Publication: Professionalism as the Bedrock of High-Value Care

In the journal Academic Medicine, VSSL team member Dr. Leah Marcotte lead-authored an article arguing that professionalism can be a key driver of practice change that can affect high-value care.

Key points that Dr. Marcotte and co-authors make:

• There are broad calls to increase "high-value care"

• Despite this attention, evidence suggests that progress towards greater value has been slow

• One potential limitation to progress is a "deficit-based reactive model"

• In turn, one solution is to channel professional values into action to engage clinicians in a way that transcends practice setting or environment.

Read the full abstract below and the article here:

“High-value care” has become a popular mantra and a call to action among health system leaders, policy makers, and educators who are advocating widespread practice changes to reduce costs, minimize overuse, and optimize outcomes in the United States. Regrettably, current research does not demonstrate significant progress in improving high-value care. Many investigators have looked to payment models, benefit design, and policy changes as the main levers to reduce low-value care delivery; thus, the prevailing approach to ensuring high-value care has been to identify and limit low-value services. This approach has a clear limitation: the number of identified low-value services has become too numerous for individual physicians to track. Using professionalism as a key driver of practice change presents an important opportunity to shift from a deficit-based reactive model to one that is proactive and uses the concepts of intrinsic motivation and medical stewardship to effect high-value care. Transforming aspirational values such as professionalism into actions that engage all physician stakeholders regardless of their position or influence, and regardless of system agility or payment structure, has the potential for bringing about real change. These concepts can be integrated into medical education, introduced early in training, and modeled by educators to drive long-term sustainable change. Physicians can, and should, embrace professionalism as the motivation for redesigning care. Payment reform incentives that align with their professional values should follow and encourage these efforts; that is, payment reform should not be the impetus for redesigning care.