McAllen, Texas: The Inside Story

Many of you already read “The Health Care Blog” (which sometimes carries my posts). In case you don’t, please check out today’s wonderful father-son interview, which puts a human face on the transformation of McAllen, Texas from sleepy border town into national healthcare icon (at least ever since Atul Gawande placed it on the map with his New Yorker piece).

The son in this case is the writer Ian Kibbe, THCB’s associate editor; his dad is David Kibbe, a family physician who practiced in McAllen in the 70s and 80s and witnessed first hand the cultural transformation that put the town in the Pantheon of Greed in the Dartmouth Atlas. As the President and his team try to nudge the culture of medical practice in the right direction, it’s vital to appreciate the forces that can cause precisely the opposite shift.

Well worth a read. 


  1. Benjamin Littenberg on July 28, 2009 at 12:39 pm

    The NY Times published an essay by Gil Welch today that tells the same story from a slightly different point-of-view. Recommended.

     [Note from Bob:  The essay is here; may require subscription]

  2. exodus on August 3, 2009 at 5:03 am

    Here is an anti-McAllen, Marshalltown in north-central Iowa.

    I worked there earlier this decade. In my opinion, the reason for cost efficiencies in Marshalltown are –

    a) paucity of specialists,
    b) most PCP’s see their patients across settings – office, hospital and long term care,
    c) easily available medical records.
    d) More discussion between patients and PCP’s regarding prognosis and end-of-life issues

    The place only recently added its first cath lab. It will be fascinating to see if this leads to cost escalation in the coming years.

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