The Health Care Blog

The Business of Prostate Cancer: Putting Profit before Patients

By Dr. Anthony H. Horan During my 30+ years as a board-certified urologist I’ve seen quite a bit of suffering, much of it needless, in my opinion. In my work both in private practice and with the VA in Fresno,...
October 27, 2009 in Physicians | Permalink | Comments (14)

Physician Accountability for Violation of Safety Rules: The Time For Excuses Has Passed

By BOB WACHTER In a recent New England Journal, Peter Pronovost and I make the case for striking a new balance between “no blame” and accountability. Come on folks, it’s time. At most hospitals, hand hygiene rates hover between 30-70%,...
October 14, 2009 in Bob Wachter, Physicians | Permalink | Comments (11)

Carrot or Stick? Should Patient Decision Aids Be Rewarded or Required?

By DON KEMPER Should we incent or require providers to prescribe patient decision aids? Should we incent or require consumers to use patient decision aids? Overtreatment is the most celebrated cause of runaway health care costs, but we shouldn’t blame...
October 1, 2009 in Costs, Patients, Physicians | Permalink | Comments (6)

Can Social Media Save Healthcare Reform?

By Daniel Palestrant Daniel Palestrant is the Founder & CEO of Sermo, the largest online physician community, and a friend of THCB’s from the Health 2.0 world. Lately Dan has been seen on cable TV representing the 110K+ Sermo members...
October 1, 2009 in Physicians, Policy/Politics, Reform, Sermo, Technology | Permalink | Comments (40)

Medical Students Want You to Know

By MICHELLE SNYDER How many of us can remember a world without cell phones? Today’s medical students would undoubtedly be among that group. So it is no wonder these future physicians rely heavily on technology as they embark on their...
September 20, 2009 in EHR, Electronic Medical Records, Physicians, Social Media, Technology | Permalink | Comments (12)

10,000 US physicians have something to say and we're not wasting time.

By DANIEL PALESTRANT, MD Today, as Congress returns to session, all 100 Senators will be listening to physicians on SERMO when they deliver the “US Physician’s Appeal” on Capitol Hill. Wasting no time, my physician colleagues and I, armed with...
September 8, 2009 in Congress, Physicians, Reform, Sermo | Permalink | Comments (46)

Our President is on the Ropes

By DR. STEPHEN KARDOS Recent pictures of President Obama suggest he is battered and on the ropes. Our President can recover if he chooses to change his fighting strategy to improve health instead of budgeting health. There is clearly emerging...
September 3, 2009 in Obama administration, Physicians, Reform | Permalink | Comments (39)

Interview with Al Waxman, Psilos Group

Al Waxman is a healthcare entrepreneur who these days runs the Psilos Group, a venture firm that invests in health care services, health care IT and device and instrumentation companies. Among their better known investments are Active Health Management, Health...
August 24, 2009 in Health 2.0, Marketplace, PHRs, Physicians, Podcasts, Policy, Technology | Permalink | Comments (0)

Sermo, malpractice, and Howard Dean

By Matthew Holt Sermo’s Daniel Palestrant got on TV with Howard Dean. It was an amusing (and short) little debate which you can find here. The best moment was at the start when Dean claimed that Sermo was just a...
July 29, 2009 in AMA, Health 2.0, Malpractice, Matthew Holt, Physicians, Sermo | Permalink | Comments (14)

Return to McAllen: A Father-Son Interview

By IAN ROBERTSON KIBBE By now, Dr. Atul Gawande's article on McAllen's high cost of health care has been widely read. The article spawned a number of responses and catalyzed a national discussion on cost controls and the business of...
July 26, 2009 in Costs, David Kibbe, McAllen, Physicians | Permalink | Comments (31)

The Case for Home Health Care

By Dr. George Taler While Congress is debating health reform and struggling to accomplish the apparently competing goals of reducing costs while improving quality, I am part of a program that does both. As co-director of the Washington Hospital Center’s...
July 25, 2009 in Chronic conditions, Congress, Costs, Home Health Care, Long Term Care, Medicare, Physicians, primary care, Reform | Permalink | Comments (8)

A Wild Pitch: HR3200 Brushes Back Health Reform

By JEFF GOLDSMITH On May 12, the flame throwing Chicago White Sox pitcher Bobby Jenks was fined for throwing behind an opposing player, Texas Rangers second baseman, Ian Kinsler. When Jenks, who can throw a 102 MPH fastball, was asked...
July 20, 2009 in Congress, Economics, Hospitals, Jeff Goldsmith, Medicaid, Medicare, Physicians, Policy/Politics, Reform | Permalink | Comments (24)

