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Berwick Names 11 Monsters Facing Hospital Industry

Cheryl Clark, for HealthLeaders Media, July 29, 2013

Berwick emphasized that the three pharmaceutical companies he named "are not doing anything illegal. They're playing by the rules. But that's my point. Not everything that's legal is proper."

He called the drug companies actions that resulted in higher costs for necessary drugs both for the public and the taxpayer, "a take the money and run behavior," and said "a civil society is going to have to give politicians and regulators tremendous courage to follow through and say, "No. That's not okay.' "

6. Resist innovations that don't help. At a major convention last year, Berwick was escorted through an exhibit hall with 6,000 vendors, one for each of the 6,000 participants. "There was fiber optic this and robotic that, ceramic this, and disposable everything. And I am absolutely sure that somewhere in the acreage of innovation there was something that could help patients that was definitely worth the money.

"But every instinct I have is telling me that what is offered as innovation in healthcare is certainly not always and maybe not even mostly truly helpful, but adds complexity and risk and we need to tell the difference."

7. Expand roles and scopes of practice for non-physicians. "We need to support new models of care that provide expanded roles for non-physicians." However, he says, the legacy payment systems don't encourage these changes. We need help from the (professional) guilds, not their opposition," but he said, many "are fighting the change."

8. Defend the poor. This monster, Berwick said, is causing him to lose sleep because the nation fails to regard healthcare as a human right. "The social safety net is vulnerable and the will to protect" social services for the poor "needs constant reinforcement that government can't provide without hospitals' support.

9. Palliative and end of life care. Berwick blasted what he called "cruel rhetoric" that equated sensible discussion of advance directives and preferences with "death panels." "But the rule in Washington favors never ever mentioning end-of-life or palliative care, or advance directives. Not in government. That is a tragic silence and it has to stop."

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7 comments on "Berwick Names 11 Monsters Facing Hospital Industry"


Peggy Gonder (8/5/2013 at 5:26 PM)
Berwick's best suggestions are the last 2: increased focus on prevention and keeping people out of the hospital, to improve health and reduce the cost of healthcare. "We let bad things happen and then [hospitals] fix them. Well, why don't we stop them from happening? Simply put, we just haven't built the institutional structure for prevention."

Laup Nepm (8/1/2013 at 5:09 PM)
The Real Monsters of Facing Medicine: Christine Cassel MD, Margaret Nora MD, Richard Baron MD, Eric Holmboe MD, Robert Wachter MD, Humayun Chaudry DO, The American Board of Medical Specialites (ABMS), the American Board of Internal Medicine (ABIM), the Federation of State Medical Boards (FSMB), Maintenance of Certification (MOC), Maintenance of Licensure (MOL), Ezekiel Emanuel and the entire Insurance Industry.

Bill Baar (7/30/2013 at 4:19 PM)
Berwick made a fortune as a consultant (Guys who tell you a million solutions but can't fix a thing themselves). It's time he took the money he's taken from the Healthcare Industry and retire. He's really gotten tiresome.