Good Strategy in a Fog of Uncertainty
Feb07

Good Strategy in a Fog of Uncertainty

There is no challenge like the challenge of creating a strategic plan in uncertain times. What do you do when you do not know what to do? That is a question that frequently challenges leaders. Over eight years ago, after Lehman Brothers had failed and the value of the stock market had fallen by almost fifty percent and we did not know if we were facing a deep recession or the second coming of the Great Depression, I was asking myself...

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It Will Be a Challenging Future For Nonprofit Healthcare Boards
Jun28

It Will Be a Challenging Future For Nonprofit Healthcare Boards

When I joined the Harvard Community Health Plan board in1990, the Chairman was a very wise and experienced executive from Federated Department Stores, Maurice Lazarus. “Moogie” as he preferred to be called,  projected a throwback image to another day when wise and experienced people went unnoticed as they devoted enormous amounts of their personal time and resources to leading eleemosynary institutions that were trying to provide a...

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Foundational Principles for the Future of Care Delivery
Jun01

Foundational Principles for the Future of Care Delivery

How will the way we deliver care in ten years be similar to the way deliver care today and how will the future be different? One thing that is already in transition is the expectation of patients. Patients want a more “horizontal” and collaborative connection with their doctors and care team. That many patients receive care from a team of providers is itself a future oriented change. Are we ready for the the real digitalization of...

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Money and Health; Relationships We Must Understand and Fix
Apr18

Money and Health; Relationships We Must Understand and Fix

Doctors and hospitals worry a lot about what they get paid. It surprised me several years ago to discover that a majority of the doctors and managers in our organization did not have an in depth understanding of the mechanisms and issues that really determined how we were paid. As I have traveled around the country I have discovered that our organization was not an exception. Misunderstandings about where the money comes from and the...

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Concierge Medicine: Still Not a Good Idea
Mar04

Concierge Medicine: Still Not a Good Idea

A few physicians in my community began to try concierge medicine in the mid nineties. My first reaction was, “Harley Street has come to Beacon Street”. If you watch Downton Abbey, Lady Mary Crawley probably took her maid, Anna Bates, to Harley Street when they went to London to get the help of a gynecologist because of Anna’s recurrent miscarriages. Harley Street is synonymous with expensive private care. The English who want to avoid...

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Medical Practice & the 8 Wastes
May14

Medical Practice & the 8 Wastes

As I reflect in early retirement on my years of practice, I am a little surprised that I am losing the names of many of my patients. I saw thousands of patients in more than a hundred thousand office visits and stood at the bedsides of thousands more in hundreds of tours of duty as the hospital-based cardiologist on call for my practice; but now, without the refresher of a recent visit, even some of the most active patients are...

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