How We Pay Our Doctors Might Be Killing Us | Big Think

How We Pay Our Doctors Might Be Killing Us

New videos DAILY

Join Big Think Edge for exclusive videos

----------------------------------------------------------------------------------

Mayo Professor and Director, Dr. Nicholas LaRusso, says we need universal access, coordinated care, value and payment reform.

----------------------------------------------------------------------------------

Nicholas F. LaRusso:

Nicholas F. LaRusso, M.D., Charles H. Weinman Endowed Professor of Medicine, is Director of the Center for Innovation at Mayo and a Distinguished Investigator of the Mayo Foundation.

Prior to becoming Center Director in 2008, he was Vice Chair for Research of the Department of Medicine (DOM), Chair of the Division of Gastroenterology and Hepatology, and Chair of the DOM at Mayo Clinic. Before assuming a faculty position at Mayo in 1977, he was a guest investigator at the Rockefeller University in the laboratory of the Noble laureate, Christian de Duve. A member of the American Association of Clinical Investigation and the Association of American Physicians, he is the former editor of GASTROENTEROLOGY and past president of the American Association for the Study of Liver Diseases (AASLD). Among other honors, he is a recipient of a MERIT Award and the Principle Investigator on two R01s from the NIH; he also received Distinguished Achievement Awards from both the American Gastroenterological Association (AGA) and the AASLD, and the Distinguished Mentor Award of the AGA. He is currently President of the AGA.

He received his undergraduate degree (magna cum laude) from Boston College, his M.D. degree from New York Medical College, and his training in internal medicine and gastroenterology at Mayo, the latter as an NIH fellow in the laboratory of Alan Hofmann.

----------------------------------------------------------------------------------

TRANSCRIPT:

question: How should healthcare be overhauled?

Nicholas LaRusso: Our new president [Barack Obama] has identified as one of his three major areas of attention, health care which by the way I personally applaud and Mayo has worked through its health policy institute to articulate the four pillars that are necessary for transforming healthcare. Those 4 pillars then provide the environment with which the Center for Innovation, and innovation across the country in health care delivery can evolve.

Those pillars are pretty simple. Conceptually, they include creating value, coordinating care, restructuring the payment system, and providing universal access. Those are the four pillars.

For the innovations that we envision helping to catalyze through our Center activities, to be maximally effective, there needs to be policy changes that address those four areas. Care coordination, value, payment reform and universal access.

Topic: An example of healthcare reform.

Nicholas LaRusso: If you’re in charge of a delivery system, and you’re being reimbursed because of the quality or value of the care that you provide, and because of the coordination that you provide, rather than on the number of tests that are done, then that provides a whole different set of incentives for you to reorganize the way you deliver health care.

This gets back to one of the four pillars of our policy initiative, and that is payment reform. Right now the payment system results in just what you expected it to do. That is, if people get paid because they do a lot of stuff, they’re going to keep doing more and more stuff to get more and more pay. But if you pay people for the quality of what they deliver, and you define quality or value, and you have metrics for value, and you make those metrics publicly available so the consumer knows where to go to get the highest value care, and you coordinate things.