HL20: John E. Wennberg, MD—Variations in Care and the Constant Search for a Better Way

Hospitals and health systems must continually examine their spending, but it won't be easy, he says. "They have mortgages on them, have bonds to pay off. The capacity is currently adjusted through the current cash flow, and in turn it is based on utilization, and reducing it is a problem," Wennberg says. He believes that accountable care organizations may be a way out—"to the extent that shared savings is implemented in a sophisticated way ...It would mean the management and physicians at a given institution could reduce capacity without bankrupting the institution or screwing up the bond market. Ultimately, things need to be worked out."

Wennberg continues to see how healthcare can "work out." Two years ago, he wrote a book, "Tracking Medicine: A Researcher's Quest to Understanding HealthCare."

In it, he writes that: "...much of health care is of questionable value and that informed patients often prefer a form of treatment other than the one their physicians actually prescribe. More care is not necessarily better at least when it comes to managing chronic illness. Care coordination and intelligent management of patients over the course of their illness which typically lasts until death counts far more than simply providing medical services."

Wennberg says he will keep studying the intricate flaws in healthcare as a means to finding ways to improve it. Even with four decades of research behind him, the opportunities for new, promising insights are enough to keep him busy for years to come.