Overkill Can Be Deadly
Dr. Doug Beer, my former colleague and longtime friend, told me a story about the way healthcare overkill can actually kill a patient. Doug, who practices internal medicine at Emanuel Hospital in Portland, Oregon, and I were talking about cancer treatment during a...
Joys and Sorrows of Healthcare Professionals
Healthcare professionals find both joy and sorrow in their work. Many of us carry scars. I think it helps to tell the stories we carry with us from our experiences in the present system, even when they are not feel-good stories. It gives us ways to think about...
Everyone Gains from Lean
Everyone, whether they are senior management, middle management, line management or the hands-on employee has much to gain from Lean. Lean can buffer the impact of chronic issues of emotional fatigue and performance pressure. It also helps with the stress of...
Born Too Soon for Lean
Lean arrived a little late for me. Even now, the Triple Aim is still more of a goal than a reality. When I think back over the system of waste in which I practiced medicine, I am left with the regret of the lost time spent licking envelopes, making calls for...
Pioneer ACOs’ Successful Efforts
Recently the Boston Globe published the much-anticipated results of the independent actuarial accounting of the results of the first two years of the Pioneer ACOs program of CMMI.(Click here to read the whole article.) I find it impossible to read this without wanting...
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...
Fostering Healthcare Innovation in Vermont
In my recent encounters with leaders who are fostering healthcare innovation in Vermont, I have observed that leadership within the ACOs, The Vermont Medical Society, forward-looking and socially oriented members of Faculty at the UVM Medical School, the leadership of...
Healthcare Innovation in Vermont
I am now involved in a small way with the Vermont Healthcare Innovation Project that is the latest of several efforts in Vermont to move away from healthcare that is fragmented, inefficient and expensive. Despite efforts to move toward value-based reimbursement and...
5 Years Later, ACA Is a Big Deal
Last month we passed a big milestone: the fifth anniversary of the ACA (Affordable Care Act). Barack Obama used 22 pens on March 23, 2010 to sign the most important piece of social legislation so far in this young century. If you have about seven minutes, you can hear...Case Study – Elizabeth Mcarthy
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