DEC. 7, 2005 | Health care in the United States must change drastically to compete in a global market, Robert Brook, M.D., vice president, corporate fellow and director of health for RAND Corporation said during a guest lecture at the University of Arkansas for Medical Sciences (UAMS).
Brook provided a sobering overview of health care during the Annie Lea Shuster Lecture on Social Medicine held Nov. 3, sponsored by the Department of Psychiatry in the
Brook described the
“There needs to be fundamental changes in the way we do business,” Brook said. He questioned why there is such a high level of training for some health care positions, which ultimately drives up the cost of the procedures they administer. Many positions might be better served by hiring people with the innate skills needed to do the job and then teaching them only the information they need to know to do their particular job well instead of sending them all the way through medical school.
“If we don’t get our house in order, most of what we do will be done overseas,” he said, adding that people already are beginning to go out of the country for treatment and various medical services provided in the
The huge amount of waste associated with health care is another reason costs are skyrocketing, Brook said, adding that experts at RAND Corp. have told him that as much as half of all medical supplies tossed out could have been used more efficiently.
Brook said another element increasing the cost of health care is the questionable number of surgeries
“About a third of common surgeries performed may not benefit the patients who have them,” he said, listing cataract surgery, hysterectomy, angioplasty, CABG, and angiography as some of the top over-performed surgeries. He said that in many cases, the surgery did not improve the length or quality of life for the patient, and suggested that many patients would respond as well to medications if provided before the health issue escalated.
At RAND Corp., Brook is responsible for focusing attention on
quality-of-care issues and their implications for the nation’s health. Most of the measures for quality of care and health status used throughout the developed world today were designed by Brook or his research teams.
Brook led the Health and Quality Group on the $80 million Health Insurance Experiment and was co-principal investigator on the Health Services Utilization Study. He was the co-principal investigator on the only national study that has investigated at a clinical level the impact of diagnostic-related groups on the quality and outcome of acute hospital care. He was also the co-principal investigator on a joint activity – including 12 academic medical centers, the American Medical Association and
Brook received a bachelor’s degree from the
RAND Corporation is a nonprofit research organization providing analysis and solutions that address challenges facing the public and private sectors around the world. Brook is also director of the Robert Wood Johnson Clinical Scholars Program and professor of medicine and health services at the
This lectureship was created in honor of Annie Lea Shuster, who administered the Robert Wood Johnson Clinical Scholars Program for 25 years. Seven of those years were spent directing the program from UAMS as the national program director. During her tenure at UAMS, Shuster’s office was housed in the Department of Psychiatry. The Clinical Scholars Program provides physicians training in the basic sciences of health services and policy research and with skills necessary for leadership positions with a focus on community based research.
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