As our nation's business leaders and elected officials seek to address the escalating cost of health care, there will undoubtedly be increasing emphasis upon utilizing the unprecedented advances occurring in computer technology to ensure that necessary, cost-effective care becomes readily available. Chronic disease treatments account for over 75% of expenditures, with obesity being a major contributor. Chronic pain affects 116 million adults; more than heart disease, cancer, and diabetes combined. No single profession can reasonably claim exclusive clinical expertise for these conditions, for which the psychosocial-economic-cultural gradient of care is so critical. To control costs and increase access, the economic incentives must be transitioned from our traditional fee-for-service and often isolated small practices, to an integrated, multi-disciplinary system, comprehensive enough to capitalize upon multi-provider and multi-discipline strengths, prevention opportunities, and cross patient-diagnosis comparisons. Change is always unsettling. Yet, future health delivery models will have much in common with the HMOs proposed by President Nixon and the Managed Care efforts of President Clinton.
Within the past decade, nearly every health profession has enhanced the education of their graduates, their scope of clinical practice, and their numbers. There are over 150,000 Advanced Nurse Practitioners (Doctors of Nursing Practice) and Physician Assistants providing quality primary care. Notwithstanding medicine's historically expressed concerns, objective evaluations of these non-physicians consistently report extraordinary competence and satisfaction by patients. Similar results exist for optometrists, physical therapists, psychologists, and clinical pharmacists. With our aging population and expanding ability to quantify health care outcomes, we must embrace a health care delivery system that is dedicated to providing the highest possible quality of patient-centered care in a cost-effective manner. The critical implementation decisions will be made at the local level. Aloha,
The Council for
