Here's a new Chapter excerpt called Getting There - happy summer everyone! We are standing on the threshold of both heaven and hell, dancing nervously between the gates of one and the ante room of the other. -Yuval Harari, Sapiens The nausea was so overwhelming it nearly sent me to the ground. I’d spent 31 …
Alpha and Omega
"After all, what's a life, anyway? We're born, we live a little while, we die. A spider's life can't help being something of a mess, with all this trapping and eating flies. By helping you, perhaps I was trying to lift up my life a trifle. Heaven knows anyone's life can stand a little of …
Would you read this book?
I've been playing with a book idea for a few months, writing and re-writing the introduction and toying with different ways to shape the chapters. It's still not fully baked, but the concept at least is formed enough to see if it would resonate... So, in the spirit of leveraging all the 21st century has …
Elementary School, Insurance, and the Free Market
As part an "Insight Council" survey I was recently asked: “If you had a magic wand and could change *only one thing* about health payment reform what would it be?" Now let's be clear - picking just one thing to fix about how America pays for healthcare is like trying to find and fix only the …
Continue reading "Elementary School, Insurance, and the Free Market"
Uncertainty
Leaders prove their worth during times of great uncertainty. We live in uncertain times. Multiple fundamental aspects of American life all face a crossroads... and healthcare is at the top of the list. With this in mind, I had the great fortune today to share my thoughts on navigating the enormous change in healthcare with …
Burnout… and a Moat of Resiliency
I remember it as vividly as a childhood nightmare. The sense of vacuum when I’d go to the well and find nothing there. The deep-seated feelings of ineptitude for all things personal and professional. Exhaustion as thick as Appalachian fog. I didn’t have a word for it at the time but I was experiencing burnout. …
On Hubris and Humility
There are times my words mark an inflection point in the lives of my patients and their families. This recognition takes time to fully appreciate, and I will never forget the first time it hit me. I was a resident working an evening shift in the ED. The place was packed with a full waiting …
Musings from Europe
I just returned from a once-in-a-lifetime trip to Europe with my wife and kids – a truly awesome (and thoroughly exhausting) experience we’ve been planning for the last year. In between seeing the old-world sites that make Paris and London ridiculously lucrative tourist destinations, I jotted a couple of healthcare-related observations I feel compelled to …
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 …