CHALLENGES INVOLVED IN DOING THE RIGHT THING

Elections in November 2020 are expected to feature health care as a top concern of voters. Already, many Democrat candidates have expressed support for enacting Medicare for All legislation. Apart from the Patient Protection and Affordable Care Act of 2010, which became law to address problems involving access, cost, and quality, since then: Congress passed the 21st Century Cures Act in December 2016, authorizing $1.8 billion in funding for the Cancer Moonshot over seven years; President Donald Trump signed the controversial "right-to-try" bill in May 2018, which bypasses drug regulators to enable gravely ill patients to have access to experimental medicines; and both the Administration and Congress continue to make strenuous efforts to rein in the high costs of many pharmaceutical products.

Assuming that enactment of Medicare for All occurs, resulting in free health care and affordable medications becoming available, what is the likelihood that health policy-related worries will cease to be of concern? An examination within the house of health care itself would suggest a need for caution. The ability to address a health problem successfully is contingent upon being able to identify it properly through an accurate diagnosis. A cursory examination across the professional landscape in domains for both physical and mental health reveals, however, that many deficiencies exist from the perspective of diagnostic capabilities.

According to an article that appeared in the August 2019 issue of JAMA Internal Medicine, in a large proportion of cases, there will be no apparent cause for a given patient’s condition—physical, psychological, or otherwise. Up to one-half of symptoms that present to physicians resist medical diagnosis, and 80% of symptoms resolve on their own within four to 12 weeks of onset. Moreover, ambiguous symptoms currently represent the fastest growing complaint by patients. Meanwhile, the results of a study published online July 11, 2019 in the journal Diagnosis confirm that diagnostic errors remain the most common, most catastrophic, and most costly of serious medical errors in closed malpractice claims. Nearly three-fourths of serious misdiagnosis-related harms are attributable to diseases in just three major categories – vascular events, infections, and cancers (the “Big Three”). A diagnostic error can mean the difference between life and death for patients. While estimates vary, it is likely that more than 100,000 Americans die or are permanently disabled each year due to medical diagnoses that initially miss conditions or are either wrong or delayed.

A paper in the September 2019 issue of the journal Psychiatry Research suggests that diagnostic errors and misclassifications are not confined to the physical realm of conditions. Study findings indicate that psychiatric diagnoses all use different decision-making rules; huge overlap exists in symptoms between diagnoses; almost all diagnoses mask the role of trauma and adverse events; and diagnoses may provide little guidance about patients and the treatment they need. Thus, expanding access to health care by providing adequate health insurance coverage to individuals who lack it is an obvious important policy step in the right direction. Yet, it is reasonably clear that upon their entering the health care system, a major challenge will persist in the form of striving to do the right thing for patients.

CHALLENGES INVOLVED IN DOING THE RIGHT THING

Indicates the importance of providing appropriate health care based on accurate diagnoses. Read More

PRESIDENT’S CORNER—ASAHP MEMBER FOCUS

Susan Hanrahan offers her thoughts on the upcoming ASAHP Annual Conference, the Institutional Profile Survey, and other relevant activities of the Association. Read More

 

ACCELERATED PACE ON CAPITOL HILL

Describes legislation involving the budget, appropriations, the health workforce, along with telehealth and rural health proposed initiatives. Read More

 

HEALTH REFORM DEVELOPMENTS

Discusses efforts to enhance quality care in hospitals and the potential impact of reimbursing at Medicare rates on the health insurance exchanges. Read More

 

DEVELOPMENTS IN HIGHER EDUCATION

Summarizes recent activity by the National Advisory Committee on Institutional Quality and Integrity, and repeal of the “Gainful Employment” regulation. Read More

QUICK STAT (SHORT, TIMELY, AND TOPICAL)

  • Aerobic Activity And Time Spent On Sedentary Behavior Among U.S. Adults

  • Unintentional Injury And Death Rates In U.S. Rural And Urban Areas

  • Achieving Better Health Care Integration Of Radiology

  • Manufacture Of Thread-Based Transistors For A Wide Range Of Health Applications Read More

AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY

  • Investing In Interventions That Address Non-Medical, Health-Related Social Needs

  • Joint Commission Educational Campaign On Preventing Falls

  • A New Proposed Fix On Long-Term Care Read More

GAP BETWEEN WHAT IS SAID BY PROVIDERS AND HEARD BY PATIENTS

Mentions how health professionals and patients may not always have the same amount of understanding of statements involving treatability. Read More

 

ASSESSMENT OF ADULT COMPETENCIES

Refers to data from the National Center for Education Statistics on the topic of adult literacy. Read More