MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'brian klepper'. Sat, 03 Sep 2011 02:31:04 +0100 http://www.medworm.com/index.php?rid=4036594&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F10%2Fupdate-on-modular-ehr-technology-harvards-smart-research.html By DAVID C. KIBBE and BRIAN KLEPPER ONC awarded four Strategic Health IT Advanced Research Project (SHARP) grants earlier this year to ”...address well-documented problems that have impeded adoption of health IT and to accelerate progress towards achieving nationwide meaningful... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4036594 Tue, 05 Oct 2010 23:00:00 +0100 4036594 http://www.medworm.com/index.php?rid=4013107&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F09%2Fhealthy-eats-for-data-hungry-doctors.html By DAVID C. KIBBE AND BRIAN KLEPPER Imagine that an innovative health plan - aware that half or more of health care cost is waste and that physician costs to obtain the identical outcome can vary by as much as... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4013107 Tue, 28 Sep 2010 23:00:00 +0100 4013107 http://www.medworm.com/index.php?rid=3924843&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F09%2Fbeyond-meaningful-use-three-five-year-trends-in-the-uses-of-patient-health-data-and-clinical-it-.html By DAVID C. KIBBE & BRIAN KLEPPER Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs. The rules and criteria are simpler and more flexible, and the measures easier to compute. But they are still... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=3924843 Tue, 31 Aug 2010 23:00:00 +0100 3924843 http://www.medworm.com/index.php?rid=3429127&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F04%2Fthcb-relaunch-to-change-focus-to-renewable-energy-fly-fishing-sailing.html By Matthew Holt The Patient Reassurance and Consumer Total Insurance Confirmation Access legislation was signed into law last week, and the powers that be at THCB have had a radical rethink about what we should do next. I myself have... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=3429127 Wed, 31 Mar 2010 23:00:00 +0100 3429127 http://www.medworm.com/index.php?rid=3318354&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F03%2Fafter-the-failure-of-reform.html By BRIAN KLEPPER AND DAVID C. KIBBE The stalemate in the bi-partisan health care summit was cast the moment it was announced. Republicans demanded that the reform process start anew, and Mr. Obama insisted on the Senate bill as the... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=3318354 Mon, 01 Mar 2010 00:00:00 +0100 3318354 http://www.medworm.com/index.php?rid=2995707&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F11%2Fthe-health-internet-vs-the-nhin-a-matter-of-control-cost-and-timing.html By DAVID C. KIBBE and BRIAN KLEPPER There is growing tension within the Obama administration's health team over who will control health data exchange: everyone (including consumers and their doctors), or just large provider organizations. The public debate will be... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2995707 Mon, 16 Nov 2009 00:00:00 +0100 2995707 http://www.medworm.com/index.php?rid=2948298&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F10%2Ftime-to-put-aside-the-intellectual-disputes-for-now.html By Matthew Holt It’s always fun to see my friends beating each other up in public....and if you read down in the comments on the post published yesterday you’ll see a significant dispute between Maggie Mahar and the Klepper/Kibbe/Lazsweski/Enthoven team... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2948298 Sat, 31 Oct 2009 00:00:00 +0100 2948298 http://www.medworm.com/index.php?rid=2943733&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F10%2Fsaving-health-care-saving-america.html By BRIAN KLEPPER, DAVID C. KIBBE, ROBERT LASZEWSKI and ALAIN ENTHOVEN So far, Congress' response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2943733 Fri, 30 Oct 2009 00:00:00 +0100 2943733 http://www.medworm.com/index.php?rid=2934629&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F10%2Fa-message-to-americas-physicians-purchasing-ehr-technology-a-shaky-state-of-affairs.html By DAVID C. KIBBE and BRIAN KLEPPER Much of the conversation and debate about physician EHR adoption has centered on the single issue of the (high) cost of purchase. However, we'd like to suggest that the situation is much more... