How far off track are we when someone suggests we look to organized crime as a model for improving health care in the U.S.?

June 26, 2019 / By L. Gordon Moore, MD

Dr. John H. Wasson has decades of research digging into what is important to people vis-à-vis health care. He has published in all the big journals, testified in the big venues, led numerous initiatives aimed at improving healthcare delivery and outcomes. I mention this because I want folks to understand that he really knows a lot about the meaning of quality, improvement and what matters to people when they interact with healthcare delivery.

In a conversation we recorded for the Inside Angle podcast, Dr. Wasson uses a radical framework—“lessons from organized crime”—to describe fundamental changes that could improve healthcare quality and costs in ways that I suspect we would all want. As you listen to his ideas, consider the experience so many of us or our family members have with health care as it is today. Consider how much time and money is poured into measuring process indicators, often at the expense of outcomes. 

I believe we are wasting vast resources extracting and reporting process indicators under the impression that they tell us something meaningful about a physician’s quality of care. While each of these process indicators may be useful as a physician works with an individual on their preventive or chronic condition needs, the aggregation of these indicators says very little about the difference between a high- and low-performing primary care physician. Wasson’s decades of research gives us different ways to understand quality and we can consider the use of risk-adjusted administrative data to understand variation in care without adding work to an over-burdened delivery system. Wasson’s ideas deserve serious consideration if we want to move from what we have, to what we want and need.

L. Gordon Moore, MD, is Senior Medical Director, Clinical Strategy and Value-based Care for 3M Health Information Systems.