The Conflict of Interest and Positive Leadership- When History Repeats.

One of the good things about getting older – at least for writers – is that stories reappear from the past but with a different twist. In fact, when stories reappear, frequently they come in two’s or three’s, and the new story is at the intersection.
Here’s an example from this week. Eric Topol was in the news.(1) I knew him as the campaigning geneticist and director of cardiovascular medicine at the Cleveland Clinic who was way out in front in questioning the safety profile of Merck’s Vioxx and exposing conflict of interest between academic medicine and pharmaceutical companies back in 2001.(2,3)
As director of the Pfizer Medical Humanities,….

The Sleepy Nature of Sleep Research: Why Watson Beat Us

Watching Watson, the computer, humiliate our human race on Jeopardy (combined with in-your-face strife and turmoil here and around the world as witnessed on Cable TV) simply reinforces how little we understand about our physiologic selves (1). Some years back of Craig Venter, the gene genius, […]

Inspiring The US Innovation Engine For Health Care

I am on a plane returning from the annual HIMSS conference on health information technologies. As I watch the borderless states go by far below, I can see the lines and circles of our interstates and highways, which previous generations had the vision and audacity to create for us. Even with the depressing […]

Accountable Care Organizations (ACO’s) and Revisiting Managed Care

Health Policy expert John Iglehart recently wrote, “One of the few major provisions of the Affordable Care Act (ACA) with solid bipartisan support establishes a new delivery model: the accountable care organization (ACO). Congress directed the Department of Health and Human Services (DHHS) to develop an ACO program to improve the quality of […]

When It Comes To End-Of-Life Decisions, Which Of These Two Women Do You Trust?

When 2008 GOP VP candidate Sarah Palin came out with her “death panels”, most of us who had worked with and advocated for “Living Wills”, “Advanced Directives” and end-of -life discussions never thought she would be taken seriously, even though there was a past history to this distortion.(1) We thought the governor’s remarks […]

Why The House of Medicine Needs To Add Nurse Education Funding To Its’ 2011-2012 Legislative Priorities

We will soon add an additional 35 plus million Americans to our health care system with the expectation of improving the overall health, productivity and competitiveness of Americans in the process. Thinking of this challenge in terms of production or provision of services, we are faced with a glaring human resource weakness – […]

Waiting and Innovating for 21st Century Healthcare

I rushed home in crazy, foggy traffic Tuesday evening to see the President’s State of the Union address. I had left work hours earlier to head to a doctor’s appointment that had taken me four months of delay to get. I showed up fifteen minutes early, knowing that I would have to do the […]

Discovering Nursing’s Full Potential: A Struggle For The House of Medicine

Ten days ago, my wife and I were blessed with the arrival of our 8th and 9th grandchildren – two little girls, Charlotte and Luca. We were also introduced for the first time, as health consumers, to the Neonatal Intensive Care Unit (NICU). The girls came early, at 34 weeks, and are working […]

President Obama and Martin Luther King: Two Leaders With One Message.

As Rev. Martin Luther King approached the podium in front of the Lincoln Memorial, his staff have recalled that he was very satisfied with their planning for the march on that day. Originally intended to terminate at the Congressional steps, the Kennedy administration, which was pursuing the historic Civil Rights Bill at the […]

Pfizer, Torcetrapib, and HDL Progress: The Dangers of Presuming To Know.

In June 2006, I was meeting privately with a member of Pfizer’s executive leadership team when he shared with me two bits of information that resurfaced in my conciousness today. The first was offered as a bit of coaching (more political than scientific) but has broader application: “Mike, don’t ever presume that you […]

Boomers, Obesity, Dollars – and BUCKAPOUND.

Aging and obesity are two intersecting and compounding megatrends. In the United States, 130 million Americans are either overweight or obese. By 2050, the percentage of U.S. citizens over 65 will reach 20 percent. That’s up from 12 percent today. (1) But the real story is how these two emerging realities play off […]

The New Year: Searching For Our Common Future

As we launch 2011, one thing is certain. We will continue to weigh the value of individuality versus commonality. What do we have in common? How different are we really, and why? Do we have a common origin? What are the forces that shape our futures? As we look forward, take a moment to read […]

What Obesity and ED Have In Common: A Medical “Trojan Horse”.

Ten years ago, during the wild first weeks that followed the release of Viagra, the first effective traetment for erectile dysfunction, much of the debate avoided the issue of effectiveness (most agreed it was effective) and focused on the question, “Should insurers reimburse for this treatment?” Two years later, states far and wide […]

How Healthy Is Your State And Our Nation?

The wire release of America’s Health Rankings®, a state by state assessment compiled by the American Public Health Association and supported by the United HealthCare Foundation, summed it up this way: “Overall Healthiness Slightly Improved, but Obesity, Children in Poverty, and Diabetes Worrisome for States’ Health….reductions in smoking, preventable hospitalizations and infectious disease […]

Cost 0f Long Term Care: State by State

Click on the map below for a state by state read of the cost of long term care such as nursing homes, assited living and at home services.

Tim Johnson- An Important Voice On Health Care Reform

On  December 5th, long time friend and colleague, Tim Johnson, will be mediating the varying voices of health consumers and health professionals on behalf of the Mayo Clinic, sponsor of “Achieving The Vision”, a Health Policy Symposium in Bethesda, MD. Tim, former Medical Editor  for ABC News and an ordained minister, is more then […]

“Meaningful Use”? Some Thoughts From Ted Shortliffe in 1991.

I wrote recently about the “meaningful use” regulations that define the requirements for federal grants and tax relief to physicians who adopt EMR’s. I’ve questioned whether the vision for the use of these technologies is under powered. To answer this question, it helps to look back if you want to look forward. Why? […]

The Grandparent Economy: Is Generosity Enough?

As the first of the 76 million US boomers reach the magic age 65 in January,2011, there has been a great deal of discussion around costs – not the least of it in health care services. But the reality is that this population has the potential to assist Society if their energy and […]

What Do Steve Jobs, The NEJM and 18 to 29 Year Old’s Have In Common?

Change is never easy. It always involves breaking through the status quo which of course holds on for dear life. But trend lines sooner or later do force adjustment. This is becoming more and more obvious in health care, troubled with high costs, variable quality and a fundamental locational disconnect – placement of […]

Why Health Care Is Going Home.

Steven H. Landers MD, MPH Source: NEJM. October 20, 2010. In Albuquerque, New Mexico, and Buffalo, New York,1 acutely ill patients have been sent out of the emergency department for hospital-like care at home. In Baton Rouge, Louisiana, and Little Rock, Arkansas, home health agencies provide chronic care management services, emphasizing care coordination and […]

Toward Accountable Care Cultures: Minding Our “Clinical Footprint”.

If , while reading this blog, you have a medical emergency, please stop reading and dial 911 or go to a nearby emergency room. Because sometimes you just need help from a doctor or other medical professional. But what about all of those other times–that aren’t emergencies–where you aren’t sure you really need […]

Advanced Professionalism

Advanced Professionalism Draft Curriculum Statement of Purpose: Advanced Professionalism is a multi-disciplinary, interactive, formative educational curriculum which defines health as the pursuit of full human potential and the health professional as a unique professional resource critical to human success. The course is designed to prepare caregivers to meet the professional demands of a modern world. […]

Should Food Stamps Fund Poor Health? The Case Against Soda Driven Obesity.

