Shifting health care from hospitals to the community will only be justified if patient satisfaction and convenience is valued above costs to the NHS, or if this shift reduces health care costs in the long term.
Clinicians are more likely to prescribe antibiotics inappropriately when they are feeling rushed, don't feel strongly that antibiotics are overused, and don't think patient demand for antibiotics is a problem in their practice.
Health system leaders should view regular and detailed assessment of physician professional satisfaction as an invaluable early warning system for potential threats to quality and safety. But simply surveying doctors on their overall levels of job satisfaction isn't enough.
Increasing the number of physicians who can prescribe buprenorphine for opioid abuse and supporting their ability to treat more patients may be the fastest approach to enhancing capacity for treatment, particularly in less populated counties.
This Perspective revisits an earlier critique of ProPublica's Surgeon Scorecard and explains in detail why ProPublica's subsequent rebuttal of our work fails to address our methodological concerns about the Surgeon Scorecard.
There is no tradeoff between recognizing the serious methodological problems in the ProPublica Surgeon Scorecard, improving the Scorecard, and encouraging providers to release their own data. All three can and should be done simultaneously.
ProPublica's Surgeon Scorecard displays "Adjusted Complication Rates" for named surgeons for eight surgical procedures performed in hospitals. This perspective critiques the methods of the Scorecard and identifies opportunities for improvement.
Use of buprenorphine, a drug to treat opioid addiction, is increasing faster than the number of doctors licensed to dispense it. Policies focused on increasing the number of patients a qualified physician could treat may be more effective in addressing this increased use than other alternatives.
The increased number and geographic distribution of physicians obtaining waivers to prescribe buprenorphine has widened potential access to effective treatment for those with addiction to heroin or prescription painkillers.
Using tools that help physicians decide whether to use expensive imaging studies such as MRI scans can help reduce the ordering of unnecessary tests, but implementation of the tools in real-world settings has many challenges.
The authors developed an updated and expanded set of buprenorphine treatment guidelines; this additional guidance may increase credentialed physicians' comfort with prescribing buprenorphine to patients with opioid use disorders.