Michael L. Millenson is president, Health Quality Advisors, LLC and can be reached on his self-titled site, Michael L. Millenson.

My totally wrong expert predictions for health care in 2025

Policy
January 27, 2025

January

In a blistering commentary, the American Medical Association’s flagship journal, JAMA, condemns the corrosive effect on patient care of the profit-seeking practices of health insurers. Separately, the organization announces that it’s selling the 13 journals in its JAMA Network to a private equity firm for $375 million “in order to enhance our mission of promoting the betterment of public health.”

February

Quickly following up on a campaign pledge to slash the federal …

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My totally wrong expert predictions for health care in 2025

Can chatbots help choose the right doctor or hospital?

Tech
June 15, 2023

While ChatGPT and Bard cannot provide reliable medical or treatment advice, there is a question of whether these chatbots can assist patients in selecting the right doctor or hospital. Surprisingly, both chatbots occasionally suggest individual physicians and hospitals, providing detailed provider information. However, the accuracy and usefulness of this information are difficult to assess. As I highlighted in a recent Forbes.com column, chatbots like Microsoft and OpenAI’s ChatGPT and …

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Can chatbots help choose the right doctor or hospital?

The hidden benefits of your health insurance plan can save your life

Policy
January 1, 2020

At kitchen tables everywhere, ordinary Americans have been grappling with the arcane language of deductibles and co-pays as they’ve struggled to select a health insurance plan during open enrollment season.

Unfortunately, critical information that could literally spell the difference between life and death is conspicuously absent from the glossy brochures and eye-catching websites.

Which plan will arrange a consultation with top-tier oncologists if I’m diagnosed with a complex …

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The hidden benefits of your health insurance plan can save your life

Your bone fracture, my cash flow: the consequences of private equity in health care

Policy
September 25, 2019

A recent article in Modern Healthcare describes how private equity firms are starting to snatch up specialist physician groups that promise rich revenues, such as orthopedists, dermatologists, and ophthalmologists.

Naturally, this is about adding value, not adding to bank accounts. Because whether it’s physicians or hospitals, health insurers or drug companies, no one in health care ever does anything except in the best interest of patients.

The Modern Healthcare …

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Your bone fracture, my cash flow: the consequences of private equity in health care

The simplest and most important question to ask in the exam room

Conditions
May 16, 2019

It was the first time the young woman had come to the health center in a suburb just north of Chicago. When the 26 year old walked into the exam room back in 2008. There was no paper chart or electronic health record (EHR) accompanying her, no background information — nothing to indicate anything but a routine annual gynecological exam.

She and her husband were about to try to have their …

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The simplest and most important question to ask in the exam room

Want to find the best doctor? Don’t rely on price tags.

Policy
March 15, 2019

STAT_Logo

Say you want to know which baseball players provide the most value for the big dollars they’re being paid. A Google search quickly yields analytics. But suppose your primary care physician just diagnosed you with cancer. What will a search for a “high value” cancer doctor tell you?

Not much.

Public concern over bloated and …

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Want to find the best doctor? Don’t rely on price tags.

How to get the doctor to really see you

Patient
November 28, 2018

Doctors are regularly deluged with advice on how to engage patients. But how can you, as a patient, get your doctor to engage with you as a person truly? Your health — and even your life — could depend upon it.

A perceived absence of empathy can significantly harm physical and mental well-being. At a recent Society for Participatory Medicine (SPM) conference (I’m a member), three …

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How to get the doctor to really see you

The complex expectations of patients toward their physicians

Patient
November 10, 2018

When my father reached his mid-80s, an accelerating accumulation of physical and mental functioning issues persuaded him to switch to a primary care physician in a concierge medical practice.

Although the doctor’s pedigree proclaimed his competence, he mostly excelled as the medical equivalent of a hotel concierge who can magically procure hard-to-get restaurant reservations at the last minute. The doctor would see my dad on short notice and make sure he …

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The complex expectations of patients toward their physicians

What baseball can teach doctors

Policy
November 29, 2017

Baseball, like medicine, is deeply imbued with a sense of tradition, and no team more so than the New York Yankees, disdainful of innovations like placing players’ names on the backs of their jerseys and resistant to eroding strict standards related to haircuts and beards.

It’s why doctors and patients alike should pay special attention to why the Yankees parted ways with their old manager and what they now seek instead. In …

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What baseball can teach doctors

Why did the GOP health plan fail? Maybe because of medical Darwinism.

Policy
April 13, 2017

“We are now contemplating, Heaven save the mark, a bill that would tax the well for the benefit of the ill.” The Conversation

Although that quote reads like it could be part of the Republican repeal-and-replace assault against the Affordable Care Act (ACA), it’s actually from a 1949 editorial in The New York State Journal of Medicine denouncing health insurance itself.

Indeed, the …

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Why did the GOP health plan fail? Maybe because of medical Darwinism.

Do these 3 things to save the AHRQ from extinction

Policy
July 17, 2015

Congress is infected with the budget-cutting bug, and building an effective immune system requires political savvy. Sometimes, it’s simple (“We bomb terrorists” or “We process Social Security checks”), but sometimes an agency struggles. Case in point: AHRQ.

A House subcommittee recently voted to eliminate the Agency for Healthcare Research and Quality (AHRQ) as of Oct. 1, 2015, the start of fiscal 2016. If you hadn’t heard the news or aren’t …

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Do these 3 things to save the AHRQ from extinction

Technology cannot lead health care transformation by itself

Tech
May 11, 2015

Two modest kiosks far in the back of a cavernous HIMSS 2015 exhibit hall symbolized two separate streams of the patient engagement effort as filtered through health information technology (IT).

One featured a Bluetooth-enabled toothbrush paired with a personalized video game to teach kids to properly care for their teeth. Call that approach, “enabling compliance.” Nearby, another kiosk showcased a computerized questionnaire to help patients understand their treatment goals and true …

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Technology cannot lead health care transformation by itself

Putting patient-centeredness into practice

Patient
May 7, 2015

Imagine patient-centered care explained as a kind of updated Norman Rockwell painting. What you’d get is a recent PBS documentary, Rx: The Quiet Revolution, which, yes, uses a famous Rockwell image of a kindly family physician (Doctor and Doll) to set the stage for what follows.

Putting patient-centeredness into practice

The 90-minute film, available for viewing online, features four extraordinary stories of inspiring health care providers working in Maine, Mississippi, Alaska …

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Putting patient-centeredness into practice

Redesign the medical home to thrive in the real world

Policy
March 14, 2014

I was reading a medical home advocacy group’s upbeat approach to a recent JAMA study that had found scant benefit in the concept when, suddenly, we tumbled into Alice in Wonderland territory.

The press release from the leadership of the Patient-Centered Primary Care Collaborative (PCPCC) started out reasonably enough. The three-year study of medical practices had concluded that the patient-centered medical home (PCMH) contributed little to better quality of care, lower cost …

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Redesign the medical home to thrive in the real world

The scandal that rocked the patient safety movement

Policy
March 2, 2014

You may never have heard the name of Dr. Charles R. Denham until the Justice Department alleged he took nearly $12 million in kickbacks from CareFusion Corp. to influence a national guideline for a product hospitals buy to prevent infections during surgery.

But you surely know the names the radiation-oncologist-turned-activist-and-entrepreneur rattles off as those with whom he has worked. They include organizations such as the Centers for Disease Control and Prevention, the Cleveland …

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The scandal that rocked the patient safety movement