Quality and Value

I applaud ASCO and the ABIM on the “Top Five" list—and President Link’s comments in this month’s ASCO Connection magazine (page 38) are right on the mark! It’s our responsibility to rein in costs and improve quality...we cannot expect to be able to continue to spend incessantly without delivering value and still be viewed as responsible citizens and guardians of the population’s well-being.

Last week, I attended the 2012 Yale Healthcare Conference—the theme was “Innovation in Healthcare: Forging Transformative Solutions.” As Karen Ignagni, President and CEO of America’s Health Insurance Plans (AHIP), delivered her keynote address, she acknowledged the leadership of professional organizations like ASCO in coming up with this list...we have the expertise to know what’s needed and not; we’ve done the research into quality, value, and outcomes; and the rest of the health care industry is relying on us to lead the charge to more fiscally responsible, evidence-based, quality care. It’s time that we all followed these "common sense rules.”

So why don’t we? For those who order unnecessary tests that are costly, potentially dangerous, and not evidence-based on the grounds of practicing “defensive medicine,” perhaps you ought to think about how to defend their practice against widely accepted clinical guidelines. For those who do so because “patients ask me to,” and/or “if I didn’t order it, someone else would,” you are your patient’s adviser and your own moral compass; take the time to educate them about the risks and benefits of tests and therapies—if all of us held ourselves to the same high standards of evidence-based care, this would not be an issue...

Ultimately, this is a time of tremendous opportunity for us as a Society and as individual oncologists to step up to the plate, set key standards, and lead the charge to improved quality and reduced costs—I’m proud that ASCO is doing just that.


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