A stark reality of the past year has been the ever-looming ICD-10 transition, which ultimately got punted on by the federal government to October 2015. With the deadline to make the transition to ICD-10 now more than a year away instead of six months (and who knows if that will even be the case next summer), I’d still wager that many health systems are working to keep their transitions on track ...

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Health behavior change is hard; if it were easy, everyone would be doing it. But running a marathon is also hard, and lately it seems that just about everyone is doing it. The health care industry could learn a lot from the increasing popularity of the marathon about how to design programs that help people make positive health behavior changes. At its core, running 26.2 miles has much in common with the process ...

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As the VA scandal unfolds, with continued revelations of secret waitlists and delayed or denied medical care, calls have been building Veterans Affairs Secretary Eric Shinseki to resign. He did just that, resigning because, “He had become a distraction as the department struggles.” President Obama, eager to show America that he was being proactive about the scandal, regretfully accepted the General’s resignation. But other than allowing the president to show that he is doing something about ...

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There are over 16,000,000 American children (21.8%) who live in official poverty and double that number who are just poor. This is not happening in an obscure country, in a continent far away. It is happening right here, across the street from you. For those enjoying a good episode of Duck Dynasty, these are not children of illegal immigrants, and the vast majority is white kids. Over 44,000,000 American children (more ...

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Reduce health costs? Stop focusing on physician salaries.My latest USA Today column is now up: Doctors are not overpaid. I explain why focusing on physician salaries won't do much to dent health costs. Also, as I wrote in a prior blog post, "Pay me like a French doctor. You know you want to," any salary comparison with other countries also needs to consider their costs of medical education ...

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The U.S. spends nearly $3 trillion a year on health care, significantly more than any other nation. In fact, America’s annual health care spending is greater than the total gross domestic product (GDP) of every other country except China, Germany and Japan. Yet our measurable health outcomes -- from infant mortality to life expectancy -- aren’t any better than nations spending much less. I’ve written about this paradox before, pointing to a few ...

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Taking a page from firefighting to fix health care In firefighting, pump physics is one of the most critical things an engine company officer must understand.  How do we "get the wet stuff on the red stuff" in sufficient quantity without sacrificing penetrating power? The inverse ratio between volume and pressure (as the water pressure increases, volume decreases) has befuddled many a rookie lieutenant. The same, I think, is now true ...

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In the forty years since I started medical school, I have worked in socialized medicine, student health, a cash-only practice and a traditional fee for service small group practice. The bulk of my experience has been in a government-sponsored rural health clinic, working for an underserved, underinsured rural population. Today, I will make a couple of concrete suggestions, borrowing from all the places I have worked and from the latest trends ...

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Labor unions have been reliable supporters of President Obama and his policies. Their support for Obamacare was critical to its passage in 2010. Yet they are continuing to learn that their members will be paying more for their health care, not less. One of the selling points of Obamacare was the lowering of health insurance costs. Nancy Pelosi promised, “Everybody will have lower rates.” President Obama was more specific, telling us that his ...

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At the end of my interview with Chip Heath, co-author of the New York Times bestsellers “Made to Stick” and “Decisive,” I asked him what topic he’d like me to cover in the future. “I’m impressed by the culture you’ve created at Kaiser Permanente in Northern California,” he said. “You’ve generated quarter-to-quarter change that I think would have taken three years elsewhere. I don’t think most organizations know how to ...

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