Recently conducted research by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health, shows patients are by in large happy with their physicians, and skeptical that government guidelines-mandates on test, procedures and medications are going to be beneficial to them.
The survey included questions about electronic medical records, and coordination of care and comparative effectiveness.
What they found is that despite the fact that the media and politicians are calling for reform, the general public by and large is ambivalent to many of the specific ideas.
Electronic Medical Records
“The public holds mixed views when it comes to the use of electronic medical records, with most believing it is important to adopt EMR technology and that doing so would improve the country’s health care delivery system while at the same time questioning both the confidentiality of such a system and the potential for cost savings.”
Robert Blendon, who runs polling programs at the Harvard School of Public Health, revealed that 72 percent said if records were computerized, their own doctors were likely to do a better job of coordinating their care; 67 percent believed that the overall quality of medical care in the country would be improved; and 53 percent say there would be fewer medical errors.
However there are many issues with health care that Americans don’t agree with Obama on, primarily on the cost and privacy. "The overwhelming majority of Americans don't think an electronic medical record will either save their family or the country money," says Blendon. Instead, people see their costs going up instead of down, especially with all the potential for fraud, waste, abuse, training, and malpractice that will be associated with electronic health records.
The poll also showed that Americans doubt such records would remain confidential. Seventy-six percent said it's at least somewhat likely that "an unauthorized person" would get access to records placed online.
Regardless, even if people think that records should become computerized because Americans are now more experienced with computerized information, privacy and fraud are still highly likely.
Do we expect the public to easily forget how many social security numbers have been stolen this year alone from credit card companies?
Do Americans know that identify theft and fraud is the fastest growing crime in America? What happens when criminals know your personal health information?
Privacy issues concerning medical records will always be of paramount concern to citizens, regardless of if they are on paper or screen. While the government is going to one extreme to collect data and information exhaustively, patients are worried about the gaps in security and privacy that will result because of a lack of resources (which already plague many executive agencies like CMS).
More research and time must be spent on the interoperability of electronic health records for a significant period of time to allow doctors and patients to decide together the best options for care. Once that research and data is compiled, the government still needs to focus on what the patients want, and not what is best for cost effectiveness, but quality.
If electronic health records improve quality, and there is empirical evidence to show that, then patients and doctors together will follow. Until then, don’t fix something unless it’s broken. Obama and his Administration should worry more about losing $72 billion per year in fraud and waste through improper payments for health care first.
Treatment
Looking at the historical data (same survey year over year), the survey shows that their has been remarkable progress in coordinated care. In 2008 26% thought coordination of health professions was not a problem today (2009) 52% thought coordination of health professions was not a problem.
Roughly 50% of respondents thought overtreatment and ordering tests was a major problem, but the same group 67% thought that under treatment was a major problem. Of course when you asked them about their individual care less than 16% thought they were either over or under treated.
This disparity is what I call the perception disparity; we have problems with the practice of healthcare but no problems with my own health care. When we bring issues down to change in their personal healthcare, the debate will be significantly more
Comparative Effectiveness
The findings from this poll most importantly show that people do not want someone else to decide which treatment is best for them, and that people have a tremendous amount of trust for their own doctors, with “nearly two-thirds responding that their doctor is already taking steps to keep down the cost of their medical care.”
Moreover, people began to worry that their doctors would lose control over their health decisions when respondents were informed that the government would appoint members to the comparative effectiveness council, which makes expert recommendations about certain treatments, “
But it is the individual doctors that the public most trusts to make these decisions. In fact, Sixty percent of people polled said their doctors often tell them the reasons for the recommended treatment, and about half said their doctors talked to them about the scientific evidence for that treatment.
The ultimate finding of the new poll suggests that “to win over the public, any change in health care will have to keep a patient's own doctor at the center of decisions about treatment.”
Doctors are fine at making their own decisions, and a comparative effectiveness council that is government controlled will only put Uncle Sam’s hand over patients and doctors more than it already is (if that’s even possible).
The patients were also not thrilled with a Government sponsored committee to determine procedures and medications.
Overall patients are happy with their personal care, do not think their own physician is over ordering tests, medications and procedures, and skeptipal of a government mandated treatment program.
The survey shows doctors have a lot of personal assets in the reform debate and should use those assets to inform policy makers of their control and effect towards patient care.