In New York City, the fourth largest city in the world, with 19.7 million people, 1.7 million or nearly 10% of its citizens use food stamps provided by the federal government and funded by public taxes. As part of the war on poverty, citizens have supported the program for a half a century. […]

Bullying Is No Longer Acceptable!

The recent death of the freshman student Tyler Clementi at Rutgers reminds us that bullying in the age of video streaming and the Internet is deadly. It also draws our attention to the fact that growing up is hard enough, and doubly difficult for gays and lesbians. Nice kids like Tyler end up […]

Poll: Will EHR Regional Extension Centers Deliver On Their Mission?

Eight months have passed since the Office of the National Coordinator for Health IT (ONC) began funding Regional Extension Centers (RECs). Sixty RECs have been created, $662 million has been awarded and electronic health record (EHR) software negotiations are under way. These steps mobilize the ONC’s mission to help 100,000 priority primary care providers become […]

Kathleen Sebelius Straight Talk To Health Insurers

Kathleen Sebelius US Secretary, Health and Human Services Original Source: Wall Street Journal In the last two weeks, my department has been accused of “thuggery” (this editorial page) and “Soviet tyranny” (Newt Gingrich). What prompted these accusations? The fact that we told health-insurance companies that, as required by law, we will review large premium increases […]

American Medical News Reports: Dr. Berwick’s “Triple Aim” Plan

Chris Salva New CMS Chief to focus on quality, organization and costs In his first major remarks on the agency’s direction, Dr. Berwick spells out his policy goals under a “Triple Aim” plan. Speaking at a conference hosted by America’s Health Insurance Plans, Dr. Berwick lauded the Affordable Care Act as “the […]

Health Reform: The Day of Reckoning Arrives

Six months ago today, the Patient Protection and Affordability of Care Act was signed into law. (1) And for many, today is “the day of reckoning”. That’s because many of the most critical consumer benefits of this transformational health bill take effect today. Yet many remain confused about what health reform is and […]

Is High Fructose Corn Syrup The Next Trans-Fat?

In the world of Mad Men consumer advertising, first you name it, then you sell it.(1) OK, it’s a little more complicated than that. In naming a consumer product, you consider what that product might mean to the consumer and study what types of terms resonate. And when the product is launched, and […]

Could Don Berwick Use Medicare To Link Medical Liability Reform To The Patient Safety Movement?

Despite all the progress in scientific research and technological advancements, at its core, health care remains a huge and complex human endeavor struggling for perfection. How huge? 900 million office visits and 35 million hospital discharges per year.(1)  How complex? Complex enough to have spurned a massive defensive and litigious malpractice system whose […]

Health Affairs: “Reinventing Primary Care” audiocast

VIDEO RESOURCE Susan Dentzer, Editor-in-Chief, Health Affairs, moderates this information and expert packed audiocast exploring the future design of primary care in the United States.

The Bug That Is Eating Manhattan: Cimex lectularius

On July 16, 2010, New York City dwellers reacted with shock and disgust at the news, Cimex lectularis had been detected in a wonder bra at Lexington and 58th. The tenant? Victoria’s Secret. Obviously it was time to get serious. It wasn’t a matter of disease – the bug doesn’t transmit disease. It was it’s […]

American Medical News: Physician smartphone popularity shifts health IT focus to mobile use

PAMELA LEWIS DOLAN American Medical News:  amednews staff. Posted Aug. 23, 2010. Doctors’ embrace of such devices puts them at a disconnect with hospitals that rely on desktop-based health technology. With physician smartphone use nearing a saturation point, doctors are in an unfamiliar position when it comes to health information technology — demanding that others […]

The Hype and The Hope of “mHealth”

Another day, another flyer arrives for a seminar on “mHealth.” One that showed up in my mailbox this week is typical: high-gloss images of mobile phones and heart signals, celebratory claims about how all of this will “revolutionize” Should New York State’s Medical Society Oppose Mandated End-Of-Life Discussions For Terminal Patients?

Nearly 30 years ago, when the consumer health movement began in earnest, health professionals responded with extreme caution, concerned that their authority and control over patients and the health care system would ultimately be challenged. To the credit of most doctors, nurses and health care leaders, caregivers have evolved, accepting that the best […]

Mayo Clinic Health Policy Center 2010 Symposium

Join the conversation and help define the next steps to advance high-value health care delivery in America by attending the 2010 Mayo Clinic Health Policy Center symposium, “Achieving the Vision: Advancing High-Value Health Care.” The event is being held Dec. 5-7, 2010, at the Bethesda North Marriott Hotel & Conference Center in Bethesda, Md. With passage […]

How Safe Is It To Walk The Streets of New York?

A decade ago, I spent an interesting year with 15 young New York executives as part of the David Rockefeller Fellowship. (1) One of the fellows that year was Janette Sadik-Khan, who at the time was managing US transit market customers for the renowned international engineering firm, Parsons Brinckerhoff. She now serves as […]

EHR’s: Healthy Relationships, Not Health Records

It’s been eleven years since my Intel colleague, John Sherry, and I first did some fieldwork studying physician practices and hospitals that were in the throes of choosing, installing, and/or experiencing EHRs (electronic health records) for the first time. Most interesting to me of these studies has been when we could get in […]

The Impact of Global Warming On Health: An Endless Summer Ahead?

In 2009 President Obama joined other global leaders in New York City for the Opening Session of the UN. One of the transboundary issues discussed was Global Warming. All agreed that the Kyoto Protocol had failed. It failed because the target to decrease emissions by some 5% was too low. It failed because […]

Bob Butler 14 Day Tribute Seminar With Links

The Bob Butler Tribute Seminar: Day 1. Aging Demographics ( Day 2. The Challenge of Longevity ( Day 3. Measuring Aging Vitality and Independence ( Day 4. When Caregivers Need Care ( Day 5. Long Distance Caregivers ( Day 6. The Economics of Living Longer ( Day 7. Financing Home Health Care ( Day 8. […]

What is a “Reasonable Risk”? Our Health and the BP Oil Spill.

Tomorrow, June 22, 2010, the IOM will convene a two day conference at the request of HHS Secretary Sebelius titled: Assessing the Human Health Effects of the Gulf of Mexico Oil Spill. According to the IOM, “During the first day’s sessions, speakers and panelists will discuss the potential adverse health effects for humans […]

IOM Hosts Meeting on Potential Human Health Effects of the Gulf Oil Spill

As oil continues to pour into the Gulf of Mexico, many questions remain unanswered. What are the potential consequences—both physical and psychological—for the short-term and long-term health of residents of affected areas? Is it safe to swim in the ocean? Can we eat seafood from the Gulf? Will drinking water be contaminated?  The […]

Will Google Deliver a Killer Health Application?

Will Google deliver a killer health application? Who knows? Neil Versel, of Fierce EMR, weighed in on June 3rd with this post: “Google is denying a report by an industry analyst that it is giving up on its much-hyped but little-used Google Health PHR. ‘The project is alive and well from a staffing perspective,” an […]

“Race to the Top” for Health Care: Will Don Berwick be our Arne Duncan?

