Prospective payment DRGs: New Jersey and the USA.

Presently, DRGs are the law of the land; we have to live with the prospective payment program and all the good and bad it engenders. In fact, many believe that the DRG system may be superseded by even more restrictive regulations. Physicians can probably adjust to the present system. But we must be certain that patient care takes precedence over cost. There are several areas in which we can act: We, the physicians, must become involved in monitoring our own hospitals and in participating in hospital committees on patient care. We must also become involved in the PROs. It would be disastrous, in my opinion, for the fiscal intermediaries to run these monitoring programs. We may have to alter our practice patterns, participating in larger groups to practice the kind of medicine we believe best for our patients. We must participate in national programs to document the effects of DRGs on patient care. The American Society of Internal Medicine, the American College of Physicians, the Council of Medical Specialty Societies, and others will be involved.