All posts by mdmunk

Asking Patients To Advocate for Their Own Safety is Not Patient-Centered Care.

Last year the New York Times reported that the aviation industry had become so safe that one could fly every day for 123,000 years before dying in an aviation crash. I wish we could say the same for the US healthcare system. Nationally, problems with healthcare quality (doing too much, doing the wrong things, and doing ...

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The Growth of Doctor Networks: Will “Healthcare Islands” Appeal to Value-Seeking Millennials?

Around the country, doctors are leaving independent practice and joining large groups owned by healthcare systems. It’s a trend: the recruiting firm Merritt Hawkins predicts that if current growth continues, over 75 percent of newly hired physicians will be hospital employees within two years. There seem to be a number of reasons for this consolidation of ...

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Academic Medical Centers Are Under Siege. Is the Best Strategy to Go Small or to Go Big and Own the Continuum?

The university hospital at my alma mater recently announced an intriguing deal. Jefferson University Hospital, around since 1825, signed a deal with an upstart company called American Well to provide “virtual ED” visits to patients who would otherwise have come to the hospital’s emergency department. A recent article in Becker’s noted: The American Well technology will ...

HMOs Are Back on the Table. And “Cheap” Isn’t Good Enough This Time Around.

If you’re a fan of 1990’s movies, you will likely remember a scene in the Academy Award winning film, As Good as It Gets. The Washington Post described the ruckus in theatres: Audiences in the Washington area have been erupting in whoops, whistles and applause when actress Helen Hunt, playing the single mother of a ...

Budget Boutique Hospitals? Will The Search for Value Lead to Market-Segmentation in American Healthcare?

Years ago, a professor in a healthcare economics course introduced a healthcare adage: never forget, he said, that the way we pay for healthcare—through insurance premiums– distorts the consumer’s perception of value per dollar in healthcare. He meant that the insured pay into the system over time and are indemnified from sticker shock when it ...

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Medical Decisions by Gestalt. A Half-Trillion Dollar Bill and the Vexing Problem of Physician Practice Variation

It’s common that the same patient seeing two doctors for the same condition will walk away with conflicting recommendations. I recently spent time with a patient who had a bad back. One doctor had recommended a conservative approach (watch it, take ibuprofen, use ice) while another recommend an MRI and possibly an epidural steroid injection.

Getting the Doctor’s Skin in the Game: “Accountable” Healthcare… A Quick Primer– and What it Means For You.

The term “accountable healthcare” has been in the media a lot over the past few years. But what exactly is “accountable care” and what does it mean for you as a patient? In about 600 words, here is the short answer. Some background: Experts generally agree that US healthcare has become unaffordable  at a rapid rate. Health ...