AJMS Presents Highlights of Town Hall Meeting on Economic Challenges in Health Care COSEHC

Newswise — While proposed solutions vary, it's clear that new approaches are needed to meet the economic challenges facing the U.S. health care system. The proceedings of a recent "Town Hall Meeting" on changes in health care economics and their impact on the quality and practice of medical care—held at the 2008 Annual Scientific Sessions of the Consortium for Southeastern Hypertension Control (COSEHC) in Baltimore—are summarized in the June issue of The American Journal of the Medical Sciences (AJMS), official journal of the Southern Society for Clinical Investigation. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

"Altogether, it is evident from the presentations at the COSEHC Town Hall meeting that we are in a time when traditional health care delivery systems are no longer capable of meeting the needs of the patient population or providing the necessary resources to address the epidemic of chronic diseases in the U.S.," according to an introductory article by Dr. Carlos M. Ferrario of Wake Forest University School of Medicine and co-authors. They summarize the talks given by a distinguished panel of experts who spoke at the Town Hall Meeting.

Diverse Viewpoints, but All Agree on Need for ChangeThe current financing of the U.S. health care system is "inefficient, inequitable, and fiscally unsustainable," according to a presentation by Dr. Ezekiel Emanuel, Chair of the Department of Bioethics at the National Institutes of Health. Dr. Emanuel urged exploration of alternative approaches to health care financing, such as guaranteed access plans or incremental reform of current plans. He also emphasized the need for increased use of electronic medical records and the creation of a medical saving account with catastrophic insurance.

Meanwhile, the passage of the American Recovery and Reinvestment Act, signed by President Obama earlier this year, has provided significant increases in funding for health care, including expanded coverage for children. Dr. Emanuel now serves as health care advisor to the Obama Administration.

Physicians need to start considering patients as consumers who play an active role in purchasing medical and health care services, said Dr. Trenor Williams of Clinovations, LLC. Based on the findings of a recent consumer survey, Dr. Williams sees patients as "becoming proactive and moving into a market driven by an informed consumer." The survey suggests that patients are seeking alternative sources of information on health care quality and willing to travel outside their community—or even outside the United States—to seek medical care.

Speakers Emphasize Paying for Quality, Maintaining ProfessionalismIn the past, health care was provided with little attention to prevention or quality of care, according to a presentation by Dr. Lanny R. Copeland of LifePoint Hospitals, Brentwood Tenn. Dr. Copeland sees a "crisis in primary care"—fewer physicians are seeking careers as primary care doctors, and medical education has not kept up with the demand for generalist physicians. Dr. Copeland thinks physicians need to play a leading role in developing a new health care system emphasizing continuous quality improvement—with doctors being rewarded for the quality, rather than the quantity, of care provided.

Dr. Thomas Valuck of the Center for Medicare and Medicaid Services (CMS) reviewed the CMS's Quality Improvement Roadmap, emphasizing the need to develop specific measures of quality in health care. He believes that Medicare must transform itself from a "passive payer" to an "active purchaser" of higher-quality, more efficient care.

Dr. Ferrario was co-chair of the Town Hall Meeting, along with Dr. Marvin Moser of Yale University School of Medicine. In closing remarks, Dr. Moser emphasized a different type of challenge: the need for physicians to maintain professionalism as health care shifts to an atmosphere of "systems and business." Dr. Moser voiced special concern about the increasing influence of industry in medicine and the overuse of technology in place of clinical judgment. He concluded, "These problems must be addressed if we are to change the system of health care delivery and make health care available to more people at a reasonable cost."

About The American Journal of the Medical SciencesFounded in 1820, The American Journal of the Medical Sciences (AJMS) is the official journal of the Southern Society for Clinical Investigation. Regular features include Clinical and Basic Investigation studies, Reviews, Historical Articles, Case Reports, Images in the Medical Sciences. Other special features include contributions from the Southwestern Internal Medicine Conference, Cardiology Grand Rounds from the University of North Carolina and Emory University, Case Records of the VA Maryland Healthcare System/University of Maryland Medicine, and Clinical Pathological Correlation from Texas A&M Health Science/Scott & White Memorial Hospital. The AJMS publishes original articles dealing with topics such as infectious disease, rheumatology/immunology, hematology/oncology, cardiology, pulmonology/critical care, gastroenterology, nephrology, neurology and endocrinology. Visit the journal website at www.amjmedsci.com.

About the Southern Society for Clinical InvestigationFounded in 1946, the Southern Society for Clinical Investigation (SSCI) is a regional academic society dedicated to the advancement of medically-related research. Its major focus is on encouraging students and postgraduate trainees (residents and fellows) to enter academic medicine and to support junior faculty success in clinical investigation. SSCI members are committed to mentoring future generations of medical investigators and promoting careers in academic medicine. Visit the SSCI website at www.ssciweb.org.

About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

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