So now what?

  While Speaker Ryan has acknowledged that ACA will remain "the law of the land for the foreseeable future," a looming question remains - what next? For all the challenges with the now shelved AHCA - and there were many - Obamacare has never been perfect and is far from becoming perfect.  There are substantial …

How to *really* bend the cost curve

Healthcare is expensive. And complicated. Its current trajectory in America - one that yields an ever-accelerating rise in both cost and complexity - is clearly unsustainable.  This reality, combined with the outsized role government plays in regulating and paying for healthcare, presents Washington with an enormous policy challenge. Healthcare's web of interconnectedness means any change …

Unchaining the Blockchain

Perhaps the buzziest buzzword of 2017 (with the potential exception of "design thinking") is BLOCKCHAIN.  Hailed as the answer to all our problems with IT privacy and connectivity across every industry worldwide, I've had more blockchain emails, articles, and messages hit my inbox in the last few months than all other "solutions of the future" …

When “Quality” reaches inside our homes…

Many potholes await us as we drive America's healthcare system down the road towards a (still slightly amorphous) vision of "population health."  Can lots of providers manage risk as well or better than the small minority of those doing so today?  Will the payment system transition fast enough to drive change but not so fast …

Getting America’s Health “Left of Bang”

One major benefit of supporting Mission's extraordinary Security team is that I'm exposed to books that wouldn't normally hit my radar.  The most recent example (thanks Robert Whiteside) is Left of Bang by Van Horne and Riley. In the book's language "bang" is the explosion of an IED, an active shooter in a hospital, a …

Medicine’s exponential acceleration

These two books are some of my most prized medical possessions.  The first, Combe's Physiology, is an 1843 edition of a text by Andrew Combe, MD, "Physician Extraordinaire to the Queen in Scotland and Consulting Physician to the King and Queen of the Belgians."  The title page takes care to note that 6 woodcuts appear …

Giving Thanks

I'm an incredibly fortunate guy. I have an amazing family, a fulfilling and healthy life, and a rewarding career as both a physician and a leader.  I have much to give thanks for this holiday weekend, but today I give thanks to American healthcare system in which I've practiced medicine for nearly a decade. American medicine …