Sean Morrison

speaker

515 appearances 4 recordings 1 series first heard Apr 2017 last heard Mar 2022

Sean Morrison’s voice in public audio — every appearance, attributed to the second.

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GeriPal - A Geriatrics and Palliative Medicine Podcast · Advance Care Planning Discussion: Susan Hickman, Sean Morrison, Rebecca Sudore, and Bob Arnold · 24 Mar 2022 podcast

And I think that

there's a lot of effort being put into something that in a healthcare system that is so broken that needs to be fixed.

We should be focusing on the other things.

And that comes back to your question about POLST.

A well done POLST in the right setting is a really helpful, really helpful care document.

A badly done POLST in the wrong setting

leads not only to discordant care, but potentially, and we saw this during COVID, the withholding of appropriate care.

And for me, the benefit, because it's so hard to get to, is outweighing the unintended consequences and side effects.

And again, no disagreement.

Yeah, I mean, I think it's really important to understand what the quality metric is.

So the NQF endorsed quality metric for advanced care planning is the presence of an advanced care plan billing code in the administrative data.

That is the indicator of quality.

And the reason that we have quality metrics within the CMS program is to ensure that patients and families are getting the highest quality care and that we're not saving money by simply cutting costs.

You know, I'm thrilled.

I mean, I really am impressed with what UCSF has done.

But UCSF is not the nation.

And I don't know the quality of those conversations that happen that lead to that billing code.

I know Bob's data that suggests that the quality of those conversations is pretty poor and that people leave with very different ideas about what was discussed.

And I also realized that if I'm, and this is sort of the person who's seen too much of the worst aspects of medicine, if I simply document that I had a discussion, even if that discussion was of incredibly low quality, I can get more money for it because I just bill for it.

And so without really any link to the outcome,

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