Creating Healthcare Success Using Lean and Redefining the Relationship Between Managers and Clinicians
Jun19

Creating Healthcare Success Using Lean and Redefining the Relationship Between Managers and Clinicians

As I look back over my experience both as a practitioner and as a medical leader, I am reminded of the joke that the life of an anesthesiologist is composed of long periods of boredom punctuated by moments of terror. Nothing describes a moment of terror for me more than knowing that the situation demands a decision, and in the moment I do not know what to do! The need to make a decision in the context of uncertainty is an apt...

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Donald Trump’s Promise
Nov22

Donald Trump’s Promise

Where Does The Real Controversy Lie? The Democratic position on healthcare and the philosophy expressed in Paul Ryan’s “A Better Way” and the brief paper that the Trump campaign had on their website agree on more than you might expect. Both sides focus on the immediate need of lowering the expense of healthcare. The differences are in the path to solution. A close reading of what is available leads to the conclusion that everyone says...

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What do the primaries mean for health care’s future?
Mar10

What do the primaries mean for health care’s future?

From the get go the pundits have been puzzled by this year’s Presidential primaries season. The confusion goes back to last June when Donald Trump announced his candidacy for the office of President. At first, the predictions were that Trump’s candidacy was a self-limited process of narcissistic personal promotion. On the Democratic side, the word was that Hillary Clinton was a “shoo-in” this time around and would not be challenged by...

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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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Optimism or Hope?
Jan07

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 caught me by surprise because although I thoroughly enjoyed the Forum and was energized by the speakers and excellent sessions, I remain painfully aware of the huge...

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Conservatives, Too, Lead Healthcare
Oct27

Conservatives, Too, Lead Healthcare

Last week in these notes I commended Maura Healey, the Massachusetts Attorney General. I had contrasted her presentation at the annual Cost Trends Hearings with the presentation of the “conservative” Governor Charlie Baker. In my view the Governor is “conservative” in the “traditional” sense David Brooks recently defined in a New York Times op/ed piece: By traditional definitions, conservatism stands for intellectual humility, a...

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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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Learning from South Africa
Sep28

Learning from South Africa

Several years ago I was fascinated by Dr. Atul Gawande’s discussion of ignorance and  incompetence. He argued that we in healthcare are no longer ignorant. We know quite a bit about pathology, pharmacology, diagnostics, and various therapeutic techniques. On my visit to Cape Town this week I was reminded of this as I passed the hospital where Christian Barnard performed the first heart transplant almost fifty years ago. The last half...

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