Have you ever heard of the butterfly effect? It’s a classic concept in complex adaptive system theory. The idea is that the energy generated from a butterfly flapping its wings, added to another burst of energy, and so on, and so on, and so on, ultimately leads to a hurricane half...
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Two more state-level experiments to support primary care have failed. Before I go over the findings, let me first say that I appreciate that some states are willing to think big and take risks by trying new approaches. Change is hard. One of the real strengths of America has been its...
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I wonder if family physicians are already getting burned out hearing about burnout. Nevertheless, it’s still an important and unresolved issue. As a brief reminder, burnout is associated with poorer patient care, physician retirement, poorer physician health, and productivity. In a related issue, America loses the equivalent of 2 large medical...
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A significant innovation in cancer therapy is known as CART, which really stands for chimeric antigen receptor T-cells. Let’s just keep calling it CART. In this treatment, a sample of the patient’s white blood cells (from the T cell line) is removed from the body and treated so that it is...
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When I was in Sweden earlier this year, I heard this phrase several times, “There is no such thing as bad weather, just bad preparation.” They said this when we asked them what they did with their children in dead of winter. The proud parents made it very clear that no...
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My thanks to Al Lewis of quizzify.com for bringing this story to my attention. It seems that a 57-year-old woman who had a history of a double mastectomy for breast cancer was told by her employer that she had to get her annual screening mammogram or she would be fined each...
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It is actually refreshing when people are honest, especially when they lift up the curtain to reveal what is really going on behind it. In a recent interview, a former manager at Lilly, confesses about the process by which Lilly set prices. For example, a product called Xigris was priced largely...
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Family physicians and others have for years complained about ridiculous quality measures such as the meaningless use program, HEDIS, MACRA, etc. To its credit, the Agency for Health Care Research and Quality was willing to take a step back and ask, “What does high quality look like?” Researchers led by Rebecca...
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I had the distinct pleasure working with family physician colleagues in Sweden recently. It was a similar experience to a trip I made to Britain about 5 years ago that I also wrote about. I got to spend some time watching one of my colleagues care for her patients in her...
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Some people think that the solution to better-supported primary care is in DPC/salaried physician payment models. I don’t think it is the best answer. I realize money is not the only motivator explaining why people perform work. Meaningful work matters too. But meaningful work that is not respected and paid for...
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