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PRESIDENT'S MESSAGE
Why We Need to Lead
 During
recent conversations with Harvard Pilgrim Health Care (HPHC) about
its new imaging-prenotification program (see article),
MMS officers and the Task Force on Medical Cost Control had difficult
decisions to make: Should we collaborate with the health plan to
address the serious problem of rising diagnostic-imaging costs,
wage an informational campaign against what seemed like a unilateral
and retrogressive approach to cost control that could potentially
delay patient access, or accept another set of administrative burdens.
We chose the "high road" by engaging HPHC in a constructive
dialogue to address its concern that diagnostic-imaging costs are
rising at an unaffordable rate.
When I first heard about HPHC's new policy,
I was surprised, because in other arenas, we have forged and maintained
productive, proactive idea exchanges with HPHC and other Massachusetts
health plans. A unilateral pronouncement was not the way the MMS
had expected health plans to deal with physicians or the rising
cost of care. In reaction, many of our members expressed frustration
and anger about the imposition of a program that further increased
administrative burdens on their practices.
We chose to put ourselves into proactive, participatory
conversations with HPHC because physicians make decisions that drive
the majority of health care costs, and it's therefore incumbent
upon us to be hands-on participants in any remodeling of the health
care system. One prime arena for physician leadership is the development
of imaging guidelines that will assist in effectively diagnosing
patients while containing costs. Without our input, the health care
system will not advance in a way that benefits patients. Health
plans need to understand that physicians are essential to achieving
meaningful reforms -- and that we will neither shirk our responsibilities
nor relinquish our appropriate role in decision-making.
Going forward, we hope to expand this spirit
of cooperative and transparent problem solving. Only solutions developed
jointly by physicians, health plans, and other stakeholders will
end up achieving effective and efficient use of medical resources,
while maintaining high-quality care.
Physicians need to lead the evolution of the
health care system. We have to become increasingly involved in the
change process and encourage our colleagues to embrace information
technology and the appropriate use of guidelines and protocols.
We also need to respond to the stressors on the system, one of which
is uncontrolled cost escalation.
For the good of our patients at this critical
juncture, no party in the multilateral effort to fix the health
care system can afford not to collaborate.
- Alan C. Woodward, M.D.
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