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  • Pausing to Recharge

    Recently I had the honor of presenting to the entire staff of an organization I have been working with a Webinar entitled, “ Pausing to Recharge”. I was asked to do this because the company, like most in healthcare, are facing enormous challenges, including an uncertain future. These challenges, as expected, were causing many of the staff to be increasing anxious, experiencing a high-stress level, ...
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  • Addressing Violence in the Workplace, Including Bullying & Sexual Harassment

    It seems as though nowhere is protected from offenses at the workplace. Every day in the news we hear the same words: Sexual Harassment Bullying Physical Violence Verbal Abuse But what we don’t expect is for these offenses to be happening in the very places that are supposed to protect, nurture, and heal people. Over the last 50 years, I have spent my career in healthcare, first as a practicing ...
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  • First, Do No Harm

    The Latin “Primum non nocere”, which translates to “ first, do no harm”, has been a guiding principle for physicians since the beginning of time. It means that whatever the intervention or procedure, the patient’s well-being is the primary consideration. Although this phase is not implicit in the Hippocratic Oath, which nearly 100% of physicians recite on graduation from medical school, its intent ...
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  • Innovation

    Innovation Recently I had the opportunity to participate in an annual event called Dallas StartupWeek. This event provides a forum for innovators, investors, entrepreneurs, incubators, founders and anyone interested in starting a business to network with just about anyone that has something to do with innovation and startups. The week includes programs focused on everything from gaming to social ...
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  • Healthcare and Complexity Science

    During the past forty years, behavioral economics and complexity theory have emerged in helping to explain why organizations and individuals act the way they do. Behavioral economics has become very main stream because of a number of best selling authors book production including, Richard H. Thaler, Daniel Kahneman, Dan Ariely, Charles Duhigg, Jonah Berger, Steven D. Levitt, Stephen J. Dubner and ...
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  • Pay Attention

    Happy New Year! I hope healthcare leaders are paying attention to what is going on outside of healthcare. With the potential repeal of Obamacare grasping most of the recent healthcare headlines, it’s easy to miss other business-worthy stories. In case you’ve missed the following, let me get you up to speed: 1) Sears, a 123 year old retailing giant, recently announced the closing of 150 stores, ...
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  • Billions and Billions Wasted on Healthcare Consultants

    Several weeks ago The Washington Post ran an article, “Pentagon Buries Evidence of $125 Billion in Bureaucratic Waste.” This article written by Craig Whitlock and Bob Woodward told the story of a study originally authorized by Deputy Defense Secretary, Robert O. Work, in 2014. The study produced results indicating there were opportunities to save $125 billion over five years. Unfortunately, the ...
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  • Are Physicians Still Professionals?

    This year, 2016, has been a challenging year for physicians and the “professional services” that they are trained to provide. In addition, the year has put into question the sincerity that many physicians have demonstrated when they took the Hippocratic Oath at graduation which mandates that whenever they are treating patients, above all, their care should “do no harm”! Early in 2016, a ...
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  • MACRA-Part 3: The Toxic Side Effects

    MACRA – Part 3: The Toxic Side Effects In the Part 2 Blog in this series, the critical success factors for MACRA were identified. Although they are challenging, they can all be eventually achieved if they have the full support of the physicians. It would seem that all physicians would support achieving the components of the value equation for all those that they serve, that being improving ...
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  • MACRA: Medicare Payment Success Factors-Part Two

    MACRA – Part 2: The Critical Success Factors Based on information in the previous blog (MACRA – Part 1: The Realities), it is clear the “train has left the station” on the demise of fee-for-service payments for clinical services and the growth of value-based payment reforms. Although the actual full implementation of this transformational program by CMS may be delayed, physician practices, that ...
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  • MACRA: The Reality, Part One

    This is the first blog of a three-part series on MACRA, Medicare’s new payment system for physicians. In it, we describe the realities of MACRA for providers. These are significant and somewhat over-whelming for many. Part 2 will be “MACRA – The Critical Success Factors”, followed by Part 3 “MACRA - The Toxic Side Effects”. In the most simplistic terms, MACRA (Medicare Access & CHIP Reimbursement ...
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  • Patient Safety and Clinical Quality Improvement

    Dr. Royer and I had a very interesting meeting with leadership from the company, Vestagen. The company produces high performance apparel for healthcare workers. The apparel has several unique qualities. “Vestagen’s VESTEX fabric has robust liquid repellency and antimicrobial properties, along with breathability, comfort and durability.” I will be the first to admit I’m not an epidemiologist nor ...
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  • First, Do No Harm

