“Doctors, patients share duty to contain costs” was the headline and with it came great expectations that maybe – finally – somebody at the “newspaper Iowa depends on” had gotten it. But, alas, those hopes were dashed within a few sentences.
The recent Des Moines Register editorial opened with this intriguing anecdote: “C.T. Tomlinson didn’t see any blockages on the images of the patient’s heart. Yet the doctor was preparing to insert a stent. ‘Sir, what are we going to fix?’ the nurse asked. The surgeon asked if he saw the 90 percent blockage. Tomlinson didn’t and looked at others in the room. They shrugged. The physician completed the procedure. The nurse later reported the incident. An investigation found the doctor had performed multiple, unnecessary procedures on patients.”
It’s worth noting that this anecdote did not come from an Iowa hospital; it’s about an HCA-owned facility as it was described in a New York Times article. Nonetheless, the Register declared, “It’s unlikely such practices are confined to only one hospital system or only to one type of procedure” and that “health care is a business.” Well, how bold, how insightful.
And how anticipatory: “We can envision the letters from doctors. We don’t perform unnecessary procedures, they will say. But when the most profitable tool one has is a scalpel, there is an inevitable tendency to use it.”
Indeed, unnecessary health care happens. IHA has critically and publicly pointed that out for years, along with the fact that, at least in the Medicare program, Iowa hospitals provide high-quality, low-cost care while overutilization runs rampant in other states. Until recently, Medicare overutilization was practically unchecked, but thanks to leadership from Iowa, Medicare is adopting the principles of value-based purchasing and demanding greater quality, innovation and transparency from hospitals.
And Iowa is not leading from behind. Hawkeye State hospitals lead by example through the adoption of Triple Aim principles and the creation and growth of the Iowa Healthcare Collaborative and its countless programs and initiatives, including, most recently, the Hospital Engagement Network (HEN).
The editorial does point out that patients sometimes blindly push for more care and it does criticize a health care payment system that incentivizes overuse. But it makes no effort to acknowledge what is being done, in Iowa or anywhere else, to bring improvement. Instead, it simply warns patients to be on their guard against this alleged plague of greedy providers.
So you won’t read about the Iowa HEN or anything similar in any recent issue of the Register. That, along with broadly painting physicians as hacks and fraudsters, is what should be generating letters. The point here is not about giving away coverage or being positive; it is about being thorough, providing the local angle, giving Iowans a complete picture that they can depend on and simply knowing what you’re talking about.
Meanwhile, it seems that the newspaper disregards its duty to inform and fuels its own cynicism about health care and how it is provided by seeking out scandal (from other states, no less) while ignoring the leadership and progress that is occurring just outside its office doors and all over the state.