[MMA News Now, Nov. 1, 2012] Harvey Fineberg, M.D., Ph.D., president of the Institute of Medicine, detailed what he calls eight key distortions in U.S. health care to a group of more than 100 physicians and hospital administrators at the Minneapolis Institute of Arts on Oct. 29.

“If we want a health care system that will be something that we can proudly describe and present in any part of the world we are going to have to contend with at least eight key distortions,” he said.

These distortions include:
1. An under-investment in prevention and wellness relative to what is spent on restorative treatment and care.
2. Inappropriate use, be it over-, under- or misuse of care. 
3. Misaligned incentives for all stakeholders. With this, he focused on the preponderance of fee-for-service rather than being compensated for results.
4. The failure to optimize the flow and transition of patients. He noted that we have many systems in health care but are not making the most of them.
5. A mismatch of complexity and volume of information to our capacity to manage and utilize it. In other words, getting the right information to the right people (decision makers) at the right time.
6. The increasing amount of patients seeking services and the misdistribution of health care workers (both types and geography). As an example, he talked about the increased number of new people obtaining insurance and the burden they will place on the workforce.
7. Substandard systems and processes that don’t ensure quality and safety for patients. He complimented the state of Minnesota for its leadership in quality measurement.
8. The traditional value in medicine placed on autonomy and independence. Physicians need to accept that they work on teams, he said. 

“Each of these problems has embedded in them the kernel of the solution,” Fineberg said. While he didn’t spell out specific solutions he advised those in attendance not to “wait for Uncle Sam” to fix things, work together and always keep health care patient-centric.

Fineberg’s appearance was made possible through The George Family Foundation, the Penny George Institute for Health and Healing at Allina Health, the Institute for Clinical Systems Improvement and the Twin Cities Medical Society.