A little-known federal agency responsible for making health care safer and more efficient has survived 20 years in Washington with a target on its back, but its time may be running out.
The Agency for Healthcare Research and Quality has made enemies because it takes a hard look at whether popular — and often expensive — treatments like spinal surgery actually help patients.
Supporters say it plays a key role in controlling health care costs and ensuring that medical practice is dictated by evidence, not the financial interests of doctors and insurers in a $3.4 trillion industry.
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I am prepared to believe that the AHRQ does some meaningful research oversight and policy analysis. But when they screw up, they can add their prestige to worsen major government messes. And in America’s so-called “opioid epidemic” they’ve screwed up big time.
AHRQ has proposed to make the opioid prescription guidelines for patients with chronic pain a mandatory standard for US medical practice. However, these guidelines, issued in March 2016 clearly violate standards of science research, and were clearly influenced by an anti-opioid bias introduced by writers who had ties to the addiction treatment industry. Many medical professionals have published scathing critiques of the CDC guidelines, with well-researched evidence of their errors, omissions, and outright scientific fraud.
Before anyone lauds the AHRQ generally, its failures on opioid policy should first be corrected by the CDC. See http://acsh.org/news/2017/03/25/cdc-opioid-guidelines-violate-standards-science-research-11050
Dr. Lawhern, I did not know this about the AHRQ, and on this matter I agree with you completely. Certainly a black eye for the agency, and one that will damage patients. (I still think funding for their base mission is very important, but this is awful.)
I met Dr. Carolyn Clancy a number of years ago, when she was the head of AHRQ and then network with some of her staff. The focus of a panel discussion we were on, was Comparative Effectiveness. Since the FDA can’t address all treatments for a particular disease, drugs, devices, surgery, interventional procedures, etc. it made sense that they would attempt to gather information. If local IDNs, Health Plans, etc. can’t evaluate various treatments and diagnositics in a Comparative Effectiveness Model, some one needs to, to assure optimal patient outcomes, safety, and if necessary, cost of care. The NIH to me, has more of a research and development role.
This is important to continue the AHRQ funding & independence to review health treatment & effectiveness, monitoring the effectiveness of treatment & subscriptions. Someone needs to oversee our health system vs those who provide services & products!
The AHRQ may do some good and purposeful work in some areas, I do not know. But I know this: The AHRQ is the agency that is responsible for policing physicians and hospitals with regard to Medical Errors, and they are failing miserably. The number of DEATHS are rising, not going down; and the number of “adverse events” causing SERIOUS HARM is in a universe all its own. The number is somewhere between 4.5 and 9 million human beings every single year. The AHRQ should be laser focused on that issue because more than 1200 people a day are dying due to distracted, unfocused medical personnel who need to know there is a price to pay for working on autopilot and feeling so blithely entitled to make mistakes that they also make no effort to perfect their skills.
Your statement “The AHRQ is the agency that is responsible for policing physicians and hospitals with regard to Medical Errors, and they are failing miserably” is false.
AHRQ is a non-regulatory agency. They produce research, which is then the hospitals’ and physicians’ duty to implement and for payers (insurers, Medicare, and Medicaid) to incentivize. Note the reduction in deaths due to central line infections that resulted from AHRQ-funded research. This came about because doctors and hospitals utilized the research. AHRQ can’t force providers to follow good advice.
Your statement shows once again the banal attitude most medical professionals have toward Medical Errors and why the AHRQ should be shut down. Part of their mandate is to bring down the number of Medical Errors, which have risen to mind-numbing status. They come up with bureaucratic devices – The Common Formats – which could, in theory, accomplish both a dramatic lowering of deaths and disability from Medical Errors and an accompanying acceptance of Personal Responsibility by those who cause those errors, and yet make the use of those Formats VOLUNTARY. If physicians and hospital personnel were forced to accept responsibility for their actions, that alone would accomplish a reduction in Medical Errors, in addition to the reduction in Errors that would come from litigation-wary Administrators who were confronted by the real numbers. This danger is an existential crisis for patients who risk their lives every time they are forced to interact with the medical profession. The AHRQ should either make the collection of these data mandatory, or get out of the way and let the Justice Department do it.
Yeah, Republicans always want to get rid of PCORI too. These two agencies do some of the most important work that can be done and need INCREASED budgets, but unlike researching new drugs and devices it’s a) not sexy; and b) will not mean a fortune for some private enterprise. In fact, they cut money going into pockets when they realize some expense isn’t warranted — and that’s why they face such steadfast opposition.