Three Initiatives to Reduce Costs and Increase Health Care Efficiencies

By DALE H. YAMAMOTO Two major objectives underlying all current health care reform proposals are to reduce health care costs and to improve the quality of health care delivery. In my recent essay, part of the Society of Actuaries’ new...
July 8, 2009 in Costs, Physicians, Reform | Permalink | Comments (6)

Meaningful Use vs. Meaningless Adoption of Electronic Health Records

By RICK WEINHAUS MD Dr. David Blumenthal, the new National Coordinator for Health Information Technology, has stressed that the goal of the ARRA/HITECH initiative is to improve patient care, not to mindlessly adopt health information technology. In this regard, he...
July 7, 2009 in Electronic Medical Records, Health 2.0, Meaningful Use, Physicians, Policy, Policy/Politics, Quality, Reform, Technology, Web/Tech | Permalink | Comments (9)

Commentology

Futurist Jeff Goldsmith's analysis of issues that could cause problems for any health reform effort that eventually emerges from the foodfight in Washington this summer provoked a wide range of reader replies. ("No Country For Old Men") Goldsmith wrote in...
July 2, 2009 in AMA, Commentology, Electronic Medical Records, Jeff Goldsmith, Malpractice, Physicians, Reader Mail, Robert Laszewski, Unions | Permalink | Comments (9)

The Myth of Prevention and EHR’s?

By SCOTT SHREEVE I was just referred this article which I found to be thoughtfully crafted. Abraham Verghese is a Professor and Senior Associate Chair for the Theory and Practice of Medicine at Stanford University. I found the article interesting,...
June 30, 2009 in Electronic Medical Records, PHRs, Physicians | Permalink | Comments (10)

How Relevant is the American Medical Association?

By RAHUL PARIKH, MD Like most doctors, I was busy seeing a full schedule of patients when President Obama addressed members of the American Medical Association at their annual meeting in Chicago. The speech was billed as a crucial confrontation...
June 20, 2009 in Obama administration, Physicians, Policy/Politics, Reform | Permalink | Comments (20)

The Story of Dr. Sidney R. Garfield

By JON STEWART “It’s about time,” declares Jay Crosson, MD, a recently retired physician executive at Kaiser Permanente, in his foreword to The Story of Sidney R. Garfield – The Visionary Who Turned Sick Care into Health Care (Permanente Press,...
June 13, 2009 in Physicians | Permalink | Comments (3)

Op-Ed: How I've Missed the AMA....

By Matthew Holt Over at Dr Val’s Get Better Health site Evan Falchuk from Best Doctors is very grumpy about Steve Pearlstein’s column in the WaPo. Pearlstein rewrites Gawande’s rewrite of Shannon Brownlee’s Overtreated. Not much surprise here—everyone is doing...
June 13, 2009 in Matthew Holt, Physicians, Policy, Policy/Politics | Permalink | Comments (17)

Data-Driven Health Care: An Interview with Jerry Reeves, MD

An under-the-radar debate is occurring in health care between those who say data shows that practice variations across the land are “unwarranted” and those who maintain that such variation is inevitable given socioeconomic population differences and cost of practice differences...
June 8, 2009 in Dartmouth Atlas, Economics, evidenced-based medicine, Health Plans, Obama administration, Patient Safety, Physicians, Policy/Politics, primary care, Quality, The Industry, Transparency | Permalink | Comments (17)

Beyond Wikipedia

By NAOMI FREUNDLICH No surprise, these days more and more doctors are searching online for medical information. What is surprising, however, is that in a recent study, nearly 50% of physicians indicated that they use Wikipedia—the open-access encyclopedia that allows...
May 23, 2009 in Physicians, Technology | Permalink | Comments (19)

Op-Ed: The True Measures of a “Good Doctor”

By CHRISTOPHER J. WHITE, MD, FSCAI Measuring patient outcomes is one way to determine how “good” a doctor is – but it is far from the only way. In our obsession with measuring performance, we seem to have forgotten that....
May 20, 2009 in Physicians | Permalink | Comments (18)

Mayo & Microsoft--a big name collaboration, with even more potential to come

By Matthew Holt Mayo Clinic and Microsoft are today launching a combined product called the Mayo Clinic Health Manager (and they’ll be showing it Thursday 23rd at the Health 2.0 Meets Ix conference). What this product does is essentially combine...
April 21, 2009 in Physicians, Technology | Permalink | Comments (8)

Following the Science To A New Era In Medicine

By WILLIAM BESTERMANN, MD "The current care systems cannot do the job. Trying harder will not work. Changing systems of care will." Crossing the Quality Chasm, Institute of Medicine, 2001 Medical leadership in the United States has not yet come...
April 20, 2009 in evidenced-based medicine, Physicians, prevention, primary care, Quality, The Industry | Permalink | Comments (4)

The Doctor Is In and Logged On.

