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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Where Healthcare Should Focus in 2016
Jan20

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 historically astute descriptions of Era 1 and Era 2 of healthcare. The first era goes all the way back to Hippocrates and Galen and was dominated by clinical autonomy and...

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Attorney General Maura Healey Leads Healthcare Reform
Oct15

Attorney General Maura Healey Leads Healthcare Reform

As a member of the Advisory Council to the Health Policy Commission in Massachusetts, I was very interested in following the internet broadcast of the annual HPC Cost Trends Hearings early in October. At the core of the presentations was a debate about healthcare costs. For me the high point came when Attorney General Maura Healey and her staff made the sort of leadership statements that suggested to me that she was not in harmony...

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The Older Americans Act
Aug14

The Older Americans Act

Recently the New England Journal of Medicine published a great article in the “Perspective” section, “The Older Americans Act at 50”.  Unfortunately the article is available online only to those who are subscribers, so I will try to give a very brief overview of its thoughtful content. I find that many physicians are totally unaware of the OAA program or–if they are aware–they do not know how to maximize its benefit for...

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The Triple Aim Before its Time
Jul14

The Triple Aim Before its Time

Lately I have been thinking again about the prescience of one of my most important mentors, Dr. Robert Ebert, who was Dean of Harvard Medical School when I was a student there. In my last blog post I cited a talk Dr. Ebert gave in 1967 at Simmons College, and I mentioned that it was a Triple Aim speech delivered 40 years before we had the Triple Aim. In today’s post I want to comment in more detail on that talk, and on the impact Dr....

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Another Hurdle Cleared at the Supreme Court!
Jun26

Another Hurdle Cleared at the Supreme Court!

  Thanks to the Supreme Court, healthcare reform has cleared another hurdle.  At 10:21 AM yesterday, as I was writing this week’s letter a banner appeared on my screen: NPR:Breaking News–Supreme Court Rules Obamacare Subsidies Are Legal Just seven words but a powerful message. Later I enjoyed looking at all the YouTube commentary on CNN. In particular I enjoyed the President’s words and the brief analysis of Jeffrey Toobin....

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Healthcare Is a Civil Right
Apr14

Healthcare Is a Civil Right

I see the current efforts to extend healthcare to all Americans to be an extension of the issues of equality of opportunity that were expressed by President Obama in his speech marking the 50th anniversary of the Civil Rights movement. Ironically, it is hard to imagine a great country with more than an eighth of its population denied access to one of the fundamentals necessary to be a productive member of society. Statistics often...

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Blocking a Healthcare Giant
Apr08

Blocking a Healthcare Giant

Recently the Boston Globe reported that healthcare giant Partners Healthcare had abandoned a three-year effort to acquire South Shore Hospital in Weymouth. The Globe called it “an unprecedented setback for an organization used to getting its way.” If I ever needed to point to one fact as evidence that we are in the midst of change, what happened to Partners’ plan for expansion is perhaps about as good an example as I could ever hope...

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