Leana Wen’s Who’s My Doctor? campaign is an important step to help health care. She endorses a total transparency manifesto where physicians can describe their sources of revenue and other potential conflicts of interest. It’s an effort to build trust. We can’t fix health care without patients’ help. A quick look at the numbers for chronic disease are compelling enough-- half of Americans have at least one chronic disease, ...

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Every patient is the only patient. - Arthur Berarducci Each person in need brings to us a unique set of qualities that require unique responses. - Don Berwick Disease-ify: To generalize and then classify a unique person's health complaint in order to match them with an effective remedy that ends to encounter; often done out of convenience, expedience, or for profit. Unique is a funny word. Every time I come across it, I am reminded of ...

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In Clay Shirky's engaging book Here Comes Everybody, he describes how professionals can be blindsided by disruptive competitors. It got me thinking about medicine. Traditionally, new technologies reached medicine in a top-down direction. The invention of MRI, for example, was first introduced to hospital administrators and department chairs as a potential new diagnostic tool. Once accepted, others further down in the medical hierarchy gained exposure. This technology wasn't disruptive because it didn't ...

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I was asked recently to predict the practice of medicine in 20 years. After stating that any such prediction is massively speculative, I indulged because it is massively fun. I am persuaded by Clayton Christensen’s arguments in The Innovator’s Prescription that healthcare will go the way of other massively disrupted industries, wherein healthcare will follow the arc of decentralization. Using the music industry as an example, the arc begins by ...

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Why does health care seem to lag behind other industries in innovation? There's a temptation to manufacture reasons that don't necessarily explain why health care has not seen the kinds of revolutionary changes evident in industries from computing and telecommunications to music and retail? People routinely marvel at how easy it is to manage their bank account these days, but they don't appreciate continuing to wait hours in their doctors' offices, ...

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Ten years on, Ian Morrison’s "Hamster Health Care: Time to Stop Running Faster and Redesign Health Care" is still eminently applicable. In his words:

Across the globe doctors are miserable because they feel like hamsters on a treadmill. They must run faster just to stand still. In … the managed care systems in the United States doctors feel that they have to see more patients to maintain their incomes. But systems ...

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We have an intuitive sense of what is meant by those urging medicine to "go digital." It seems to refer to modernizing, becoming more flexible, and basically following the path of modern computing and information technology. Is it useful to think more rigorously than this hazy conception, without necessarily reading a special report from The Economist? Digital information is special because it can be transmitted to and instantiated within any number of ...

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Many fellow medical students are eager to improve "the system." However, an overeager attitude offers both promise and peril -- promise that budding physicians are inspired to improve the inner workings of their chosen field, peril in that our naiveté may simply clutter the very complexities we seek to improve. How do we strike a balance between getting involved and getting in the way? I found guidance in law professors Raustiala’s and Sprigman’s ...

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