By RAHUL PARIKH Wow. I've just taken care of three patients in 12 minutes, and I didn't do it by "churning" them through my office as if it's some sort of factory assembly line. Rather, those patients (their parents, more...
April 14, 2009 in Electronic Medical Records, Physicians, Rahul Parikh, Technology | Permalink | Comments (14)

Five Recommendations for an ONC Head Who Understands Health IT Innovation

By David C. Kibbe, Brian Klepper and John Moore. Now that the legislative language of the HITECH Act -- the $20 billion health IT allocation within the economic stimulus package -- has been set, it's time to identify a National...
March 6, 2009 in Brian Klepper, Current Affairs, David Kibbe, Electronic Medical Records, evidenced-based medicine, Health 2.0, Physicians, Policy, Policy/Politics, primary care, public health, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (14)

Google Health sharing--simple but potentially important

By Matthew Holt Today late afternoon PST Google flipped the switch on an important change/add to Google Health. Recently they’ve been adding more and more little features, such as printing & graphing, and in the last month getting CVS retail...
March 4, 2009 in Consumers, e-patients, Electronic Medical Records, Google, Health 2.0, Matthew Holt, Physicians, Technology | Permalink | Comments (11)

Frances Dare explains HITECH, really well

By Matthew Holt Frances Dare from Cisco is a buddy of mine who has more and more been their student of what's going on in Washington. Given that we just saw the biggest piece of health care IT legislation ever...
March 4, 2009 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Podcasts, Policy, Policy/Politics, Technology | Permalink | Comments (0)

Getting "the CCHIT question" wrong

By Matthew Holt There’s been a lot of blather from one commenter (who may or may not be a front for a group of malcontents) on the WSJ Health Blog and lots of other blogs about CCHIT and whether it...
February 24, 2009 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Policy, Policy/Politics, Technology | Permalink | Comments (8)

Podcast: Blues VC fund invests in Phreesia

By MATTHEW HOLT I’ve been following Phreesia since it was two guys in an apartment trying to figure out how to make the patient check-in at the doctors office a better and more useful experience. Today they announced an $11m...
February 17, 2009 in Consumers, Health 2.0, Physicians, Technology | Permalink | Comments (8)

Dr. George Lundberg for Surgeon General

By Brian Klepper The report that Mr. Obama's Surgeon General choice might be neurosurgeon and CNN medical correspondent Dr. Sanjay Gupta produced an upwelling of strong opinion, particularly in the medical community. Some argued that Dr. Gupta has clearly demonstrated...
January 25, 2009 in Brian Klepper, Current Affairs, JAMA, Physicians, Policy/Politics, public health, The Industry, Transparency | Permalink | Comments (17)

Rationing -- how will it be spun?

By Sarah Arnquist The House of Representatives' $825-billion stimulus package proposed last week included $1.1 billion to fund comparative effectiveness research -- research that evaluates two or more medical technologies or treatments to see which is most effective. This is...
January 23, 2009 in Obama administration, Physicians, Policy/Politics | Permalink | Comments (11)

Five "Shovel-Ready" Health Care Reforms

By Brian Klepper & David C. Kibbe Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We...
January 21, 2009 in Brian Klepper, David Kibbe, evidenced-based medicine, Health Plans, Marketplace, Obama administration, Physicians, Policy, Policy/Politics, primary care, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (18)

As Medical Tourism Grows, Hold On We're In For a Wild Ride

By Bob Wachter Until now, medical tourism has been a curiosity, iconic “Wow, Look How Flat the World Is Becoming,” fodder for stories on 60 Minutes. But as health insurers and employers get into the act, get ready for some...
January 17, 2009 in Bob Wachter, Health Plans, International, Physicians, The Industry | Permalink | Comments (25)

Confessions of a Cultural Anthropologist: The Cause and Cure of High Health Costs

By Richard Reece Today’s medical students are being inducted into a culture in which their profession is seen increasingly in financial terms. Add in such pressures as the need to pay off enormous debts, and it is not surprising that...
January 13, 2009 in Marketplace, Physicians, primary care, Quality, Technology, The Industry, Web/Tech | Permalink | Comments (13)

The Connected Medical Home: Health 2.0 Says "Hello" to the Medical Home Model

By David Kibbe & Joe Kvedar The concept of participatory medicine is taking hold, fueled, at least in part, by what we see as two complementary forces, these being the patient-centered medical home (PCMH) and Health 2.0. Health 2.0 is...
December 22, 2008 in Electronic Medical Records, Health 2.0, Physicians, Policy/Politics, Technology | Permalink | Comments (18)

Washington, Please Don't Bail Out the Health Care Industry

By RICK PETERS A health care Marshall Plan -- $50 Billion stimulus to get electronic health records (EHRs) in every doctor’s hands or $50,000 to each physician -– what an incredible marketing job. Detroit, are you listening? Stop whining to...
December 19, 2008 in Economics, Electronic Medical Records, Obama administration, Physicians, Policy, Quality, Technology | Permalink | Comments (45)

An Open Letter to the Obama Health Team

By David C. Kibbe & Brian Klepper It seems likely that the Obama administration and Congress will spend a significant amount on health IT by attaching it as a first-order priority to the fiscal stimulus package. We take the President-elect...
December 19, 2008 in Obama administration, Physicians, Technology, The Industry, Web/Tech | Permalink | Comments (48)

Jack says cover the uninsured & spend less!

