Integration Can Support Clinical Quality, Technology Efforts

Article excerpt

A Conversation with Robert I. Field, PhD, MPH, JD

Robert I. Field, PhD, MPH, JD, on faculty at the Drexel University public health and law schools in Philadelphia, formerly led business planning and development for the primary care network of the University of Pennsylvania Health System. He recently spoke with Medical Economics Editor-in-Chief Lois A. Bowers, MA.

Q: In a previous position, you helped health systems acquire physician practices. What do you think of today's practice acquisition trends?

A: It's déjà vu all over again. We're kind of repeating the 1990s. It seems like a lot of health polices like that just go around in circles, which you can say is either encouraging or discouraging, depending on your point of view.

Because of my background, fundamentally, I think [these acquisitions are] a good idea, but I also was involved with a very specific kind of integration, with a large academic medical center.

Medicine gets more complex almost by the day, both clinically and economically. We cannot have the present level of clinical sophistication without a complicated economic environment

People pine for the old days of the solo practitioner and the shingle. That was fine when you treated a heart attack with bed rest, but it's not fine when you have dozens of drugs and procedures and surgeries and diagnostic tests that cost a huge amount of money and that require huge teams to perform. We're not going to go back to those [solo practitioner] days, certainly not if we want the present quality of care. So that means that a doctor has to be part of a larger organization.

One of the biggest problems with medical care in the United States is its disjointed nature and the extent to which it is compartmentalized and different providers don't communicate with one another and care is not coordinated. …