Family physician, author, blogger, speaker, physician leader.

Recent Articles

ICYMI – In Case You Missed It – January 2017 – for Physicians and Physician Leaders

Last month Lemonaid expanded from 7 to 14 states. The newest include AZ, OR, VA, GA, CT, RI and OH. These join CA, NY, PA, MI, WA, FL, and IL. We also added video capability to our asynchronous model. It has been fun thinking through and implementing coverage across 4 time zones and different modalities and creating a trusted health care brand with matching organizational culture.  All new! Never been done! No playbook or checklist to refer to. A lot of coaching, mentoring, debating, and listening. It’s what you do when you are the chief clinical officer! Health Care My newest blog post – Why Smart Use of Digital Health Technology Can Make Health Care More Affordable. American Well will be eBay in providing a technological platform for providers and patients. Geography and physical plant won’t matter as much. Can primary care be in the cloud? Using drones to solve […] Read More »

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Why Smart Use of Digital Health Technology Can Make Health Care More Affordable

“When companies start unbundling costs, it is a sign of increasing consumer power and weakening market power.” This is what CEO David Goldhill and author of Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong told me once. Airlines have unbundled everything that used to be included in a plane ticket. No longer do tickets include meals, in-flight entertainment, and the ability to check in baggage. Today, travelers get to choose what they want and don’t want. Further signs can also be seen in other markets. Cable TV customers are cutting the cord and picking only the services they want. No longer do they need to pay high monthly fees for a package of hundred of channels. Content providers like HBO, CBS, and others now offer stand alone services which is more convenient, accessible, and on-demand for a much lower monthly. These are signs of increasing […] Read More »

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ICYMI – In Case You Missed It – August 2016 – for Physicians and Physician Leaders

“Rahm Emanuel (White Chief of Staff) came to [President Obama] and said you’re gonna have to pull the bill because if you push this legislation [health care reform], you will lose in 2012. [Obama] knew there would be somewhere between 10 and 30 million people who would not get health insurance. Millions of people are being discriminated against by insurance companies [Obama] ‘when you have people more worried about the politics of it than what’s right and what’s wrong, I want you to think about the number of the people all across this country who are looking for some help.’ He’s thinking to himself if i decide not to push forward, what do I say to all those people who came up to me with tears in their eyes telling me that they need this to save themselves and if that means that i’m a one-term president then I’m a […] Read More »

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Why Future Accountable Care Organizations Will Come from Start-ups

With Obamacare and creation of health insurance exchanges, many believed that health insurers would compete for patients much the same way hotels, rental cars companies, and airlines compete for customers. By comparing identical benefits packages from different insurers, patients could select their insurer based on the monthly premium and the extent of the hospital and physician network. In a recent Vox article, Erza Klein urged insurers do ”something like Southwest Airlines: low prices, narrow networks, exceptional customer service, and not much else”.  Klein believes insurers don’t have the tools necessary to meaningfully impacting a patient’s long-term health and avoidance of costly medical complications that would justify the upfront costs of prevention and treatment if a patient simply switched to a different insurer the following year. To Succeed in Health Care Own Every Touch Point The problem with Klein’s premise is that unlike insurers, Southwest Airlines can ensure an exceptional customer experience because […] Read More »

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Why Captain Chesley “Sully” Sullenberger Would Have Been a Great TPMG doctor

One of my roles as an Elected Representative for the Roseville Medical Center was to write monthly newsletters to inform and update colleagues about changes both internal and external to Kaiser Permanente. I’d also pen original pieces which highlighted themes I felt were critical for our organizational success in becoming the model for health care in the nation. This one is from the August 2010 Elected Rep Newsletter. It is still one of my favorites. I recently read Highest Duty: My Search for What Really Matters by Captain Chesley “Sully” Sullenberger, the pilot of US Airways Flight 1549, forever known as the Miracle on the Hudson, to learn more about aviation safety and see if there were parallels to patient safety. What I learned was far greater. Doctors and the healthcare industry have opportunities to do much better beyond just patient safety. The reason he and his flight crew were […] Read More »

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