Keynote Lecture: Future of teaching, practice of medicine begins today

San Francisco-When it comes to the teaching and practice of medicine, what is the future of the United States health-care system and how will physicians arrive there? Michael V. Drake, MD, current chancellor of the University of California, Irvine, and soon-to-be president of The Ohio State University, Columbus, addressed these concerns in the Shaffer-Hetherington-Hoskins Lecture during the Glaucoma 360 CME Symposium.

Dr. Drake focused on health-care reform and why it is needed today. He based his support of the Federal Patient Protection and Affordable Care Act (PPACA)-passed in March 2010-on data showing the United States health-care system to have more deaths and occurrences of treatable diseases and disorders than nineteen other developed countries-(European Union [EU], Japan, and Canada included)-between 1997-1998 and 2002-2003. 

“The United States has 50 more deaths [per] 100,000 population for diseases that are treatable, which is a huge difference between the United States and other countries,” Dr. Drake said. “This is an indictment of the U.S. system. We are the poorest performer in outcomes.”

In addition, health-care costs are 50% higher than in the EU, having risen by 818% from 1970 to 2010 and escalating faster than the other countries.  

He presented data showing that in California, life expectancy is linked to the zip code in which a person lives.

A difference of 15 years exists in the San Francisco Bay Area even within a city or town. Most of these discrepancies are based on socioeconomic status of a person’s neighborhood. Zip code differences do not support the core principle of medicine that requires good health-care delivery to everyone.  

Dr. Drake lamented the politicization of the PPACA, citing inaccurate claims of “death panels” in the legislation. The requirement that physicians explain end-of-life care options to patients was removed from the bill, even though hospice-care data demonstrated patients in hospice died in less pain, their families suffered less depression, average costs were lower overall than hospitalization, and patients lived 2 weeks longer.

“Politicization trumped informed data,” Dr. Drake said. 

He underscored that the rate of increases in health-care costs has slowed slightly with these costs increasing 7.4% in 2009-2008 and 6.3% in 2013-2012, according to the Milliman Medical Index.

He cited changes made at the UC Irvine Medical Center Hospital from 2012 to 2013 by simply focusing on patient intake procedures. By having each incoming patient observed and examined by a team of health-care providers, the hospital reduced deaths/quarter by 50 individuals.

“We can measure things we do, then change the way we practice medicine and change overall outcomes,” Dr. Drake said.

He advocated physicians embrace modern information systems, citing the new current practice at UC Irvine Medical School whereby students are given all the tools they need at the outset of their program. Students are given touch-screen computers (iPad, Apple) that contains books, syllabi, schedules, and other information to ensure their success as physicians.  

For more articles in this issue of Ophthalmology Times’ Conference Brief, click here.

To receive weekly clinical news and updates in ophthalmology, subscribe to the Ophthalmology Times eReport.