Two years ago, Medicare implemented a policy that prevented physicians and other healthcare providers from being compensated for performing an inappropriate procedure, or if a procedure led to unnecessary complications. Now, private health insurers in Tennessee, and Tennessee’s Medicaid program, TennCare, are following suit.
Under the new plan, which takes effect in July 2012, physicians and hospitals will no longer be compensated for conditions relating to retained foreign objects, inappropriate surgeries or other invasive procedures, and procedures performed on the wrong body part. According to a recent study, one in five medical diagnoses or treatment plans may be incorrect. Such errors may result in 40,000-to-80,000 hospital deaths annually.
Additionally, more Tennessee employers and health insurers are now emphasizing using specialists, and encouraging patients to obtain second opinions, to reduce diagnostic errors. For example, one Tennessee physician stated that utilizing breast-imaging specialists might result in more cancers being timely diagnosed. He noted that radiologists who specialize in breast imaging find 75% more cancers on screening mammograms than general radiologists.
Commentators have supported these measures. Timothy J. Vogus, an assistant professor at Vanderbilt University’s graduate business school, opined that not rewarding healthcare providers for patient misadventures “moves things in the right direction because it gets people thinking more about safety.” Similarly, Jim Jirjis, M.D., an internist and the Chief Medical Information Officer at Vanderbilt University Medical Center in Nashville, stated, “When people jump to conclusions too quickly without considering a lot of the common and uncommon causes of the patients’ symptoms, then often the patient is misdiagnosed and the real underlying problem isn’t addressed.” Dr. Jirjis further stated, “A good doctor is somebody who listens to you, who thinks and has broad experience and knowledge — and can bring it all together.” Likewise, Randy Kinnard, a Tennessee attorney who represents medical malpractice victims, and a former Tennessee Association for Justice president, stated, “Carelessness occurs and causes not only damage to the patient concerned and their family, but to the whole health-care system.”
Tennessee’s proposed reforms are big steps towards improving patient care and safety. However, they should not be the only one that states, including Kentucky, implement. Nonetheless, if all states were to be as proactive as Tennessee, incidence of potentially devasmedical mistakes may decline.