" The Most Complicated Piece of Health Care is the Revenue " (Say What?) - The Shameless Managerialism of a Hospital CEO
IntroductionManagerialism, in my humble opinion, is one of the major reasons why the US health care system is so dysfunctional. We have long discussed how people whom we first called "generic managers" have taken over health care. Increasingly, health care organizations, including hospitals, pharmaceutical companies, health insurance companies, government agencies, etc are now led by people with management training, but not necessarily with any training or background in medicine, biomedical research, epidemiology, public health, or health care policy. We began noting how suchgeneric managers often prioritize sh...
Source: Health Care Renewal - June 2, 2017 Category: Health Management Tags: generic management generic managers managerialism mission-ignorant management Source Type: blogs
Robert Martensen's A Life Worth Living
Robert Martensen,A Life Worth Living: A Doctor ' s Reflections on Illness in a High-Tech Era (New York: Farrar, Straus& Giroux, 2008). In recent years, doubtless because of the anxious disquiet of so many who have witnessed experiences of their friends and families, books examining “end-of-life issues” have become so numerous as almost to constitute a little genre of their own. At first glance, Dr. Martensen’s book appears to fall neatly within this category. The emergency physician and medical historian recounts numerous memorable patient stories, discusses technology o veruse at end of life an...
Source: Health Care Renewal - May 29, 2017 Category: Health Management Source Type: blogs
Evidence-Based Policy Making? - Dumb Things Politicians Say About Health Care Policy
There have been multiple legislative attempts at major health care reform in the US. Typically, such attempts feature considerable public debate, including speechs, congressional committee hearings, sometimes progressing to debates by the House and Senate. (For example, see thisFrontline chronology of the proceedings up to the passage of the Affordable Care Act, aka " Obamacare, " in 2009.) Usually the discussion includes some real experts on health care policy, and some real health care professionals, and at least appears to reference some data about medicine, health care, and health economics. Whether p...
Source: Health Care Renewal - May 23, 2017 Category: Health Management Tags: health care reform postmodernism Source Type: blogs
Will the Current Crises Finally Prompt America to Address How it is Haunted by Corruption and Impunity?
There is one tiny silver lining in the political storm clouds swirling over the US. Some of the issues about which we have been ranting onHealth Care Renewal are no longer so easily dismissed. We have long harangued about the ruinous effects ofhealth care corruption, the role ofimpunity in enabling worsening corruption, our lack of good ways to challenge these problems, and our ongoing inablity to even discuss what amounts to taboo topics (which we dubbed the "anechoic effect. " ) In response, we have been called alarmists, nay-sayers, and worse. Now the parade of crises created by the Trump regime ...
Source: Health Care Renewal - May 19, 2017 Category: Health Management Tags: anechoic effect health care corruption impunity Source Type: blogs
Death By A Thousand Clicks: Leading Boston Doctors Decry Electronic Medical Records
Channeling Lyndon Johnson on Walter Cronkite, in clinical medicine, when you ' ve lost Boston (including MGH), you ' ve probably lost the health IT war.Death By A Thousand Clicks: Leading Boston Doctors Decry Electronic Medical RecordsMay 12, 2017By Drs. John Levinson, Bruce H. Price and Vikas Sainihttp://www.wbur.org/commonhealth/2017/05/12/boston-electronic-medical-recordIt happens every day, in exam rooms across the country, something that would have been unthinkable 20 years ago: Doctors and nurses turn away from their patients and focus their attention elsewhere — on their computer screens.By the time the doctor can...
Source: Health Care Renewal - May 18, 2017 Category: Health Management Tags: healthcare IT dissatisfaction Healthcare IT failure Massachusetts General Hospital MGH texting while driving Source Type: blogs
Massive ransomware cyberattack in U.K. Hits 16 Health Institutions, many doctors reported that they could not retrieve their patients ’ files, but not to worry - no patient information was looked at or compromised
Perhaps doctors and nurses are clairvoyant? Who needs records, anyway?Cyberattack in U.K. Hits 16 Health InstitutionsNew York Times DAN BILEFSKY and RAPHAEL MINDER MAY 12, 2017https://www.nytimes.com/2017/05/12/world/europe/uk-national-health-service-cyberattack.html LONDON — An extensive cyberattack hit Britain’s National Health Service on Friday,blocking doctors from gaining access to patient files, causing emergency rooms to divert patients and stoking fears about hackers ’ ability to wreak havoc on vital public services.Spanish and Portuguese companies, including Telef ónica, Spain’s large...
