An unleashed demand for health care services

It slipped by so fast that I almost missed it.  It wasn't, after all, the main point of this news report by NPRs John Ydstie on All Things Considered.  It was on the economy as a whole.  Here's the audio recording.Listen at minute at 2:57 and hear the story of the one growth area of the economy:It looks as thought the advent of Obamacare and the provision of insurance to people who previously didn't have it has unleashed demand for...

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Letting ideological purity stand in the way of common sense

Health care policy is rife with fads, unsupported and analytically flawed approaches to try to influence the way care is delivered with simple--but wrong--metrics used to determine unwarranted penalties.There, I've said it.  But please don't put me as an ally of nay-saying doctors and hospitals who really don't want to improve the quality of care.  I've been devoting many years to advocating for patient-driven care, eliminating preventable...

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Sometimes, it really stinks

Doug Wojcieszak's passion is to get hospitals and doctors to see the value of apology and to have them make it part of their standard of care.  He often tells positive stories about places that have done this well, but every now and then he has a story that makes you cringe.Here's the latest example of the latter. Lest you have a doubt about Doug's feelings, he titled...

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CLER progress?

The ACGME, the body that certifies US residency training programs, notes:As a component of its next accreditation system, the ACGME has established the CLER program to assess the graduate medical education (GME) learning environment of each sponsoring institution and its participating sites. CLER emphasizes the responsibility of the sponsoring institution for the quality and...

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Women Leading

Last year around this time, I had the pleasure to tell you about a new book, The Orange Line, A Woman's Guide to Integrating Career, Family and Life, by Jodi Detjen, Michelle Waters, and Kelly Watson.  Now Jodi is offering a special three-day master class called "Women Leading" at Suffolk University on May 15-17 from 8:30AM to 4:30PM. Here's the description:Take your...

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I want my money back

Like many people, I have been following the saga of the failed state health care exchanges, Massachusetts being one.  But a sentence in today's New York Times article about the Oregon exchange took my breath away:Oregon has received $305 million in federal grants to build its exchange, according to the Congressional Research Service. The Census Bureau reports the number of households in Oregon as 1.5 million. So we (yes, we) have spent about...

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Acetaminophen Caution and Guidance

We often take Tylenol pills or other acetominophen products (like some night time cold remedies) without thinking of them as drugs with possible harmful side effects.  An article in Medscape by Charles Argoff, entitled "Acetaminophen Caution and Guidance," reminds us to be careful. He says doctors should advise patients to read the labels of the prescription and over-the-counter...

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GRACE: It all started by asking why, five times

Back in 2010, I reported on a protocol developed by Dr. Melissa Mattison and others called GRACE (Global Risk Assessment and Careplan for Elders). As noted then, this program was designed to improve the care of all hospitalized elders, with the hope of reducing the risk of delirium, falls, pressure ulcers, functional decline, etc.But let's go back to the genesis of GRACE,...

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Tensions and Tempers on WIHI

Madge Kaplan writes:The next WIHI broadcast — Transforming Tensions and Tempers on Health Care Teams — will take place on Thursday, April 24, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Neil Baker, Principal, Neil Baker Consulting and CoachingNan Cochran, MD, President, American Academy on Communication in Health Care (AACH); Director,...

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The slippery slope between academia and pharma

I want to be very careful about how I present the following information, as I mean to suggest no improper or illegal behavior on the part of any individual.  Instead, consistent with my previous columns on these matters, I mean to suggest that it is a slippery slope when people in academic medical centers join the boards of directors of pharmaceutical companies. The issue...

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Texting while "driving" in the OR

We all know we shouldn't text while driving, right? Because if you are going 30 miles per hour, your car has gone 44 feet for every second you are looking down at your iPhone. Bad things can happen even at that speed.  At 60mph, you go 88 feet per second.  Imagine how much damage you can do in that situation.  But remember the guy who said, "I only text on the highway"?Well, now comes a new set of "drivers," doctors who text or otherwise...

