SPECIAL REPORT: Dr. David Schale, president, Kern Radiology
| Thursday, May 28 2009 06:21 PM
Last Updated Thursday, May 28 2009 06:21 PM
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Dr. David Schale
Health-care reform is desperately needed, requiring action from Washington to accomplish a careful, thorough overhaul. Optimally, there would be revolution rather than an evolution of American health care.
Extensive change requires a broad diversity of involvement. As a radiologist in a private practice employing about 185 and volunteer team physician for Foothill High School, I have a few observations.
Lack of access to quality health care is the fundamental problem. As heavily taxed as we our, this should not be an issue. Our system is currently far too inefficient to deliver without ridiculous increases in expenditures.
Reform in the delivery system will increase efficiency and quality. One source of wasteful spending is “physician self-referral,” where doctors invest in expensive equipment and then use it on their patients, resulting in over-utilization and increased health-care costs.
Aggressive care for patients with hopeless conditions, when comfort care would be more appropriate, dramatically increases costs. This “futile care” demands a society-wide discussion of priorities in health care.
Pharmaceutical advertisement of prescription drugs directly to the public dramatically increases pharmaceutical costs without significant patient benefit.
The Joint Commission for the Accreditation of Hospitals intermittently inspects all hospitals wishing to be reimbursed by Medicare. We are forced to discard perfectly good, non-outdated sterile supplies, driving up health-care costs in the name of “quality assurance.” Other expensive requirements placed on hospitals are questionable and lead to staff frustration and high turnover rates, especially among nurses. We must reformat “quality assurance” to focus on patient well-being.
We must also consider restructuring physician pay (primary care specialties are underpaid); personal responsibility; the insurance industry and cost structures; HMOs and emphasis on preventive health; keeping health care in the primary care office; and controlling legal costs.
Obviously health care is a behemoth topic but I fervently hope for a positive outcome.
