Wednesday, May 1, 2013

All Time Top Five Medinnovation Blog Posts:The Reasons Why
A man always has two reasons for what he does – a good one, and the real one.
John Pierpoint Morgan (1837-1913)
On December 11, 2006,  2331 days and 2799 posts ago, I launched Medinnovation. 
My reasons for composing these posts were  and are: 1) a good one – to inform readers what’s going on out there in  health innovation and reform; 2) the real one – to give you my opinion about what’s real, bad, or ugly about  innovation and reform events.
This is my 2800th post.   The formula for these posts remains the same: 
  • An opening quote for context and relevance
  • a statement of the problem
  • background
  • solution or resolution
  •  Recently, a summarizing tweet. 
A simple, clear, and direct way to show you how you have responded to these posts is to list the top five in overall readership views over the last  six years, then to explain why these posts show your good judgment.

·            Is Practice Fusion’s “Free” EHR for Real? May 23, 2010, 6438  page views

Practice Fusion’s business model,  a “free” electronic health record for physicians, paid for by advertisers catering to physicians, is a good example of creative innovation.   It is also an example of the power  of venture capital,  a new business model,  technological communication,  data storage in “the cloud,”   the central role of small practices, coaching doctors to qualify for federal incentives,  and recognizing that relieving physicians of IT business  and technological pressures are essential if an interoperative national communication IT system is  ever to  be developed.

Anything "free" and useful with a return on investment is irresistable.

·           Americans and Their Medical Machines, May 9, 2010, 3683 page views
Here was my opening paragraph, which helps explain why health costs in America are so high:
Obsession with medical technologies and machines characterizes American’s cultural expectations. We tend to think of our bodies as perpetual motion machines, to be preserved in perpetuity. If the face of our machines sag, we lift its faces up. If our pipes clog, we roto rooter them out or stent them. If impurities gum up our machinery, we filter them out. If our joints give out or lock up, we replace them. If we want to remove something in the machine’s interior, we take it out through a laparoscope. If the fuel or metabolic mix is wrong, we alter the mix or correct the metabolic defect with drugs If anything else goes wrong, we diagnose it and rearrange it electronically.”

Medical machines can be mechanical, electronic,  robotic, or radiologic in nature, as long as they smack of technological progress.

·           Interview with Richard “Buz,” Cooper, MD, Prophet of Physician Shortages and Challenger of Policymaker Assumptions, January 24, 2009, 3440 page views.
I conducted this interview two years before  the Patient Protection and Affordable Care Act passed.  Eight years before, Doctor Cooper had predicted that a widespread physician shortage was imminent.  In the interview said the new health law was on a collision course with this shortage.  His words?  “The picture that emerges is uncomplicated and unambiguous . In simple numeric terms, the number of physicians is no longer keeping up with population growth,  The ability to service the population is further compromised by the increasing complexity of care that physicians provide the  decreasing time commitment that physicians are willing to make.  These limitations collide with  economic trends that predict a growing demand for physician  services.”

In this interview, Cooper comments that federal policymakers often overlook or underestimate these factors.  This attitude often puts him at odds with the academic and governmental elite.
·           Reprinting of “Americans and Their Medical Machines” in The Health Care Blog, with comments by readers, Mary 17, 2010,  2982 page views
After my post on “Americans and Medical Machines” appeared, it was reproduced in The Health Care Blog,  America’s most widely read health care reform blog along with multiple physician comments.
Here is my response to these comments:
I meet most mornings for coffee with a group of 65 year + males, and all of us have experienced an invasive medical procedure - cataract surgery, coronary stents, abdominal aneurysm stents, hip and knee replacements, rods in the vertebral column - and I'm happy to report because of these wonderful procedures, we're all productive and functioning. “

“On the payment side, however, collectively these procedures, more widely available and more quickly accessible than in any other country, are driving Medicare over the financial cliff.”

“Obamacare promises to cut $535 billion out of Medicare. Can this be done without rationing these procedures in some way and without running into stiff political resistance from those of us who have come to expect the benefit of these technological innovations. “

 “My fondest hope is that we about to enter the age of Disruptive Innovation and Disruptive Decentralization, already signaled by Health 2.0 and portable devices that can be deployed in physicians offices and patients ‘ homes, to be put into action at lower costs in more convenient settings. “

For the public and physicians alike,  the lure of medical machines to "fix" disease  problems has an enduring appeal.  Robotic surgeries, medical imaging,  and computer data gathering and generated artificial intelligence are examples.
·           Health Reform: The Blogosphere (BS) and Search Engine Optimization (SEO), January  27, 2011 1916  page views
Why this blog post is popular puzzles me.  Perhaps among physicians  one reason is that independent bloggers like myself seek to offer insights into Obamacare, a "fiendishly" complicated, confusing, hard to explain, and politically unpopular  federal law that effects every American and every physician.  In this post, I observe that there are 133 million Internet blogs out there in the Blogosphere (aptly abbreviated  BS) and one way to bob on the Internet seas above other blogs is through Search Engine Optimization (SEO),  and  through  the Social Media, Facebook, Twitter, and You Tube.

Tweet: Medinnovation readers favor blogs featuring disruptive innovations. medical machines, physician shortages, and ease of technological adoption.



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