The Health Care Delivery System: A Blueprint for Reform

Concern about the state of the American health care system has reached a slow boil. Health care consistently ranks among the top three issues that the American public wants policy makers to address, and it is increasingly intertwined with growing worries about economic insecurity.

High costs, gap-ridden coverage, and sporadic quality are the health care problems that most concern Americans, yet most of the policy discussion is focused on the issue of coverage. To ensure that the other problems are not forgotten, the Center for American Progress and the Institute on Medicine as a Profession partnered to develop the book, "The Hidden Care Delivery System: A Blueprint for Reform", which offers recommendations and pathways to systemically promote efficiency, quality, patient-centeredness, and other characteristics of a high-performing health system. Its blueprint includes the vision for how different parts of the system should be structured and should function. It also proposes specific policies that the next administration and Congress could adopt to set change in motion over the next five years.

This book will ensure that when the opportunity presents itself, the next administration will be ready with grounded politics that are more than patches and can serve as pathways toward the high-performing health system that is not just possible, but essential, to better health and a prospering economy.

IMAP Shows How Academic Medical Centers (AMCs) Are Regulating Relationships with Drug and Device Makers (9-10-08)

New public database features “Best Practices” toolkit to guide those seeking effective ways to address conflict of interest in medicine.

JAMA article: New Developments in Managing Physician-Industry Relationships (9-3-08)

Over the past 2 years, policies governing the relationship between physicians and pharmaceutical and device companies have undergone remarkable changes. A 2004 task force appointed by the American Board of Internal Medicine Foundation (ABIM) and the Institute on Medicine as a Profession (IMAP) found existing guidelines to be lax.1 At that time, the industry's Pharmaceutical Research and Manufacturers of America (PhRMA) Code ignored many salient issues, such as disclosure, speaker's bureaus, and ghostwriting and set only modest boundaries around dispensing food, gifts, and travel reimbursements.2 The American Medical Association's ethical guidelines largely duplicated PhRMA's; however, on such practices as gift taking, it was even more permissive.3 The American College of Physicians acknowledged the influence of gifts on physician practices but did not prohibit them.4 Government bodies, including the Office of the Inspector General of Health and Human Services, essentially endorsed the PhRMA Code.5 . . .

Exemplary Policies and Toolkits on Conflict of Interest

These best practices recommendations come out of an ongoing study by the Prescription Project’s research team.

Media articles in response to the February 12, 2008 editorial "Academic Medical Centers and Financial Conflicts of Interest"

David Rothman's JAMA editorial is referenced in two articles

Editorial by David Rothman Published (Journal of the American Medical Association, 2/13/2008): Academic Medical Centers and Financial Conflicts of Interest

In an editorial, David Rothman discusses sources of individual and institutional conflicts of interest and efforts to address them.

Colloquium/Press Conference on Annals Article

Colloquium/Press Conference on Annals Article

Book Reviews in The New Republic (11/07)

David Rothman's reviews of Jerome Groopman's book How Doctors Think and Atul Gawande's book Better: A Surgeon's Notes on Performance were published in The New Republic's Nov. 07 issue. To view the article, please go to the journal's website at  www.tnr.com.

Article in Annals of Internal Medicine: (12/4/2007) Professionalism in Medicine: Results of a National Survey of Physicians

This article presents and discusses results from a national survery on whether practicing physicians agree with and act consistently with norms of professionalsim. The survey found that while physicians agreed with standards of professional behavior promulgated by professional societies, their behavior did not always conform to those norms.

PROFESSIONALISM AMONG PHYSICIANS: RESULTS OF A NATIONAL SURVERY (12/3/07)

Nearly One-half of the Nation's Doctors Fail to Report Incompetence or Medical Errors, Journal Study Reports



First Survey of Its Kind Shows Doctors' Individual Behavior At Odds With Their Own Ethical Standards for the Profession



View accompanying IMAP Chartbook here.

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