Author Archives | Richard

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How’d I Do?

October 20, 2017


How'd I do?

Here is another iteration of an issue that has popped up before. More specifically, we have seen some hospitals protest that their compensation shouldn’t be docked due to high readmission rates, since they see sicker patients. Etc. But in this blog post, we see the issue reappearing in the guise of a question as to whether a surgeon’s “individual” procedure outcomes should be reported to the public.

This is a classic damned if you do, damned if you don’t situation. I would think that if I were pondering having a surgical procedure performed on my body, I would very much like to have access to surgical outcomes data, yes at the level of the individual surgeon, that have already been compiled. Why not?

BUT. If surgeons decide not to perform certain procedures on certain patients solely because the patients’ compromised status might lead to bad outcomes and bad PR, that seems unfortunate to put it mildly.

Bottom Line. Read the article and ponder what should be done here if you were responsible for making this important decision. 

Not an easy one!

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As Sexy as Grey’s Anatomy???

October 19, 2017


Grey's Anatomy

Ponder this blog post! You can read it at a couple of different levels. First, in terms of entertainment value, I think we would all acknowledge that ER’s make for better television than do Primary Care offices. All that blood, and running around, and…but the older among us can remember Marcus Welby, M.D., a show that ran from 1969 through 1976, which actually did glorify the compassionate role of the Primary Care Physician.

Times have changed, and I’m guessing that poor Marcus would get rather pathetic ratings in 2017.

More important, however, is what all of this has to say about our attitudes toward “medicine.” As is so eloquently stated in this article, the American public clearly thinks that medicine is about fixing acute problems, rather than about preventing chronic ones. Sad!

Bottom Line. So, we are caught in a circle here. Consumer attitudes help to determine what is shown on the broadcast media, and the broadcast media help to drive consumer attitudes. Even in the Marcus Welby era, the good doctor was known for helping patients through crises, rather than for helping them to avoid crises through diet and exercise. BUT. How do we communicate to patients that the important role of medicine in general, and of Primary Care, in particular, is to help patients tailor their prevention and detection programs?

How indeed?

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Pain Scales, Patient Satisfaction = Physician Compensation + Death

October 18, 2017


Pain Scales


As is noted at the beginning of today’s referenced blog post, everybody knows that the U.S. is awash in an opioid epidemic so we will not spend a lot of time on that riff.

What I do need to point out with some embarrassment, however, is how all of the words listed in the title, above, fit together. Embarrassment because I never thought of this before, and should have. As you read this ER doc’s post, you will see that pain scales have unfortunately provided a convenient shorthand for patients to use in the Emergency room to score drugs. AND. Physicians are concerned that if they do not provide pain relief in response to such solicitations, they will be reported to be providing less than excellent patient satisfaction. AND. They are concerned that this will lead to a lowering of their remuneration according to today’s compensation formulas. AND. So, they write the requested prescriptions. AND. A byproduct of all of this is death and the “opioid epidemic.”

Bottom Line. Yup, this is all pretty sequential. The question is, where in this series of steps do you intervene to slow the downward spiral? The blogger seems to believe that eliminating the use of the pain scales would take some of the stupidity out of this progression. He also notes that we need to eliminate our obsession with treating pain. All pain, he rightfully points out, does not need to be suppressed. Last but not least, the elimination of the connection between Rx’ing narcotics and patient satisfaction and physician compensation is obviously necessary if we are to stem the opioid epidemic.

 Yikes! Lots of required interventions and modifications here. Where to start???

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You Are Leasing What from Who???

October 17, 2017


Senator McCaskill

By now I am sure that you all know this story. Allergan offloads the Restasis patent to the Mohawk tribe and “leases” it back. Reason? The “sovereignty” of Native American tribes limits patent challenges.

But check this out. Senator McCaskill, pictured above, has introduced legislation that would eliminate what she describes as this “brazen” loophole in the patent system.

Bottom Line. What will pharmaceutical companies think of next? First it was moving their “Headquarters” to Europe to lower their tax bases. Now this. Somehow this doesn’t look like our companies are trying to be taken seriously by the American public!



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Chaotic Storage

October 16, 2017


Chaotic Storage

Amazon. You know that the company always amazes me. To share an additional dose of amazement with me, check out this video.

What you will learn is that Amazon’s warehouses, some of which are well over a million square feet each, use “chaotic storage.” Translated, that means that items are not organized by category, but rather by bar code. A piece of jewelry can be in the bin next to one holding green sweaters. Doesn’t matter, since the computer driven robots doing the picking of merchandise don’t care about categories anyhow.

What, you might legitimately ask yourself, does this have to do with the healthcare vertical? Answer: Everything. More specifically, I compare the elegance of the warehousing/fulfillment system that Amazon has set up with what we experience in health care.

My wife and I rely on the Medical University of South Carolina (MUSC) in Charleston when we have significant medical issues. Excellent medical care. BUT. In order to schedule an appointment, you first talk to someone in Central Scheduling, who then hands you over to someone in Department Scheduling who then tries to help you. Result? Casey scheduled an appointment with one of the leading specialists at MUSC. As usual, she scheduled it about a month out. The day before the appointment, she got an email telling her that the doctor was not in the office that day, so she and the others scheduled patients would be seeing a Physician Assistant. With all due respect to PA’s, that was NOT what we were going to drive four hours for. Appointment cancelled.

Here’s the punch line. We decided that Casey should see the local expert in this treatment area, with whom many of our neighbors have been quite pleased. Casey then used the online portal of the local practice to schedule an appointment. We show up at the appointed time to find an office empty of anyone except a receptionist, who apologetically tells us that the doctor is in surgery and yes, they have been having a lot of trouble with their scheduling link! We now get to try again tomorrow at a different office which requires an additional 30-minute drive. Stay tuned on whether they got this one right!

