Weekend miscellany

The New York Times reports about a bioethicist Howard Brody, MD, who in a New England Journal of Medicine editorial encouraged his colleagues to bring down health care costs  by using the "Top 5 solution." In an interview with Dr. Brody, the good doctor explained that

The basic idea is that each [medical] specialty would decide on the top five procedures or diagnostic studies that are done commonly but only really help a small fraction of patients. These are things like arthroscopy for osteoarthritis of the knee or MRI’s and CAT scans, all of which are massively overused, not because they help but because of our enthusiasm regarding high technology.
Once each specialty has gone through the research evidence and decided on its “Top Five,” the respective professional organizations would take a public stand, issuing guidelines and recommendations against overuse of those “Top Five” procedures or studies.
By taking a public stand and making it harder for individual doctors to say, “Oh, I know better,” we could build real momentum for cost containment. And we would ultimately all benefit because we don’t need all that technology. You can still be as healthy without it.

How I do love common sense.

In the strange bedfellows department, the American Medical Association ("AMA") has announced that it "has selected Ingenix CareTracker(TM) as the first electronic health records (EHR) system offered through the AMA's new online health information solutions platform for physicians." For the past decade, the AMA has been bludgeoning Ingenix and its parent company United Healthcare over the alleged errors in the Ingenix ususual, reasonable and customary databases that many insurers used to price out-of-network physician services. In January 2009, the AMA and Ingenix settled the AMA's lawsuit. The settlement and the New York Attorney General's separate resolution of the Ingenix UCR database controversy likely will bend the healthcare cost curve up, which had been the AMA's objective.