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2934629 Wed, 28 Oct 2009 00:00:00 +0100 2934629 http://www.medworm.com/index.php?rid=2875982&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F10%2Fwhy-standards-matter-2-health-it-enters-a-new-era-of-regulatory-control.html By DAVID C. KIBBE and BRIAN KLEPPER The recent history of electronic medical records in ambulatory care, or what we now call EHR (electronic health record) technology, can be divided roughly into three phases. Phase I, which lasted approximately 20... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2875982 Wed, 07 Oct 2009 23:00:00 +0100 2875982 http://www.medworm.com/index.php?rid=2882992&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F10%2Fwhy-standards-matter-1-the-true-meaning-of-interoperability.html By DAVID C. KIBBE and BRIAN KLEPPER Americans are generally skeptical of words that otherwise intelligent and articulate people can't pronounce. "Interoperability," like nu-cu-lar, is one of these. After a while, these words can take on a mystique all their... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2882992 Sun, 04 Oct 2009 23:00:00 +0100 2882992 http://www.medworm.com/index.php?rid=2757684&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F09%2Fwill-republicans-be-spoilers-or-problem-solvers-on-health-care-reform.html By BRIAN KLEPPER and DAVID C. KIBBE In theory Congress' return from recess next week could offer a new beginning to the health care reform process, giving everyone a chance to take a deep breath and recalibrate the components of... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2757684 Tue, 01 Sep 2009 23:00:00 +0100 2757684 http://www.medworm.com/index.php?rid=2751916&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F08%2Fadvice-for-state-rec-planners.html By DAVID C. KIBBE & BRIAN KLEPPER On August 20th, HHS Secretary Kathleen Sebelius and ONC head David Blumenthal announced $598 million in grants to set up about 70 "regional extension centers" (RECs) that will help physicians select and implement... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2751916 Sun, 30 Aug 2009 23:00:00 +0100 2751916 http://www.medworm.com/index.php?rid=2737731&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F08%2Fhealth-care-reforms-deeper-problems.html By BRIAN KLEPPER and DAVID C. KIBBE Congress' health care reform debate has highlighted how American governance is broken and the difficulty of addressing our national problems. Take, for example, whether health care is in crisis at all. Conservative commentators... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2737731 Tue, 25 Aug 2009 23:00:00 +0100 2737731 http://www.medworm.com/index.php?rid=2709139&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F08%2Fwhy-standards-matter-1-the-true-meaning-of-interoperability.html By DAVID C. KIBBE and BRIAN KLEPPER Americans are generally skeptical of words that otherwise intelligent and articulate people can't pronounce. "Interoperability," like nu-cu-lar, is one of these. After a while, these words can take on a mystique all their... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2709139 Sun, 16 Aug 2009 23:00:00 +0100 2709139 http://www.medworm.com/index.php?rid=2670804&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F08%2Ffinally-a-reasonable-plan-for-certification-of-ehr-technologies.html By DAVID C. KIBBE and BRIAN KLEPPER A caution to readers: This post is about methods for certifying Electronic Health Record (EHR) technologies used by physicians, medical practices, and hospitals who hope to qualify for federal incentive payments under the... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2670804 Mon, 03 Aug 2009 23:00:00 +0100 2670804 http://www.medworm.com/index.php?rid=2593094&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fbehind-the-curtain-wendell-potter-on-the-industrys-management-of-care-and-reform.html by BRIAN KLEPPER Stop what you're doing and take out a half-hour to watch this week's superb Bill Moyers' 3-part show, especially the extended interview with Wendell Potter, former CIGNA VP Corporate Communications, for a frank, insider's discussion of how... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2593094 Thu, 09 Jul 2009 23:00:00 +0100 2593094 http://www.medworm.com/index.php?rid=2588206&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fwhy-congress-should-listen-to-and-incorporate-bob-laszewskis-health-care-affordability-model.html By BRIAN KLEPPER Over the last few months, I have become increasingly disheartened over the prospects for meaningful health care reform. First, the process is terribly conflicted, and it shows. In the first quarter of 2009, the Center for Responsive... