I have family in Canada, and so often find myself flying from Boston to Toronto. There are two ways to fly: you can take Air Canada from Logan to Toronto’s International Airport a couple of times a day. Or, for the past 10 years, you can fly on a small turboprop operated by Porter Airlines from Logan to a small municipal airport located on an island in Toronto’s harbor.
Since it started flying in 2010, I’ve always preferred Porter because it’s a scrappy little airline that successfully disrupted the big guys by offering great service, friendly staff and easy airports. To me, the airline was always a textbook example of how small entrepreneurial companies that have a relentless focus on the customer can win.
You may have seen the ads for Simplisafe on TV: it’s a do-it-yourself home security system that you can buy for a couple hundred bucks and install in an hour. Instead of having a home security company come to your house and wire your windows and doors to a central monitoring box, Simplisafe is a wireless system that connects to the cellular network. You buy various sensors that connect wirelessly to the base station and for under 20 bucks a month you can connect to central monitoring services. They don’t require a monitoring contract – you pay month-to-month. And, you can take the system with you when you move.
If recent popular posts on the big physician blogs are any indication, some US physicians are beginning to crack.
Three of the most read recent posts on KevinMD are on the topics of physician burnout, knowing when to quit medicine and—frighteningly– on the conditions that lead physicians to suicide. Along with my now quotidian experiences interacting with unhappy doctors, I’m suspicious that we may be reaching the end of physician professional practice as we know it.
My sense is that external demands, adjacent innovations and a flood of new medical knowledge are pushing our existing “physician production model” to its limits and it’s reflected in the anxiety many doctors are feeling.
I regularly think back to perhaps the most important talk I’ve ever heard addressing the current dysfunction in US healthcare. It was delivered by Dr. Brent James, from Intermountain Health who attributed the huge ongoing problems in healthcare to (only) three main drivers. These are:
- A dysfunctional payment system that encourages utilization
- The painful evolution of medicine from a craft business to an industry
- Clinical uncertainty driven, partly, by the rapid growth in medical knowledge