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How to come to terms with wanton cruelty

A friend whose mother was murdered in Kabul, Afghanistan last month teaches us a lesson in how to come to terms with wanton cruelty.   If you feel inclined to support her family's non-profit organization in support of education and service opportunities for Afghan boys and girls, click here.A small thank you to everyone who has made this month one surrounded with...

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Look, you can watch this happen in real time!

Those of you who had any doubt at all about the points I raised in my recent post about how the daVinci robot system has extracted funds from the health care system, check out this story by Jaimy Lee and Harris Meyer on Modern Healthcare, "Surgical Robot Costs put Small Hospitals in a Bind."  Excerpts:Memorial Hospital of Converse County last year purchased a $2 million...

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I, Robot has nothing on the truth

Here's the IMDb summary of the 2004 movie I, Robot:In the year 2035 a techno-phobic cop investigates a crime that may have been perpetrated by a robot, which leads to a larger threat to humanity. But we don't have to wait until 2035.  We've seen a different kind of "crime" perpetuated by a robot during the last decade or so.If we could start all over again, would we want...

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Congratulations to Willy Spaan

I met Willy Spaan many years ago, during a visit to my former hospital. Later, he invited me to his hospital, Jeroen Bosch Ziekenhuis in the Netherlands, to conduct a number of seminars and workshops on quality and safety and other process improvement.  I'm very pleased to pass along, now, this announcement:Prof. dr. W. Spaan, Chairman of the Management Board of the Jeroen...

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Shelter in Place

One year later:  A few days after last year's Boston Marathon bombing, while the police and others were searching for the remaining suspect, the Governor asked people to "shelter in place," to stay at home and avoid being on the streets.A sign of the cooperation received is this traffic map of the Boston metropolitan area on that day.  All routes are shown as green,...

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Berwick DID like the UK system after all

In a remarkable show of disinterest by the mainstream media in Massachusetts, it appears that only the Associated Press cared enough about Don Berwick's proposal for a single payer plan to give it the attention of a reporter. Here's the story: BOSTON (AP) — Democratic candidate for governor Don Berwick on Wednesday called for a ‘‘single health care payment system’’ for Massachusetts.Berwick, who headed the federal Centers...

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Acts of leadership and courage can be powerful forces for social change

Two lovely articles crossed my desk, and I'd like to share them with you.The first is by Peter Pronovost, called "The ripple effect." Excerpts:Cornell University sociologists Milena Tsvetkova and Michael Macy explained how we are much more likely to perform a kind act when we experience or witness one. Experiencing a small kindness is more potent than observing on.There is a large segment of health care workers who want to do the right thing,...

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Meanwhile, south of the Massachusetts border

Just when I thought that Massachusetts health care environment was complicated, along comes this story from ConvergenceRI.  Richard Asinof is a tireless reporter who documents the health care comings and goings in the state.  We could use someone of his energy and depth in Massachusetts, someone who connects current events with what has happened in the past--with...

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Amazing. Miraculous. Groundbreaking. Incredible.

Gary Schwitzer from HealthNewsReview.org makes this point on Twitter:A journalist must work hard to fit “amazing, miraculous, groundbreaking, incredible” into 1 robotic surgery story.He is referring to this piece on TheSpec.com. Although the entire story is worth reading, I especially like this approach to the scientific method:The new donation will support the funding of...

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Three days to help Alex go back in time

Our buddy Alex Green has made good progress on his IndieGoGo project to step back in time and engage in old-fashioned typesetting.  Three days are left, and he's 91% percent of the way there.  Please help bring back a bit of the past. Contribute he...

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Berwick proposes Medicare for all in Massachusetts

Massachusetts gubernatorial candidate Don Berwick is holding a press conference on Wednesday, April 16, at 7pm at Bakst Auditorium at Boston University's School of Medicine to present his plan called "Medicare for All," a single payer system for the state.  Many will be curious to see what he proposes.As one of Don's supporters in the Democratic primary race, I don't...

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