Something is about to change And the effects on all of us will profound. Telemedicine is one of the key tools I encourage my clients to use as they break free of the world of corporate medicine. Telemedicine companies privately contract with services and address patient concerns over phone or video, in exchange for a per visit fee. To stay on top of the game, I work within tele-health services myself. And in January, I...
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As much as I hate the term “Millennials,” I love working with them. More than any other cohort, they’re comfortable thinking outside the box — and they do so with a healthy cynicism born of hard experience, they can tell when they’re getting screwed at a much younger age than I ever could. Over the past decade, clinician compensation has increased at a rate below that of the real inflation rate. And taking into account...
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This is what my wife’s grandmother, the healthiest person I have ever known, told me as I accompanied her to an ophthalmologist at the age of 90, her first doctor’s appointment in decades. “Forty years without seeing a doctor was the best thing I ever did.” So, what’s the problem with the EHR . . . They will cause you to consume more healthcare—a lot more. From selling your information to marketers to encouraging you...
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Meet Jeff. A Family Practice physician who formerly owned his own practice, he sold out to a regional healthcare organization, got out of debt and is working with his former patients as a PCP for the company that bought out his group. He’s doing great. Freed from debt, he’s able to do his work and enjoy his family. He’s working with a scribe, seeing almost four patients an hour and generating a ridiculously high risk-score...
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At General Electric, Jack Welch pioneered the cultural breakthrough that was the Work-Out. Small groups of employees on or just behind the front lines met without bosses to discuss common concerns. When the bosses were allowed in at the end of the session, they had to make up-or-down decisions on the spot in response to the recommendations that had been created. The technique changed GE, and through the legions of managers who went through it,...
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Command and control has failed to bend the cost curve enough. Price transparency and consumer-driven care is next. Basic medical care will become a can of corn—as long as the can is properly sealed and dated, price will trump all. And the race to the bottom begins. And margins shrink. And empires fall. You must not let yourself become a commodity. You must establish yourself as a value-generator—not to some external third-party but directly to...
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A certain large retail chain is going all in with its in-house clinics. Not only for urgent care, but for full-blown primary care. Will patients accept the chain as their personal clinician? Can regular doctors and their organizations hope to compete? Wal-Mart got to where it is by offering its customers real value. Even at the expense of destroying the unique local retailers. Who’s to say they can’t do that with the town doctor? I...
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Last week we saw that the “Number Needed to Treat” (NNT) was a great way to decide whether the drug or the test that your clinician recommends is a “No” or a “Hell ,Yes.” Most people outside of medicine, and many inside, have never heard of that term. This despite all the billions spent advertising medication and testing. Why is that? Because if you understood what NNT was and actually knew the NNT for most...
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The engagement with my “Rules for Dictators” series surprised even me. The greatest criticism? Business books don’t help. Clinicians who have contacted me have flatly stated that, in response to their corporate environment, they had already read their fair share of business success books. The Go-Giver. Who Moved My Cheese? The One Minute Manager. They had read them all, tried to apply the lessons—and then nothing. The same frustrations, the same lack of impact and...
Read MoreYour journey through the academy is complete, my mission objective fulfilled. But your mission is about to begin. To summarize: Your strategy Address, document and submit as many risk-based diagnostic codes as appropriate for each patient—all while staying reasonably sane. Your tactic Submit yourself to the idea that the common risk codes associated with specialty interventions—Acute MI, Stroke, Lung Cancer, will all be submitted without your...
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