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The Wall Street Journal just got spanked.  Hopefully the flogging will end up in the public square.

It may not, which is why I'm sharing the information below.

Their recent opinion piece by Daniel Henninger entitled "Obamacare's Lost Tribe:  Doctors" tried to make the case that the horribleness of the "Law's new PQRS (Physicians Quality Reporting System)" would cause doctors to...  well, it's not clear.  "Give up on medicine" was one implication.  The article implies that the entire ACA should be repealed, because the doctors want it to be, or something, because the PQRS-related provisions will just destroy the doctor-patient relationship, probably!  

The piece cites a JAMA article in support of it's point.  Problem is, the doctors who wrote the JAMA article, when notified of the WSJ piece, were less than happy that their article was cited in such a way.  And they let the WSJ know.

The WSJ article: Obamacare's Lost Tribe:  Doctors

The JAMA article cited in the WSJ piece:  Assessing Individual Physician Performance Does Measurement Suppress Motivation?

My email to one of the JAMA article's authors, Dr. Christine K Cassel:

Dr. Cassel,

The WSJ has published an article critical of the ACA, and it it your JAMA article (Assessing Individual Physician Performance, Does Measurement Suppress Motivation? Christine K. Cassel, MD; Sachin H. Jain, MD, MBA) is cited in a way favorable to the WSJ's article main point.

How do you feel about this?  Was the intention of your article that the entire ACA should be repealed due to uncertainties with the 2012 hospital VBP provision and the 2015 "value not volume" provision?

Thank you,

And Dr Cassel's response to me:

Thank you for your email.  The Wall Street Journal  misrepresented Dr. Jain and my views in their editorial.  We are both very strong supporters of the ACA.  Our letter in response (submitted today) is below.


Christine K. Cassel, MD MACP
President and CEO
American Board of Internal Medicine
510 Walnut Street, Suite 1700
Philadelphia, PA 19106

And her response directly to the WSJ, which may or may not see the light of day - except for here:
Daniel Henninger’s column (ObamaCare's Lost Tribe: Doctors ) fundamentally misrepresents our perspective as well as key facts about the Affordable Care Act (ACA) and the Physician Quality Reporting System (PQRS).  ACA did not create PQRS, it was established during the Bush administration and by a Republican Congress.

As we noted in JAMA, we believe in and support efforts around physician measurement –measurements that are meaningful, improve quality of care and have patient care-centered goals.  

Physicians are, at their core, scientists – scientists who believe in evidence and measurement.  They are also very used to being assessed and evaluated.  From medical school through residency to practice they demonstrate to themselves, their peers and the public that they have met the standards of the profession through exams, board certification and Maintenance of Certification.  Physicians use performance data from these and other programs to identify areas for improvement.

But the measurement world isn’t perfect. The Affordable Care Act (ACA), in its wisdom, understands that and has created mechanisms to examine innovative approaches to care delivery and measurement.   In fact, many programs of the ACA (Accountable Care Organizations and the Innovations Center to name two) focus on enhancing the physician patient relationship and put doctors and other health professionals in the driver’s seat for designing new approaches to care delivery.

We have no misgivings about the appropriateness of measuring physician’s performance – we believe it is important, vital, to improving the quality and safety of health care in this country.  It is unfortunate that Mr. Henninger chose to use our analysis on how to improve physician measurement as a way to demonize the ACA and cause unnecessary fear for patients.  The ACA will not damage the relationship between ill patients and physicians – in fact it will allow more patients to get the care they need.

Christine Cassel, MD                          Sachin Jain, MD
Philadelphia, PA                                 Boston, MA

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