4
COM Outlook . Fall 2012
HPD Chancellor’s Communiqué
—
Fred Lippman, R.Ph., Ed.D.
use of simulation and standardized patients, which all relate to
health care reform.
An example of the professional symbiosis I just discussed can
be witnessed by the enhanced role of nursing professionals, who
have become far more prepared educationally to take on the re-
sponsibilities of patient co-care under a doctor’s direction. Today,
about 85 percent of the personalized patient care provided in a
hospital setting occurs through the management of the profes-
sional nursing staff. Similarly, although it’s been occurring over
a longer period of time, physicians and pharmacists as well as
optometrists and ophthalmologists have been working together
collegially to coordinate a patient’s overall care.
We recognized this paradigm shift over 10 years ago, as did
most medical schools, which have gradually incorporated into
their curriculums the medical home or healthy home concept.
What this means is health care professionals are communi-
cating and cooperating with one another more than ever to
be involved with and cognizant of the composite nature of a
patient’s health record. The way you keep the general public
healthier and the way you provide health care more efficiently
is by having all the information of what occurs within the pa-
tient’s health care life available to every health care profession-
al that comes in contact with that patient.
In addition to the mandate issue, there has been consider-
able anxiety regarding the creation and requirement of elec-
tronic medical records, which are already proving to be a
dramatic tool in the reduction of medical error and medical
mismanagement. If a health care professional can access a pa-
tient’s medical history with the simple stroke of a computer key,
the benefits are immeasurable.
Hopefully, we will get to the point where the most impor-
tant person in this discussion is the one who has to be cared
for—the patient. The goal of any health care legislation should
be to improve care for all Americans and provide them with
both the access and opportunity to obtain effective and quality
health care to help better their lives.
It is often difficult to gain insight into
the decisions of the legislative and
judicial branches of the U.S. govern-
ment, especially when it comes to
the subject of health care reform and
the Patient Protection and Affordable
Care Act. The process involved is ex-
tremely complex, which is why indi-
viduals such as myself who have been involved in health care
regulation and health care delivery for many years always find
it interesting to watch as
experts
that are external to the health
care arena, such as policymakers and members of the media,
offer their comments.
What I’m addressing relates to long-term goals and conse-
quences in reference to not only the philosophy but also the
actual written law. While portions of the Patient Protection and
Affordable Care Act were stricken by the Supreme Court, most
of it was upheld. In some ways, it’s a bit befuddling because
several of the issues that were inherent to the decision have
been around for years. For example, the mandate issue was
brought forth nearly 25 years ago by bipartisan policymakers to
try and bring some fiscal sense to how health insurance would
work effectively. Without mandated health insurance for all citi-
zens, the proponents’ consensus opinion was you would never
have enough people in the pool to be able to deal with the fis-
cal consequences of the very sick vs. the fact you don’t have
healthy people in the group.
In all probability, mandates would offer the general public
a better opportunity to have lower pricing. It’s just like saying
everyone has to shop at Wal-Mart or Publix. If that were the
case, then eventually they will be competing with one other
and driving down the costs from a corporate perspective for
greater profitability. Because I’ve been a health care insider for
so many years as a previous owner of several pharmacies, I al-
ways knew my competitors were driving down costs because
of the volume of prescriptions they were dispensing, so I had
to be equally as competitive. It is difficult to understand the
sustained noise relating to the mandate issue.
I’ve stated this before in previous issues of
COM Outlook
,
but the truth is health care reform actually started well over a
decade ago. It began within the medical schools and the health
professions schools, including here at NSU’s Health Professions
Division where we built into our curriculums the inherent re-
sponsibility to communicate and cooperate with your co-pro-
fessionals. This transformation began at least 12 years ago in
the College of Osteopathic Medicine when we started to adapt
the curriculum by transitioning to small-group teaching and the
