You Don’t Define Great Customer Service. Your Customer Does.

My car was in the shop last week and I reserved a car at a neighborhood Enterprise rental location.  About a half-hour before they closed for the day I showed up at their office and stood in a line of four people, all of us waiting to pick up our cars. If you’ve ever rented ...

The New-Economy has Created a Trade Deficit in Small Cities and Towns. Healthcare Spending is the Bulwark

I recently drove through Lewiston, Maine.  It’s no longer the flourishing city it once was, though until the early 20th century Lewiston (seen in the drawing above) was a booming American mill town.  Its factories, hydro-powered by the Androscoggin River, were linked by rail to Boston and other large cities.  Like many mill towns in New England, ...

Healthcare’s Age of Acceleration

  I recently finished Thomas Friedman’s excellent book, Thank You for Being Late: An Optimist’s Guide to Thriving in the Age of Accelerations. In it, Friedman makes that case that we are living through an unparalleled time, marked by what he calls “accelerations” that are happening faster than humans are able to adapt.  He argues that we ...

On the Tragedy of the Commons: the Toxic Effects of Drug Co-Pay Coupons

Last week I was driving through Phoenix when I saw this sign at an intersection: It struck me that this was a perfect example of what happens when clever business folks figure out a way to short circuit the normal laws of consumer behavior.    How’s it work?  Bring your car in and the glass shop bills ...

Specialists and Practice Guidelines: On the Cash Cow in the Room

Here’s a personal story about medical overuse and willful ignorance. Stay tuned for the punchline. First, a little background: a couple of weeks ago I came across a great study on medical overuse, specifically adherence to national recommendations published in 2012 regarding the use of the PSA (prostate specific antigen) blood test to screen for prostate cancer.

On the “Bay State Boondoggle”

The Boston Globe recently ran an article discussing layoffs at Baystate Health, a large health system in Western Massachusetts.  The system is planing to lay off 300 employees to try to close a $75M deficit.  According to the Globe, the deficits are mainly driven by declining Medicaid reimbursement, but, more interestingly, by a $23M hit to Medicare revenue ...

Healthcare’s “Modern Movement”

For most of my childhood our next door neighbor, Nick, ran a niche sports magazine from his home.  Trained as an architect at the University of Toronto, Nick went on to work (for only a couple of miserable years) as an municipal architect with the city before dedicating himself full-time to sports. One of Nick’s most memorable ...

Browse Categories