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February 2000

Decision Support Is Changing Health Care

Arch Dermatol. 2000;136(2):249-250. doi:10.1001/archderm.136.2.249

HEALTH CARE in the United States is undergoing unparalleled change. Employers and the federal government have sent a clear and repeated signal that they wish to maintain or increase the quality of health care that is coupled incongruously with slowed growth in the percentage of gross domestic product spent on health care.1 This, in turn, leads to pressure on insurers to decrease premium costs and encourages providers to do more with less. While all forecasts point to dramatic increases in the demand for health care services in the next 5 to 15 years, the marketplace is sending a clear message to our profession that cost growth in excess of inflation is unacceptable.2 The response of health care providers to these imperatives has been uncoordinated at best. We, as physicians, have been unable to craft a compelling strategy that affirms the value of the American health care model and the appropriate role of highly qualified providers delivering a quality product. Our response has been factious.3-5 An alternative conclusion is that the business model in current use is no longer viable, given the apparent imperative of society that we continue to provide high-quality services under noninflationary cost growth.