Health care “disruption” doesn’t have any rules!

Novel strategies often “appear” full blown. Sometimes they appear to be counterintuitive. Often there seem to be conflicting ideas out there. New players enter the competition. There is no continuum within which to place different initiatives. So DOCTOR is taking a break to try to learn more and perhaps might come back “disruptively”! Here are

Read more ›

In 2018 the CVS-Aetna “Unicorn” will buy a mega-hospital system and become a very disruptive patient “ownership” trajectory

2017’s headline is the rapid transformation of the American health care system with disruptive hybrid private sector mergers, mega-hospital system mergers creating horizontally and vertically super-sized systems, and major capital expansion investment by academic medical centers to retain national and regional “anchor” supremacy. And the explanation by pundits of the various competing trajectories. My approach

Read more ›

I am still a family medicine physician and still see my own patients each day. My nurse and I review all messages for the day and all phone calls are returned before we leave. (A)

Sounds great! But with the transformation of health care more and more physicians are “employed” and not in “private practice.” The Medical Group Management Association reports that more than 50 percent of physicians are now employed by organizations affiliated with health systems. In some specialties, like cardiology, that is closer to 75 percent. Discussion of

Read more ›

I went on my morning walk committed to losing the weight I gained over the summer

After turning on my GPS app to monitor my walking time, pace, distance, and calories burned, I started thinking about how technology can change physician/ patient communication for the better, if used thoughtfully. For example, an article discussing the stethoscope as a historical artifact, raises the question are our physicians’ early or deferred adopters of

Read more ›