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Tag: Kim Bellard

THCB Gang Episode 97, Thursday June 30

Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday June 30 were THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); Principal of Worksite Health Advisors Brian Klepper (@bklepper1); futurists Ian Morrison (@seccurve); and fierce patient activist Casey Quinlan (@MightyCasey). Lots of discussion of the Dobbs ruling and also of the CAA regulations which have gotten somewhat less play in the press. Quite the impassioned discussion !

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

THCB Gang Episode 95, Thursday June 9

Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday June 9 were THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); fierce patient activist Casey Quinlan (@MightyCasey); Principal of Worksite Health Advisors Brian Klepper (@bklepper1) & Queen of all employer benefits Jennifer Benz (@jenbenz)

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

Hey, Old Guys!

BY KIM BELLARD

OK, how many of you had on your women-in-power bingo cards that, in 2022, Sheryl Sandberg would be out at Facebook but Queen Elizabeth II would still be Queen?  It’s the Queen’s Platinum Jubilee, marking seventy years on the throne.  She’s getting a lot of love for that tenure, but it makes me think, geez, some people just don’t know when to step away.

Perhaps what sparked my cynicism about the Queen was an op-ed by Yuval Levin, Why Are We Still Governed by Baby Boomers and the Remarkably Old?  Dr. Levin is, of course, referring to the U.S., and he’s spot-on about our governance problem.  But I think the problem goes further: we have too many old people running our companies and major institutions as well.  

Whether it is, say, healthcare, education, or the military, we’re so busy protecting the past that we’re not really getting ready for the future.

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AI are (going to be) people too

BY KIM BELLARD

My heart says I should write about Uvalde, but my head says, not yet; there are others more able to do that.  I’ll reserve my sorrow, my outrage, and any hopes I still have for the next election cycle.  

Instead, I’m turning to a topic that has long fascinated me: when and how are we going to recognize when artificial intelligence (AI) becomes, if not human, then a “person”?  Maybe even a doctor.

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I Want to Believe

BY KIM BELLARD

I know, I should be writing about hot topics like monkeypox or the baby formula shortage, but, c’mon, Congress held hearings last week about UFOs – the first in 50 years!  I mean, I followed Project Blue Book in the 1970’s, watched “The X-Files” in the 1990’s, and have seen UFO videos on YouTube.  If Congress is starting to take UFO’s seriously, how could I not?  

And for those of you who don’t see any possible connection to healthcare (except for those unpleasant alien probes…), let me put it to you this way: by 2050, is it more likely that:

  • We’ll know what UFOs actually are;
  • We’ll have fundamentally reformed the U.S. healthcare system.

I thought so.

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What Do You Mean, “Innovation”?

BY KIM BELLARD

One of my favorite movies is The Princess Bride. Among the many great quotes is one from Inigo Montoya, who becomes frustrated when the evil Vizzini keeps using “inconceivable” to describe events that were clearly actually taking place. “You keep using that word,” Inigo finally says. “I do not think it means what you think it means.”

So it is for most of us with the word “innovation” – especially in healthcare.

What started thinking me about this is an opinion piece by Alex Amouyel: Innovation Doesn’t Mean What You Think It Does.  Ms. Amouyel is the Executive Director of Solve, an MIT initiative whose mission is “to drive innovation to solve world challenges.” It sees itself as “a marketplace for social impact innovation.”    

In her article, Ms. Amouyel notes that traditional definitions of innovation focus on the use of novelty to create wealth. She doesn’t dispute that view, as long as “wealth” includes the less traditional “community wealth,” which includes “broadly shared economic prosperity, racial equity, and ecological sustainability.” I suspect that innovators like Jeff Bezos or Elon Musk don’t ascribe to that view of innovation.

Ms. Amouyel’s view is: “For me, innovation is about solving problems. And if innovation is about solving problems, what problems you are solving and who is setting about solving them is key.” She notes the multiplicity and difficulty of both global and community-level problems that we face, and urges: “Most urgently, we should zero in on problems that affect the most underserved among us.”

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The Licensing Walls Come Tumbling Down

BY KIM BELLARD

Abortion rights continue to be one of the most heated issues in American politics, super-fueled by last week’s leak of a draft Supreme Court opinion that would overturn 1973’s Roe v. Wade and return the issue to the states to decide. 

I’ll leave it to others more qualified than me – women, for example — to weigh in on abortion itself, but I want to talk about how abortion pills are going to force changes to our healthcare system that many may not be ready for.

Although the stereotype of abortions is a procedure done by a physician in an office/clinic, the majority of abortions in the U.S. are now done through the use of abortion pills.  It is a two step process, and the two medications must be prescribed by a physician. Until last December, women were required to see a physician in person, but the FDA permanently lifted those requirements, following a temporary waiver during the pandemic. The pills are considered both highly effective and safe.  There are startups, like Hey Jane and Just the Pill, that specialize in them.

