Creating Healthcare Success Using Lean and Redefining the Relationship Between Managers and Clinicians
Jun19

Creating Healthcare Success Using Lean and Redefining the Relationship Between Managers and Clinicians

As I look back over my experience both as a practitioner and as a medical leader, I am reminded of the joke that the life of an anesthesiologist is composed of long periods of boredom punctuated by moments of terror. Nothing describes a moment of terror for me more than knowing that the situation demands a decision, and in the moment I do not know what to do! The need to make a decision in the context of uncertainty is an apt...

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Let’s Keep Trying to Save the Gains of the ACA
May02

Let’s Keep Trying to Save the Gains of the ACA

It may seem strange to you, but each time I hear that the president and the Republican leadership are making an effort to resuscitate their attempt at repealing and replacing the ACA, I immediately think of the surprising last scene from “Fatal Attraction,” the terrifying 1987 movie with Glenn Close and Michael Douglas. You may remember that in the chilling last scene Douglas is attacked with a butcher knife by Close. She is obsessed...

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Perhaps an Explosion Would Be the Most Efficient Route to the Triple Aim
Apr25

Perhaps an Explosion Would Be the Most Efficient Route to the Triple Aim

After the failure of Paul Ryan’s American Health Care Act to get passed over the internal squabbling of House Republicans despite their forty four vote majority, David Brooks wrote an interesting tongue in cheek column entitled “The Coming Incompetence Crisis.” He articulated his concern:   …I worry that at the current pace the Trump administration is going to run out of failure. So far, we’ve lived in a golden age of...

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Where We Should Focus
Apr18

Where We Should Focus

In a recent essay Michael Dowling, the CEO of Northwell, the massive health system with 21 hospitals in metropolitan New York and Long Island, points out that the most frustrating aspect of the current healthcare debate is that “it is ideological and not practical.” He describes the debate as “…contentious, tumultuous and exhausting to keep up with.” These comments set the stage for his central contention that through it all and...

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Looking Underneath the President’s Comments About “Repeal and Replace”
Mar07

Looking Underneath the President’s Comments About “Repeal and Replace”

As the “talking heads” who analyzed the President’s speech and Governor Beshear’s Democratic party response were fading into the 11 o’clock news, Verizon offered an advertisement that contained as much or more wisdom than anything that I had heard over the previous two hours.       Why promise something that you can not deliver? (Verizon Ad)   The President seems intent on the delivery of everything that he promised...

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“Repeal and Replace”: Finally, Something From the Republican Leadership
Feb28

“Repeal and Replace”: Finally, Something From the Republican Leadership

This last week Congress has been recessed for the Presidents’ Day holiday week. Paul Ryan accurately anticipated that many of Republican members of Congress would be having town meetings with their constituents and would face angry voters who wanted to talk down the plans to “repeal and replace” the ACA. Ryan met with his troops on the Thursday before they left Washington for their week of hometown meetings. Like a good general,...

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