Don Berwick is a patient centric, consumer oriented radical

The recess appointment of Dr. Donald Berwick as head of CMS has incited a furor among politicians outraged at what they claim are his advocacy for rationing and fondness for Britain’s National Health Service.

To support their claims, these politicians are using Berwick’s own words, in a way eerily reminiscent of the recent Shirley Sherrod debacle.

It started with Glenn Beck, master of the one-word quote, and then slipped over into more mainstream politicians.

What’s really troubling about all this, in addition to the blatant political motivation, is Berwick is pretty closely aligned with core conservative values.

Don Berwick is now, and has always been, a patient-centric, consumer-oriented ‘radical’ who’s concept for the ideal system is one that is almost entirely patient-focused. Here’s Berwick’s ideal health plan from a piece by Ezra Klein:

1. Hospitals would have no restrictions on visiting — no restrictions of place or time or person, except restrictions chosen by and under the control of each individual patient.

2. Patients would determine what food they eat and what clothes they wear in hospitals (to the extent that health status allows).

3. Patients and family members would participate in rounds.

4. Patients and families would participate in the design of health care processes and services.

5. Medical records would belong to patients. Clinicians, rather than patients, would need to have permission to gain access to them.

6. Shared decision-making technologies would be used universally.

7. Operating room schedules would conform to ideal queuing theory designs aimed at minimizing waiting time, rather than to the convenience of clinicians.

8. Patients physically capable of self-care would, in all situations, have the option to do it.

“I suggest that we should without equivocation make patient-centeredness a primary quality dimension all its own, even when it does not contribute to the technical safety and effectiveness of care,” he says.

Pretty radical, indeed – returning power to the patient, from the practitioner.

If Berwick’s opponents just took a minute to read what the guy really stands for, they’d discover he’s pretty much aligned with many ‘conservative’ principles – self responsibility, ownership, consumer-centered policies and practices.

Unfortunately, they just don’t care about who Berwick really is – they’ve decided he’s the stick they’re going to use to beat this Administration, regardless of whether he’s good, bad, or indifferent.

As Maggie Mahar noted in Health Beat, “Thomas Scully, who led the CMS under President George W. Bush [said of Berwick] : “He’s universally regarded and a thoughtful guy who is not partisan. I think it’s more about … the health care bill. You could nominate Gandhi to be head of CMS and that would be controversial right now.”

Joseph Paduda is the principal of Health Strategy Associates, and blogs at Managed Care Matters.

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