In July, 2009, as the battle remained fully engaged on a legislative fix for health care reform, a very different approach to educational reform was announced in Washington. The United States Department of Education released the draft priorities, requirements, definitions and selection criteria for the $4.35 billion “Race to the Top” grant […]

Survey on Drug Safety from Research America!

Research America! Press Release, May 20, 2010— Nearly three-quarters of Americans are confident in our system for reviewing the effectiveness and safety of new medicines and medical devices, yet 41% say it takes too long to approve a drug and allow it to be sold to consumers. These are among the findings in a new […

Health Human Resources: New Jobs/New Job Descriptions

As Health Care transforms, experts say they are hiring new health care workers – but not necessarily with the same job descriptions. Freelancer Vickie Elmer reported Sunday in the Washington Post (SOURCE): Maybe you never will work as a nurse or a doctor because you get dizzy each time you see blood. Yet health care […]

Doctors Don’t Discuss Diet With Obese Patients

Source: Los Angeles Times “With the nation’s high rates of obesity and the low odds of weight loss, perhaps weary doctors are just giving up. National statistics show that only about half of obese Americans were advised by their doctors to cut down on fatty foods. The rate, from a 2006 survey, has not changed […]

Sun Facts: The Age of “Sunfusion”

We’re about to enter the sunny season, and for many it’s “sunfusion” – sunlight confusion. Is sun exposure good or bad? Let’s start here: Sun Beds (tanning salons) – bad.(1) But what about everyday natural sun? On the positive side: boosts Vitamin D (may protect against diabetes, heart disease, osteoporosis and other diseases), […]

Testimony to Senate Aging Committee: National e-Care Plan Needed Now

This week, almost 6 years to the day of giving similar testimony to the same Senate Special Subcommittee on Aging, I had the opportunity on behalf of theContinua Health Alliance ( to reflect on the persistent barriers that prevent the widespread implementation of telehealth, aging-in-place, and what Continua calls “e-care” (for “electronic care”) technologies. In this […]

Testimony to Health IT Policy Committee on the use of health IT for patient and family engagement

Verbal testimony delivered today in Washington DC: “I am honored to testify today about using health IT to facilitate more patient and family engagement in our own health, wellness, and care. My social science career has spanned almost 20 years of doing R&D of patient engagement technologies. These past 11 years, I have […]

What Is The Meaning of Celibacy? Science and Enforced Sexual Abstinence.

The current crisis and controversy that has enveloped the Catholic Church and its leadership and victimized its most vulnerable parishioners shows no signs of abating. This is largely the result of non-transparency, cover-up, and litigation rather than the result of an open and scientifically rigorous examination of cause and effect.  In 1979, while […]

GE Health: On The March

The Web 2.0 Summit in San Francisco has come and gone. One element on full display was the progress of GE Health. I’ve been predicting that homes will be the ultimate destination of new diagnostics and that, by 2020, most of what is done in a doctor’s office will be done in the home – […]

Changing Our Perspectives on Healthcare Reform

This has been a hard–occasionally embarrassing and even frightening–time to be an American. The healthcare reform and reconciliation bills have ushered in some of the nastiest political bickering and fear mongering seen in my short lifetime. Our media megaphone that so thrives on conflict, over-simplification, and 24 X 7 soundbites has left us […]

Electronic Health Records and Clinical Trials: An Incentive to Integrate

As we wait for the federal government to finalize important sections of the Health Information Technology for Economic and Clinical Health Act (HITECH), there is a lot of talk about the financial incentives for implementing electronic health records (EHR). And understandably so. Practices that implement an EHR under the federal government’s […]

Texas Tech Accelerates Training For Family Medicine

LUBBOCK, Texas — Texas Tech University’s medical school will soon become the first in the U.S. to offer aspiring family doctors a three-year degree at half the cost of a traditional four-year path, university officials said. The program, which begins this fall, is aimed at addressing a national […]

Tom Linden’s Postmortem on Physician Journalists In Haiti

I’ve been involved in physician journalism for 30 years, at one point serving as president of the National Association of Physician Broadcasters (now the National Association of Medical Communicators) and authored a Health Professional Media Code of Ethics in 1992.  A great friend and first class journalist through those years has been […]

The 1992 Health Professional Media Code of Ethics

Health Professional Media Code of Ethics Blending The Ethics of Journalism and Health Care Mike Magee MD I. ACCURACY:  We believe our highest responsibility is to provide clear, concise, current, and accurate health information to the public in support of participatory health care. 1. Information provided should always be truthful ad well substantiated. 2. Sources […]

Massachusetts Health Care Reform Reviewed As a Model for National Plan

PRESS RELEASE – Waltham, MA—March 24, 2010—On Tuesday, President Obama signed into law U.S. health care reform legislation, leaving many Americans wondering how it will affect them, their families, and businesses.  The national health care reform bill was modelled on groundbreaking 2006 legislation in Massachusetts requiring all adults […]

Home Based Health Leaders, Unite!

I like to think of myself as being a lot like George Clooney. Okay, okay, more like Ryan Bingham, the airport- and airmile-addicted character he plays in the recent movie, Up in the Air. (Except I don’t have his good looks, frequent romantic liaisons with strangers, or a job downsizing other people…other than that, […]

Obama’s Goal: A Better America and Better Americans

Then Senator Obama, on the Senate floor in 2005 said, “We need somebody who’s got the heart, the empathy, to recognize what it’s like to be a young teenage mom; the empathy to understand what it’s like to be poor, or African American, or gay, or disabled, or old.” (1)  He wasn’t talking […]

Could Health Reform Correct America’s “Empathy Deficit”?

On June 22, 2006, then Senator Barack Obama had this to say at Northwestern’s 148th Commencement (1): “There’s a lot of talk in this country about the federal deficit. But I think we should talk more about our empathy deficit — the ability to put ourselves in someone else’s shoes; to see the world through […]

IHI announces “WIHI Radio” – Free with Enrollment

Welcome to WIHI  How to Join   WIHI is an exciting new “talk show” program from IHI, connecting you to the cutting edge of health care improvement. It’s free, it’s timely, and it’s designed to help dedicated legions of health care improvers worldwide keep up with some of the freshest and most robust thinking and strategies for […]

Do You Know What A Population Pyramid Is?

If you take a look at the map, you can see that Africa, and to a lesser extent for South and Southeast Asia and Central America, have relatively high numbers of individuals who are young. Gary Fuller in 1995 described this as a “youth bulge”1995. Some have suggested that an excess in […]

Consumer Health Information Entrepreneurs: On The Move

Health information entrepreneurs are moving forward on the consumer side, with or without US health reform. As the video below demonstrates, they are looking birth to death, and see the advantages of multi-generational family promotion. Here’s the promo on a Toronto, Canada based firm marketing to the US patient: (Video – press here) About Us […]

Why Rush Vendor Certification of EHR Technologies?

A surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they’ve fallen off Democrats’ broader health reforms.  David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don’t […]

Will doctors and nurses climb aboard the GE “healthymagination” train?

