When my children were growing up, I advised them, “Don’t choose any profession in which your worth is determined by knowing a body of information or using algorithmic thinking. If you do that, you’re toast.” ”Toast” because monopolies on information have been supplanted by the internet, and algorithmic thinking replaced by computers and artificial intelligence. Incredibly, this seismic shift in what society values has occurred in just a single generation. And that’s ...

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As a physician and businessman, I wish the future looked better for PCPs. But history suggests things will get still worse. The history of business teaches us disruptive innovation always starts from below. The “untouchable” market leader is threatened by a less expensive version of its own product. The smug incumbent ignores the unprofitable downscale threat. Then the new competitor decides to go upscale, is forced to innovate as a result, and ...

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My generation of physicians was much like yours. My were also “the best.” We’d risen to the top of every academic pyramid: middle school, high school, college. We could be anything we wanted to be. We chose medicine, partly for noble reasons. Our bodies were wondrous and we got to help people. But also for some not so noble reasons: the money was good, everyone would look up to us, and we’d ...

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I was the "TV doctor" at the CBS, NBC, and ABC affiliates in Minnesota and Chicago for 25 years. I was on air several times a day and anchored my own news block. I did some good. I organized a colon cancer early detection campaign while presenting a series on the illness. One-hundred thousand viewers picked up Hemoccult tests, 25,000 sent them in, and I received a plaque that says, “Thank you for ...

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Are physicians unruly children? That’s the attitude I see at hospital C-suite meetings. (As in, “Our doctors are protesting our new unproven proton beam therapy center. How cute! They think they know how hospitals work: Even cuter, they think their opinion matters.") Chuckles all around. That smiling dismissiveness doesn’t surprise me. Call me cynical, but when people have power over other people, they become contemptuous. And in today’s world hospital executives have that power ...

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When I was in medical school, “real” doctors saved lives. Period. Specialists who focused on a patient’s quality of life, (the plastic surgeons, bariatric surgeons, holistic practitioners, infertility experts, etc.) were considered sellouts. (We won’t even consider the med school status of future psychiatrists.) We disparaged these doctors because they could be saving lives and chose not to, because they were often paid (God forbid) out-of-pocket by their patients, and because they ...

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