Sources re Medicare Reform > the Chair of Family Practice at KU Medical School

[patrice]

http://www2.kumc.edu/fammed/freeman.html

This is a fellow I met during the Health Care debate last year. He is known to quote Physicians for National Health Program.

Regarding the matter of payments to providers: Dr. Freeman's most recent blogpost is titled: Greed Corruption and Medical Procedures: Ignoring or Suppressing the Evidence and it concerns the matter of the nature of scientific proof and other factors of concern that are involved in medical decisions made by providers.

http://www.medicinesocialjustice.blogspot.com/

This is not the first time that orthopedics organizations (which for some reason choose to use the British-style diphthong “orthopaedics” despite being Americans who do not make a practice of using other medical diphthongs such as haemorrhage, oesophagus, or oedema) have chosen to to attack evidence-based rules by political means. When, back in 1995, the Agency for Healthcare Policy and Research (now the Agency for Health Quality and Research, AHRQ) issued evidence based guidelines that recommended that certain popular (and remunerative) back surgeries for back pain were not very effective, the orthopedic groups were able to convince Rep. Henry Bonilla (San Antonio) to introduce legislation to de-fund the agency! (“Agency’s report provokes a revolt”, by Neil A. Lewis, NY Times September 14, 1995).That’s playing hardball! However, the procedure, vertebroplasty, was overused, usually didn’t work and often caused harm. Interestingly, mounting evidence of its inutility continues to this day, recently for vertebral fracture in the British Medical Journal, the results of which summarized by the editors of Journal Watch General Medicine.

I don’t want to pick especially upon orthopedists (or orthopaedists), although as high-income procedural specialists, they have been involved in more than their share of these issues. Many of the IOM’s recommendations involve procedures done by other specialists, including cardiologists. Indeed, we need to applaud the work of the academic cardiologists who have done the studies that show that many of these procedures that constitute a major source of income for their practicing colleagues (the pâté and vichyssoise if not the bread and butter) are not indicated.

The researchers doing this work are some of the true heroes of medicine. Those who hold on to evidence-free procedures because they make a lot of money from them need to be careful that they do not join the villains.

If you are interested in the issue of Medicare PAYMENT Reform, I hope you visit Dr. Freeman's blog as it is fully archived and quite searchable.

[RKP5637]

1. K&R !!! n/t