    The Latin “Primum non nocere”, which translates to “first, do no harm”, has been a guiding principle for physicians since the beginning of time. It means that whatever the intervention or procedure, the patient’s well-being is the primary consideration. Although this phase is not in the Hippocratic Oath which nearly 100% of physicians swear to on graduation from medical school, its intent is ...
    Continue Reading
  • Teaching 'New Dogs' New Tricks

    Most leaders in health care today know that physicians are the significant driver of the quality and costs associated with medical care. Because today payment reform is being driven by the value equation, the traditional roles providers have played in the past must be transformed. These transformations are requiring changes in practice style and focus, which many of the older physicians are ...
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  • Medical Devices: Healthcare's Heroes and Enemies

    Recently I was asked to present at the annual meeting of the MDMA – The Medical Device Management Association. The program committee requested that I speak about the most significant changes over the last five years and what I am forecasting for the next five years. In addition, they indicated the audience of device inventors, investors, and regulators from CMS and the FDA, would be interested in ...
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  • The Opioid Crisis: The Physician's Role

    Dr. Sanjay Gupta, the Chef Medical Correspondent for CNN, recently wrote that overdoses are the most common cause of preventable deaths in America today. In addition, the 2016 presidential primaries have highlighted states where opioid addiction and related deaths are their governments’ number one concern. Although drug dealers are part of the problem, we are reminded that doctors have contributed ...
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  • The Knowledge Worker in Healthcare

    Question: Are nurses being educated and treated as knowledge workers? Background: As early as the 1950’s, Peter Drucker identified numerous challenges and opportunities related to the growth in knowledge work and knowledge workers. In Drucker’s 1973 book Management he stated, “Managing knowledge work and knowledge workers will require exceptional imagination, exceptional courage, and leadership of ...
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  • 2016 and Beyond

    We have no special powers. We are not clairvoyant. Rather, we have lived within the healthcare management world for nearly 100 years, combined. We all recall the days docs made house calls. Being entrenched in the ever changing health care scene, the three of us made many predictions. Some of which, people may have thought were ludicrous. But, today, they are all a part of health care reality. ...
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  • Healthcare 4.0

    In 2010, Michael Lewis enriched our lives through the book, The Big Short, by explaining how a small group of individuals became extremely wealthy by short selling the US housing market. To make everyones’ Christmas more special, Hollywood decided to further the enrichment process by having holiday movie goers relive the financial crisis by releasing the The Big Short in movie form. Being a ...
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  • Let's Get Started

    We can delay no longer. For many of the past several decades we have pursued only half measures and lip service toward needed response to a tidal wave of demographic (particularly aging and extended life expectancy) and financial change…but, more importantly, spending on individuals. Federal projections, done by the Congressional Budget Office, for Medicare and Medicaid have identified that ...
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  • Part Two - Are the Causes for Negative In-Patient Growth Really Positive?

    In Part I of the blog series we wrote regarding the first four causes of the negative growth in hospital admissions being experienced in most parts of the US. Most would agree that these causes, although affecting the growth of hospitals admissions negatively, are really leading to better clinical outcomes, which in many cases are more affordable and accessible. The additional eight causes that ...
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  • Are the Causes for Negative In-Patient Growth Really Positive?

    In most parts of the United States the number of hospital admissions have been decreasing between 3% and 8% in the last several years. The mean length of stay, although more variable from institution to institution, has stabilized or decreased. Gross revenue increases are being consistently reported due to more uninsured becoming insured, better contracts from some payers, clinical outcomes, and, ...
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  • National Regionalized Service-Line Centers--Better care?

    A recent article published in Health Affairs, authored by Sanir Soneji, a PhD working in the Dartmouth Institute of Health Policy and Clinical Practice, questions the value of U.S. cancer care. He states that: “screening, prevention, and treatment have extended life for oncology patients, but at a higher cost in the U.S. than in Europe, without a corresponding decrease in cancer deaths. For ...
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  • Three By Three: The Three Critical Success Factors in Healthcare

    In a recent meeting, several people in the audience asked me what are the basis things that they should know and remember that will assist them in being successful in their leadership roles in the ever increasing complex healthcare industry? Knowing that one should keep the solutions, even to complex problems, as simple as possible if they are to be successful and sustainable, I answered by saying ...
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  • What Is Going To Be Left?

    As technologies and innovations continue to create more and more non-invasive procedures, the movement of “once required” inpatient care is moving rapidly to safer ambulatory settings where often better and less costly medical outcomes are achieved. This transformation is also being fueled by marked increases in the types of anesthesia that has become available over the last decade which permits ...
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