By Matthew Holt It’s no secret what the Dartmouth group’s solution for the health care system has been — reduce practice variation, get surgery and physician resource use rates similar to the Mayo Clinics' of the world, and take the...
December 18, 2008 in evidenced-based medicine, Health Plans, Physicians, Policy, Policy/Politics | Permalink | Comments (5)

The Hospitalist as Bed Czar: Indispensability, But At What Cost?

By Bob Wachter In last week’s Annals of Internal Medicine, Eric Howell and colleagues describe an innovative experiment in which the hospitalists at Johns Hopkins Bayview became the institution’s bed czars. It worked. So should my program and yours take...
December 18, 2008 in Hospitals, Nursing, Physicians | Permalink | Comments (1)

Low tech ways to improve patient care: sleep and manners

By Michael Miller, MD A few recent reports point to ways for improving the quality of physician delivered care that has little to do with technology or complex interventions. The first involves how physicians interact with patients, and the second...
December 17, 2008 in Patient Safety, Physicians, Quality | Permalink | Comments (2)

EMR use: on the steep part of the S curve, or being replaced by a new idea?

By Matthew Holt Ten plus years ago, I was giving talks suggesting that at some point relatively soon the EMR was going to become a reality. In 1999, at Harris Interactive I actually got the chance to launch a study...
December 14, 2008 in Electronic Medical Records, Health 2.0, Matthew Holt, Physicians, Technology | Permalink | Comments (14)

The Medical Home Bandwagon and the One-Hoss Shay: Expectations and Assumptions

By RICHARD REECE, MD Have you heard of the wonderful one-hoss shay that was built in such a wonderful way? Logic is logic. That’s all I say. Now in building of a chaise, I tell you there is always somewhere...
December 10, 2008 in Electronic Medical Records, Physicians, Policy/Politics, primary care | Permalink | Comments (11)

Transforming medicine and saving lives

By Sarah Arnquist This week, Don Berwick will announce the results of the 5 Million Lives Campaign before thousands of people in Nashville attending the National Forum on Quality Improvement in Health Care. Twenty years ago, it was almost heretical...
December 9, 2008 in Electronic Medical Records, Hospitals, Patient Safety, Physicians, public health, Quality | Permalink | Comments (5)

Resident Duty Hours and Patient Safety: Did The IOM Get It Right?

By Bob Wachter The Institute of Medicine just released its long-awaited report on trainee duty hours. It is well researched and balanced, and its recommendations appropriately reflect what we know vs. what we believe. Now the fun begins. Let’s start...
December 9, 2008 in Bob Wachter, Hospitals, Patient Safety, Physicians, Quality | Permalink | Comments (1)

Confessions of a Physician EMR Champion

By David Kibbe Starting this month and continuing for the next year or so, I'll be presenting a standard talk to physician audiences entitled "Confessions of a Physician EMR Champion," subtitled "A Conversation with American Physicians About How to Save...
December 8, 2008 in Electronic Medical Records, Physicians, Policy, Technology | Permalink | Comments (101)

Who Will Speak for Independent Physicians at the Reform Table?

By Richard Reece Talk to the chief executives of American’s prominent health –care institutions, and you might be surprised what you hear: When it comes to medical care, the United States isn’t getting its money’s worth…A high-performance 21st century health...
December 4, 2008 in Physicians | Permalink | Comments (15)

Embracing palliative care as mainstream medicine

By Bob Wachter I’m on clinical service now and my patients are dying left and right. And I’ve never been prouder of my own care, and that delivered by my colleagues and hospital. When I was in training, a patient’s...
November 30, 2008 in Hospitals, Physicians, Quality | Permalink | Comments (11)

Rethinking compassion in medicine

By Michael Miller Two recent events made me think about how traditional medical care and medical education address the issue of compassion. The first was at the annual dinner for the Kenneth B. Schwartz Center when they gave out their...
November 26, 2008 in Physicians, Quality | Permalink | Comments (5)

MD Rating Sites: Current State of the Space and Future Prospects

By Ruth Given Ruth Given has spent the last few months doing an exhaustive study of the physician ratings business. Ruth is an independent health economist and consultant who has in the past worked for Kaiser, the California Medical Association...
November 10, 2008 in Health 2.0, Physicians, Technology | Permalink | Comments (19)