(VIDEO here) “How much do you think my hospital should invest in electronic medical records over the next few years?” This was the question asked of me last year by a CEO of a large Health Care System. He was a member of the American Hospital Association’s Long Range Policy Committee. And I […]

After The Failure Of Reform

The stalemate in the bi-partisan health care summit was cast the moment it was announced. Republicans demanded that the reform process start anew, and Mr. Obama insisted on the Senate bill as the framework going forward. The President may now offer a more modest reform bill that […]

Be Engaged, not Entertained, by the National Healthcare Debate

I’ve been sneaking in and out of meetings all day to catch snippets of the President’s “Healthcare Summit” (insert flying graphics and dramatic theme music here!) with Congressional members at Blair House. Colleagues in D.C.—some of them in the actual room—have been sending me texts and emails with juicy one-liners from the wit […]

This Week’s Presidential Summit: Is It About Money Or Satisfaction?

Today is the Healthcare Summit in Washington. There will be a great deal of discussion about efficiency, effectiveness and holding down the cost of health care. Money and time spent were also the topic of a JAMA article this week  focused on declining physician work hours in concert with declining physician reimbursement over the past decade.(1) […]

Institute For Health Care Improvement

No matter what size our organization is, we all seek novel solutions to the seemingly intractable everyday problems that plague us. We’re aware that we need new thinking, fresh ideas, and innovation to make gains in efficiency, quality, and overall performance. The good news is that if we incorporate innovation as a management practice […]

Medical Diagnostic Imaging Coming To A Home Near You?

In 2006, I predicted that much of what currently occurs in the doctor’s office would eventually be done by devices in the home with data transmitted automatically and wirelessly to one’s care team. OK you say for blood work and vital signs, but never diagnostic imaging. Well as you can see below in a piece […]

Telemedicine To Have A Role In Haiti

I wanted to update you on our mission and our anticipated date of deployment of tomorrow, 11 February 2010. Perhaps the most exciting news is that our telemedicine / tele-behavioral health mission has been elevated to the level of White House interest.  The National Operations Center of the …US Department of Homeland Security (NOC-DHS) has […]

Has Techmanity Become A Major Component Of Advanced Health Professionalism?

Here’s the question: Can technology advance compassion, understanding, partnership and professionalism? Parallel studies of large cohorts of patients and their physicians in the late 90′s in the U.S., U.K., Germany, South Africa, Japan and Canada revealed consistent agreement on the primary definers of a successful patient-physician relationship. They were compassion, understanding and partnership. Patients also […]

Operation Smile/Haiti Update

I have almost completed my first day at Fond Parisien Field Hospital here in Haiti. It is absolutely beautiful here, green mountainous with clear blue skies. It is hard for me to imagine that not far from here there is complete devastation. This morning we had about 138 patients, and throughout the day I believe […]

Healthcare Reform: We Can’t Wait For Washington

“Well, I guess you are done blogging since healthcare reform is dead now?” Ouch! This comment came from a friend–from someone who says he actually likes some of my blogs and is eager for healthcare reform to happen. But I can understand his presumptions. The pages of ink spilled on the speculation about […]

Absent Joy, Can Medicine Sustain Professionalism?

Eli Ginzberg PhD (1911 – 2002) Here’s the question: Is is possible to sustain professional behavior in a setting that is incapable of supporting personal and professional growth, and a system where money trumps joy most of the time? Last week, I had the opportunity to spend two days at the University of North Carolina […]

Operation Smile/Haiti Update

Bitter and Sweet   After becoming a part of the daily life of the Haitians in this camp it is time to say good-bye. Another team from Operation Smile will be relieving us and our last day was bitter and sweet. The Bitter We have a tent with three young girls ages 12, 9 and 7. […]

The Role of Consumers in Defining Health Professionalism

Here is the question: In a modern preventive and prospective health care system, supported by the relationship between the people and the people caring for the people, should the consumer help define health professionalism and continually assess health professionals performance as defined by this code? In the previous four segments of this deep […]

Operation Smile/Haiti

Saturday, Jan. 30, 2010 The camp has progressed a lot since we have been here. Volunteers have really learned the system of things and we are working fluidly with the other smaller teams and camp administration, who works on getting more volunteers and supplies. People are really used to the basic nature of life – […]

“Innovators and Visionaries” Expert Panel

Innovators and Visionaries was prepared by FACCT – Foundation for Accountability with support from The Robert Wood Johnson Foundation.  Dozens of clinicians, policymakers, researchers, and advocates were kind enough to discuss their current thinking and future directions with us. We are particularly grateful to the following people for taking time for extended interviews: Ian Morrison, […]

The Role of Consumers In Defining Health Professionalism

Here is the question: In a modern preventive and prospective health care system, supported by the relationship between the people and the people caring for the people, should the consumer help define health professionalism and continually assess health professionals performance as defined by this code? In the previous four segments of this deep […]

Operation Smile Harnesses Resources and Skills for Haiti

With the unprecedented disaster in Haiti, Americans from all walks of life have responded in any way they could to lend support. As the immediate rescue activities have come to an end, infrastructure and health care have entered center stage. Traditional NGO’s with a focus on clean water, shelter, food and avoidance of […]

New Jobs for New Healthcare: 5 Ideas for Growing a Careforce for the 21st Century

In a blog entry months ago, I wrote about how Baby Boomer women–and creating a new “careforce”–are critical for healthcare reform to succeed. And I promised back then to put out some ideas the following week for creative ways to grow that innovative workforce. Okay, I got sidetracked on other topics and missed […]

Under-Visioning Professionalism: Deming, Berwick & Sensemaking

The question: Can a health professional be “professional”  in a fundamentally misaligned health system? If not, does a health professional have to contribute to health system transformation to behave professionally?     Professionals are generally members of a vocation with special training, highly educated, enjoy special trust and work autonomy, abide by […]

Under-Visioning Professionalism: Deming, Berwick, & Sensemaking

The question: Can a health professional be “professional”  in a fundamentally misaligned health system? If not, does a health professional have to contribute to health system transformation to behave professionally?     Professionals are generally members of a vocation with special training, highly educated, enjoy special trust and work autonomy, abide by […]

Don Berwick’s “Escape Fire” Speech in 1999

Escape Fire: Lessons For The Future of Health Care Don Berwick MD Escape Fire is an edited version of the Plenary Address delivered at the Institute for Healthcare Improvement’s 11th Annual National Forum on Quality Improvement in Health Care,in New Orleans,Louisiana,on December 9,1999.  On December 9, 1999, the nearly 3,000 individuals who attended the 11th […]

Healthcare Reform: Too Big To Fail

Rumors of the demise of healthcare reform have been greatly exaggerated. After Scott Brown’s upset victory for the Massachusetts Senate seat, the news media and blogosphere are abuzz. Ah, folks, we have ourselves an official media frenzy! Let the hyperbole begin: “The world has changed,” “Everything is different […]

What ever happened to the Tavistock Principles and What is the consumers’ role in defining Professionalism?

