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...
Looking Forward with the Triple Aim
It is surprising that we have no good metrics to track our progress toward the Triple Aim. We have lagging numbers on what we spend as a nation and debatable public health indicators of gross population metrics. No one knows how many healthcare organizations have...
Leaping Barriers to the Triple Aim
In  “The Triple Aim: Care, Health, And Costs” Berwick, Nolan and Whittington describe American healthcare as the most fragmented, most expensive and least effective care delivery system among all of the advanced economies of the world, and they identify the barriers...
Making the Triple Aim a Common Vision
The core ideas of what the IHI calls the Triple Aim were articulated by Robert Ebert, Dean of Harvard Medical School in 1965. Our understanding of the Triple Aim was accelerated by two important books, To Err is Human (1999) and Crossing the Quality Chasm (2001),...
Lean Supports Healthcare Service and Leadership
It is paradoxical that despite all of the opportunities for professional satisfaction in healthcare, Â one of the issues of greatest concern that challenges the Triple Aim is the emotional health and happiness of healthcare professionals. Healthcare is populated by...
In Defense of Lean
Rarely do you see a clinician, researcher, teacher, philosopher, ethicist and writer all bundled up in one person inside one white coat. Jerome Groopman has been such a person. Dr. Groopman and his wife Dr. Pamela Hartzband, an endocrinologist, are one of healthcare’s...
Where Healthcare Should Focus in 2016
I have been looking forward to 2016 and asking myself where healthcare should focus in the year ahead. In this connection, Don Berwick’s speech at the 27th Annual IHI Forum had a profound effect on me. You can watch it on YouTube. I appreciated his insightful and...
The ACA, Five Years In
A recent article in the New England Journal of Medicine offers us food for thought as we contemplate the Affordable Care Act (ACA) at five years and look forward to its next challenges in 2016. If you have not read it, the article is entitled “Health Care Reform’s...
Optimism or Hope?
During the week after I had given a very positive review of the 27th IHI Forum in my weekly “Healthcare Musings” I received an email comment from one of the regular readers who wrote to me saying that he admired my optimism, but he just did not feel it. The comment...Case Study – Elizabeth Mcarthy
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