Patient Experience

Creating Value through Crowdsourcing & Finding “Value” in the New Year

Earlier this month, I took a day trip to the University of Michigan Frankel Cardiovascular Center for their inaugural value challenge. Little did I know that when I arrived, I would be part of an all-star judging team that would be giving away $100,000 (a.k.a. real money) complete with a “big check”, a la Publisher’s Clearing House, to the best idea to improve value! Given that I do not see patients on our cardiology service, I was starting to wonder if I was in over my head. The good news is that value was defined quite broadly by different stakeholders; I was able to follow along, even though I wasn’t up to date with the latest in intra-aortic balloon pumps. We heard from 5 finalists. Interestingly, 3 of the ideas centered on specialized teams to improve care coordination for specific conditions such as atrial fibrillation, pulmonary embolism, or cardiogenic shock. While…

The Medicaid Overhaul And How Hospitals And Its Providers Could Be Hardest Hit

Given the signs Paul Ryan, Speaker of the House, has flashed during his tenure, expect phase one of the health care financing overhaul to be heavily focused on Medicaid. The incoming administration aligns with this change (#6), as does the president-elect's choice of Tom Price for HHS Secretary.    This turn will have an impact on hospitals and something you should pay attention to.  You will see lots of press over the coming months, and you will hear the term Medicaid block grants.  You should have an opinion, especially if you work in a rural, safety net, urban, or academic medical center.  I would imagine that holds true for many of you. (more…)

A Letter to My Patients

To my next patient: I often avoid putting my politics on my sleeve, as I don’t want that to get in the way of our relationship. I want you to know that I treat you as a fellow human being, no matter your race, gender, sexual orientation. With the election results, what will change about how I treat you at the bedside? Nothing. I may know about your criminal past. I see that tattoo underneath your gown. I hear your profanity-filled screed because you won’t get that MRI today. I know you don’t follow the treatment plan, that you are here illegally or that you are a refugee from another country. I will still care for you no matter what. It’s one of the blessed things we instill in each other in medicine. I saw someone like you recently: 28 years old, working hard, with 2 jobs, but neither provided…

VIP Syndrome

I was reading a nice piece eulogizing David Bowie.  If you are a fan of his you know what a towering figure he was in the music world.  Given he died of cancer, I was also thinking about the docs involved in his care and their absolute pledge to him to guard his celebrity.  HIPPA aside, if you know the man or like his music, you must be in awe and most certainly, aimed to satisfy his expectations. If you work in a big town, you have probably seen your share of VIPs come and go into your facilities as well.  And you have also witnessed or partaken in the privileges accorded to them by request from above or out of your reverence. By VIPs, of course, I mean starting quarterbacks, lead singers, chairs of the board, and local luminaries and donors with deep pockets. I was curious about the…

The Head and the Heart

One of my favorite bands, The Head and the Heart, released Signs of Light last month. A more pop album than their prior folk rock versions, it’s still a good listen. The group states the origin of the name comes from a recognition that doing what you love – in this case, music – creates unintended sacrifices in the rest of life, such as relationships and friendships. Life is filled with these balances. The world today seems to be polarizing on notions of ideas that feel right versus ideas that are thoughtful. In reality, it’s some combination of both – to sell ideas, they require simple messaging with depth of thought. That same philosophy applies in life, and of course, in the hospital as well. Hospital comes from hospes, the Latin word for stranger, host or guest. Hence, the origin of similar words such as hostel, hospice, hotel and hospitality. A patient is…
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