I can’t make up this stuff. I am on several listservs that publish medical news items. I understand that there are probably several staffers that contribute to the daily blasts, not knowing what the others are doing. But I assume there is still some sort of editor that makes sure the...
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I took a little time off to focus on my new part-time private practice and Family Medicine payment model. Now that it’s up and running, I look around and the healthcare system still stinks, so I guess I’ll keep writing. My payment model is available for any U.S. Family physician at...
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After my last post, a reader with the stage name “Spring Texan” wrote the following: Ummm, don’t you mean “the Trump tax cuts are just another trip to the candy store” for rich people and corporations? Comparatively little goes to ordinary people and that phases out. Don’t see any “candy store”...
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In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
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In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
Read More »

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
Read More »

In our recent paper criticizing how industrial Quality Improvement has been misapplied to primary care, we didn’t just complain, we made suggestions for a better way forward. This was under the assumption that regulators and payers will continue to insist on some kind of numeric reporting of outcomes by physicians or...
Read More »

Traditional industrial QI does not work in primary care. A recent publication brilliantly makes this case on both theoretical and practical levels ;-). On a theoretical level, primary care is best thought of as a complex adaptive system, not a simple linear mechanical system. Think of complex adaptive systems as kind...
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The AAFP’s recent statement on Advanced Primary Care calls for adopting the “five key functions of the Comprehensive Primary Care Plus Initiative.” This was an experiment under Obamacare where CMS tried to create innovative primary care payment approaches, which was mostly patterned after NCQA PCMH thinking. It started in 2012. Mathematica Policy...
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A key part of Obamacare is not going so well. But before I continue, I assume that some of my readers won’t know some of the acronyms, so I’ll define them. An ACO is an Accountable Care Organization, which was created in the PPACA (Obamacare). The spirit of an ACO was...
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