Doing your part to stem overuse of the health care system, from the Harvard Heart Letter

You may have read about a Maryland cardiologist who lost his medical license because he implanted hundreds of unneeded stents into people's coronary arteries. In the April 2012 issue of the Harvard Heart Letter, Editor in Chief Thomas Lee, M.D., writes that such blatant overuse of the health care system is rare and that "the vast majority of doctors put the people they treat first, far ahead of any personal financial interests."

The main driver of overuse is the fragmented health care system itself. Add to that the near-weekly market introduction of a new drug, technique, or device that promises to improve our well-being, and you have an environment that conspires to fuel overuse and medical cost inflation.

The solution to the fragmentation problem, says Dr. Lee, lies partly in rearranging health care providers into groups that take collective responsibility for people's health care outcomes—and get paid accordingly. "Today, most doctors are paid piecemeal for what they do, and no doctor can take sole responsibility for a person's health because so many different providers and processes are involved," observes Dr. Lee. But it will take time to create these new integrated groups, called accountable care organizations (ACOs) and medical homes.

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