Archives By Month: June 2011
Physician Assisted Killing
A patient with obstructive sleep apnea came in for his annual evaluation. He had been snoring for decades, but about six years ago, his wife noted that his snoring stopped abruptly in the middle of the night. She observed her husband and noted that his chest was still moving, as if he was breathing, but […]
The Mammography Debate Continues
Over-diagnosis and over-treatment WE RECENTLY NOTED THE U.S. PREVENTIVE SERVICES TASK FORCE ON MAMMOGRAPHY SCREENING ALONG WITH DR. ROBBINS CAUTIONS IN THE 1980’S – WE RETURN TO THE DEBATE: SEE THE HPUSA MARCH ISSUE. THERE ARE VALID CONCERNS ABOUT THE OVER-DIAGNOSIS AND OVER-TREATMENT OF “DUCTAL CARCINOMA IN SITU” (DCIS) AND SMALL, SLOW-GROWING INVASIVE BREAST CANCERS […]
Lean HealthCare requires defunding ObamaCare
Viewpoints: ObamaCare should be defunded – now Sally Pipes – Special to THE BEE – Friday, Apr. 01, 2011 Last week, the Obama administration’s top lawyer, acting Solicitor General Neal Katyal, asked the Supreme Court not to honor Virginia Attorney General Ken Cuccinelli’s request to fast-track his state’s constitutional challenge to the federal health care […]
Every industry is getting lean; we no longer have a choice
David J. Gibson, M.D. Director, Clearway Health Solutions You may have missed reading a thought provoking article from Thomas Freedman in the NYT yesterday. The article entitled Average Is Over (see attached below), is particularly relevant as it relates to the political debate that is evolving with a trajectory that is progressively being divorced from […]
A Medical Correlative
Many patients never learn or even suspect that the CT examination, the echocardiogram, or the magnetic resonance imaging study that they underwent was neither necessary nor indicated. Chaos in the Cockpit Herbert L. Fred, MD, MACP Tex Heart Inst J. 2012; 39(5): 614. PMCID: PMC3461665 On 1 June 2009, Air France Flight 447, an Airbus A330 en route […]
The Most Energetic Area of Lean Practice
James Womack: The Lean Movement With the current activity to increase the minimum wage, we need to review what James Womack said in 2008 when he was reflecting on the progress of the Lean Movement: “One critical indicator is our success in extending lean thinking to new industries and activities. In recent years I have […]
Healthcare Mergers are not lean but are in a race to the bottom
I’ve been following the Lean Marketing column from Kevin Meyer’s “Superfactory” site for a decade or so. Medicine and Healthcare in General has a lot to learn from other industries. A recent posting by his associate, Bill Waddell, was very instructive. Mr Waddell states that he is “glad to have grown up in America before […]
A Challenge
This year we were obligated to take on 250 ObamaCare patients. These were patients without insurance, on welfare, on Medicaid who were given HMO insurance. This was a more massive change in our practice than I could have anticipated in my wildest imagination. I had to promise my front office this was an obligation to […]
Solo or small groups have the leanest healthcare
Abstract Nearly two-thirds of US office-based physicians work in practices of fewer than seven physicians. It is often assumed that larger practices provide better care, although there is little evidence for or against this assumption. What is the relationship between practice size – and other practice characteristics, such as ownership or use of medical home […]
Medicare’s Benefits exceed Contributions by 300 Percent
Obama’s ‘Conversation’ on Entitlements By HOLMAN W. JENKINS, JR, WSJ A couple retiring last year paid $109,000 into Medicare but can expect $343,000 back from the system. Nobody should be surprised that public-sector workers in Wisconsin and elsewhere are fighting to preserve every penny of their promised benefits. Nobody should be surprised that state governors—and […]