This week I continue my dive into “Advanced Professionalism”, a purposely disruptive process that explores whether it is possible to practice professionalism in a system with profound structural flaws in design, center of influence and measures of success. A quick review. Two weeks ago I began with a list of “desirable attributes” […]

The Silver Lining

Massachusett’s voters’ stunning rejection of Democrat Martha Coakley, in favor of a not-very-impressive Scott Brown, should be exactly the splash of cold water that the Democratic party – and Congress as a whole – needed. The defeat can be understood in two ways: one large and one fairly […]

“Advanced Professionalism”: A View Standing On Others’ Shoulders

As I mentioned last week, I’ve been in the early stages of a purposefully disruptive project titled “Advanced Professionalism”, which involves reviewing a decade of Medical Education literature on the topic with an eye toward challenging traditional thinking. All sources this week pointed to the seminal work of Dr. Thomas S. […]

A New Decade Resolution: 50% of Care to the Home by 2020

I’m not usually one for New Year’s resolutions. Either they are so small in scope so as not to rise to the level of “resolution” status or so big that they will take far more than one year to accomplish. And besides, I don’t like disappointing myself during […]

Alternate Views of Professionalism In Medicine: From “A Flag In The Wind” by Thomas S. Inui MD (AAMC, 2003)

The following lists appear in:. Inui, TS. A Flag In The Wind: Educating For Professionalism In Medicine. February, 2003. AAMC. numbers have been changed but correspond to original source references. Table 1. Alternative Views of Professionalism in Medicine: AAMC Medical School Objectives (1) ■ Knowledgeable (scientific method, biomedicine) ■ Skillful (clinical skills, reasoning, condition managing, […]

“Advanced Professionalism”: A View Standing On Others’ Shoulders

Thomas S. Inui MD As I mentioned last week, I’ve been in the early stages of a purposefully disruptive project titled “Advanced Professionalism”, which involves reviewing a decade of Medical Education literature on the topic with an eye toward challenging traditional thinking. All sources this week pointed […]

Should I have a PAP Smear?

The “pap smear” (Papanicolaou test) is used to screen for cervical cancer as part of the gynecological examination.  It can reveal early, pre-malignant changes to the cervix.  It is done by gently scraping the cervix with a wooden or plastic spatula and then by inserting […]

American Cancer Society Cancer Action Network

Cancer survivors and their families have an extraordinary reason to celebrate this New Year thanks to a historic vote by the U.S. Senate last week to approve comprehensive health care reform.  This giant step forward represents a decades-long legislative battle to improve the country’s health care system.  People like Dan Brodrick whose wife died of cancer because […]

ABIM Visual Depiction of Professionalism

ABIM visual depiction of the words physicians most associate with medical professionalism: From the ABIM Site: Preamble: The centerpiece of our engagement in medical professionalism is Medical Professionalism in the New Millennium: A Physician Charter, which we authored in 2002, in partnership with the American College of Physicians Foundation.

Desirable Attributes in Health Care Professionals

With the New Year, it is helpful to step back and take a hard look at where we are and where we need to go. In this light, I was doing some background research this week at the crossroads of compassion, understanding and partnership for a project I’m working on, and came across […]

Where Are Christians For Health Reform?

Michael Millenson  December 23, 2009;  Many of us Jews who take our Judaism seriously have been giving co-coreligionist Joe Lieberman a hard time, in the Jewish press and elsewhere for his obstructionism on health care reform. We believe the Connecticut senator’s actions are inconsistent with his famously deep commitment to religious observance.  […]

Progress in 2009. How Are We Doing?

FEATURED VIDEO As 2009 comes to an end, we naturally reflect on what has been accomplished, and what remains to be done. The major themes that seem to be seeping through include “Have we done enough?”, “Have we done more harm then good?”, “What side of our human nature will dominate the immediate […]

Tips For Reevaluating Your Healthcare Spending

Mary E. Ward Guest Correspondent  All you have to do is listen in on the debates and conflicts centered on health care reform and you get some clue as to how astronomical the costs can become. For those who must spend money on health care expenses the need for ways to evaluate the expenses becomes […]

“Meaningful Use”: Health Information Technology

Zoe Baird, President, Markle Foundation Dear Colleagues, It has been almost a year since President Obama signed the Recovery Act with economic stimulus that included about $40 billion to help finance health information technology. Soon, we expect that Medicare and Medicaid programs will release criteria for the “Meaningful Use” of health information technology (IT)—the metrics […]

In Rural Areas, More Women Falling into Health Care Gap

In Rural Areas, More Women Falling into Health Care Gap Women ages 50-65 face unique barriers to obtaining health care, MU researcher says   Story Contacts: Emily Martin, Sr. Information Specialist, (573) 882-3346,    Kay Libbus, Professor, Sinclair School of Nursing, (573) 882-0285,   COLUMBIA, Mo. – (Dec. 15, 2009) For Americans living in rural areas, obtaining and maintaining health care can be challenging. […]

Artificial Sweeteners, Obesity, and The Holidays

Featured Video Dr David Ludwig, in a recent editorial comparing natural sugars with artificial sweeteners in the Journal of the American Medical Association, noted that  ”Problems occur when sugars—chiefly sucrose and the chemically similar product, high-fructose corn syrup—are refined, concentrated, and consumed in large amounts. Without the protection conferred by an intact, natural […]

Health Care Reform Irony

Garrison Bliss On Huffington Post:  “If offered the choice, how many of you would sign up for access to a primary care physician 24/7 for a flat monthly fee of $49-$79 per month? Imagine — no more lengthy waits for a doctor to see you and no more dealing with insurance companies for routine, preventive […]

Nonprofit Home Health Providers Express Concerns in Health Reform Debate

Emily Swanson, VNAA The Visiting Nurse Associations of America (VNAA) is still deeply concerned about the Medicare home health cuts proposed in the Senate healthcare bill (H.R. 3590), the “Patient Protection and Affordable Care Act,” despite being significantly lower than the House bill’s proposed cuts; $42.1 billion and $54.7 billion, respectively, over ten years. “We […]

California HealthCare Foundation Report

September 2009 Of the $2.2 trillion in total U.S. health care spending in 2007, 75% ($1.7 trillion) went to care for patients with chronic conditions. Despite this staggering expenditure, there are pervasive problems with the quality […]

What The Charter School Movement Can Teach Us About Health Reform

(Featured Video) We live in a transformational time. The speed of change fueled by aging demographics, increased multi-generational complexity, a global economy, the digital revolution and consumerism with counter-balancing rights and responsibilities (to be determined), have over-taken nearly ever sector in our society. Education, energy, environment, labor, housing, transportation – all shaken to […]

GE Buy Expands Home Health Line

December 1, 2009 Healthcare has acquired Living Independently Group Inc., which sells the QuietCare wireless, sensor-based passive patient monitoring system for use in assisted living facilities, senior communities and private homes. Terms of the acquisition were not disclosed. Waukesha, Wis.-based GE Healthcare in September 2008 announced it would market QuietCare. GE also acquired an undisclosed […]

World AIDS Day 2009: How Far Have We Come?

