The authors, Mark A. Kelley, MD, CMO of Henry Ford Health System, and Robert Huckman, a professor at Harvard Business School, say that instead of providing information to help patients choose a provider once a certain treatment has been selected, “perhaps patients are seeking an answer to a more fundamental and personal question: ‘Is the proposed treatment or procedure the best option given my condition, my financial status, and my social or family situation?'”
The authors promote shared decision-making, where physicians present clear information on risks and outcomes as a better alternative than leaving it to patients to interpret statistical information after a treatment decision has largely been made. However, they warn shared-decision making faces several roadblocks:
“Most clinicians have neither the time nor the financial incentives to make such investments, especially in a fee-for-service environment. With physicians motivated to provide more care and patients lacking the information to question such care, there are few natural brakes on medical utilization. By focusing patients on choosing between providers of specific services, current public reporting thus does little to keep the proverbial horse of medical utilization inside the barn. Indeed, it provides a guided path for its escape.”
For educated consumers who are confident in their course of treatment, current quality data can empower them to choose the best provider for their needs, and that’s a great thing. But I do agree with the authors that quality transparency, just like pricing transparency, has a long way to go.