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2588206 Wed, 08 Jul 2009 23:00:00 +0100 2588206 http://www.medworm.com/index.php?rid=2510465&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F06%2Fa-dream-of-reason.html By BRIAN KLEPPER and DAVID KIBBE The dream of reason did not take power into account...Modern medicine is one of those extraordinary works of reason...But medicine is also a world of power. -Paul Starr, The Social Transformation of American Medicine,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2510465 Sun, 21 Jun 2009 23:00:00 +0100 2510465 http://www.medworm.com/index.php?rid=2469493&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F06%2Fthe-health-industrys-achilles-heel.html By BRIAN KLEPPER and DAVID C. KIBBE "You never want a serious crisis to go to waste." - Rahm Emanuel, White House Chief of Staff Timing matters. The health industry has demonstrated steadfast resistance to reforms, but its recently diminished... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2469493 Wed, 10 Jun 2009 04:00:00 +0100 2469493 http://www.medworm.com/index.php?rid=2389742&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F05%2Fan-open-letter-to-the-new-national-coordinator-for-health-it-part-3-certification-as-the-elephant-in.html By DAVID C. KIBBE and BRIAN KLEPPER In the first and second parts of this series we talked about how and why there is no universal definition for the term "EHR." Instead there is a legitimate, growing debate about the... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2389742 Tue, 05 May 2009 04:00:00 +0100 2389742 http://www.medworm.com/index.php?rid=2364994&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F04%2Ffrom-health-20-meets-ix-a-breathtaking-display-of-possibilities.html By BRIAN KLEPPER (Boston) Jane Sarasohn-Kahn and I were quickly comparing notes this morning. Our impression is that, compared to past meetings, this one seems more characterized by doers than observers. This conference brings together a dizzying array of tools... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2364994 Thu, 23 Apr 2009 04:00:00 +0100 2364994 http://www.medworm.com/index.php?rid=2364996&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F04%2Fby-david-c-kibbe-and-brian-klepper------one-of-the-important-decisions-before-dr-blumenthal-and-his-colleagues-at-onc-and.html By DAVID C. KIBBE & BRIAN KLEPPER One of the important decisions before Dr. Blumenthal and his colleagues at ONC and HHS is whether the national health information network will be one of closed appliances that bundle together proprietary hardware,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2364996 Wed, 22 Apr 2009 04:00:00 +0100 2364996 http://www.medworm.com/index.php?rid=2348004&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F04%2Fan-open-letter-to-the-new-national-coordinator-for-health-it-untying-hitechs-gordian-knot-part-1.html By DAVID C. KIBBE AND BRIAN KLEPPER Congratulations to David Blumenthal on being named National Coordinator for Health Information Technology (ONCHIT). Dr. Blumenthal will be the person most responsible for the rules and distribution of the American Recovery and Reinvestment... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2348004 Sun, 19 Apr 2009 04:00:00 +0100 2348004 http://www.medworm.com/index.php?rid=2348020&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F04%2Fthe-continuity-of-care-record-becomes-a-standard.html By BRIAN KLEPPER We live in a time of such great progress in so many arenas that, too often and without a second thought, we take significant advances for granted. But, now and then, we should catalog the steps forward,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2348020 Fri, 10 Apr 2009 04:00:00 +0100 2348020 http://www.medworm.com/index.php?rid=2307079&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F03%2Fwill-cigna-remake-the-health-plan-marketplace.html By BRIAN KLEPPER America’s health plans are floundering. If their job has been to provide the nation’s mainstream families with access to affordable care (let’s leave quality out of it for the moment), they have failed miserably, though they were... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2307079 Mon, 30 Mar 2009 04:00:00 +0100 2307079 http://www.medworm.com/index.php?rid=2256108&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F03%2Fis-health-care-a-bursting-bubble.html By Brian Klepper and David C. Kibbe More than at any time in recent memory, powerful forces are buffeting the health care sector. We are in the midst of profound upheaval, driven by market and policy responses to the industry's... