As an American medical student doing an elective in Thailand, I was initially troubled when I saw how Thai patients were treated. I'm not speaking of the way Thai physicians apply medical science, mind you -- they rely on UpToDate and sundry U.S. guidelines just as we do -- but that was mostly where the similarities ended. Morning rounds with the team of residents (sans attending, but apparently there was one ...

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When someone is arguing that our health system needs an overhaul, one of the most common reasons they cite is because it is "built on a flawed foundation of fee for service." Of course we blame fee-for-service reimbursement for the rampant overtesting, overtreating, and fragmentation (among other things) in our health system, but this doesn’t mean that it is inherently bad, and here’s why. First, a little contextualization will help. Fee ...

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While attending the Institute for Healthcare Improvement Annual Forum recently, my friend, Jared Conley, and I had the good fortune of finding ourselves standing a table away from Don Berwick in a relatively empty conference room. As MD/PhD in Health Policy students, we were interested in asking him a question about ACOs, so we approached him and introduced ourselves, hastily adding, "We know you’re busy, so we just have ...

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