Categories

Author Archives

John Irvine

Is Your Marketing the Love Child of Warren Harding?

Warren G Harding Wants to Run Your Marketing After nearly a century of fighting for the legitimacy of her “love child” daughter, the long-time mistress of President Warren G. Harding, was recently vindicated by new DNA testing.

The tenacity of Nan Britton and her family helped to prove that America’s 29th president fathered more than the Teapot Dome corruption scandal. Harding never met his out-of-wedlock daughter, Elizabeth Ann, but demonstrated presidential timber by providing financial support for her until he died in office at the age of 57.

For Chief Marketing Officers, the outcome of this juicy scandal might provide some hope that hard work and determination can help them to legitimize the often maligned marketing function, and perhaps increase their stature and length of tenure at the senior management table.

Unfortunately, there are no DNA tests to validate marketing as a legitimate member of the CXO family of business functions. But there are some unscientific ways to accomplish that goal within your company:

Continue reading…

ACA Database: Private Alternatives to Medicare?

Henry writes:

“What if someone approaching age 65 who lives in New Hampshire does not want to enroll in Medicare—what kind of health insurance alternatives might be available?”

Inside Baseball: The DoD EHR

The health information technology (HIT) world has been hit by a watershed event like no other. The Department of Defense (DoD), widely respected for its indiscriminate generosity to contractors, has awarded the most coveted prize in recent HIT memory – the Defense Healthcare Management Systems Modernization (DHMSM) contract.

And the winner is… Leidos, the contractor formerly known as SAIC. A couple of years ago, when the race for the DoD contract began, Leidos/SAIC selected Cerner as its EHR of choice for this contract. The smart money though was on Epic and its Big Blue partner because they are and seemingly always have been the safest procurement choices for top brass in any large organization.

A stunned HIT “community” initiated its favorite game of providing post facto authoritative explanations ranging from cute to grotesque. Here are the most common and least specious opinions:

Continue reading…

ACA Database: I’m In Hell. Long-term Facilities Are Cutting Services Due to the ACA’s Reimbursement Changes

Anonymous writes:

Currently nursing homes are dumping vent patients,and respiratory services due to reimbursement dollars. The home I will be removed from at the end of the month has succeeded in removing respiratory services and sending residents against their will to other facilities. This has begun. Staffing has been minimal due to inhospitable working conditions. Imagine your bill being thousands of dollars a month and lying in feces for hours waiting for one aide to get to you, who has 45 other patients. The mission statements all so wonderfully worded to make you feel your loved one getting the best care possible. But these are just words not to be followed just a sales pitch. Their defense we can’t get staff! No wonder everything under disciplinary action you may not go home cause nobody is coming in to relieve you. Mgmt does not answer phones on their off hours to provide help or solutions but arrives monday to write up whom ever was involved.

Why Doctors Are Leaving Medicine For Tech

flying cadeuciiThe world looks different when you’re eighteen and when you’re thirty – in some cases because your perspective has evolved, other times because the world has changed.  Men and women drawn to careers in medicine while in high school or college are finding that when they emerge on the other side, things aren’t quite what they expected.

Typically, this is portrayed as the (well-worn) “Narrative of Disillusionment” – i.e. idealistic youth drawn to help people discover the practice of medicine is more rushed/bureaucratic/corporate/burdensome than they were expecting, and now are searching for new opportunities.  While there’s a measure of truth to this arc, I’m not sure how different it is from any other career choice, which tend to be attractive in the abstract (A prosecutor!  A screenwriter!  A journalist!), perhaps less so when you’re actually doing it.

While there’s no doubt that practicing physicians face many (well-documented) challenges, many also continue to love what they do, and find the opportunity to help others — even with all the paperwork — still accessible, and still rewarding.

My hunch is that many of the physicians who leave medicine do so not because the negative externalities have become so bad, but rather because the range of potentially appealing alternatives has become so good.

A recent NPR blog focused on Bay area physicians leaving medicine to become entrepreneurs has sparked considerable dialog on social media (see here for my recent discussion of physicians-turned-entrepreneurs).  My sense is that many physicians are attracted to entrepreneurship not to escape medicine, but to deliver on their perception of medicine’s promise.  Frontline providers, as Aenor Sawyer of UCSF’s Center for Digital Health Innovation frequently emphasizes, offer vital insights into where the existing system may not be working, and where innovation is sorely needed.

Continue reading…

ACA Database: Are There Any Plans in the Works to Force Doctors to Accept Obamacare?

flying cadeuciiAfter several attempts at trying to find doctors who accept my lame-o ACA health plan (Blue Cross Blue Shield advantage HMO), I finally reached my limit today when a rather important appointment got cancelled unless I wanted to pay cash, because “we don’t accept your policy”.  When I googled “none of my doctors accept my Obamacare health insurance”, your article came up.