December 1st was World AIDS Day, and the big news came out of South Africa. Current President Jacob Zuma, determined to pull the country out of the medical dark ages, announced that HIV pregnant women would now receive anti-retroviral therapy. His predecessor, Thabo Mbeki’s policies and those of then health minister […]

New Initiative: “Positive Charge” to Help Address Barriers and Provide Support to People Living with HIV/AIDS

World AIDS Day marks new collaboration between the National AIDS Fund and Bristol-Myers Squibb WASHINGTON–(BUSINESS WIRE)–The National AIDS Fund (NAF) and Bristol-Myers Squibb Company (NYSE: BMY) announced today their intention to launch “Positive Charge,” a new multiyear initiative aimed at helping to break down the barriers that prevent people living with HIV from receiving HIV care, treatment and […]

The Politics Of Evidence Based Medicine

The US Preventive Task Force revised recommendations on the frequency of mammography couldn’t have come at a worse time. I guess the only sensible conclusion about the timing has to be the head-in-the-ivory-tower attitude of academics to life in the real world.  Congress has now decided to debate the […] presents:

Last Thanksgiving weekend, many of us bloggers participated in the first documented “blog rally” to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes. It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, […]

Evidence & Economics, Emotion & Entitlement:The Politics of Proof in the Current Breast Cancer Debate

I am not a breast cancer expert. Nor are the majority of you who are reading this. Nor are the hundreds of millions of Americans witnessing the media- and partisan-fed furor over the change in guidelines about breast cancer screening for women between 40 and 50 years of age. I’m pretty sure no […]

The Infinite Loop of Finger Pointing: Chemotherapy, Congress, CMS, & the CBO

“Janice” is dreading her 65th birthday next month, and not for the reasons you might imagine. She is actually proud to be turning 65, especially because doctors told her ten years ago that she only had a year to live. I met her in 1999 when she was first diagnosed with a rare disorder that’s not […]

IOM:Integrative Medicine and the Health of the Public Report

Integrative Medicine and the Health of the Public: A Summary of the February 2009 Summit Released: Type: Workshop Summary Topic(s): Quality and Patient Safety, Food and Nutrition, Diseases, Environmental Health, Substance Abuse and Mental Health, Women’s Health Activity: Summit on Integrative Medicine and the Health of the Public Board(s): Studies under the IOM Executive Office     […]

Will Business Force Reform Back To The Drawing Board?

Until now, non-health care business has been noticeably absent from the health care reform proceedings, and quiet about the bills’ impacts on their management of employee benefits, on cost, and on the larger issues of global competitiveness. Where have the voices been of the powerful business leaders who […]

FRONTLINE’s “Sick Around The World”

“Sick Around The World” Reid’s first stop is the U.K., where the government-run National Health Service (NHS) is funded through taxes. “Every single person who’s born in the U.K. will use the NHS,” says Whittington Hospital CEO David Sloman, “and none of them will be presented a bill at any point during that time.” […]

World Diabetes Day: “Life For A Child” Sundance Premier

NEW YORK – The award-winning documentary Life for a Child will make its world television debut on the Sundance Channel on World Diabetes Day ‘ Nov. 14, 2009, at 8 p.m. EST/PST. Directed by Academy Award® nominee Edward Lachman, the film follows the journeys of children with type 1 diabetes amid the verdant mountains […]

HIV/AIDS: Punishing Success?

Early Signs of a Retreat from Commitment to HIV/AIDS Care and Treatment Over the past decade, enormous resources have been mobilized globally to address the HIV/AIDS crisis on a large scale. Doctors Without Borders/Médecins Sans Frontières (MSF) has seen first-hand the achievements, as well as some of the shortcomings, of these efforts in the […]

Saving Health Care, Saving America

So far, Congress’ response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives have obligated themselves to their benefactors’ interests rather than to those of the American […]

Who Was Norman Borlaug and The Problem With America’s Short Attention Span

Few would argue that there is a great cultural shift going on in America today. Agree or not, we’re questioning our opinions, priorities, and beliefs. Every sector is up for grabs – financial, health care, agriculture, energy and education. Dealing with change on this level seems all the more daunting because of […]

Healthy Choices For Children: A Critical Look at Gerber Graduates Cereal Bars and Healthy Alternatives

Meredith Magee Donnelly / Guest Blogger Looking at the list of ingredients on a box of Gerber Graduates Cereal Bars I was surprised to see high fructose corn syrup listed as one of the first ingredients in both the crust and the filling.  On the back cover of Nutrition Action Healthletter, one of my favorite sources for nutritional […]

After 40 Years Patients Still Crave Attention And Respect

October 21, 2009 | Patient Advocacy The Doctor/Patient Relationship What do patients want? Despite the technological promises of the Health 2.0 movement, in some ways it’s really no different today than it was forty years ago. An article that appeared in Time Magazine on May 13, 1966 says: “Today, Americans get far […]

Stop The Fictional Fears

Ah, with those powerful words in the title of this blog, I am bound to get lots of attention. Or to distract lots of attention. I tried really hard not to write this blog entry, to swallow my outrage and stifle my word processor. I chose something pleasant and calming the […]

Lifespan Planning Records

If we allow ourselves to dream of a better health care system — one that permits us to feel connected, supported, and in control of our own health destiny — two words come to mind: information and planning. The more information we have about our own health history and […]

Supplements: What You Don’t Know Can Kill You

About 114 million Americans consume dietary supplements every day in America. That’s 1 out of every 3 citizens and 1 out of every 2 adults. What’s included in the general supplement waste basket? Vitamins, minerals, botanical products, amino acids and tissue extracts. Before 1994 herbal products were considered food additives and regulated […]

Worried About Aging? Look Below The Skin At Lysosomes.

When most of us worry about aging, we look at our reflection in the mirror, and see what’s going on above the skin. But recent discoveries tell us that aging may be all about what’s going on below the skin, and inside our cell factories.1 It’s becoming clear […]

After 40 Years, Patients Still Crave Attention and Respect

September 13, 2009 | Patient Advocacy The Doctor/Patient Relationship What do patients want? Despite the technological promises of the Health 2.0 movement, in some ways it’s really no different today than it was forty years ago. An article that appeared in Time Magazine on May 13, 1966 says: “Today, Americans […]

Will Health Reform Transform? Ten Transformers.

In the wake of last evening’s remarkable speech by President Obama before both branches of Congress, the Administration and Congress must now skillfully move forward in their effort to secure Health Reform. Their focus must remain squarely on locking in the major Health Care sectors and their induced cost containment concessions, and […]

Health Care Reform

Health Care Reform August 26, 2009 Doctors (and Nurses) Without Borders: Rethinking Licensure  August 25, 2009 Sometimes emergencies teach us things about how the world should be even in normal times. On August 28th,         2005, a dear friend called me in a panic. He had been rushed to Mississippi as part of […]

Seat Belts: Why We Need Laws And Government Regulation

VIDEO: The first seat belt installed in an American automobile was featured in a Nash model in 1949. It wasn’t the first indication that automobile manufacturers realized that their machines could be hazardous to our health. In 1901 the Oldsmobile rolled out the speedometer and my own state Connecticut set the […]

Death Panel Nonsense and Evidence Based Medicine

VIDEO As the debate over health reform continues to create a storm of opinion and a range of emotions across the nation, a group of experts struggle quietly to steer our nation’s health system toward an endpoint that would simultaneously increase quality while better managing cost. Getting there is not made easier by bogus and […]

Fat Tax: Paying Big For Poor Nutrition


Here is the cold hard truth about Prevention according to the Institute of Medicine’s senior scholar J. Michael McGinnis. People who die early in America have mostly themselves to blame. Dr. McGinnis’s analysis reveals that 30% of early deaths  are driven by genetics or inherited vulnerabilities; 20% are the result of poor environmental or social […]

Fat Tax: Paying Big For Poor Nutrition

Here is the cold hard truth about Prevention according to the Institute of Medicine’s senior scholar J. Michael McGinnis.  People who die early in America have mostly themselves to blame. Dr. McGinnis’s analysis reveals that 30% of early deaths are driven by genetics or inherited vulnerabilities; 20% are the result of poor environmental or social […]

