Every New Year, we commence another round of solutions to fix our expensive health care system. 2018 will be no different. A predicted 5.5 percent increase in medical costs over last year will no doubt spawn new efforts to contain direct payments to providers or transfer costs to consumers—or both. No solution has appeased health […]
The Crux of Shared Decision-Making: Who Is Actually Deciding?
Shared Decision-Making is an emotionally charged topic for both physicians and patients. Physicians believe they have their patients’ best interests at heart by guiding them into better health through therapies to improve their conditions. Physicians may believe, in fact, that by explaining health status and treatment alternatives (followed by asking the patient to decide), they […]
Is Shared Decision-Making the Path to Improved Provider Performance?
As an escalating percentage of Americans (including children) are diagnosed with diabetes and hypertension, the health care system is straining to control costs and demonstrate good clinical outcomes. No surprise that providers blame patients for lack of compliance with therapies or lifestyle changes that will improve their health status. Hence the uptick—some say warranted—in incentives […]
For Tough Medical Decisions, Hard Choices Require Hard Facts—Not Conventional “Wisdom”
What matters in medical decisions is what we know, not what we think. In the late 1980’s I cared for a pregnant woman with breast cancer. Breast cancer is the most common form of cancer in pregnancy, but uncommon in frequency, occurring in about 1 in 3,000 pregnant women. Providing and receiving treatment is certainly […]
Medical Treatment Should Be Based on More Than Just “Doing Something”
Memory is malleable. This was made quite clear to me at my recent 50th high school reunion. Despite my fallacious recollections, I could not dispute the data of my forgotten activities, awards and foibles captured in pictures and written comments in my high school yearbook. Then there were the comments about my behaviors “back then,” […]
What the Dog Show Taught Me: Performance Improvement Is Not Just Science, But Art
Last week I attended the Bearded Collie Club of America National with my two highly energetic and driven dogs, along with about two hundred other competitors. A calm vacation it was not. My dog athletes enjoyed multiple days of performance competition, capped off by show competition. For people who believe dogs are pets and don’t […]
If Federal Policy Can’t Improve Health Care, What’s Next? 5 Trends to Track
Health care has been extraordinarily resistant to change. Escalating costs have been at issue since the early 1980s—think about it!—but continue to rise unabated. Ask anyone participating in the system, be they physicians or other health care providers, payers or patients, and you will be inundated with complaints about health care economics, outcomes or processes. […]
Physician-Patient Interaction: Where We Should Begin to Measure and Improve Medicine
Data is not always the path to identifying good medicine. Quality and cost measures should not be perceived as “scores,” because the health care process is neither simplistic nor deterministic; it involves as much art and perception as science—and never is this more the case than in the first step of that process, making a […]
Redesigning Health Care for the New Consumer
A consumer-driven culture shift is emerging in health care that will change the dynamics of health care purchasing decisions and impact providers’ bottom line. It is being fueled by policies that are increasing the share of health care expenses paid by consumers. Benefit plans with higher deductibles and copayments, choices narrowed to providers who demonstrate lower […]
How to Recognize “Fake” Medical News — And Why It Matters
Is coffee good for you? A recent headline suggested that people who drink coffee live longer. Sounds great to me. I drink a lot of coffee, so maybe I will be immortal. But, wait, another report links coffee to cancer. Dang. Estrogens were once touted as a life saving elixir for women of elegant ages, […]