They are coming in fast under the radar, out of peripheral vision, in the magician’s other hand—and they will change everything. New ideas, surprising networks, stealth business models that may change health care profoundly, are bubbling up in pilot programs, experiments and full-on corporate transformations. There is something here that does not yet have a name, that no one is yet calling a movement, that no one is yet seeing ...

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So there was a neurosurgeon who called a plumber for a house visit. The plumber arrived and after spending an hour bestowed the neurosurgeon a bill of $500. The surgeon was stunned; he said, “Even I don’t charge this much after a surgery." The plumber stood up, gave him a sly look and said, "well that is why I am a plumber now; I used to be a neurosurgeon." I mention this ...

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When I was in training as a resident and a fellow, I remember taking only a couple of sick days over the entire 6-year period. And I had to stay home because I could not stop praying to the porcelain Goddess during a bout of a particularly nasty flu, despite a vaccination. I actually took pride in my health record, and attributed it directly to being rather sickly as a child. ...

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A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP ACP: Health care innovation in the Affordable Care Act The Patient Protection and Affordable Care Act (PPACA) has important provisions – improved access, safety and quality among them – that have the real potential to improve health and health care and, lower costs. Two recent reports remind us of the urgent ...

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The Disease Management Care Blog received this posting from an experienced nurse with a background in clinical and administrative medicine. We’ve all seen them. Those vacuous workplace posters exhorting teamwork, creativity and other forms of inspiration and accomplishment. A version has begun to creep into our nation’s health care facilities. reminding everyone of the need for privacy, how infections can be spread and the importance of patient service. And if my ...

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by James Baker, MD Once the recession is over (maybe that should be "if the recession is ever over"), it’ll be time to do something about the deficit. The way to do that is to get healthcare costs under control. But I don't see how containing fee-for-service medical practice does the trick because, outside of family practice, I cannot see how to get away from fee-for-service, for the most part. I think ...

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Among the many provisions in the Patient Protection and Affordable Care Act are elements intended to assure that every American has access to healthcare that is patient-centered, affordable, and of the highest clinical quality. In my mind, one of the act's most essential goals is to establish a National Health Care Quality Strategy -- one that integrates disparate federal and private sector initiatives, building on and expanding current quality assessment and ...

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Legend tells of an Athenian named Pheidippides who, in 490 B.C., ran from the battlefield at Marathon to Athens, telling of the victory over the Persians. Proclaiming the news that Athens would be spared pillage and fire, the Athenian dropped dead. The story is a myth. But the marathon, like most things worth doing, does offer both risks and rewards. Because it gives a chance to go beyond usual boundaries, with ...

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The Futurama exhibit from the 1939 World’s Fair, although pretty in exhibition form, looks like a terrible place to live. It’s a world of machines, concrete, and efficiency. How boring! Futurists have always imagined the “what can we do?” scenarios. They’ve never really asked the questions:

  • What should we do?
  • What do people want that would make them feel more alive and more happily human?
Jane Jacobs, in her excellent book
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I like reading Maggie Mahar’s Health Beat. She usually gets it, from the function of insurance to the complexities of assorted payment systems, I get the sense that she is generally rational when it comes to paying for health care. This doesn’t mean there aren’t times when she gets it wrong. Her embrace of primary care provided by nurse practitioners shows a truly spectacular ...

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