Asani offers thoughts on religious illiteracy

I'm moving off health care for this post.  Sorry to those who object, but sometimes other topics (beyond soccer!) raise issues that I like to explore with you. This one is particularly appropriate as many of us enter into a special weekend, comprising both Yom Kippur and Eid-al-Adha.  Read on if you'd like.If you're like me, a non-Muslim living in a world in which...

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45 days buys you very little

While I appreciate the efforts of Defense Secretary Chuck Hagel to improve the quality of care in the Military Health System, his order directing "all health care facilities identified as outliers in categories of access, quality and safety to provide action plans for improvement within 45 days" is ill conceived.Sure, they'll come up with plans.  After all, they have...

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There's many a slip 'twixt the cup and the lip

"How could it happen?" is the question everyone's asking.No, not the guy who walked into the White House past the Secret Service.The nurse who asked the question.  CNN reports:The first person to be diagnosed with Ebola on American soil went to the emergency room last week, but was released from the hospital even though he told staff he had traveled from Liberia.Hospital officials have acknowledged that the patient's travel history wasn't...

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Walid offers a summary

Continuing our series on the CMS Open Payments database, I offer this chart prepared by Walid Gellad, and posted on Twitter at @walidgellad, summarizing the payments made from Intuitive Surgical to doctors and hospitals for five months in 2103.  Gellad describes himself as "Primary care physician. Health services research. Co-direct Pitt Center for Pharmaceutical Policy...

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Money and trust

In my post below, I offer some information about payments made nationally by Intuitive Surgery to hospitals and doctors to support the extended use of the daVinci surgical robot.  Here, I take a look at some local examples.  As I searched through the Massachusetts listings, two names popped out as repeated recipients of cash or in-kind payments and services in amounts...

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Walking around money

It's been a long time since I wrote about the extremely close relationship between the University of Illinois Chicago, its surgical faculty, and Intuitive Surgical, the manufacturer of the daVinci robot.  I am drawn to do so again by the publication yesterday by CMS of the Open Payments database, showing payments from manufacturers to doctors and hospitals.  The...

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And now, robotic hernia surgery

First it was prostate removals, then it was hysterectomies, then it was gall bladder removals, and now (tah dah!), Intutive Surgical offers robotic hernia surgery.  Again, another procedure that is already offered at low cost and with excellent results.Please watch over the coming days as people start to correlate the names of surgeons who have endorsed these "advances"...

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Walking down the aisle

I've often admired the people who work in physical medicine and rehabilitation.  Beyond the technical skills involved, there are often strong relationships built among patients, families, and caregivers.Here's one example from Alegent Health Immanuel Rehabilitation Center, where a young woman fulfills her dream of walking down the aisle on her wedding day.Here's more about Gina Giaffoglione, who has a pretty remarkable sto...

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Look what happens when the facts are presented

A reader writes:I thought you would appreciate this overview of a study from the University of Utah on patient decision making when health care costs and outcomes are transparent.  The authors studied the decisions made with regards to laparoscopic versus open appendectomy on pediatric patients when both cost (obviously higher w/ lap) and outcomes (similar w/...

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You can only shake your head and wonder

The Attorney General's 73-page filing with the Court about her (now slightly revised) deal with Partners Healthcare System deserves at least 73 pages of rebuttal, but that isn't going to happen. You see, as noted in Commonwealth Magazine:The timing of Coakley's response seemed designed to maximize her aggressive response to her critics and minimize pushback. Her aides released the amended deal, the comments on the original deal, and her responses...

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Please, no lawyers in youth soccer!

A parent writes to the president of a youth soccer program (names changed):Thank you again for offering to advocate on behalf of my daughter, Mary, who wishes to comply with her pediatrician's advice not to remove the very small studs with which her ears were pierced this morning.  I've taken the liberty of drafting a legal document that would eliminate any liability that NGS might possibly have in connection with Mary's compliance with...

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MED QIPS takes off at Georgetown Medical School

Self-styled as "the first-ever club for patient safety at Georgetown Medical School," MED QIPS is up and running!  Medical Students for Quality Improvement and Patient Safety have set a goal of raising awareness and fostering advocacy for patient safety at the medical school level.  This is an exciting step forward, partially coming out of the students' participation...

