Choosing the right doctor is one of the most important healthcare decisions your employees can make. It seems like such a simple concept, but not everyone is on the same page when it comes to the subject. People choose their physicians based upon everything from a recommendation from their neighbor or co-worker, to a convenient location to an attractive listing in the Yellow Pages.
But choosing the right physician is far too important to be left to hit or miss.
During a recent visit to Atlanta, author and physician Dr. Mehmet Oz discussed the importance of finding “Dr. Right.” Oz, professor and vice chairman of Cardiovascular Services in the Department of Surgery at Columbia University Medical Center, is co-author of “YOU: The Smart Patient,” a book that devotes an entire chapter to “Finding Dr. Right.”
Oz made a compelling case for carefully choosing the right physician by providing a strong set of criteria that your employees can use to help them make wise decisions. If your employees take a proactive role in choosing a physician, they empower themselves in navigating the healthcare system more effectively.
With the growing popularity of consumer-directed health plans (CDHPs), more employees are assuming responsibility for healthcare decisions and shouldering a larger part of the financial consequences of those decisions.
And what healthcare decision is more basic than choosing the doctor who is the best match for you and your medical needs?
So many choices
Some people might ask what difference it makes whether you choose Dr. Johns versus Dr. Smith. Behind that question is an assumption – that the quality of care from all physicians is equal. That assumption is incorrect.
A landmark study in the New England Journal of Medicine reports that patients received health care consistent with established quality guidelines only about half of the time. Even more concerning is the fact that about 10 percent of patients received care that did not meet quality guidelines and was potentially harmful.
Much of what is driving concerns about finding quality physicians, hospitals, etc., is the fact that there is huge variability in the care given to Americans. The variability may be from one region of the country to another or one area of a state to another. The use of evidence-based medicine is a crucial means of addressing that variability. The strongest possible evidence as developed through peer-reviewed research should back the care received by Americans. Such an approach is an important means of removing variability and promoting the best possible care.
UnitedHealthcare is strongly focused on promoting the use of evidence-based medicine for all Americans as a means of promoting quality health care services. UnitedHealthcare's commitment to quality health care is demonstrated by UnitedHealth Premium¯, which is available to all our Georgia customers. Using health claims data, the program evaluates physicians in 19 specialties for both quality and efficiency of care.
The program's quality measures are based on evidence-based medicine and standards developed by medical specialty societies, independent medical panels and national quality organizations. Members have direct access to the results of those evaluations through www.myuhc.com, where physicians who have met quality criteria and efficiency criteria receive two stars. Quality is the primary focus and a physician is only eligible to be evaluated for an efficiency designation if he has met the quality criteria.
Employers have choices, too
Choosing the right healthcare practitioner is not just a concern for your employees. You also have a stake in the physician decisions made by your employees. You should be more aware of the importance of decisions being made by your employees and their families because poor decisions and the resulting mistakes of those decisions can have a significant impact on your bottom line.
Both over- and under-utilization of care can result in higher healthcare costs. And the resulting higher healthcare costs directly impact premiums. The old adage “do it right the first time” is as true in health care as it is in building a bridge. Every time some healthcare procedure or decision is inappropriate, a remedy may be necessary.
The original cost and the remedy's cost are a lot greater than if treatment was appropriate from the outset. Plus, there are significant costs associated with patient pain or discomfort and longer absences from the workplace. Nationwide and across Georgia, there is a strong and consistent voice from employers calling for quality health care and health coverage that is affordable. One solution is to identify and use the services of physicians, hospitals and other healthcare professionals who have demonstrated that they delivery efficient quality health care.
It is a fact of life in 2007 that consumerism is a dominant force in the emerging healthcare and health coverage fields. Millions of Americans already are enrolled in CDHPs and employers are increasingly looking to CDHPs to help contain health benefit costs while continuing to make coverage available to employees.
Forty percent of employers now rate CDHPs as the most effective (health) plan design for controlling costs. And with that trend comes the increasing role for employees in decisions affecting their health care. The employee who has made the necessary effort to choose the right physician is in the enviable position of having a vital partner in making and implementing those healthcare decisions.
Employees gather information to shop for cars, choose hotels and buy cell phones. Now, with the availability of information and tools to help them, your employees can be empowered to make informed healthcare decisions.
