ABIM president on quality

Christine Cassel, MD is president and CEO of the American Board of Internal Medicine (ABIM). Guest blogging at Kevin MD, she writes about quality in the delivery of health care. In the first half of the post she develops the premise that it takes both good systems of care and good individual docs to do the job. That's self evident. Few would argue against it.

From there she goes on to address what skills (and consequently what training needs) are important for the individual doc, and that's where it gets muddy. She writes:

Physicians need new knowledge and skills – including the ability to manage teams, information, resources and population-level data.

It's not clear where she's going here, because none of these areas are new. The management of teams, which is multidisciplinary care under the physician's direction, has been a cornerstone of the quality and safety movement for at least a decade. The management of resources became critical, and a major focus of practice in 1985 with the advent of DRGs and later in the mid 90s with managed care. And what is the management of population-level data? It sounds like EBM, which started as a “movement” in 1992.

She goes on (my italics)---

More specifically, doctors need special expertise in longitudinal care for a population of patients – built by a trusting, personal relationship that is not limited to site of care, organ system or disease type.

Sounds like a move away from the hospitalist model back to traditional practice. Interesting.