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Wachter and Gibson on overuse

Here's a superb conversation between two of the world's experts, Robert Wachter and Rosemary Gibson, on the following issue: What is the magnitude of overuse in medicine?  And what to do about it.  The depth of their knowledge and understanding is something to behold. This should be required reading for all in the health care world.The opening [but keep reading!]:Dr. Robert Wachter, Editor, AHRQ WebM&M: What is the magnitude of overuse...

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Can health care help hire our heroes?

I know we all feel gratitude to the men and women of our armed forces and do our best in helping them re-enter civilian society after their tours of duty.  One leading program along those lines, run by the US Chamber of Commerce Foundation, is called "Hiring Our Heroes."  The program was launched in March 2011 as a nationwide initiative "to help veterans, transitioning service members, and military spouses find meaningful employment opportunities."It...

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When leaders don't lead

I made note last week of the strange silence from our state's largest insurance company, Blue Cross Blue Shield, with regard to the pending antitrust settlement between the Attorney General and Partners Healthcare System.  The impetus for my column was a strong statement by the state's other insurers that the proposed deal would be bad for the state's health care system and consumers.But I didn't make it personal.  The Boston Globe's Thomas...

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Encouragement: Please keep sending forth a tiny ripple of hope

Being a patient advocate--trying to change the world or at least your corner of it to make health care safer, higher quality, more transparent, and more patient driven--is hard work.  It can also be lonely work.  It can also be discouraging because the pace of change in this field sometimes feels like watching a race between a snail and a flow of molasses on a cold...

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CLER on WIHI

Madge Kaplan writes:The next WIHI broadcast — September 24, 2014: From Here to CLER: Graduate Medical Education and the Clinical Learning Environment Review (CLER)  — will take place on Wednesday, September 24, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Kevin B. Weiss, MD, MPH, Senior Vice President, Institutional Accreditation, Accreditation...

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The irony of on-line advertising algorithms

Sometimes the irony of on-line advertising algorithms is made evident.  How about this article in the New York Times--focused on the adverse impacts of hospital mergers--being tagged with an ad from Partners Healthcare System!  ("We're rethinking health care," says the corporation.  Are we convinced?)Mores seriously, this article explains why Partners needed...

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Screening the screenings

Here's an excellent piece about "wellness screenings" by John Lundy at the Duluth News Tribune.  The underlying theme about unnecessary testing and the business of selling such tests is important.  John's presentation is very well done.As Gary Schwitzer notes in a message to health care reporters, "Imagine the impact if this kind of story was published by papers big and small across the country." An excerpt:The screenings — for stroke,...

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In memoriam: Katherine McQuade Toig

The world lost of one its true angels this week with the death of Katherine McQuade Toig, RN.  Katie was a beacon of light to all who knew her.We first met when she was a nurse in training at BIDMC.  She was always dropping by my CEO office with questions and ideas. As a colleague said, "She wanted to save the world."  In so doing, she constantly questioned...

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How fast can a proton go down a drain?

I've had a number of people write to me upon seeing Jaimy Lee's story in Modern Healthcare:The Indiana University Proton Therapy Center will close in December, marking the first time a proton-beam therapy center in the U.S. has shut its doors since the rapid proliferation of the costly treatment centers began about a decade ago. University executives and an independent...

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We use autonomy as a defense to the need to appear to be impossibly perfect

Gene Lindsey's weekly email letter invariably contains some gems.  Here's one from this week. He cites Sally Kilgore, president and CEO of Modern Red School House Institute, from her co-authored book Silos to Systems. The book is about how the education system might be improved. Gene says:Her introduction concludes with insight that is applicable to healthcare. Envisioned by Donald Schon (1973), a learning organization is one that is “capable...

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Goal Play! hits 10K

I just received notice that Goal Play! has sold 10,000 copies.  I am honored that so many people have read and enjoyed these leadership lessons and recommended the book to their friends and colleagues.  Thank y...

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2014 Sepsis Heroes

I was so pleased to be invited by Dr. Jim O'Brien to participate in the Sepsis Alliance 2014 Sepsis Heroes ceremony in New York City.  Here are the awardees:Laura Messineo is a critical care nurse who is passionate about increasing sepsis awareness among healthcare professionals and the public. Although she has been a nurse since 1991, it would be several years before...

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