About 50 physicians and health care leaders gathered in Madison on Tuesday for a health care forum sponsored by the Wisconsin Medical Society featuring Don Berwick, MD, MPP. A pediatrician, Dr. Berwick was administrator of the Centers of Medicare & Medicaid Services (CMS) from 2010 to 2011 and served as president and CEO of the Institute for Healthcare Improvement (IHI) for nearly 20 years.
“Don Berwick has devoted his professional life to creating strong communities and saving lives,” said Molli Rolli, MD, chair of the Society’s Board of Directors, in her introduction. “He continues on a relentless journey to improve our health care system and to enhance the lives of every American regardless of where they are from and regardless of how much money they earn.”
In his opening remarks, Dr. Berwick said Wisconsin was special to him because of work being done in Madison when he became involved in health care quality in the mid-1980s, because his wife attended law school at the University of Wisconsin and because of the “pioneering” work of health care leaders in the state.
“For the entire time that I’ve been obsessed with how to make health and health care better, I keep finding the kind of vision that I see in the very people who are here today,” he said.
Doctor Berwick shared his thoughts about health care in the United States today and in the future. Currently missing, he said, are the proper management of chronic illness and the lack of focus on wellness.
“We built a disease-fixing system without building a health-creating system,” Dr. Berwick said. “That’s more and more haunting us. It haunts us in terms of the lifestyles we lead, obesity, chronic disease that could be avoided. It has brought us a tremendous economic burden.”
Compounding the situation, he said, is the linkage of health care performance and society’s macroeconomic condition as well as a tough political environment. In Massachusetts, where Dr. Berwick is a candidate for governor, “the ability of government to invest in meeting its moral duties is compromised because health care costs are up 59 percent in the past decade,” he said. “It’s a transfer of opportunity that’s very hard to justify.”
Doctor Berwick called the current health care situation a moral test. “It’s the idea that how frail and vulnerable our commitment is to each other when the stresses grow, and we don’t feel like we have abundant resources with which to meet those stresses,” he said. “We just take things away … from the voiceless – in Medicaid, in food stamps, social safety nets, mental health care.”
The alternative, he said, is the Triple Aim of better care, better health and lower costs. There are examples in Alaska, Colorado, Wisconsin and other states where this is achieved, Dr. Berwick said. Improvement is about learning, but doing so “in a complex endeavor when we’re all in this together is a little more complicated.”
“This is about changing our work, changing the work of care,” Dr. Berwick said, noting that before the forum began Society President Timothy McAvoy, MD, was using an electronic tablet to refill prescriptions, answer messages and perform other tasks that now are possible outside of the office because of electronic health records.
An internal medicine physician from Waukesha, Dr. McAvoy said he was simply “doing the work a doctor does.”
To Dr. Berwick, though, “that’s what revolution looks like. It’s a new way to do your work. In this case, he shortens cycle times, he’s much more efficient,” he said. “It’s probably better for the patient, it’s probably lowering costs and it’s certainly more satisfying for (Dr. McAvoy).”
Back to December 19, 2013 Medigram