In the course of writing 2550 blogs to date, my attention has shifted to profound transformations in medical practices, government interventions into clinical freedoms, electronic information technology revolution, role of physician and American culture on these monumental events, and how physicians are adjusting to what’s transpiring out there, much of it beyond their control.
- Rhyme because there often seems no rhyme or reason for what’s happening and events are so harsh and complex they do not lend themselves to straightforward prose.
- Rhetoric because the political and management talk is often so abstract and lofty that it deosn't truly indicate what’s taking place on the ground.
- Reality because someone needs to bring these complex and sometimes chaotic events into a sharper focus to which we can all relate.
- Recognize reforming health care is complex and doesn’t lend itself to sweeping innovation by centralized government or fragmented markets.
- Do not try to spell out in detail what needs to be done because no one is smart enough to know.
- Acknowledge that outcome data has a place but must be balanced against intuitions, needs, and motivations of patients and physicians.
- Go to the edge of clinical events to see what works and is affordable.
- Deal realistically with the paradoxes and tensions of change which will never please all of the people all of the time.
- Know that multiple actions must be tried to see what direction to take before one proceeds with some grandiose scheme.
- Listen to gossip, rumors, conversations, and dissent before taking subsequent actions.
- Look for simple systems that work independently before incorporating them into an integrated complex system.
- Mix cooperation with competition, realizing that independent entrepreneurs are going to strike out on their own.
- Physicians, Poetry, and Humor - Health reform, being a human thing dependent on human foibles and behavior, is much too serious to be taken seriously all of the time.
- The Physicians Foundation , New Voice of Medicine -Through its national surveys, white papers, and research grants, this organizatihn has shown a bright light on what’s really happening out there to physicians.
- The Physician Culture and the American Culture- Their Affect on Health Reform.
- Primary Care and Specialty Care – Their Roles and Evolution in Health Reform.
- Medical and Health Care Innovation. Parallel but Not the Same.
- The Information Revolution and Medical Records – and the Patient-Physician Relationship.
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