All posts by mdmunk

Will Physician “Trust Platforms” Make System Affiliation Less Important? Considering Airbnb and Holiday Inn

In this week’s New York Times, columnist Thomas Friedman makes a great observation regarding the emergence of what he calls the “sharing economy.”  This is the peer-to-peer, internet enabled economy where ordinary citizens rent car trips and unused rooms.  It’s an area that has exploded in recent years, a trend fueled by the 80 million members of Generation Y– many who prefer ...

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Downed Airliners, the GM Debacle and the Real Danger of Groupthink in Large Organizations

The scenario plays out something like this:  an organization pulls together a team of people to work in a stressful environment.  The team coalesces and after some time a shared set of norms emerges. Everyone begins to do things the same way.  When narratives outside this shared experience emerge, the group closes its ears and marginalizes the outside ...

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A “Certificate of Not-Needed” Process: The Solution to Hospital Bed Surpluses?

Imagine that you were the “state administrator for hospitals” and were given the unenviable task of shuttering 30% of the hospital beds in your state.  How would you decide which beds to keep, and where?  Would you shutter a handful of hospitals entirely, or would you reduce capacity at every hospital across your state?  Would you be ...

Healthcare Mergers are the End of the Beginning: Some Lessons From the US Airline Business

There has been a lot of recent discussion about the value of large healthcare mergers, such as Partners ongoing acquisitions in the Boston area and the recent large merger between Baylor and Scott & White in Texas.  Supporters argue that these create better integration of care and economies of scale.  Opponents argue that these deals ultimately drive up costs, ...

Failing Academic Healthcare Systems: Are Mergers the Answer?

Challenges at many academic medical centers aren’t news.  At a time of declining reimbursement and patient migration to lower cost community alternatives, many academic systems are trying to figure out how to position themselves. In light of these challenges, I read with great interest news of a recent deal between Banner Health (a large and well-run not for ...

Reusable Rockets and Orbiting Nano-Satellites: A Lesson for US Healthcare?

A spectacular story about scientific disruption comes to us from last week’s Economist magazine. The authors write that, over the past few months, a hundred tiny satellites have been launched in orbit at a fraction of the cost of a traditional satellite.  Called nano-satellites, these 4-inch cubes are cheap, often constructed in simple workrooms with off-the-shelf ...

Squeeze the Consumer or Squeeze the Prescriber? Conflicting Ideologies and the Rise of High Deductible Health Plans

If you were designing a program to lower healthcare costs, would you direct your efforts at the medical consumer, or the medical prescriber?  Do you create a system where an informed and empowered consumer drives the market, or one which regulates providers and holds them accountable for the services they deliver? The answer, I think, would depend on ...