurse practitioners and physician assistants.
Being able to provide high-quality health care is a primary driver of job satisfaction among physicians, and obstacles to quality patient care are a source of stress for them. For example, the systems for electronic health records in use today are cumbersome to operate and contribute to their dissatisfaction.
Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.
California health regulators should begin collecting physician identifiers as part of their routine data collection efforts about the services provided at the state's hospitals. Such a move would help providers improve quality by aiding efforts to benchmark performance and reduce variations in the delivery of care.
Health care providers are encouraged to implement “shared decision making” in which patients and doctors together choose the treatment that is best for each patient. However, doctors need more instruction on how to engage patients and better information systems to make sure patients know their options and receive individualized care.
Commercial health plans and Medicare are using cost profiles to identify which physicians account for more health care spending than others, while devising strategies to reward those who provide quality care at a lower cost. Doctors with less than 10 years of experience had 13.2 percent higher overall costs than those with 40 or more years of experience.
People who visit retail medical clinics are less likely to return to a primary care physician for future illnesses and have less continuity of care. However, no evidence suggests that retail medical clinics disrupt preventive care or management of diabetes, two important measures of quality of primary care.
Promoting immunizations as a part of routine office-based medical practice is needed to improve adult vaccination rates, a highly effective way to curb the spread of diseases across communities, prevent needless illness and deaths, and lower health care costs.
A new online tool, called the "Unintended Consequences Guide," is available from the U.S. Agency for Healthcare Research and Quality to help hospitals and other health care organizations anticipate, avoid, and address problems that can occur when adopting and using electronic health records.
Most Massachusetts physician groups are using results from a statewide patient survey to help improve patient experiences, but a significant number are not making use of the information or are making relatively limited efforts.
Profiles created for physicians based on the cost of the care they provide can vary widely depending upon the methods used by insurance companies to create the profiles.
Rewarding primary care physicians for providing better care to patients could end up widening medical disparities experienced by poorer people and by minorities. Increasing the number of primary care physicians is also not enough to boost U.S. health care quality and lower costs.
Increasingly common insurance plans that encourage patients to receive care from physicians who keep medical costs lower are based on unreliable estimates of doctor performance and may not achieve the intended savings.