Jeffrey Kaplan, MD

The doctor-patient relation is not symmetric -- it is a relation of trust.

Meaningful health care reform will never happen until we face some uncomfortable truths.

Ten action items for improving the quality of care delivered by the US health care system.

Are health care quality improvement efforts destined to fail for lack of objective evidence and an intensified focus on the cost of care?

Studies show that there are few physician characteristics that patients can use to accurately estimate the quality of that physician's performance.

Tying physician reimbursement and incentives to quality outcomes will improve the care delivered to patients with complex chronic conditions.

The use of EMRs in the patient-centered medical home can reduce diagnostic error and improve coordination, communication, and continuity of care.

Rising healthcare costs have produced calls for reduced physician payments, caps on vendors' profits, and changes to how we pay for medical school.

Healthcare reform will fail without reduced costs, realigned incentives, integrated care, and a focus on primary care and preventive medicine.

Even with the passage of healthcare reform, we still have an expensive, inefficient, uncoordinated, more complex healthcare delivery system.

US healthcare ranks poorly against the systems in other developed countries in terms of cost efficiency and outcomes. How can we realign payment and utilization incentives to reward high-quality, patient-centered care?

If current physician-centric healthcare reform efforts don't reduce costs, improve value, eliminate defensive medicine, or produce a better payment model, maybe it's time to shift focus and responsibility from physicians to patients.

When it comes to healthcare reform, a former industry executive says we should be wary of top-down, Washington-driven reform that produces more bureaucracy, less freedom of choice, and higher costs.

If we're serious about reducing healthcare expenditures in this country, is reducing physician income an essential and inevitable component of meaningful cost control and healthcare reform?

Nearly everyone agrees that the rising cost of healthcare is unsustainable and that the current efforts at healthcare reform will do little if anything to reduce healthcare expenditures. Although there seems to be no shortage of proposals on what should be done, there is little consensus on whether any of them will succeed.

Paying physicians based on outcomes rather than based on the number of procedures or services performed will ultimately reduce costs, entice more residents to select primary care, and lead to better care for patients.

Physicians face a variety of "perverse" economic incentives that pit their financial self-interests against the well-being of their patients. And our current efforts at healthcare reform are not doing enough to fix these problems.

Is your insurer on your side? How furious do you become when they seem to use technicalities to refuse you coverage?

We asked in part 1 of this post how we can pay for healthcare reform, stating the simple answer is to determine what saves money while improving care, and then focus our attention.

How can we pay for healthcare reform? The simple answer is to determine what saves money while improving care, and then focus our attention. Part 1 of this article looks at issues of cost, quality, and access.

Are we prepared to care for people with chronic or complex conditions?

Health information technology has become a national priority and there are incentives for using an EHR.