Healthcare Reform Controversy Focuses on Diabetes Case

Healthcare reform has dominated the headlines and stirred passions from both sides of the aisle in Congress. However, one idea that is gaining steam with some members of Congress has critics up in arms. The concept, which is already being used by some insurers already use, calls for providing doctors with a roadmap on how best to treat patients with a particular disease and then rewarding those medical professionals that follow those guidelines. Read the full article here:

Standards of care are nothing new. Whether issued by the American Diabetes Association or the American Association of Clinical Endocrinologists, they serve as a comprehensive starting point. I think that if a checklist sort of thing were to be used by overworked doctors to ensure that they don’t miss anything then both doctors and patients would benefit. This sort of thing is in pace at Johns Hopkins and has resulted in a substantial decrease in their infection rates. As you might imagine, implementation was greatly resisted since it focused on basics like hand washing, IV insertion, etc.

What is different is that compensation for providers would be tied directly to adhering to these guidelines. I think that would be a great motivator, especially for practitioners outside the hospital setting. A basic set of standards could also be provided to patients to facilitate compliance, but more importantly to enable them to be an informed consumer of heath care services.

Quality Standards are fine. I make a living as a Quality Control Technician. However, quality levels are instituted to maintain an “average” level. What happens with those patients that need care on levels above the standard. The unknown factor is whether or not the standard is “good enough” and above levels will or will not be part of the program. In my case the ADA and the AACE standards are not stringent enough to maintain my health. Both standards place me in jeopardy of complications caused by my diabetes. I set the standard for my care because my GP was not informed enough to know better and was actually preparing me for the “inevitable” complications.

Part of my job in the hospital setting was to make sure that my department met all Federal, State, and local requirements and to make sure that the department fared well under the “eagle eye” of the Joint Commission. I also served on the cardiac team that developed standards of care for cardiac patients especially those undergoing open heart surgery. These standards of care were not developed overnight nor were the policies and procedureds that were developed by each department. The Standards of Care were constantly being tweaked to make sure that patients were receiving optimal care using the latest technologies…

One of my concerns is whether these Standards of Care would be developed over a period of time by people who are truely tuned in to the needs of the diabetic and are aware of the latest treatment techniques. Or would they just be thrown together using antiquated methods of treatment, i.e. sliding scales, etc.

As Tom said Standards of Care are nothing new. But again we are talking about the government getting involved in something they know nothing about.

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