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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SBIRT fights alcohol abuse

Last year, I wrote about the college drinking phenomenon known as Thirsty Thursday and pointed out that a significant percentage of Emergency Room patients at St. Elizabeth's Hospital come from nearby Boston College, arriving with a diagnosis of alcohol poisoning.That's the bad news.  The good news is that a group of volunteer undergrad pre-meds from the same school participate...

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A bit harsh on Minute Clinics

I really admire Shannon Brownlee, but I have to take issue with the parts of her Providence Journal article in which she takes CVS to task for running Minute Clinics in their stores.  But perhaps we end up in the same place anyway!In summary she argues:For-profit retail clinics are a bad sign to anyone who understands the special role of primary care in providing good health care to a very sick nation.Primary care is one of the few places...

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The third golden handshake

Blue Cross Blue Shield has, in some respects, been a leader in Massachusetts in pursuing the agenda to bend the health care cost curve.  But the company has a blind spot when it comes to Partners Healthcare System.  Worse, it has a history of caving to the economic interests of the dominant provider, even when doing so undercuts the company's stated goal of bending the cost curve.  It has now engaged in three golden handshakes with...

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Privileged parking

I don't want to appear to be nitpicking, but sometimes the decisions that are made by health care people are indicative of underlying problems--or just obliviousness.  Here, for example, I find it hard to understand why the doctors who work in this multi-specialty clinic--which includes orthopaedics and urgent care--should have reserved parking places that are closest...

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Sepsis Heroes

Will you be in New York City on Thursday evening, September 18?  Please join us for Sepsis Heroes.Sepsis Alliance is hosting its 3rd annual Celebration of Sepsis Heroes on September 18, 2014. We received a record-breaking number of nominations this year from people who wanted to recognize healthcare workers, friends, family members, and facilities. This year, we are...

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Turning Turtle -- Is this how doctors are socialized?

Here's another short excerpt from a draft of a book--Turning Turtle--being written by my friend and colleague.  As I described below, Samuel Jay Keyser--Professor of Linguistics (Emeritus) at MIT--suffered from a debilitating fall that left him severely injured and experiencing the health care system in a way he could have never imagined.  This moment takes place after his second surgery for spinal cord injuries. One day a solo doctor...

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Turning Turtle -- Tribute to the EMTs

My friend and colleague Samuel Jay Keyser--Professor of Linguistics (Emeritus) at MIT--writes of a recent incident that left him severely injured and experiencing the health care system in a way he could have never imagined. He's in the midst of writing about the events and was kind to share a draft of his first chapter of a forthcoming book--Turning Turtle--with several of...

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A terrible burden imposed on doctors

Please take a look at this short video from Danielle Ofri, author of What Doctors Feel.A perceptive quote from her:"As doctors, if we fail, it’s not something outside of us; it is us. We are the error. The shame is so powerful that most doctors will never come forward about an error. I think the socialization of doctors makes it extremely hard for us to admit a mistake. We tend to pick perfectionists as medical students, knowing that...

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A son's legacy

Here's a short video featuring Patty Skolnik in which she explains how the tragic death of her son led to her engagement in helping clinicians learn how to help patients and families be more properly involved in making informed medical decisio...

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Experts file in Court: The proposed AG-PHS settlement is flawed

Following my earlier post about comments from an FTC official, please see a bit more on the proposed agreement between the Massachusetts Attorney General and Partners Healthcare System--in the form of a filing with the Court from the American Antitrust Institute.  AAI is an independent and non-profit national research, education and advocacy organization devoted to advancing the role of competition in the economy, protecting consumers, and sustaining...

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