If I had Three Wishes From the A.I. Genie
May16

If I had Three Wishes From the A.I. Genie

I do not stake my hopes for the future of healthcare on new legislation or changes in payment methodologies. Those are necessary but insufficient if we are ever going to respond effectively to the challenge to achieve   …Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time…in settings that support caregiver wellness. I believe that the challenge of the Triple Aim...

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A Time to Renew and Expand Our Sense of Professionalism
Mar21

A Time to Renew and Expand Our Sense of Professionalism

Retirement is a time of reflection. Most of one’s agency lies in the past. I must organize opportunities to transfer bits of experience, insight and wisdom to those who still do the work if I am to have the joy of continuing to contribute to the dream of a future where we enjoy   …Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time…in settings that support...

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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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Dartmouth and Iora Health, Partners in Innovation
Aug30

Dartmouth and Iora Health, Partners in Innovation

I recently accompanied Dr. Rushika Fernandopulle on a visit to the Iora practice site in Hanover, New Hampshire which was created in partnership with Dartmouth College, King Arthur Flour (an employee owned company) , and the New England Carpenters Health Benefits Fund. The Hanover site opened in March 2012, a little over a year after the New Yorker article by Atul Gawande that introduced so many of us to Dr. Fernandopulle. I have been...

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Lean Supports Healthcare Service and Leadership
Feb02

Lean Supports Healthcare Service and Leadership

It is paradoxical that despite all of the opportunities for professional satisfaction in healthcare,  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 very competent and caring people who chose their profession because of their desire to contribute to better care. Many of those same people are becoming disillusioned, angry...

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In Defense of Lean
Jan27

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 power couples. Together they are providing the world access to their insights and to their biases in popular books like How Doctors Think and Your Medical Mind: How to...

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D. F. Wallace, Burnout, and Healthcare
Aug26

D. F. Wallace, Burnout, and Healthcare

What does David Foster Wallace have to tell us about burnout? More than most healthcare professionals might think. The publicity for The End of the Tour, a new film starring Jason Segel as Wallace, has reminded me of the message I took away from the first Wallace book I ever read, This Is Water: Some Thoughts, Delivered on a Significant Occasion, about Living a Compassionate Life (2009). Before 2009 I had missed out on David Foster...

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Joys and Sorrows of Healthcare Professionals
Jun12

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 transforming healthcare delivery for the future. Recently I had the pleasure of some long conversations reflecting on the healthcare system with my former colleague and friend...

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