The way Dr. Christine Cassel sees health care, physicians have two fundamental responsibilities: First and foremost, physicians must take care of their patients as best they can. But Cassel also believes physicians need to serve as stewards of society’s resources.
“This is something that has not always been embraced by my profession, but I think a really important aspect of what it means to be a good doctor is to advance health care that is mindful of not being wasteful,” Cassel said. “The profession needs to be accountable to itself and to the public for being up-to-date on knowledge of science and being sure to deliver the highest possible quality of care.”
In today’s 10:45 a.m. morning lecture in the Amphitheater, Cassel will speak about what kinds of information 21st-century patients and families need to have to be informed health care consumers. She also plans to explore some of the ways consumers can access this information.
Cassel is president and CEO of the National Quality Forum, the gold standard for health care measurement in the U.S. that aims to empower health care consumers with the information and tools they need to make important decisions. She will draw on her experience with the NQF to provide information about both the quality and also the cost of health care.
Cassel explained that the methods for communicating the quality of health care have changed drastically. In the past, patients would find out about the quality of a particular doctor or facility through word of mouth or, more rarely, through magazines ranking the top doctors and hospitals.
Now, there’s been a “proliferation of Internet sites that are ranking everybody in the world,” Cassel said, and “every hospital in the country has a billboard saying they’re No. 1 in somebody’s ranking.” This sort of chaos isn’t helpful for consumers.
“There is actually a science behind how you measure quality of care that has advanced enormously in the last decade,” Cassel said. “But consumers … don’t know anything about that. It’s very technical stuff. So one of the things I’m going to point out is that the savvy consumer is going to be getting more and more of this information and is going to need to have some guidance through the jungle of information about health care quality.”
Cassel also hopes to better equip consumers to sift through the “political shouting match about rationing and death panels” and to more realistically evaluate the cost of health care.
“There have actually been surveys showing that consumers think that higher-priced health care means that it’s better,” Cassel said. “In other parts of your life, that’s not the case; you understand that if you shop around for a good car, it’s not necessarily the most expensive car that’s going to be the best car or the most reliable car. But in medical care, there hasn’t been that much useful information that consumers can base their decisions on.”
With that lack of information in mind, Cassel helped to establish Choosing Wisely, an online initiative to promote conversations between patients and their doctors. Choosing Wisely provides information from trusted specialists in 40 different areas of medicine, information which is then translated for patients by consumer intermediaries such as Consumer Reports, AARP and Wikipedia.
“Instead of being scared that an insurance company is keeping a patient from getting what is needed,” Cassel said, “the patient is empowered to ask the doctor, ‘Do I really need this test, or can’t I wait a couple weeks to see whether I get better?’ So trying to say more is not necessarily better. Consumers need to feel empowered to ask doctors some tough questions, but they need to have trusted information if they’re going to begin to think that way.”
Cassel’s underlying philosophy is that health care should be recognized as a human right and that it needs to be delivered as efficiently as possible.
“I know that our country has not always endorsed health care as a right, but I think most other advanced countries have endorsed that concept,” Cassel said. “Once you open that possibility, the question is, between the private sector and the public sector, how do you put that philosophy into action? The Affordable Care Act is one step in the right direction, but it still leaves some people without insurance; and for some of the people who will have insurance, it still isn’t the kind of insurance that really gives you access to coordinated care of all of the kinds that you need.”