Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Health care is not affordable for everyone, there are great disparities in access and many are uninsured, yet it is a right. There's unexplained, if not unwarranted variation in care management's quality, practice, cost-efficiency, effectiveness, and caring, itself; some of that explains why the U.S. spends more with oftentimes worse results when compared to many other industrialized nations. It's time for reform and the current recession can be the stepping stone if not the catalyst we need. What's missing from reform proposals is at once fundamental and absolutely required; it is being aware of what's going on and what is not. This is a call for measurement and management.
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EBM is a term fostered by Dr. Gordon H. Guyatt (a Hamilton, Ontario internist) and colleagues [JAMA, 1992]. According to The Centre for Evidence-based Medicine (Univ. of Oxford, UK) , it is the "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research."
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A broad range of players, some non-traditiona, aiding patients and clinicians to improve patients' quality of life and other outcomes, a discussion worth having.
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