Euthanasia, Abortion, Communism, Trillions of Dollars, Losing Freedom, and Town Hall Mobs

(Stop the Spread of Fictional Fears!) by Eric Dishman on August 12, 2009 Ah, with those powerful words in the title of this blog, I am bound to get lots of attention. Or to distract lots of attention. I tried really hard not to write this blog entry, to swallow my outrage and stifle my […]

Investing In Early Childhood Health And Education

VIDEO The United Nations Children’s Fund issued a Health Report Card in 2007.1 It reviewed six dimensions of health including material well-being, health and safety, educational well-being, peer and family relationships, behaviors and risk, and subjective well-being. Where did the US fall in the rankings? In 5 of the 6 […]

Healthy Choices for Children

A critical look at Gerber Graduates Cereal Bars and healthy alternatives Looking at the list of ingredients on a box of Gerber Graduates Cereal Bars I was surprised to see high fructose corn syrup listed as one of the first ingredients in both the crust and the filling.  On the back cover of Nutrition Action […]

New Initiative Launches on the Future of Nursing

At some point in the near future, whether it’s this fall, as President Obama hopes, or early 2010, as more and more politicians are warning, we will transition from the “health reform debate” to “health reform implementation.” As front-line providers of care, nurses will play a critical role in the implementation of health reform—no matter […]

Here’s A Healthcare Stimulus Package Tip … Reserve a Doctor Before It’s Too Late!

The elements of health reform just aren’t adding up when you assess the limited number of personnel available to provide quality and timely care. I may be reminiscent of a broken record, but the healthcare sector does not currently have sufficient physician or allied health workforces to ‘absorb’ another 47 million people actively seeking clinic […]

Searching for Health Reform In All The Wrong Places

July 17, 2009 Over the past few weeks, I have had a serious case of “news junkyitis” for everything I could find out about healthcare reform as Congress and the Obama administration debate what to do for our country’s healthcare crisis. I’m trying to be hopeful that real reform will happen–that […]

Can We Afford Not To Do Prevention?

The debate on Health Care Reform is now focused on predicting the cost accurately. Logic suggests that investing in prevention will save money long term. Besides it’s clearly the right thing to do. Take for example colorectal cancer, the second leading cancer killer in the United States.1 Some 90 million Americans are at risk of […]

Medical Malpractice Reform

Why Obama Deserved the AMA Standing OvationWhen President Obama recently addressed the American Medical Association (AMA) and signaled support for malpractice reform, he received a standing ovation. No surprise there. But the truth is this reform is long overdue, and will better serve the people as well as those caring for the people. Medical malpractice […]

Medical Malpractice Reform: Why Obama Deserved the AMA Standing Ovation

Story of the Week | June 30, 2009 Medical Malpractice Reform Why Obama Deserved the AMA Standing Ovation.When President Obama recently addressed the American Medical Association (AMA) and signaled support for malpractice reform, he received a standing ovation. No surprise there. But the truth is this reform is long overdue, […]

Smoking Out the Ad Industry

Money Talks Last week, after decades of fighting dating back to FDA Commissioner David Kessler’s valiant attempts, the FDA was finally granted authority to regulate tobacco. Congress passed the Family Smoking Prevention and Tobacco Control Act, which President Obama is now expected to sign into law.1,2 This landmark legislation controls elements of manufacturing, marketing, and […]

Water Pricing and Control

Who Should be in Charge? Who owns more water then any other individual in the US today? That would be T. Boone Pickens, the oil billionaire who describes water as “the new oil” or “blue gold.” He sees water as the ultimate commodity, to be bought and sold.1,2 Water is already a $500 billion dollar […]

Digitizing Health

Two years ago, the major national primary care organizations went public with their patient-centered “Medical Home” concept.1 Since then, the AMA and 17 other specialty societies, as well as many Fortune 500 companies have endorsed the movement. This includes a vote of confidence for primary care, patient centrality, coordinated team care and payment reform to […]

Public Trust and Transparency

Keeping the Faith with Patients Constructive collaboration between doctors or researchers and industry can be important in advancing the health of the public. These relationships can promote the development of new medications and medical devices, but they may also pose the risk of biased judgment. Some relationships have risks but little or no benefit—aside from […]

Long-Distance Caregiving

Colliding mega-trends are increasingly pitting family loyalties against workplace loyalties. As the U.S. population has aged, families have become more mobile, separated by distance, and occupied by work demands. Large numbers of women have entered the workplace and global competitiveness has placed increasing emphasis on worker retention and productivity. Thus, family caregiving from a distance […]

Private Health Insurer’s House of Cards

There is a reason we are the only advanced nation in the world with employer-based health insurance. It is the result from a defensive move by GM in the late 40′s, intended to prevent the Toledo-based union from expanding its hold on GM workers by creating health benefits.1 Within ten years, 70% of all big […]

Medical Societies Embrace Water As Their Issue

On April 28th, I will be visiting the Massachusetts Medical Society and its Committee on Global Medicine & Environmental and Occupational Health. They are sponsoring the opening of my “Drops of Life” tour.1 Over the next two years, I will be visiting health organizations and universities with a dynamic, big screen, one-hour journey through the […]

How Much Should My Hospital Invest in EMRs Today?

“How much do you think my hospital should invest in electronic medical records over the next few years?” This was the  question asked of me last week by a CEO of a large Health Care System, who was a member of the American Hospital Association’s Long Range Policy Committee, after I had just shared with […]

Ix: Information Therapy

Most people know by now that Electronic Medical Records got a boost from President Obama’s stimulus package- $19 billion to  be precise. This money will help to incentivize hospitals and doctors to get moving. Currently, fewer than 20% of hospitals a nd 25% of physicians’ offices are fully automated. Obama’s administration believes that moving the dial […]

The Integrative Medicine Movement

Any combination of “medicine” and “philosophy” often is cause for deep skepticism. But a philosophy of medicine and, more importantly, health, need not seem so strange or incompatible with the evidence-based medicine with which we tend to be  more comfortable. For integrative medicine, this philosophy is a strategy—a way to view and approach the public […]

Triple Jeopardy

Universal access to healthcare requires an adequate supply of doctors, but the numbers just don’t add up! With the economy  in a tailspin and the traditional “blue chip” industries joining America’s bread lines, The Obama administration intends to restructure one of the last “cash cows” of the economy – the American healthcare system – to […]

Staying Healthy for Less

Our country is experiencing a financial downturn. People are jittery and scared. You can feel it in the air. What we need is a bit of a boost from people who have weathered adversity in the past. My nominee is Elfisio Farris, a first generation   American from Sardinia, the large island off the western coast […]

Unhealthy Fears

There is apparently a great deal we don’t know about the current global financial crisis. But one thing we do know is that people are scared. And when people are scared, they not only make different decisions, but they make themselves sick as well. I will be studying fear levels at the “Woodbury Commons” polling […]

“Medical Home” Vision

Too much medical, not enough home As we listen to thought leaders and experts in medical education, public health, chronic disease management, global health and the dual burden of disease, wellness and prevention,  and alternative health, two things are clear. First, change is in the air. Second, our thought processes are converging, even as our […]

Alternative Medicine Goes Mainstream

Don’t forget palliative careAs populations age in the United States, chronic illnesses create an uncertain medical future. By 2030, a fifth of the U.S. population will be over 65, and many will face the challenges of managing one or more chronic illnesses for a significant number of years, including physical and psychological distress, functional dependency […]