Source: Health Care Renewal - May 12, 2017 Category: Health Management Tags: cyberattack healthcare IT risk healthcare IT utopianism NHS no information was looked at or compromised Patient care has not been compromised ransomware Source Type: blogs
Don't Know Much About Health Care, Health Care Research or Quality - Yet Appointed New Director of Agency for Healthcare Research and Quality (AHRQ)!?
The Agency for Healthcare Research and Quality (AHRQ) is a US government agency, part of the Department of Health and Human Services (DHHS), whosemission is toproduce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that theevidence is understood and used.It is known for providing grants for sophisticated clinical and health services research, some that uses complex statistical methods, often informed by the the precepts of evidence-based medicine and medical decision makin...
Source: Health Care Renewal - May 11, 2017 Category: Health Management Tags: AHRQ DHHS managerialism Source Type: blogs
New HHS Secretary, rather than singing unabashed praise for EMRs like his predecessors, states the obvious. However, the " solutions " are the usual boilerplate.
In the past, politicians on both sides of the aisle have generally sung unfettered and uncritical praise for electronic medical records and other health IT systems.Perhaps letters like this one from Jan. 2015, from near 40 major US medical societies bemoaning the injurious effects of health IT on medical practice, have finally had an effect: http://mb.cision.com/Public/373/9710840/9053557230dbb768.pdfFirst page preview of Jan. 2015 medical societies complaint letter to HHS about health IT. Full letter athttp://mb.cision.com/Public/373/9710840/9053557230dbb768.pdfIn any case, this recent article caught me by surp...
Source: Health Care Renewal - May 6, 2017 Category: Health Management Tags: big data datapalooza healthcare IT burden healthcare IT difficulties healthcare IT dissatisfaction interoperability ONC Tom Price MD Source Type: blogs
New HHS Secretary, rather then singing unabashed praise for EMRs like his predecessors, states the obvious. However, the " solutions " are the usual boilerplate.
In the past, politicians on both sides of the aisle have generally sung unfettered and uncritical praise for electronic medical records and other health IT systems.Perhaps letters like this one from Jan. 2015, from near 40 major US medical societies bemoaning the injurious effects of health IT on medical practice, have finally had an effect: http://mb.cision.com/Public/373/9710840/9053557230dbb768.pdfFirst page preview of Jan. 2015 medical societies complaint letter to HHS about health IT. Full letter athttp://mb.cision.com/Public/373/9710840/9053557230dbb768.pdfIn any case, this recent article caught me by surp...
Source: Health Care Renewal - May 6, 2017 Category: Health Management Tags: big data datapalooza healthcare IT burden healthcare IT difficulties healthcare IT dissatisfaction interoperability ONC Tom Price MD Source Type: blogs
Through the Revolving Door, Darkly
While the rare appointments to top health care positions by the Trump administration deservedly get considerable media coverage, lower level appointments sneaking through therevolving door do not. So we hereby present our latest roundup of same, in chronological order by first coverage.Lance Leggitt from Health Care Lobbyist at Baker Donelson to Chief of Staff for the Secretary of Health and Human ServicesThis appointment first appearedin StatPlus on March 2, 2017 but was behind a paywall. It was more recently covered in the New York Times in along article about revolving door appointments not specific to healt...
