April 2010 – Page 6 – The Health Care Blog

Don Berwick: An Activist Takes the Reins at CMS

Apr 2, 2010• 30

By BOB WACHTER, MD

While the health reform bill will have many effects, one of its most profound will be to unshackle the Centers for Medicare & Medicaid Services (CMS). Under the legislation, CMS is now far freer to undertake a variety of pilot programs and demonstration projects designed to improve quality, safety and efficiency, and to convert the successful ones into policy. And, if that wasn’t enough for those who have long been praying for a more activist CMS, we now learn that President Obama will select Don Berwick, the world’s most prominent advocate for healthcare quality and safety, to be the next CMS administrator. Although I’ve sparred a bit with Don over the years on matters of philosophy, I think he is a superb choice.

Don’s story is well known – a Harvard pediatrician and policy expert who became passionate about improving healthcare well before it was fashionable, he ultimately left his full-time academic perch to pursue his calling. In 1991, he founded the Institute for Healthcare Improvement, which ran on a shoestring for its first decade, fueled largely by the considerable power of Don’s vision and personality.Continue reading…

Human

Apr 2, 2010• 4

By ROB LAMBERTS

If there is a central theme to my work, it is this: medicine is a human thing.

On the Facebook page of my podcast, I recently asked for readers to tell me some of the “war stories” they have from the doctor’s office. What are some of the bad things doctors do wrong? I quickly followed this with the flip-side, asking readers to comment on the best interactions that they’ve had with their doctors.

The response was overwhelming, and equally quick to both rant and rave. They told stories about doctors who didn’t listen, explain, or even talk with them. They told about arrogance and disconnectedness from the people from whom they were seeking help. They also told about doctors who took extra effort to listen and to reach out in communication. They talked about doctors who genuinely seemed to value them as humans.Continue reading…

Getting Over The New Normal

Apr 2, 2010• 17

By MICHAEL TURPIN

“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.” Charles Darwin

In her 1969 Book, On Death and Dying, Dr Elisabeth Kübler-Ross describes the five stages of grief. Over a 27 year career marked by mergers, acquisitions, and perpetual change, I have come to accept these five stages as necessary rites of passage that humans must endure as they navigate the inevitable shoals of change. It seems we all must endure denial, anger, bargaining and depression before we finally break through to acceptance.

While we all intellectually agree that our healthcare system is broken and is in profound need of change, most preferred that all the heavy lifting required to reduce healthcare costs as a percentage of US GDP, occurred on someone else’s watch. As Woody Allen once quipped, “ I don’t mind dying. I just don’t want to be there when it happens.”Continue reading…

THCB relaunch to change focus to renewable energy, fly fishing, sailing

Apr 1, 2010• 20

By Matthew Holt

The Patient Reassurance and Consumer Total Insurance Confirmation Access legislation was signed into law last week, and the powers that be at THCB have had a radical rethink about what we should do next.

I myself have led this effort. Given that all the major problems in the health care system in the US have more or less been solved by the recent law, it’s apparent that a blog focusing on only health care is going to be pretty superfluous. Some of the more frequent and most important THCB contributors are have also subtly told us that they’re ready to move onto other things.

Brian Klepper told me that with a combination of both leadership from Congress and employers “85% of everything I think we need in health care is done.” Brian plans to spend even more time sailing his catamaran off the coast of Florida and down to the Caribbean where he’ll be focusing on his new business with David Kibbe of importing cheap Cuban rum to Florida—at least until the embargo is lifted. Bob Wachter has decided that with a combination of the new health care bill and with Don Berwick taking over all his work on patient safety, hospital care is about as good as it’s going to get. Bob is going to stay in health care, but he’s taking a crack at the issue of the rural physician shortage by moving to Idaho to start a solo primary care practice. He’ll be opening his new practice just as soon as the bunker is built and stocked with sufficient supplies.