dreamliner The stories have now been relegated to the back pages: “Smoldering batteries forced safety regulators to ground Boeing’s new 787 Dreamliner jets.” This is a glimpse into the challenges that this aircraft and company seem to have been besieged by. The recent grounding of the fleet comes on the heels of other safety related incidents that while “typical” with a new plane ...

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We all know about Medicare, the federal government health insurance program for Americans who are over the age of 65 and/or disabled. We know that as we have begun to live longer, the Medicare population has ballooned and the costs of the program are, by most estimates, “unsustainable.” We also know that Medicare, despite being a government program, is beloved by America’s seniors. If it was an unpopular program, Congress would ...

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An elderly doctor passes away, and he find himself standing before the Pearly Gates.  The Almighty greets him and says,  “In recognition of your stellar life of service to your patients, family and community,  I welcome you to paradise.  And because I know that doctors have a great sense of curiosity about all things, you can now ask me any question—any—and I will answer it.”   The doctor ponders for a ...

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Rapid change is engulfing health care across the United States, but the strategic responses of organizations to these changes are sharply divided. In the shift that has been broadly shorthanded “from volume to value,” many organizations across the country are deeply engaged in moving toward “value” by building new partnerships, affiliations, capacities and economic structures, striving to bring better health and health care to more people for less money. At the ...

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As a physician who is involved in educating medical students, I am often asked for career advice. Medical students are by nature smart and ask very good questions. "Will I be able to pay of my student loans if I choose primary care?" "Will I have a balanced lifestyle if I decide to go into primary care?" I try to be both encouraging and realistic.  However, far too often I have ...

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shutterstock_39558046 The weakest aspect to Obamacare is in its cost control strategies, or lack thereof.  The predicted savings from converting to electronic medical records (EMR) have failed to materialize.  And the Rube Goldberg-esque plan to save money by penalizing hospitals and doctors for having poor HCAHPS scores has reaped its own set of unforeseen complications. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is the Press-Ganey ...

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dreamliner If you think that medical errors are a thing of the past, you are mistaken. It has been 14 years since the Institute of Medicine's report "To Err Is Human" shattered the myth that most, if not all, physicians are all-knowing practitioners with flawless skills and infallible judgment. The story of what happened in the report's wake was predictable:

When the Lexington, Kentucky VA Medical Center pioneered the “disclosure and offer” risk management strategy in 1987, it sought to make patients whole without the need to litigate.  As part of this process, before meeting with injured patients, VA risk managers contacted the patient and recommended they seek their own legal counsel who they were welcome to bring to the meeting.  The VA viewed this as a necessary step for ...

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shutterstock_86514196 It can be difficult to keep up with the jargon, countless proposals and complicated policies that surround the debate over Medicare reform.  Whether you are discussing premium support, changing the eligibility age or Medicare for All, there is one relatively simple concept that patients should make a point to pay attention to – one that directly impacts them – and is the ...

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shutterstock_108241016 Over the past decade, there has been yet another debate about whether pay-for-performance, the notion that the amount you get paid is tied to some measure of how you perform, “works” or not.  It’s a silly debate, with proponents pointing to the logic that “you get what you pay for” and critics arguing that the evidence is not very encouraging.  Both sides ...

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