Synergy - July/August 2012 - (Page 20)

industry feature Doing the Right thing foR the Right Reason By R. Dean White PEER REvIEw: S ometimes you just have to go back to the Old West: It all boils down to cowboys and outlaws. Before I discuss cowboys and outlaws, I need to explain Aristotle. Now, do I have you confused or interested? Aristotle, in his classic book “Nicomachean Ethics,” as discussed in a book by Barry Schwartz, “Practical Wisdom: The Right Way to Do the Right Thing,” (Riverhead Books, New York, 2010) explains it this way: We need to see how the current reliance on strict rules and regulations and clever incentives improve medicine [and how these] laws undermine the very wisdom of practitioners that are needed to make these practices better. Rules without wisdom are blind and at best guarantee mediocrity. Evidence-based medicine is a great concept and is certainly valid in most instances, but it is important we don’t throw out common sense and practical wisdom when we try to apply it in each and every circumstance. Peer review can be too narrow and needs to 20 / SYNERGY ju ly /a ugust 2012 be a dialogue, not a monologue, between those who practice medicine and those who seek to guide it. Most of us do not like to acknowledge that all medicine was alternative at some point. An open mind is the window to wisdom, and it is wisdom that we need to apply to the peer-review process. Schwartz goes on to say: Rules and incentives may improve behavior of those who don’t care, though it will not make them wiser. But in focusing on the people who don’t care, the targets of our rules and incentives, we miss those who do care. Even worse, rules can kill skill and incentives can kill will. I have been involved with peer-review committees for the last 40 years, and I have developed five basic principles of physician behavior, including the following: 1. ll physicians want the best outcomes for A their patients. 2. hysicians will not change their clinical P practice or their behavior patterns if they think it does not satisfy principle number one. E 3. veryone in the system must be held to the same standard. 4. here are always two, and many times T three, sides to every story — including clinical pathways. I 5. f physician or employee satisfaction is your primary goal, then all your efforts will be in vain. The practice of medicine is still both art and science. It is difficult, if not impossible, to apply metrics to the art part. In my experience, the bond between the physician and his or her patient is critical to excellent patient care. Quality is personal. Hopefully you seek your medical staff leadership from the ranks of the excellent and not from the politicians of the medical staff. Leadership today is about change and how to manage and direct it. Leaders need to be nurtured to see the whole picture, and administrators need to trust them. 

Table of Contents for the Digital Edition of Synergy - July/August 2012

Synergy - July/August 2012
Editor’s Column
President’s Column
Contracting 101, Part I
Key Takeaways from CMS ’ Revisions to Allow Flexibility and Eliminate Burdensome Conditions of Participation (CoPs)
ABMS Establishes Time Limits for Achieving Board Certification
Peer Review: Doing the Right Thing for the Right Reason
NCQA CVO Surveyor’s Point of View
Wyoming Association Takes Off with Expectations as High as the Tetons!
Synergy Product Guide
BYLAW BITS
NAMSS News
Happenings
Consultants Directory

Synergy - July/August 2012

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