Panel Discussion USPSTF Recommendations: Process and Impact on Real-World Provision of Care

John Santa MD MPHDirector, Health Ratings CenterConsumers Union

Panel Discussion USPSTF Recommendations:Process and Impact on Real-World Provision of Care

Disclosures

• General internist, most recent practice at the VA in 2008.

• Employed by Consumers Union, publisher of:– Consumer Reports– ConsumerReportsHealth.org– Multiple other print and electronic publications

• Independent of industry• Non profit, non partisan

Systems are perfectly designed to get the results they achieve.

Key Principles

• Consumers should be involved “from the start….at the top”….for appropriate tasks.

• Independence, transparency, a supportive environment needed for constructive and credible engagement.

• Playing field needs to be level. A “referee” needs to enforce “discipline.”

Options

• Involve at key steps, in key roles.

• Make information available to consumers at crucial decision points. Accept input.

• Make decision making transparent and independent of subsets of stakeholders.

• Accept feedback on decisions, enable reconsideration if appropriate.

Input to USPSTF Draft Recommendations

• Make consumers aware– Diverse media – Consider innovative strategies– Target for balance

• Define reasonable boundaries around input.– Limits on characters, time– ? able to submit data

• Access to comments.• Focus on balance and level playing field

– Identity options– Conflict of interest options

• Feedback from USPSTF on impact of comments.

“When you’re through learning, you’re through.”

John Wooden--former UCLA basketball coach