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2256108 Thu, 12 Mar 2009 04:00:00 +0100 2256108 http://www.medworm.com/index.php?rid=2232051&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F03%2Ffive-recommendations-for-onc-head-who-understands-health-it-innovation.html By David C. Kibbe and Brian Klepper Now that the legislative language of the HITECH Act -- the $20 billion health IT allocation within the economic stimulus package -- has been set, it's time to identify a National Coordinator (NC)... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2232051 Wed, 04 Mar 2009 05:00:00 +0100 2232051 http://www.medworm.com/index.php?rid=2182256&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F02%2Fcheck-out-the-ted-talks.html By Brian Klepper The uber-fabulous (and expensive) TED conference - 4 days, $6,000 and sold out a year in advance - a collection of some of the world's most thoughtful, innovative and high achieving individuals, has just finished, and many... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2182256 Wed, 11 Feb 2009 05:00:00 +0100 2182256 http://www.medworm.com/index.php?rid=2167327&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F02%2Fthe-ama-wins-a-round-against-patient-information.html By Brian Klepper On January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2167327 Fri, 06 Feb 2009 05:00:00 +0100 2167327 http://www.medworm.com/index.php?rid=2128715&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F01%2Fgeorge-lundberg-md-an-alternative-candidate-for-surgeon-general.html By Brian Klepper The report that Mr. Obama's Surgeon General choice might be neurosurgeon and CNN medical correspondent Dr. Sanjay Gupta produced an upwelling of strong opinion, particularly in the medical community. Some argued that Dr. Gupta has clearly demonstrated... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2128715 Fri, 23 Jan 2009 05:00:00 +0100 2128715 http://www.medworm.com/index.php?rid=2153826&cid=t_140090_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fcats-and-dogs-can-we-find-unity-healthcare-it-change This blog first appeared at The Health Care Blog. - Ed. Those of you paying attention for the past few days might have noticed on the one hand a sense of optimism and unity as Barrack H. Obama, somewhat somberly, began his Presidency. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=2153826 Thu, 22 Jan 2009 17:48:31 +0100 2153826 http://www.medworm.com/index.php?rid=2121315&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F01%2Ffive-shovel-rea.html By Brian Klepper & David C. Kibbe Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2121315 Wed, 21 Jan 2009 05:00:00 +0100 2121315 http://www.medworm.com/index.php?rid=2092425&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F01%2Fwelcome-to-heal.html By BRIAN KLEPPER Well, here we are at the beginning of 2009. On TV we’ve learned that the unlimited spending and brilliant, if socially pathological, heroics of Dr. Gregory House, unfailingly saves his patients from unknowable complexity and the abyss... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2092425 Fri, 09 Jan 2009 05:00:00 +0100 2092425 http://www.medworm.com/index.php?rid=2083741&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F01%2Flets-reboot-a-1.html By DAVID KIBBE and BRIAN KLEPPER Yesterday we tried to put EHRs into perspective. They're important, and we can't effectively move health care forward without them. But they're only one of many important health IT functions. EHRs and health IT... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2083741 Tue, 06 Jan 2009 05:00:00 +0100 2083741 http://www.medworm.com/index.php?rid=2080950&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F01%2Flets-reboot-ame.html By DAVID C. KIBBE & BRIAN KLEPPER Kibbe & Klepper are back with an update to their pre-Christmas piece on EHRs and the forthcoming Obama Administration's investment policy towards them. Lest you think that this is just a small group... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2080950 Mon, 05 Jan 2009 05:00:00 +0100 2080950 http://www.medworm.com/index.php?rid=1990165&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F11%2Fsmall-business.html By Brian Klepper John Sinibaldi, a well-respected health insurance agent in St. Petersburg, Fla., has become prominent in Florida's broker community because he counsels and services a large book of small business clients and studiously tracks the macro trends that... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1990165 Tue, 25 Nov 2008 05:00:00 +0100 1990165 http://www.medworm.com/index.php?rid=1980282&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F11%2Fthe-wsjs-ceo-co.html By Brian Klepper This past Monday and Tuesday, The Wall Street Journal convened an extraordinary conference of about 100 CEOs to develop and recommend issue priorities for the new Administration. (See the participant list here.) This meeting brought together the... