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 »

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...
Read More »

A recent survey of physicians asked several questions about prescribing practices. The primary report was that only primary care physicians cited costs as one of the most important considerations in their prescribing habits. Out of 10 factors, all of the ologists ranked cost as the sixth or less most important consideration. Pulmonologists...
Read More »

Just about every U.S. medical student who’s ever said they want to go into family medicine, or even other primary care fields, has heard this (or something like it): “Why do you want to waste your brain?” A new study shows what we in family medicine have always known/suspected. The comments...
Read More »

There was a nice opinion piece in JAMA Internal Medicine recently where the primary author talked about moving from the U.S. to Switzerland and his experience in both systems. Primary care physicians are allowed to bill based on time there. This includes travel time, phone work, and documentation time. What a concept!...
Read More »

A study in the latest Health Affairs took a snapshot of utilization and costs associated with retail clinics. These are the small clinics located in Wal-Mart, CVS, Walgreen’s and the like. They were touted by proponents as low-cost options for primary care. They are usually staffed by nurse practitioners or physician assistants....
Read More »

Atul Gawande, MD, who is the doctor-writer who has published frequently in the New Yorker and has published several well-regarded books, has written a great piece in the latest New Yorker. It’s called Overkill. It’s basic premise is that he went back to McAllen, TX to see how things were going 5...
Read More »