TMC PULSE

t m c » p u l s e | o c t o b e r 2 0 1 7 34 To learn how you or a loved one can get involved, call 713-745-3511 or visit mdanderson.org/houstonhpvtrial HPV*-related throat cancer is on the rise in men. MD Anderson Cancer Center, the nation's leader in cancer care, is seeking men to help us develop a screening test to detect this cancer early, when it's easiest to treat. Males ages 50-59 residing in the U.S. are invited to participate in this unique study and will have access to tests not available to the general public. Together, we're Making Cancer History. ® You will be asked to: • Come to an appointment in the Texas Medical Center (parking costs covered) • Sign an informed consent document • Complete a questionnaire • Provide a blood and saliva sample *human papillomavirus Are you at risk for throat cancer? Initial Visit Includes consultation, exam & adjustment Let our licensed chiropractors relieve your aches and pains this Backtober so you can live life to the fullest. Stop by a clinic today! NO APPOINTMENTS | NO INSURANCE NEEDED Don't let pain hold you back THIS BACKTOBER! West U (713) 588-0858 | thejoint.com 3177 W. Holcombe Blvd. Houston, TX 77025 *Offer valued at $39. Valid for new patients only. See clinic for chiropractor(s)' name and license info. Clinics managed and/or owned by franchisee or Prof. Corps. Restrictions may apply to Medicare eligible patients. Individual results may vary. © 2017 The Joint Corp. All Rights Reserved. Is It Time to Start Paying Doctors Salaries? Salaries cut down on paperwork and remove incentives for costlier patient treatments M edical care in the United States is high-tech and high quality. It's innovative. But it's also expensive. About a third of annual U.S. medical spending is wasteful, and about $200 billion of that waste is due to "overtreatment," according to many estimates. Donald Berwick, M.D., a physician who ran the federal agency that admin- isters Medicare and Medicaid, knows the topic well. He calls overtreatment "the waste that comes from subject- ing patients to care that, according to sound science and the patients' own preferences, cannot possibly help them." Berwick and others blame fellow physicians for this overtreatment. Doctors, generally speaking, are paid via a system called "fee-for- service." The more treatment they provide—and the costlier that treat- ment is—the more money they make, often as a result of bonuses tied to the amount of care they deliver. It's not that different from the way many other professionals get paid, from plumbers to lawyers to insurance agents. Paying fee-for-service is not unreasonable, but the big problem is that the person who decides whether it's necessary for a patient to undergo an operation or an expensive test is the same one who's paid to administer it. Marcia Angell, M.D., a physician and former editor of the New England Journal of Medicine, has called it the problem of the physician being a "dou- ble agent." "I doubt most physicians are even conscious of this in their decision- making," said Arthur "Tim" Garson Jr., M.D., director of the Texas Medical Center's Health Policy Institute. Overtreatment can take many forms, like when a doctor orders a blood test that another physician recently ordered, or when a doctor orders repeated imaging in response to minor symptoms. For patients, overtreat- ment can lead to high bills, height- ened anxiety and wasted time. Some researchers have managed to quantify the scale of the problem. For example, the Dartmouth Institute for Health Policy and Clinical Practice estimates that 30 percent of Medicare clinical care spending could be avoided without worsening patients' health outcomes. Attacking overtreatment is not simple, but the Centers for Medicare & Medicaid Services (CMS) has set out to change the way physicians are paid. CMS is transitioning from B y R y a n H o l e y w e l l

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