Not surprisingly, since the leak searches for “abortion pills” have hit all-time highs.

The states that have been passing various abortion bans have not ignored the loophole that abortion pills represent. There are a variety of restrictions that have been enacted, such as requiring in-person visits to outright banning use of telehealth for them. In those states, some women have opted to travel out of state to do the telehealth visit and/or to receive the pills via the mail. 

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Healthcare Suffers from Patient Bias

By KIM BELLARD

If you went to business school, or perhaps did graduate work in statistics, you may have heard of survivor bias (AKA, survivorship bias or survival bias).  To grossly simplify, we know about the things that we know about, the things that survived long enough for us to learn from.  Failures tend to be ignored — if we are even aware of them. 

This, of course, makes me think of healthcare.  Not so much about the patients who survive versus those who do not, but about the people who come to the healthcare system to be patients versus those who don’t. It has a “patient bias.”

Survivor bias has a great origin story, even if it may not be entirely true and probably gives too much credit to one person.  It goes back to World War II, to mathematician Abraham Wald, who was working in a high-powered classified program called the Statistical Research Group (SRG).

One of the hard questions SRG was asked was how best to armor airplanes.  It’s a trade-off: the more armor, the better the protection against anti-aircraft weapons, but the more armor, slower the plane and the fewer bombs it can carry. They had reams of data about bullet holes in returning airplanes, so they (thought they) knew which parts of the airplanes were the most vulnerable.

Dr. Wald’s great insight was, wait — what about all the planes that aren’t returning?  The ones whose data we’re looking at are the ones that survived long enough to make it back.  The real question was: where are the “missing holes”?  E.g., what was the data from the planes that did not return?

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THCB Gang Episode 89, Thursday April 28, 1pm PT 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang on April 28 for an hour of topical and sometime combative conversation on what’s happening in health care were: THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); medical historian Mike Magee (@drmikemagee); patient safety expert and all around wit Michael Millenson (@mlmillenson) & Principal of Worksite Health Advisors Brian Klepper (@bklepper1). Matthew had COVID so didn’t do much & Kim ran the show. Lots of discussion on telehealth, primary care, private equity and much more…

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

We Love Innovation. Don’t We?

BY KIM BELLARD

America loves innovation.  We prize creativity.  We honor inventors.  We are the nation of Thomas Edison, Henry Ford, Jonas Salk, Steve Jobs, and Stephen Spielberg, to name a few luminaries. Silicon Valley is the center of the tech world, Hollywood sets the cultural tone for the world, and Wall Street is preeminent in the financial world. Our intellectual property protection for all that innovation is the envy of the world. 

But, as it turns out, maybe not so much. If there’s any doubt, just look at our healthcare system.  

———

Matt Richtel writes in The New York TimesWe Have a Creativity Problem.”  He reports on research from Katz, et. alia that analyzes not just what we say about creative people, but our implicit impressions and biases about them.  Long story short, we may say people are creative but that doesn’t mean we like them or would want to hire them, and how creative we think they depend on what they are creative about.  

“People actually have strong associations between the concept of creativity and other negative associations like vomit and poison,” Jack Goncalo, a business professor at the University of Illinois at Urbana-Champaign and the lead author on the new study, told Mr. Richtel. 

Vomit and poison?  

A previous (2012) study by the same team focused on why we say we value creativity but often reject creative ideas.  “We have an implicit belief the status quo is safe,” Jennifer Mueller, a professor at the University of San Diego and a lead author on the 2012 paper, told Mr. Richtel.  “Novel ideas have almost no upside for a middle manager — almost none, The goal of a middle manager is meeting metrics of an existing paradigm.” 

You’ve been there.  You’ve seen that.  You’ve probably blocked a few creative ideas yourself. 

The 2012 research pointed out: “Our findings imply a deep irony.  Prior research shows that uncertainty spurs the search for and generation of creative ideas, yet our findings reveal that uncertainty also makes us less able to recognize creativity, perhaps when we need it most.  Moreover, “people may be reluctant to admit that they do not want creativity; hence, the bias against creativity may be particularly slippery to diagnose.”

In the new study, participants were given two identical descriptions of a potential job candidate, except that one of the candidates had demonstrated creativity in designing running shoes, but the other in designing sex toys (the researchers note: “the pornography industry plays a significant role in the refinement, commercialization, and broad dissemination of innovative new technologies”).  The participants explicitly rated the latter candidate as less creative, although their implicit ratings showed equal ratings.  

The researchers concluded:

Collectively, the findings strongly support our contention that implicit impressions of creativity can readily form, be differentiated from a traditional explicit measure, and uniquely predict downstream judgment, such as hiring decisions, that might be relevant in an organizational context.

This matters, they say, because: “the findings of study 4 seem to square with real world examples of highly creative people who were ignored until well after their death because their work was too controversial in its time to be recognized as a creative contribution…”

Umm, anyone remember Ignaz Semmelweis?

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