The Courage to Improve

Inspired by Dr. Gawande’s thoughts on waste in the healthcare system and what we can do about it.

Did you catch Dr. Atul Gawande’s recent article in The New Yorker (May 11, 2015). It’s entitled, “Overkill. An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?” It’s a follow-up to an article he wrote six years ago called “The Cost Conundrum: What a Texas town can teach us about healthcare.” Both articles tackle the  issue of healthcare costs in the United States. As I read his latest article and went back to recall his earlier one, I found myself admiring the courage it took for Dr. Gawande to write them. As a healthcare provider himself, you might think he’d like to brush the topic under the rug and hope that people don’t give it much thought. But he does exactly the opposite.

In “The Cost Conundrum” (2009), Dr. Gawande had reminded us that “Our country’s health care is by far the most expensive in the world. In Washington, the aim of healthcare reform is not just to extend medical coverage to everybody but also to bring costs under control.” Likely to the dismay of many in McAllen, Texas, Dr. Gawande looked to that community for answers since McAllen was at the time one of the most expensive healthcare markets in the country. Dr. Gawande had written that “In 2006, Medicare spent fifteen thousand dollars per enrollee here (McAllen), almost twice the national average” and “three thousand dollars more per person here than the average person earns”. He compared McAllen to El Paso, another Texas community with essentially the same demographics and generally the same healthcare offerings and services (“neonatal intensive care units, advanced cardiac services, PET scans, and so on”) but with Medicare expenditures (which he cited as ‘our best approximation of overall spending patterns’) in 2006 at about half as much as in McAllen. Continue reading the complete article on GE Health IT Views.

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