ABIM President and CEO Highlights Role of Physician Assessments in Health Reform
Washington, DC, January 29, 2009 – Christine K. Cassel, MD, President and CEO of the American Board of Internal Medicine and board certified physician in Internal Medicine and Geriatrics, testified today before the Senate Health, Education, Labor, and Pensions Committee highlighting the importance of improving health care quality and value by integrating best practices into the delivery of medicine – and doing so with the full participation and investment of the physician community.
A co-author of the seminal Institute of Medicine (IOM) report, Crossing the Quality Chasm: A New Health System for the 21st Century (2001), Dr. Cassel commented on progress since the report was released and offered ideas on how to move forward to improve the quality of American health care. Read the full text of the testimony.
Dr. Cassel stressed the need to simultaneously focus on assessing and enhancing the skills and competencies clinicians need to practice in a 21st century system and the importance of physician involvement in the development of approaches to improve medical outcomes and constrain cost growth.
ABIM certifies about one in three physicians in practice today. Dr. Cassel noted that physicians welcome the opportunity to examine their practice if they can use that information to drive improvement. She noted that by integrating measures that better reflect physician practice, not only do we have the opportunity to raise the bar on the quality of care we deliver, we also can identify flaws in the current measures landscape. Dr. Cassel cited examples of the unintended consequences of some performance measures that, although well intentioned, have been less than perfectly executed:
“Our current performance measurement system assumes that a correct diagnosis has been made and may even result in performance payments that stem from faulty diagnoses.”
Dr. Cassel stressed that making the correct diagnosis and recommending an appropriate treatment plan requires up-to-date knowledge of new therapies, an evolving understanding of the strengths and weaknesses of existing therapies and, often, the skill to know how to manage and integrate multiple therapies. Maintenance of board certification in internal medicine tests medical knowledge and provides scenarios to assess clinical judgment and management. It also requires physicians to examine their own practices and develop a plan to improve their care.
Dr. Cassel also discussed the patient-centered medical home and underscored the importance of care delivery reform and aligning payment to support such models. System change alone cannot drive payment, physician skills and standards need to be part of the mix:
“Policy discussions about the patient-centered medical home … are largely focused on practice infrastructure and related payment models that can facilitate integrated and coordinated care, but fail to emphasize the competencies that physicians and other clinicians need to effectively meet the promise of the medical home concept. These competencies must be a part of primary care residencies and physicians in practice need support to work effectively in teams and engage patients in managing their chronic conditions, among other skills.”
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