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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The Joy of Working in an Integrated System of Care That Is Continuously Improving
Apr11

The Joy of Working in an Integrated System of Care That Is Continuously Improving

I believe that better care that is economically sustainable and available to everyone while producing healthier communities without unacceptable personal sacrifices from individual health professionals is only possible in a professional environment and culture that respects the contributions of all health professionals. When I use the phrase “I to we” I am talking about everyone who is employed in healthcare from the staff that parks...

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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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It’s Still The Truth, Ten Years Later
Feb14

It’s Still The Truth, Ten Years Later

In the January 29th New England Journal of Medicine Foller, et. al. published an interesting article, “Population Health–A Bipartisan Agenda for the Incoming Administration from State Leaders.” The first paragraph said a lot.   The common goal of health policy leaders at the level of state government in the United States is promoting the health and well-being of all populations to the greatest extent possible within fixed...

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Is This The Shape of Things To Come?
Dec06

Is This The Shape of Things To Come?

As the President Elect announced his choice for Secretary of Health and Human Services and for the Administrator of CMS, I could not help but think back to the several times when as CEO of Atrius Health I had gone to the offices of HHS at 200 Independence Avenue SW, just a few blocks down from the Capitol dome. As I was reflecting on those heady past moments of promise for the ACA and the Triple Aim and what the new appointments might...

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Old Fashioned Values Applied to Complex Times in Healthcare
Sep13

Old Fashioned Values Applied to Complex Times in Healthcare

  An “Interested Reader “ and friend recently sent me a eulogy that he delivered at his father-in-law’s funeral. Let me give it to you to read, and then invite you to think with me about Don Berwick’s recent call for Era 3, the “Moral Era” of healthcare.   I have been thinking about my nearly 50-year long relationship with Granddad, …Charlie to work colleagues, friends and neighbors. He brings to mind Churchill’s...

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Looking Forward with the Triple Aim
Feb25

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 incorporated the Triple Aim into their strategic plans. We have very little to help us judge what organizations are accomplishing and no way of comparing their results to...

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Leaping Barriers to the Triple Aim
Feb17

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 to improvement. Their assertion remains a triple surprise for me. First, it was a true statement. Second, it did not disturb more people. Third, it is still true. The...

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