Is it possible that health care can become more effective, more personalized, more attuned to real health and wellness in a manner that truly benefits the patient as a customer/client? The answer is “yes” but it will require understanding the dysfunction in the delivery system today, dealing with the growing shortage of primary care physicians and their non-sustainable business model, changing the insurance paradigm from prepaid medical care to (high deductible) ...

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Healthcare costs keep rising. Your insurance premiums go up, your deductible and co-pays go up, pharmacy benefits go down. Despite the high cost you get little time with your physician, insurance statements are complex beyond belief and “customer service” seems to be a foreign concept. To combat high costs we are often told that rationing will be necessary. Is that true? Why are costs so high in this very dysfunctional healthcare ...

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There is enormous waste in American healthcare delivery. One estimate is anywhere from 20% to nearly 50% of total expenditures are frankly unnecessary. What is this waste?  Is it real? Could it be eliminated or at least reduced? How difficult would such a reduction be to achieve? And what would be the unintended consequences? Donald Berwick, the former administrator for the Centers for Medicare and Medicaid Services, along with Andrew Hackbarth ...

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Are you a frustrated patient because you get little time with your physician each visit? Are you a frustrated physician who would like to spend more time but can’t make it work financially? Here are some developing approaches. Reimbursement rates for primary care visits are low, so primary care physicians (PCPs) need to see many patients to cover office expenses. There are many ways that PCPs are using to escape the ...

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America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the same time has a dysfunctional care delivery system. A new vision is needed. Vision is a leadership concept that presents an idea, garners support and then develops the coalitions to bring it to fruition. America needs to envision what its care delivery system should be and then determine, as ...

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Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but more involvement by nurse practioneers and others. And increasing appreciation of the value of integrative medicine. These are but a few of the disruptive changes in care delivery that are coming. I have posted concepts on how the health care delivery system will change in coming years – quite ...

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Ours is a provider-oriented system. Doctors like me and (former) hospital executives like me hate to admit it but it is true. Consumerism will slowly but surely drive it toward being a patient-oriented service model. What do patients and their families want from the health care delivery team? First and foremost is respect followed by service given in a high quality, very safe manner. Patients expect that the information gap ...

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There will be some very disruptive and some transformational changes in the way health care is delivered, not as a result of reform, but as a result of the drivers of change described in a previous post on KevinMD.com. They included an aging population, an obese society, shortages of doctors, and emerging consumerism, among others. I interviewed in depth about 150 medical leaders from across the United States to collect ...

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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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More chronic illnesses, more diseases of old age, consumers demanding more quality and safety, physicians no longer in typical private practice, and high deductible health care polices are each about to cause major changes in the practice of medicine and how it is delivered to patients. Will this come about smoothly or, more likely, with some serious hand wringing? Health care delivery will change substantially in the coming years. This is ...

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