Do you or does anyone else know if there is some kind of plan of action for doctors to be forced to accept these ACA plans?  This year alone, I have yet to visit ONE of my previous doctors who will accept an ACA plan (and I didn’t even get the cheapest plan!).  Having had past surgeries, I feel it imperative to “go with who you know”, in that I want to see my past surgeon when there is a problem a year later that might need to be addressed.  Beyond frustrated!  And I don’t even live in a small town!!  I am in Dallas, Texas, with thousands of doctors!

ACA Database: The High Price of Specialty Drugs Is (Literally) Killing Me

flying cadeuciiJoyce J wrote in with this to say after reading Steve Findlay’s post on Medicare’s 50th Anniversary last week.

“Just yesterday, I was on my last and final rant relative to the price of not only specialty drugs, but also Tier 3 drugs! So much of a rant that I considered writing my Congressman Tim Murphy. After much thought, I decided to suck it up, pay the price and let my congressman work on bigger issues.(before reading your article today!)

I realize that I am not he only pathetic one that this drug price debacle affects, but for some reason, as a hard worker my entire life (in, none other than the healthcare profession), an upstanding, tax paying, law abiding citizen, somehow I feel I am being raped by the system.

I am 66 years old. I am a widow for 20 years. I am on Medicare part A and part B.(?$104/month) My secondary insurance is Highmark PPO Blue. ($605.89/month). After retirement, I maintained my husband’s health insurance as my supplement because of 1 tier 3 drug that I currently use. Due to Multiple Sclerosis, Lupus, breast cancer (none of which I chose to have) I could essentially be using multiple specialty drugs. I’ve declined all, except for the one Tier 3 drug, brand name, Provigil.

It has been a miracle drug for me relative to severe fatigue and loss of concentration and overall, daily function.”

Continue reading…

Of PCPs and THC

Screen Shot 2015-07-29 at 10.25.39 AM

The drug test came back abnormal.  There was THC present.  I walked back to Mrs. Johnson and raised my eyebrows.

“What’s wrong?” she asked, not used to whatever kind of look I was giving her.

“Uh, you forgot to mention to me that you smoke weed.”

She blushed and then smirked.  “Well, yes, I guess I forgot to put that down on the sheet.  I don’t do it real often, but sometimes it takes mind off of things.  I just get real anxious about my kids, my husband…and my heart problems. I only smoke one or two a night”

She’s not your usual picture of a pot-head.  She’s in her sixties, has coronary heart disease, irritable bowel, hypertension, is on Medicaid, and is the essential caricature of the the poor white folk who live in the deep south.  And she smokes weed.

I was doing drug testing on her as part of my office policy.  Mrs. Johnson gets 30 Percocet per month, and so clearly poses a high risk of drug trafficking, escalation to PCP, crystal meth, and LSD, and ending up behind bars for the rest of her life.  That’s why I had to test her.  And now I caught her in a lie, trying to cover-up her use of illegal drugs.Continue reading…

The ProPublica Report Card: A Step In the Right Direction

Ashish JhaLast week, Marshall Allan and Olga Pierce, two journalists at ProPublica, published a surgeon report card detailing complication rates of 17,000 individual surgeons from across the nation. A product of many years of work, it benefitted from the input of a large number of experts (as well as folks like me). The report card has received a lot of attention … and a lot of criticism. Why the attention? Because people want information about how to pick a good surgeon. Why the criticism?  Because the report card has plenty of limitations.

As soon as the report was out, so were the scalpels. Smart people on Twitter and blogs took the ProPublica team to task for all sorts of reasonable and even necessary concerns. For example, it only covered Medicare beneficiaries, which means that for many surgeries, it missed a large chunk of patients. Worse, it failed to examine many surgeries altogether. But there was more.

The report card used readmissions as a marker of complications, which has important limitations. The best data suggest that while a large proportion of surgical readmissions are due to a complication, readmissions are also affected by other factors, such as how sick the patient was prior to surgery (the ProPublica team tried to account for this), his or her race, ethnicity, social supports—and even the education and poverty level of their community.

Continue reading…

Calendar: Powering Medical Research With Data: The Research Analytics Adoption Model

Screen Shot 2015-07-22 at 12.54.34 PM

TODAY JULY 22/ 1 PM EST Analytics are becoming imperative to researchers in recruiting patients into studies, making  breakthrough discoveries, as well as monitoring the clinical implementation of these discoveries.

This webinar will be for organizations that want to leverage their enterprise data to power more  effective research.

THCB’s MATTHEW HOLT SAYS: “HealthCatalyst are a highly interesting and fast-growing database company not to mention a THCB supporter. This webinar should be required for anyone interested in how healthcare organizations can leverage their existing data to power medical research and build strong clinical trial programs. Check it out.

assetto corsa mods