Medicine
I would disagree with Washington Post reporter Lena Sun's dramatic description of the U.S. Preventive Services Task Force - the American Medical Association's Relative Value Scale Update Committee (RUC), which recommends how much Medicare should pay for practically every piece of work that doctors do, would have my vote for "most powerful physician group." However, her recently published investigative piece provides rare behind-the-scenes insight on the inner workings of the USPSTF panel, the scientific and political controversies its work has engendered over the years, and the unwanted regulatory authority that was bestowed on it by the Affordable Care Act. It's a must-read for anyone interested in the intersection of preventive medicine and health policy. Even though it has been more than 5 years since I was a staffer for the Task Force, the concluding paragraphs resonate with the end of my experience:
Such groups as the American Cancer Society say the best way to shelter the task force from even subliminal pressure is to keep it focused on what the evidence shows. Figuring out how that translates into what insurance should pay for ought to be the job of a separate entity, one that ACS notes could weigh broader public-health and social impacts.
For instance, if colonoscopies are strongly recommended as a preventive service — therefore costing consumers nothing extra — does the coverage also include the anesthesiologist involved in the procedure? What about the office visit that takes place beforehand? And what happens if the doctor finds a polyp and a pathologist determines it is benign — is it still covered? (Yes to all.)
Task force members “were pigeonholed into this role,” said Caroline Powers, a director of federal affairs for the cancer society’s advocacy arm. “It’s an inappropriate role.”
- What Scientific Progress? For Breast Cancer Screening, Congress Acts Like It's Still 2002
When I resigned from the staff of the U.S. Preventive Services Task Force to return to academia, I said that one of my reasons was to give the USPSTF one more "private sector ally" by being freed to "speak my mind" about the adverse effects of political...
- Mammograms And Death Panels: Why The Preventive Services Task Force Keeps Pulling Its Punches
Health reform was supposed to have been good news for the U.S. Preventive Services Task Force. Until 2009, this independent panel of federally-appointed experts in primary care and preventive health was not particularly well known, and its evaluations...
- Psa Testing: Will Science Finally Trump Politics?
Maybe the third time will finally be the charm.In early November 2009, the U.S. Preventive Services Task Force voted unanimously to update its 15-month old recommendations on screening for prostate cancer in men younger than 75, changing its previous...
- "politics Trumped Science": Breast Cancer Chemoprevention
On November 17, 2009, in the same issue of the Annals of Internal Medicine that contained the U.S. Preventive Services Task Force's controversial new recommendations on screening for breast cancer, the journal also published a report on the comparative...
- "politics Trumped Science": The Stories Behind The Sound Bite
Last November, when I publicly announced my resignation from the support staff of the U.S. Preventive Services Task Force after 4 years as a medical officer at the Agency for Healthcare Research and Quality, media reports suggested that I had done so...
Medicine
"The most powerful group of doctors no one has ever heard of"
I would disagree with Washington Post reporter Lena Sun's dramatic description of the U.S. Preventive Services Task Force - the American Medical Association's Relative Value Scale Update Committee (RUC), which recommends how much Medicare should pay for practically every piece of work that doctors do, would have my vote for "most powerful physician group." However, her recently published investigative piece provides rare behind-the-scenes insight on the inner workings of the USPSTF panel, the scientific and political controversies its work has engendered over the years, and the unwanted regulatory authority that was bestowed on it by the Affordable Care Act. It's a must-read for anyone interested in the intersection of preventive medicine and health policy. Even though it has been more than 5 years since I was a staffer for the Task Force, the concluding paragraphs resonate with the end of my experience:
Such groups as the American Cancer Society say the best way to shelter the task force from even subliminal pressure is to keep it focused on what the evidence shows. Figuring out how that translates into what insurance should pay for ought to be the job of a separate entity, one that ACS notes could weigh broader public-health and social impacts.
For instance, if colonoscopies are strongly recommended as a preventive service — therefore costing consumers nothing extra — does the coverage also include the anesthesiologist involved in the procedure? What about the office visit that takes place beforehand? And what happens if the doctor finds a polyp and a pathologist determines it is benign — is it still covered? (Yes to all.)
Task force members “were pigeonholed into this role,” said Caroline Powers, a director of federal affairs for the cancer society’s advocacy arm. “It’s an inappropriate role.”
Also this week, my editorial "A Public Health Framework for Screening Mammography: Evidence-Based vs Politically Mandated Care" appeared in print in the Journal of the American Medical Association (it was posted online in mid-January). My students were more impressed at my being mentioned in the Post, but this publication was a personal milestone. Many thanks to my co-author, Georgetown University law professor Larry Gostin, for organizing my initial thoughts and helping to complete and publish this paper in record time.
- What Scientific Progress? For Breast Cancer Screening, Congress Acts Like It's Still 2002
When I resigned from the staff of the U.S. Preventive Services Task Force to return to academia, I said that one of my reasons was to give the USPSTF one more "private sector ally" by being freed to "speak my mind" about the adverse effects of political...
- Mammograms And Death Panels: Why The Preventive Services Task Force Keeps Pulling Its Punches
Health reform was supposed to have been good news for the U.S. Preventive Services Task Force. Until 2009, this independent panel of federally-appointed experts in primary care and preventive health was not particularly well known, and its evaluations...
- Psa Testing: Will Science Finally Trump Politics?
Maybe the third time will finally be the charm.In early November 2009, the U.S. Preventive Services Task Force voted unanimously to update its 15-month old recommendations on screening for prostate cancer in men younger than 75, changing its previous...
- "politics Trumped Science": Breast Cancer Chemoprevention
On November 17, 2009, in the same issue of the Annals of Internal Medicine that contained the U.S. Preventive Services Task Force's controversial new recommendations on screening for breast cancer, the journal also published a report on the comparative...
- "politics Trumped Science": The Stories Behind The Sound Bite
Last November, when I publicly announced my resignation from the support staff of the U.S. Preventive Services Task Force after 4 years as a medical officer at the Agency for Healthcare Research and Quality, media reports suggested that I had done so...