Source: Health Care Renewal - May 2, 2017 Category: Health Management Tags: conflicts of interest DHHS health care corruption regulatory capture revolving doors US Department of Justice Source Type: blogs
Health Insurance For Me But Not for Thee? - How Legislators Tried to Rig the Repeal of the ACA to Keep Their Own Health Insurance Affordable
The turmoil swirling around the new Trump administration has flushed into the open some things that the public heretofore was probably not meant to see....We have been writing a lot lately about how the insiders who run large health care organizations, and benefit mightily therefrom, try very hard to control the health care policy discourse, and keep us distracted from their wizardry behind the curtain. Again, these days the curtain is likely to get blown away.Sarah Kliff just reported in Vox about a provision newly inserted into the proposed American Health Care ActWednesday night, text leaked of a new Republican am...
Source: Health Care Renewal - April 26, 2017 Category: Health Management Tags: deception health care reform oligarchy US Congress Source Type: blogs
Pontifications About Health Care Reform Written by Insiders Who Benefit from the Status Quo - Worse Than We Think
Perceptions that the US health care system is dysfunctional and needs major reform go way back. Atimeline from the Tampa Bay Times noted President Theodore Roosevelt ' s proposal for a national health service in 1912. Nonetheless, as we have discussed endlessly, most attempts at reform failed, and health care dysfunction seems to be getting worse.One big problem may be that we don ' t understand how much discussion of health care reform is driven by those who benefit from the status quo. A Personal AnecdoteWhen I began my academic career in 1983, I was often in the audience for talks about how to fix healt...
Source: Health Care Renewal - April 17, 2017 Category: Health Management Tags: Amgen conflicts of interest deception health care reform Institute of Medicine Mayo Clinic Merck National Academies public relations Source Type: blogs
Pittsburgh Post-Gazette: " Medication errors in hospitals don ’t disappear with new technology " . Government: " It's the doctors' fault. " I am cited.
In conclusion:While I wish the Pittsburgh Post-Gazette article was longer, in its limited space its author did touch upon the major relevant issues well regarding the PA Patient Safety Authority study and its implications towards national Health IT policy.ONC ' s Dr. Andrew Gettinger ' s responses, however, seems to reflect an unwillingness of he and the government to acknowledge Bad Health IT. His repsonses also appear to show a lack of appreciation of the complaints about EMRs from nearly 40 medical societies. " It ' s the doctors fault " for not training enough.He does acknowledge that better IT would be a g...
Source: Health Care Renewal - April 10, 2017 Category: Health Management Tags: Andrew Gettinger MD Donald Rucker Healthcare IT experiment healthcare IT risk ONC Pennsylvania Patient Safety Authority Pittsburgh Post-Gazette Siemens Healthcare Steve Twedt Source Type: blogs
" A Radical Idea for Health-Care Reform: Listen to the Doctors " - Oops, I Mean Listen to the Corporate Executives, Directors, and Lobbyists
It has been the season for health care reform in the US since at least the Nixon administration. We have endlessly discussed the unholy triad of health care dysfunction: rising costs, declining access, and stagnant quality.These days, with all the furor over whether Obamacare should be repealed and replaced, let alone, or improved, it is still the season for health care reform. Last weekan article by David Ignatius in the Washington Postentitled " A Radical Idea for Health Care Reform: Listen to the Doctors, " appeared. Since onHealth Care Renewal we are all about trying to uphold physicians ' profe...
Source: Health Care Renewal - April 7, 2017 Category: Health Management Tags: boards of directors conflicts of interest deception disinformation health care reform propaganda Source Type: blogs
Part of the Solution, or Part of the Problem? - Health Care Corporate CEOs on Physician Burnout
Physician burnout is in the news again. Late in 2015, an article by Shaneyfelt and colleagues in the Mayo Clinic Proceedings showed an increase in the proportion of physicians reporting at least one symptom of burnout to 54.4% in 2014(1), up from the 45.5% they reported in 2012(2). A March 28, 2017,post in the Health Affairs blog based on the latest article warning about burnout and suggesting how to address it got considerable attention.Background - Physician BurnoutHowever, physician burnout is hardly new. As wewrote in 2012 about the predecessor the 2012 Shaneyfelt article, this is just the latest in a...
Source: Health Care Renewal - April 2, 2017 Category: Health Management Tags: burnout conflicts of interest corporate physician generic management governance leadership managerialism mission-hostile management physicians Source Type: blogs
