Dr Kerin Adelson Discusses Evolution in Physician Response to Quality Care Initiatives

Over time, a gradual acceptance among physicians has been observed in adopting quality care initiatives that provide cost-saving, improved patient experience in cancer care, said Kerin Adelson, MD, associate professor, chief quality officer, and deputy chief medical officer for Smilow Cancer Hospital at Yale New Haven/Yale Cancer Center.

Transcript

AJMC®: How has the reception to quality care initiatives among physicians evolved over time?

Dr Adelson: So, I think that there has been a gradual acceptance that data is honest and that we all have to sort of look at the data and incorporate that into evaluation of our practice. I think for many, many years, the doctor knew best, and to some extent may still, but there was initial resistance to imposing practice standards on somebody's individual practice, that they were the advocate for their patient and outside standards may not sort of reflect the doctor-patient relationship or may even get in the way of it.

I think that there is gradual understanding that evidence-based medicine matters, that the data about how we practice is actually relevant to the care that we give and to the cost of care, and that overutilization is both costly and can actually harm the patient experience by increasing the burden of care or the treatment burden on a patient.

So, I think that sort of the sweet spot is the idea that patients don't want to spend all their time in a CAT scanner if they don't need to, and they don't want to spend all their time getting procedures that could be avoided. So, it is understanding that sometimes appropriate utilization will both save money and improve patient experience–where the alignment occurs–and that is sort of the selling point, I think, for quality initiatives.