Tuesday, May 12, 2009

More on the three magic elements of reforming health care.

To reform" health care" (and to fix the nation's economy) we are told we must have electronic medical records, government funded and managed comparative effectiveness research and more prevention.

In regard to the first I strongly recommend that you go here and read about just how much trouble there has been so far with the security of computerized medical information and why does anyone really believe that problem will just go away. Go here to see a good summary of other non-security related serious issues with the EMR proposed panacea.

In regard to the second I strongly recommend that you go here to learn the real reason that Dr.Rich favors government funded and managed comparative effectiveness research which he designates as "CER" as opposed to the generic term of cer. Dr Fogoros makes the argument that all cer may be biased so it is not the case that he favors CER because it will be not biased.Read his entry to see where his argument goes. I suspect more that a few advocates of CER will not be pleased.

Of course, even if we have much more cer with the addition of the CER to the data base, it will be all for nothing unless the medical profession gets on board and acts according to the published comparative effectiveness research. The grand guru daddy of the hospitalists. Dr. Bob Wachter suggests for those who won't go along they should be". dragged" along. Wonder who will be doing the dragging. In the new world of CER,will there be the draggers and the dragees? You betcha.Dr. Wachter in his dragging proposal is less concerned than is the new AMA president regarding the risk of malpractice suits if adherence to the CER directed guidance leads to the withholding of certain procedures that arguably lead to bad patient outcomes.

All in all it may be a good time to be a retired doc but as for being a patient, not so much.

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