Amid all the political rancor and media hoopla currently surrounding the American healthcare system and the clamor for reform from all sides, one question has gone unasked; what exactly is this thing we call healthcare? Is it the local hospital with its giant façade and ambulances coming and going all hours of the day and night? Is it the clinic where you sit and wait to have your blood pressure ...

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The fundamental challenge in any high-risk industry is balancing “productivity” versus “safety.” The term “protection” is frequently used within the scientific literature to express the role of safety departments within an organization. Described this way, it might sound as if the safety experts are framing the debate to suggest “the evil factory bosses are continually speeding up the assembly line, while the righteous safety-folks are yelling ‘slow down!’” This essential ...

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When I moved from the news business, writing about crime and investigating corrupt politicians and police officers, to the healthcare industry in the mid-1970s, we measured only the basic hospital performance indicators -- including census, staffing, inventory, days in accounts receivable and average length of stay. The data was not in real time by any stretch of the imagination. By the time the information was produced and distributed to managers, ...

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One advantage of being a surgeon and an MBA is the opportunity to observe different ways of approaching and responding to challenges.  My surgical training and 25 years of practice in academic and community hospitals have helped me become more comfortable with making major decisions despite the lack of perfect information.  Although I find that it takes longer to bounce back from nights on call, I relish the excitement of ...

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The U.S. spends far more on cancer care than 10 European countries, but according to a new study, it may be “worth it” as “the value of the survival gains greatly outweighed the costs.” The study, published this week in Health Affairs, found that U.S. spending on cancer care, in 2010 dollars, increased by 49% from 1983 through 1999, from $47,000 per cancer case to $70,000 per case. Meanwhile, in ...

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Who better knows how to fix a leak than a plumber? Who better knows how to repair a cracked doorway than a carpenter? Who better knows how to solve the conundrum of our leaking cracked health care system than a doctor? Doctors are an important part of public discussions about health care reform.  Our prescriptions drive healthcare costs.  We are the crucial middlemen between the biomedical industry and patient health. Sharing our first hand experiences in health care ...

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I’ve just come back from my semi-annual renewal in my belief that family medicine is the foundational solution to make healthcare more affordable in America: the interim session of the Texas Academy of Family Physicians. The most important activity at these meetings is the networking: the chance to bounce ideas and experiences off colleagues from around the state. The issue of cost came up and two colleagues in private practice told ...

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Fed up with our health care delivery system? Maybe even angry? What should a person do? What can a person do? I recently wrote a post on drivers of change in health care delivery such as the aging population, adverse lifestyle behaviors, shortages of physicians and developing consumer expectations. I planned to follow up today with what those drivers will produce as change in the delivery system. But a commentator responded ...

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Imagine you’re a physician, and you have a full schedule of patients to see the day after the Supreme Court has thrown out the entire Affordable Care Act. Imagine you never liked “Obamacare” in the first place, so you are feeling pretty good about the Supreme Court decision. Your first patient, an elderly retiree named Mrs. Jones, comes in for her annual Medicare wellness visit—one of the new Medicare preventive benefits ...

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When DrRich decided to become an electrophysiologist over 30 years ago, it was because he wanted to help figure out how to prevent sudden death.  Sudden death from cardiac arrhythmias is estimated to kill over 300,000 Americans each year, and at the time, some of the more recent victims of sudden death had been DrRich’s friends or loved ones. Because cardiac arrhythmias – even the lethal ones – can virtually ...

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