Time for straight talk This week we’ve seen opposition to the Obama Administration Stimulus Package with a lead sound bite from the opposition about “Millions for Condoms.” In the past, the battle over condoms has often engaged around what approach to birth control and disease prevention is most successful. Back in 1986, Surgeon General C. […]

The New Science of Vascular Disease

Science has given us a new understanding of how cardio-metabolic disease works Here’s an important new column about vascular disease by my good friend Dr. Bestermann…By William H. Bestermann M.D. Vascular disease and the conditions that produce arterial problems consume roughly one- third to one-half of the $2 trillion annual spend […]

Rebooting America’s Health IT Conversation Part 2: Beyond EHRs

The Obama health care team should consider a wide range of useful, innovative health IT options Yesterday we tried to put EHRs into perspective. They’re important, and we can’t effectively move health care forward without them. But they’re only one of many important health IT functions. EHRs and health […]

Regulating Health

The story of lead poisoningThe recent financial crisis in the U.S. unleashed a passionate debate on the absence of sufficient regulation to protect the interests of Americans. But as regulations associated with health in America well illustrate, it’s not enough to have regulation. You must have the right type of regulation at the right time,  […]

Rebooting America’s Health IT Conversation Part 1: Put EHRs in Context

To get its health care infrastruction buildout effort right, the Obama team should think more broadly than EHRs     On December 19th, we published an Open Letter to the Obama Health Team, cautioning the incoming Administration against limiting its Health Information Technology (IT) investments to Electronic Health Records (EHRs). […]

Postpartum Depression

A serious condition that shouldn’t be ignoredPostpartum depression is a serious condition that can have devastating consequences when it goes unrecognized or untreated. It affects one in eight women who give birth, yet it is just now getting the attention it deserves. One woman described it this way, “I thought I would be overjoyed when […]


7 VISIONS to guide the build-out of a new health care system As we move toward a new administration, and our new leaders and their challenges are laid out before us, it is useful to ask ourselves, “Do we know what we want to build?” For health care, I’ve given this question some serious thought […]

Share Health Commentary

No Time for Health Like the Holidays

When it comes to sodium, excess is the American way. Convenience is to blame as much as the kitchen table salt shaker: the most common sodium culprits are not created in our own kitchens but come already packaged from the grocery store or served through a drive-thru window. However, high sodium in our diet, with […]

An Open Letter to the Obama Health Team

Electronic health records would be the easy-but-wrong emphasis of an Obama health IT effort 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 at his […]

Osteoporosis: A Growing Epidemic

It’s time to get this serious health issue under controlMost of us have heard about osteoporosis, but we’re about to start hearing a lot more. That’s because the incidence of osteoporosis is sharply rising as populations age in the United States and around the world. This growing epidemic will have major implications for our society, […]

Water Disinfection for Developing Countries

December 03, 2008 Water Disinfection for Developing Countries Unique water filtration unit has the potential to make a big difference. Paul S Auerbach MD Wilderness and outdoor activities take many of us to the farthest reaches of the globe. Adventures in the mountains, forests, oceans and deserts […]

Fact or Fiction: Electronic health records save money

The jury’s still out on whether EHRs reduce cost, but it appears they enhance value.  Today the actuarial consulting firm Milliman is convening a town hall meeting in Seattle focused generally on health care reform, but specifically on Electronic Health Records (EHRs). The larger Seattle metropolitan area is a hotbed of […]

Small Group Coverage: A Report from the Trenches

Small business is drowning in the current health care market. John Sinibaldi, a well-respected health insurance agent in St. Petersburg, FL , has become prominent in Florida’s broker community because he not only counsels and services a large book of small business clients, but because he also studiously tracks the macro trends that impact coverage for […]

The One Slide Project: “Engage in Grace”

With Thanksgiving upon us, we have much to be thankful for, and much still left to  accomplish. Health care statesmen Paul Levy, CEO/President of Beth Israel Deaconess, Lachlan Forrow of Harvard and others this month have launched the project “Engage in Grace”, which zeroes in on one pressing need: end-of-life decision making and care. Their idea: […]

HIV – Still Going Strong in the U.S.

Testing is essentialThink we have the upper hand on HIV in the U.S.? Think again. The Forum for Collaborative HIV Research will be convening leaders in the field this month to get the word out. In their words, here are the facts: “Nearly 60,000 Americans were infected with HIV last year, and some 250,000 people do […]

America’s CEOs Set Priorities for the Obama Administration

The Nation’s Most Influential Business Leaders Have Developed Consensus Priorities for America’s FutureThis past Monday and Tuesday, The Wall Street Journal convened an extraordinary conference of about 100 CEOs to develop and recommend issue priorities for the new Administration. (See the participant list here.) This meeting brought together the nation’s industry power players. Several Senators […]

A Simple Thank You

Feedback from a reader about Barack ObamaMy post last week on election of President-elect Obama, positive leadership, and our future drew a large number of responses to the site, pro and con. I share with permission one comment from Susan Karim of Braintree, Massachusetts, with her personal wish for openness as we confront significant challenges […]

The Changes We Need

Renewed energy and enthusiasm are not enough for health care reform. We need a paradigm shift.These are, as the Chinese curse reputedly called them, interesting times. If the burst of new Democratic health care reform proposals is any indication, the fresh breeze of the Obama campaign’s “Yes We Can” optimism is blowing across the nation. […]

Smoke-Free America

Creating tobacco free campuses.In health care, it can sometimes feel like we’re just spinning our wheels — examples of progress appear few and far between and getting ahead of the disease curve seems just out of reach. But when a ray of hope comes shooting through the clouds, it’s often because good science has met […]

President-Elect Obama, Change and Positive Leadership

Good reason to hope Yesterday, a former colleague and fellow child of the 60′s asked me to participate on a HHS consensus group exploring caregiving. I responded, “For many of us who were involved in the 60′s, and saw our worst fears realized in the loss of our great leaders, the war and the terrible […]

Can Health Plans Explain Why They Aren’t Re-Empowering Primary Care?

The health care crisis can be traced in part to the marginalization of primary care

PEPFAR Funding Renewed

An effort to improve our world As we prepare for the upcoming election, many will evaluate the President’s performance over the past eight years. Even President Bush’s greatest critics, however, acknowledge his demonstrated commitment to global health. Perhaps the most notable example of this impressive commitment is the President’s Emergency Plan for AIDS Relief (PEPFAR). […]

Don’t go to the Hospital Without these Ten Safety Tips

A trusted family member or friend should be your advocate Heading to the hospital?  Don’t go alone.  Knowing exactly what’s going on with your care is critical. Medical mistakes unfortunately do happen in hospitals and shockingly, it is reported that 238,337 patients died from potentially preventable medical errors during 2004 through 2006, according to HealthGrades’ […]

The Financial Crisis and Medical Bankruptcy

Will the financial crisis accelerate medical bankruptcy?As we’ve learned over the past few weeks, America’s finances have been massively mismanaged in the wake of intentional dismantling of our historic checks and balances. What we’ve also been forced to acknowledge is that our economy, on a national and global level, is an extraordinarily integrated affair. Everything, […]

Leave a Reply

Your email address will not be published.