NASH on the Road

Since Labor Day 2010 I have been traveling back and forth across our nation discussing all aspects of Health Reform---from the impact on quality and safety to the implementation of an Accountable Care Organization. I have found most persons to be very confused about this complex legislation. I have also found that Academic Medical Centers are racing to comply with ACO legislation with little understanding as to the core cultural elements.AMCs need to recognize that "accountability" is a significant challenge---it calls for a sweeping change of our culture.It means we must all self evaluate and measure the outcomes of our work together. It means that subspecialists will see their incomes slightly diminish and that primary care docs will see a modest increase.It means a willingness to practice based on protocols and the best available evidence, where it even exists. Finally, it means we must also change the training paradigm to reflect these new realities. This is a tall order indeed.From the Kansas Hospital Association, to Allina Health, to Spectrum Health, to Texas Health Resources, to Adventist Health, to Temple Medical School, my message has been consistent----it is all about changing the culture of practice!! On another note, be sure to tune in to WHYY as the hit show "Marketplace" will be coming to Philadelphia on Friday night November 19th to focus on the new empowered patient.I have been asked to be one of three panelists on this national show. More news to follow.....DAVID NASH