Quality Care, Affordable Care. Book Offers Keys to Putting Doctors in Control

The topic of healthcare coverage is white-hot right now, but the real job of reducing healthcare costs needs to begin now as well. Reducing healthcare costs is an extremely difficult job, one which requires out-of-the-box thinking to succeed.

Fortunately, reducing variation in healthcare delivery offers a great deal of promise. 

By AAPL Staff
February 20, 2020

In the book, "Quality Care, Affordable Care: How Physicians Can Reduce Variation and Lower Healthcare Costs," Dr. Lawrence Shapiro explains how by using the simple but potent variation-reduction process, physicians can take charge of healthcare reform to improve health and reduce the cost of care.

In the book, Dr. Shapiro tells the story of how the variation-reduction program at the Palo Alto Medical Foundation (PAMF) saved $31 million by instituting a series of specialty-oriented variation-reduction programs.


Dr. Shapiro is a board-certified physician with a specialty in pulmonary medicine. He served as  the Managed Care Director of the Palo Alto Medical Foundation (PAMF), a community-based, not-for-profit medical foundation headquartered in California's Silicon Valley. He created and directed the innovative variation-reduction for PAMF.

"All medical groups and hospitals in the United States are facing the problem of unsustainable increases in healthcare costs," said Dr. Shapiro. "Variation reduction offers them a solution for remaining competitive in a rapidly-changing healthcare environment."

From Pilot to Transformation

The health reform initiative depends heavily on bending the healthcare cost curve by reducing unnecessary and wasteful variation in care. Reducing variation isn't an easy task, and many healthcare organizations aren't sure where to begin. But if physicians truly want to be captains of the healthcare ship, they need to take responsibility for healthcare costs, and variation reduction puts the control back into their hands.

In Quality Care, Affordable Care, Dr. Shapiro offers key insights that can help healthcare leaders begin the process of building a variation-reduction program in their organizations. Dr. Shapiro details how the variation-reduction effort at PAMF grew from a pilot led by a single employee to full implementation across dozens of specialties and full-scale transformation of care.

Along the way, he lays out what worked and what didn't work, how PAMF addressed physicians' concerns during the variation-reduction rollout and how he helped develop "local experts" to address regional issues. The book also introduces the five "pillars of variation reduction," principles developed by the variation-reduction team as guideposts for PAMF's ongoing efforts.

Best of all, Dr. Shapiro offers a step-by-step overview outlining what's involved in creating a variation-reduction program within a healthcare organization, including the data, organizational capabilities, structure and physician engagement efforts needed to move such a program forward.

This book offers a practical, hands-on guide to getting a variation-reduction program in place that physicians will sign up for. It offers a unique take from a physician leader who has personally led a highly-successful program and explains in plain language how to take advantage of his experience.



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