Episode 25: Why U.S. doctors provide low-value care

No expert has gained more insight into the organizational factors associated with physician and health-system performance than Stephen M. Shortell.

He is a graduate school professor and dean emeritus of UC Berkeley’s School of Public Health. He is currently conducting research on Accountable Care Organizations (ACOs) integrated care models, innovations in healthcare delivery, and examining the application of the Lean management in U.S. hospitals. He is the author or co-author of 10 books and has published more than 300 peer-reviewed papers in a variety of organizational and health services/health policy research journals. Dr. Shortell is an elected member of the National Academy of Medicine (formerly the Institute of Medicine), past editor of Health Services Research, and past president of the Association for Health Services Research (Academy Health). He holds PhD, MBA and MPH degrees.

In this episode of Fixing Healthcare, he explains how perverse financial incentives combine with a lack of technology to prevent American doctors from providing high-value, patient-centered care. In addition, Dr. Shortell dives deep into the current state of U.S. healthcare and what it will take to emerge from the coronavirus crisis better than before. Also in this episode, we cover the following topics:

  • Why so many doctors fail to follow evidence-based approaches.
  • Why a third of Medicare beneficiaries receive low-value services.
  • What Dr. Shortell has learned from studying the “social determinants of health” and their impact on clinical outcomes.
  • The role of race and the effects of racism in American healthcare.
  • Whether the Affordable Care Act will survive, adapt, or die.
  • What American healthcare has gotten right and wrong during its coronavirus response.
  • How to address the rapidly rising cost of drugs.
  • What to do about the decline of hospitals in the United States.
  • How to improve rural healthcare.
  • Whether a program like Medicare Advantage could be a national solution to high costs and poor quality.

READ: Full transcript of our discussion with Stephen Shortell 

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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.