The feminization of health care is fundamentally changing care delivery in the United States and it is doing so in ways that will accelerate the pursuit of improved quality and affordability. Historically, health care providers and health care leaders have…
The feminization of health care is fundamentally changing care delivery in the United States and it is doing so in ways that will accelerate the pursuit of improved quality and affordability.
Historically, health care providers and health care leaders have been selected for and nurtured traits that are traditionally seen as “masculine” — traits such as heroism, independence, and competition. Yet it …
In the past, physicians were responsible for both the business and practice of medicine. While administrative personnel played an important and complementary role in practice and hospital management, physicians were the cornerstone. In comparison, today the leadership structure in medicine…
In the past, physicians were responsible for both the business and practice of medicine. While administrative personnel played an important and complementary role in practice and hospital management, physicians were the cornerstone. In comparison, today the leadership structure in medicine is now an entirely foreign landscape. Administrators dominate medical practices today and, according to the New York Times, …
Let's get this straight. I am a penny pincher, who hates waste and wants a lean and efficient government. But, that said, we have to face the fact that our massive privatization of what once were government functions has been…
Let’s get this straight. I am a penny pincher, who hates waste and wants a lean and efficient government.
But, that said, we have to face the fact that our massive privatization of what once were government functions has been a failure. There are some public services that get really loused up when done privately and for profit.
Manny Alvarez is a 23-year-old college student with the misfortune of having not just a devastating cancer -- but the wrong devastating cancer. The chemotherapeutic agents shown to be highly active against his specific tumor cells are FDA approved for…
Manny Alvarez is a 23-year-old college student with the misfortune of having not just a devastating cancer — but the wrong devastating cancer. The chemotherapeutic agents shown to be highly active against his specific tumor cells are FDA approved for the treatment of leukemia, but not for the stunningly rare kind of sarcoma with which Manny has been diagnosed. Nothing is …
California is in the middle of an historic drought, with the government setting limits on how long people can sing in the shower. Farmers in the state may soon need to cut back on planting or production, as ground water…
California is in the middle of an historic drought, with the government setting limits on how long people can sing in the shower. Farmers in the state may soon need to cut back on planting or production, as ground water dries up. But California is still fruitful ground for testing promising ways to improve how health care consumers, otherwise known as …
Recently, health insurance companies across the nation have petitioned to increase premium rates for customers covered under the Affordable Care Act (ACA). In North Carolina, Blue Cross Blue Shield (BCBS) has proposed a 25.7 percent raise in premiums; in New…
Recently, health insurance companies across the nation have petitioned to increase premium rates for customers covered under the Affordable Care Act (ACA). In North Carolina, Blue Cross Blue Shield (BCBS) has proposed a 25.7 percent raise in premiums; in New Mexico, BCBS requested a 56.1 percent raise; and, in Georgia, Alliant Health Plans has submitted a proposal for a hike as high as 85 …
Mergers and acquisitions aren’t two words that usually find their way into medical lexicon, but that is rapidly changing. However, health care, like many industries, is experiencing a new round of mergers and acquisitions that is reshaping local and national…
Mergers and acquisitions aren’t two words that usually find their way into medical lexicon, but that is rapidly changing. However, health care, like many industries, is experiencing a new round of mergers and acquisitions that is reshaping local and national markets, as well as impacting the availability and affordability of health care services for millions of patients. According to many industry and Wall Street experts, we are on the front …
In many communities around the country, hospitals are one of -- if not the -- largest employers. Consequently, there are undoubtedly economic issues that would befall an area if its hospital were to close. But this post isn’t about that.…
In many communities around the country, hospitals are one of — if not the — largest employers. Consequently, there are undoubtedly economic issues that would befall an area if its hospital were to close. But this post isn’t about that. It’s about the health care consequences, and by extension, the health consequences that might arise in a community when a hospital closes its doors.
There is a scene from the movie Dr. Zhivago that, no matter how often I see it, sends chills down my spine. Yuri returns home from World War I after the communist revolution in Russia and runs into his half…
There is a scene from the movie Dr. Zhivago that, no matter how often I see it, sends chills down my spine. Yuri returns home from World War I after the communist revolution in Russia and runs into his half brother. Yuri finds that not only has his house has been taken over, but being a doctor, he has been “assigned” …
The Affordable Care Act (ACA) has changed Medicare for the better, and produced higher quality of care for patients. But whether the new shifts in Medicare policy will lower the total cost of health care, remains unclear. And that could…
The Affordable Care Act (ACA) has changed Medicare for the better, and produced higher quality of care for patients. But whether the new shifts in Medicare policy will lower the total cost of health care, remains unclear. And that could present the program with a major problem in the future.
For the first 40 years of Medicare, most enrollees opted for the traditional fee-for-service Medicare program. The main reason for doing so was …
If I had groused two years ago that we were getting doctored to death, you would’ve thought me obtuse. When I claim today, though, that every head bump doesn’t need an MRI, you get it. There’s a growing buzz about…
If I had groused two years ago that we were getting doctored to death, you would’ve thought me obtuse. When I claim today, though, that every head bump doesn’t need an MRI, you get it.
