1. Panel Discussion USPSTF Recommendations: Process and Impact on Real-World Provision of Care John Santa MD MPH Director, Health Ratings Center Consumers Union Panel Discussion USPSTF Recommendations: Process and Impact on Real-World Provision of Care

2. 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

3. Systems are perfectly designed to get the results they achieve.

4. 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.”

5. 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.

6. 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.

7. “When you’re through learning, you’re through.” John Wooden-- former UCLA basketball coach