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

Tag Archive for Malcolm Gladwell

Healthcare Future in 2030 – Think Car Insurance. Doctors Will Work for Walmart and CVS.

With health care reform and the creation of a retail marketplace to buy health insurance via exchanges, the future of healthcare delivery has become cost shifting from employers to employees. What will health care look like in 15 to 20 years? Think car insurance and retirement planning. In a future post, I will cover how health care will look like retirement planning. This new reality will impact both patients and doctors in a very different way. Auto Insurance – Don’t Use It! People will trade low premiums for higher deductibles. In auto insurance, people avoid filing claims for fear of increasing future premiums and access alternative services like windshield repair and body shops to get the job done without using insurance. This will also occur with high deductible health insurance as now it will be essentially catastrophic health insurance and not comprehensive health insurance. This is a perceptive championed by […] Read More »

Would Doctors and Patients Pick a Better Health Care System If They Saw It?

we believe Integrated will triumph Fragmented every time – Steve Jobs, Apple CEO Two articles recently got my attention. The first was an interview by Dr. Robert Pearl, CEO of the Permanente Medical Group with my favorite author and thinker Malcolm Gladwell. On Pearl’s on Forbes blog, he answered Gladwell’s request to tell people what is was like to be a doctor. The second was a NPR article  “When Facts Are Scarce, ER Doctor Turns Detective To Decide On Care” by Dr. Leana Wen, patient advocate and author of the book When Doctors Don’t Listen. Both articles reminded me how doctors and patients have different realities simply by where they practice. As a practicing primary care doctor in an integrated health care system, which is partnered with a physician led medical group, these stories were quite foreign to me. These stories were once my reality in residency but no longer […] Read More »

Will Technology and a New Cohort of Gen X Doctors Save Health Care?

I recently stumbled across a blog post by Dr. Jay Parkinson, an entrepreneur and founder of Sherpaa, who reflected on a recent private breakfast with New Yorker and best selling author Dr. Atul Gawande. The question posed by Gawande: Can technology be a change agent for health care? From Parkinson’s blog post, the response is: The inevitable answer is yes, with one important caveat. It’s not the technology that will change the practice of medicine, it’s the doctors who use the technology who will end up changing it. And it won’t come overnight. Many of the most influential doctors practicing medicine today have an antagonistic relationship with computers. Change will only come in a massive way when the under-40 generation takes control. Under-40s expect technology as impressive as Facebook, twitter, kayak, and tumblr to influence each and every moment of our practice. My generation simply doesn’t know how to live […] Read More »

Is Making Primary Care More Professionally Satisfying As Simple As Lowering Panel Size?

As a practicing primary care doctor, I very much enjoy my career choice. I’m fortunate enough to be in a large multispecialty practice that is collegial and forward thinking. If I was in a smaller practice like other colleagues, I would not quite feel the same. Yet concern about how to make primary care attractive for both future doctors and those currently in practice has been something I’ve been occupied with since 2010. It is simply about lowering panel size? Though that may help, the answer is more complex than that. In this post and a future post, I ask that question and propose a framework on how primary care can be better and how physician leaders might best address the problem. In 2006, my medical group transitioned to an electronic medical record (EMR). Interestingly, nothing changed on the amount of time doctors spent in the office. After becoming more […] Read More »

Why Doctors Should Read Malcolm Gladwell’s David and Goliath. Can a David Fix Health Care?

October 1st was a special day. The Affordable Care Act (ACA) also commonly known as Obamacare continued to march forward with the opening of the insurance exchanges. The federal government shut down because Republicans and Democrats disagreed around Obamacare funding. Most importantly, October 1st was when I could finally read Malcolm Gladwell’s new book David and Goliath. Gladwall ponders why do underdogs succeed when we least expect them to? Is it possible that advantages a Goliath has can be a disadvantage? When might a disadvantage for an underdog appear to be an advantage? As I put his observations together, I wondered are there any learnings for doctors and the health care system? Absolutely. A David typically does not have the resources or power to make a difference as viewed by conventional terms. Gladwell uses stories like the US civil rights movement, successful individuals with a dyslexia, and his excellent New […] Read More »