There’s a growing buzz about Americans receiving too much health care. In fact, overtesting and overtreatment are the main source of health care’s amazing expense. You can …
Paying someone to mow your lawn is a pretty straightforward affair. Ryan the lawn guy will look at the lawn size and maybe the hilliness of your yard, and you’ll settle on a price for mowing and trimming it. When…
Paying someone to mow your lawn is a pretty straightforward affair. Ryan the lawn guy will look at the lawn size and maybe the hilliness of your yard, and you’ll settle on a price for mowing and trimming it. When you decide to contract for Ryan’s services on a more regular basis, payment might get a little more complicated. If you pay Ryan every time he mows your lawn he …
Co-management agreements are growing in popularity as health care shifts to outcomes-based reimbursement models. Physicians and hospitals contract with one another in quality-oriented pay-for-performance arrangements, in which physicians oversee and manage service lines (most commonly orthopedics, oncology, and cardiology). The…
Co-management agreements are growing in popularity as health care shifts to outcomes-based reimbursement models. Physicians and hospitals contract with one another in quality-oriented pay-for-performance arrangements, in which physicians oversee and manage service lines (most commonly orthopedics, oncology, and cardiology).
The overarching goal of these agreements is quality improvement, which benefits all parties involved — especially the patient. The hospital benefits financially in part from reducing costs and physicians receive a base …
This is one of those columns that will risk the respect and friendship of some of my closest colleagues in the health care world. In addition to disagreeing with me, they may argue that I am giving aid and ammunition…
This is one of those columns that will risk the respect and friendship of some of my closest colleagues in the health care world. In addition to disagreeing with me, they may argue that I am giving aid and ammunition to “the enemy,” where the enemy might be viewed as those forces in the health care world who really don’t want …
Dr. Atul Gawande is an American surgeon and public health extraordinaire. He is one of the most successful physician authors of this century, and he writes routinely for the New Yorker. His most recent article discussing unnecessary health care is,…
Dr. Atul Gawande is an American surgeon and public health extraordinaire. He is one of the most successful physician authors of this century, and he writes routinely for the New Yorker. His most recent article discussing unnecessary health care is, as expected, a good read.
I applaud Dr. Gawande’s passion towards advancing medicine. And, yes, there is universal agreement that we need to be better in America at providing high-quality low-cost health …
Some months back I read an interesting interview with Jonathan Skinner, a researcher who works with the group at the renowned Dartmouth Atlas of Health Care. More than anyone else I can think of, the people at the Dartmouth Atlas…
Some months back I read an interesting interview with Jonathan Skinner, a researcher who works with the group at the renowned Dartmouth Atlas of Health Care. More than anyone else I can think of, the people at the Dartmouth Atlas have studied and tried both to understand and to explain the amazing variations we see in how …
Recently, I was back in the United Kingdom for a short trip home. It happened to be the week of the general election, and after a long campaign the country finally went to the polls on Thursday. For those of…
Recently, I was back in the United Kingdom for a short trip home. It happened to be the week of the general election, and after a long campaign the country finally went to the polls on Thursday.
For those of you unfamiliar with U.K. politics, for the last five years there’s been a coalition government between David Cameron’s Conservatives and the Liberal Democrats (the first coalition government for 70 years). The …
One of the goals of the Affordable Care Act (a.k.a. Obamacare) was to increase access to primary care physicians. The notion is that if people have insurance it would be easier for them to get appointments with primary care physicians.…
One of the goals of the Affordable Care Act (a.k.a. Obamacare) was to increase access to primary care physicians. The notion is that if people have insurance it would be easier for them to get appointments with primary care physicians. This is because many physicians are unwilling to accept new patients who are uninsured.
Further, a key component of the ACA was to increase physician reimbursement for Medicaid because this program …
It’s very hard to find a product or service that is both lousy and unaffordable. Such expensive duds are usually quickly replaced by cheaper and better competitors. Prior to the Affordable Care Act, health care was becoming more expensive every…
It’s very hard to find a product or service that is both lousy and unaffordable. Such expensive duds are usually quickly replaced by cheaper and better competitors. Prior to the Affordable Care Act, health care was becoming more expensive every year while simultaneously becoming less convenient, less personal, and less satisfying. In 2009, I wrote a series of four posts explaining how the health care marketplace reached such …
In October, 2013, at the launch of the Affordable Care Act, I predicted that the health insurance exchanges about to go into effect would grow in popularity and improve the health insurance marketplace, then so imperfect. Twenty months later, the…
In October, 2013, at the launch of the Affordable Care Act, I predicted that the health insurance exchanges about to go into effect would grow in popularity and improve the health insurance marketplace, then so imperfect.
Twenty months later, the exchanges are proving effective in reducing the number of uninsured and are beginning to provide the information people need to make an informed selection about which plan is best …
