“Many of the difficulties in present medical practice can be overcome, wholly or in part, by group organization. . . Some of these difficulties are: lack of coordination . . . lack of adequate supervision and control over the quality of medical care . . . the difficulty experienced by patients in choosing qualified physicians; the unnecessarily large expenditure for overhead costs made by practitioners in individual private practice; and the increasing complexity of medical service,” concludes the Committee on the Costs of Medical Care, in a report published in 1932.

In 2001, the Institute of Medicine’s Crossing the Quality Chasm report concluded the very same thing! Sadly, little progress has been made since the 1932 report.

We have highly trained medical professionals. We have advanced information technology. And we have growing public demand for change. But unfortunately, we aren’t all working together. Some segments of our population are overtreated; others are undertreated. Costly medical expenses and efforts are often duplicated. Medical information doesn’t always reach the right people at the right time. The most proven treatments are not always utilized or available.

Americans continue to be served by a fragmented, uncommunicative health care system that drives up the cost of care without necessarily improving the quality. Alternatives to this fragmented system are sorely needed.

Happily, alternatives already exist in this country. They are called integrated delivery systems, accountable care organizations, high-performing delivery systems, and the “medical home.” We call them coordinated care organizations.

“Obama Visits Clinic Known for Quality Care, Controlling Costs,” by David Brown, The Washington Post, July 23, 2009

The Post takes a more in-depth look at The Cleveland Clinic, a CAPP medical group, that was touted by President Obama as a model of health care efficiency and quality.

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“Yes, models for cost-efficient health care do exist,” by Jim Landers, The Dallas Morning News, July 28, 2009

CAPP group Scott & White is featured in this article that reviews some of the Dartmouth findings on organizations that can curb health care costs.

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“Atul Gawande: The Cost Conundrum Redux,” by Atul Gawande, The New Yorker, June 23, 2009.

Gawande responds to the skeptics of his highly publicized New Yorker article.

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“The Cost Conundrum: What a Texas town can teach us about health care,” by Atul Gawande, The New Yorker, June 01, 2009

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