I’m a big fan of the current Direct TV ads. One of my favorites involves a guy who goes to a self-help seminar, becomes overconfident, goes to Las Vegas and loses everything, and has to sell his hair to eat. The ads are all based around the theme of avoiding making mistakes by becoming something that you are not intended to become. I think there is much for doctors to learn ...

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They both are and they both aren’t. I’ve never seen a week in health care policy like last week. The media reports have to be in the thousands, all trying to make sense of the furious debate between Obama and Romney over Medicare. As someone who has studied this issue for more than 20 years, it has also been more than exasperating for me to watch each side trade claims and for ...

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Basketball imposed my first patient experience in the American health care system. A loose ball and flying elbow saw me to an x-ray machine and a consult with a respected surgeon in New York City. The wait at the hospital was long. CNN blazed through the speakers and the only reading material was a sea of People magazine. For hours, I found myself in a blinking contest between Blitzer or Kardashian. Once in ...

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The decision is in – and it is likely to have a substantial impact on this year's elections, the Congress, the Court, the healthcare industry, and all Americans. Of all the commentary I've read in the wake of the recent Supreme Court decision, Time Magazine's "Special Report: The Health Care Decision" struck me as the most balanced and comprehensive. In the lead article, "Roberts Rules," author David Von Drehle skillfully dissected the ...

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Annie Lowrey’s July 28 article “Doctor shortage likely to worsen with health law” in the New York Times noted the growing shortage of primary care doctors particularly in economically disadvantaged communities, both in rural and inner-city America. This problem will likely  get worse before it gets better as more Americans gain coverage and seek a regular source of care. As the article suggests, training more doctors and incentivizing them ...

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Our septic tank backed up recently. When I say backed up, I mean, into the basement. And when I say into the basement, I mean, out of the bathroom and onto the carpet. And under the walls. The stars were aligned, and I had to go to work. My wife borrowed a Shop-Vac and rented a steam cleaner. I was assigned to call the septic-tank guy. The kids helped clean ...

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Several years ago I had dinner with a woman who had served in the late 1990s as the national Chief Medical Officer of a major health plan. At the time, she said, she had developed a strategic initiative that called for abandoning the plan's utilization review and medical management efforts, which had produced heartburn and a backlash among both physicians and patients. Instead, the idea was to retrospectively analyze utilization ...

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During my college years, we loved the album Bat Out of Hell by Meat Loaf. We would wail along with Meat Loaf as he screamed out his passionate interpretation of Paradise by the Dashboard Lights. Another memorable song on that album was Two out of Three Ain’t Bad, which offers an important lesson to those of us interested in health care reform. No, Meat Loaf was not a medical policy wonk ...

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Across the nation, the medical calendar starts in July, not January. Every July 1, hospitals are infused with new, eager interns who have just graduated from medical school. To get off to a good July start, I give a talk to the obstetrical and gynecology interns and residents about medical professionalism. It is mandated (and rightly so) by the ACGME (Accreditation Council for Graduate Medical Education) that we teach, mentor ...

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At academic medical centers (AMCs) all over the country, health care delivery and payment reform are becoming reality. AMCs need to think in a new way about the markets they serve. Timing for AMCs transforming care delivery is critical. We need to find the perfect middle ground, or what I like to call the “Goldilocks Factor.” AMCs need to transform delivery, definitely not too slowly, but not too fast for ...

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