When 3rd-party payers became part of the doctor/patient relationship, however, cost containment was solidly, and permanently, linked to quality. Now, DCs were having to figure out not only how to quantify what they did, but to justify it. As Dr. McClelland says, “Medicare and 3rd-party coverage turned our world on end. We had not been asking questions [related to cost containment]. We just did whatever it took to get people better with whatever techniques we had incorporated into our practices. We haven’t begun to look at ‘dosages,’—how many visits it should take to relieve a simple, uncomplicated strained back vs. keeping that question open-ended.”
Just what is quality health care? Lawrence H. Wyatt, DC, DACBR, says it’s “the provision of the most appropriate care by the most appropriate provider to a particular patient in a timely fashion with primary attention paid to patient safety, patient-centered care, and the use of evidence-based medicine.” Interestingly, Dr. Wyatt says that in the rapidly evolving world of consumer-driven health care, patient satisfaction won’t be considered primary by 3rd-party payers, but that physician scorecards “will soon be used as a critical component of quality care.”.
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