Bottom Line. Question. What technology can we bring over to health care to ensure that our minds and bodies are treated as well as the “Happy Boxes” you see being managed in this video???

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Disruptive Innovation

October 13, 2017


Disruptive Innovation

Trigger Warning. This piece has absolutely nothing to do with healthcare marketing, so if that is all you are interested in, leave now and stop back tomorrow.

BUT. This piece has lots to do with disruptive innovation, a.k.a. thinking out of the box. Check this out. What you will see is something unlike anything I have ever seen before. You see, DUFL is a personal valet service for the harried traveler. Sign up, and you get a personal DUFL closet, to which you send your traveling clothes. Before a trip, use their app to tell DUFL what clothes you will need for this journey. DUFL will pack them neatly in a suitcase, and send them to your destination.

When you are about to leave for home, simply throw your soiled clothing into the suitcase and send it back to DUFL. You guessed it. They will do the required laundry and dry cleaning, and put the clothes back into your virtual closet until your next trip when the process starts all over again.

Bottom Line. SO. This is definitely disruptive thinking. We have certainly never seen anything like it before. Blue Ocean Strategy (if you don’t remember, look it up) and all of that. That is the good news BUT. Will the service really feel like it is saving the consumer as much time as promised? And will that be perceived as being worth the price, whatever that is?

Oh, and their service better be perfect. Showing up at a hotel for a week of business appointments and finding that your luggage is not waiting for you is an event that would NOT likely lead to your giving DUFL a second chance. Even hearing of a friend or colleague having that happen to them would likely be end game for your considering/using the DUFL system. 

And how do you do marketing research for a service like this? As Steve Jobs made so clear, you can’t really do marketing research on something so new and different that people don’t know that they need it.

Would I have used the service when I was traveling 80% of the time? Maybe. If it was user friendly and appropriately priced.

Would you???

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Too Close for Comfort

October 11, 2017



Check out this post. What you will see is story of an Ob/Gyn who learns a lesson from a patient. A lesson about how important little gestures of support can be for a patient who has just been told that she is having a miscarriage. Little gestures like offering a quiet room for the patient to use to call her husband. Or the doctor walking out with the patient to show that she cares.

Bottom Line. In our previous post, we talked about the importance of understanding “trust” in the physician patient relationship. What does it mean? How does a doctor create it?

So. Today’s word is “support.” And the questions are the same. What does it mean? How does a doctor create it? 

What other words/concepts like this are important for us to understand? Hint. Spend some time roaming around the site from which we pulled this post.  See if you can come up with another word or two that will help to tune your ear to “voices from the heart of medicine.”

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What Does “Trust” Mean To A Patient???

October 10, 2017


What Does Trust Mean To A Patient?

Take a couple of minutes to read this “essay.”  Funny.  We use words like “trust” all the time, without stopping to ponder their meaning.  BUT. As this Ob/Gyn makes crystal clear, we should stop and think about such words.  When we do, we can come to some very important realizations.

For example, as this article points out, trust is at the center of the physician-patient relationship, which in turn is at the heart of the practice of medicine.

AND. For the physician-patient relationship to work, each party must trust the other.

Finally. Patient trust results from a complicated combination of things that the doctor controls, things that the patient controls and things that are inherent in the situation in which they find themselves. Think about that trichotomy when you read the cases that the blogger describes in this post.

Bottom Line. Trust. A simple word. Or maybe not!

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Keep It Going!!!

October 9, 2017


Keep It Going!!!

We have already talked about this case. A nurse arrested for “failing” to follow a policeman’s orders to draw blood from an unconscious patient who wasn’t charged with anything. No warrant. No nothing!!!

But take a few moments and read this blog post. Importantly, it provides a nurse’s very lucid perspective on this matter. Two things pop out at me that I had not considered when I first read about this.  First is the fact that the officer said he had never had a nurse deny his order to draw blood before. As is pointed out very clearly here, this means that previously, other staff members had apparently violated patients’ rights since they were unaware of the hospital policy, were scared of the cops, or all of the above.

Second, the blogger suggests that given that this matter has gone viral and gotten its 15 minutes of fame, nurses need to use this opportunity to make sure that members of their profession receives the respect they deserve. Quietly doing their jobs won’t cut it. They need to speak up, and take some of the actions enumerated in this post to keep the matter in the public eye AND to get the protection that they clearly need.

Bottom Line. I continue to marvel at the studies, reported in this blog in the last couple of weeks, that found that healthcare workers are second only to law enforcement officers in terms of the level of personal risk that they face simply by going to work. 

 WOW! Here is a great opportunity for a healthcare company to step in and make a very positive impression by helping those on the “front lines” (!!!) to figure out how to protect themselves.

 How about your company???

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9 Employee Benefit Trends to Watch In 2018

October 6, 2017


9 Employee Benefit Trends to Watch

According to this recent article in Employee Benefit News, next year will see nine important new trends in employee benefits.  While some will relate to our healthcare vertical, like a focus on workplace wellness (Haven’t we heard that one before?), others will focus on financial planning, assistance with student loans, etc.

In the healthcare arena, I especially like the trend which looks to increasingly integrate health benefits and retirement benefits. VERY responsive to the needs of our times, in which planning to have good healthcare coverage in retirement years, when health problems really loom, makes all the sense in the world.

Bottom Line. But wait! Step back a little, and take another look at this list of trends. The unifying theme here is clearly that all of these trends fit together to help employees to lead less stressed, more enjoyable lives. 

 All good. My only questions are:  At what cost? and Who pays?

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