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1980282 Fri, 21 Nov 2008 05:00:00 +0100 1980282 http://www.medworm.com/index.php?rid=1974771&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F11%2Fclarification-o.html By Brian Klepper Here's an attempt to recover from two mistakes yesterday. My post on our dismal prospects for real health care reform prompted a couple readers - thanks to Hal Andrews and Fred Goldstein - to take me to... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1974771 Wed, 19 Nov 2008 05:00:00 +0100 1974771 http://www.medworm.com/index.php?rid=1974768&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F11%2Fdaschle-tapped.html By Brian Klepper The Caucus, the New York Times Political Blog, reports that senior Obama aides have said that Mr. Obama offered the nomination for Secretary of Health and Human Services to Tom Daschle of South Dakota, the former Democratic... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1974768 Wed, 19 Nov 2008 05:00:00 +0100 1974768 http://www.medworm.com/index.php?rid=1968458&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F11%2Fthe-changes-we.html By Brian Klepper These are, as the Chinese curse reputedly called them, interesting times. If the burst of new Democratic health care reform proposals is any indication, a fresh breeze of the Obama campaign's "Yes We Can" optimism is blowing... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1968458 Tue, 18 Nov 2008 05:00:00 +0100 1968458 http://www.medworm.com/index.php?rid=1920846&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F10%2Fthe-elephant-in.html By Brian Klepper & David Kibbe Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan.... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1920846 Thu, 30 Oct 2008 04:00:00 +0100 1920846 http://www.medworm.com/index.php?rid=1894477&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F10%2Fan-impending-ha.html By Brian Klepper Nothing focuses the mind like an impending hanging. -- Samuel Johnson I've been preparing for tomorrow's 3rd Health 2.0 conference in San Francisco, where I'll join my pals Matthew, Indu Subaiya, Jane Sarasohn-Kahn and Michael Millenson amid... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1894477 Tue, 21 Oct 2008 04:00:00 +0100 1894477 http://www.medworm.com/index.php?rid=1844431&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F10%2Fhealth-care-and.html By Brian Klepper Over at HealthLeaders, Dr. Richard Reece and I have an article, Will Primary Care Be Re-Empowered By An Ailing Economy?, arguing that the turmoil in the larger US economy – and particularly the tightening of credit –... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1844431 Thu, 02 Oct 2008 04:00:00 +0100 1844431 http://www.medworm.com/index.php?rid=1720217&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F08%2Fchastened-and-m.html By Brian Klepper Yesterday, Ron Pollack of Families USA led a call with bloggers -- unfortunately, I couldn't be on it -- to discuss the Harry and Louise Return -- the new health reform campaign sponsored by five prominent organizations:... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1720217 Thu, 21 Aug 2008 04:00:00 +0100 1720217 http://www.medworm.com/index.php?rid=1700378&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F08%2Ft-shirt-health.html By Matthew Holt So this is how fashion insurgencies start…Brian Klepper sent me this email. I assume they felt like the two Hollywood starlets who show up at the Oscars wearing the same dress! “So David Foster, Director of Product... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1700378 Wed, 13 Aug 2008 04:00:00 +0100 1700378 http://www.medworm.com/index.php?rid=1660695&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F7%2F28%2Ffrom-description-to-action-the-future-of-health-20-tools.html Last week The Health Care Blog ran two articles about new wiki sites that will develop and continuously update medical information. (A wiki is a “content collaborative” that allows anyone (or anyone authorized by the site) to contribute or modify content; Wikipedia is the best known example.) In Medicine Meets Wiki, Jane Sarasohn-Kahn brought our attention to MedPedia, a collaboration between major academic institutions and governmental agencies to clearly describe the entirety of current medical knowledge. Then Bob Wachter described Google’s new Wikipedia competitor, Knol, and suggested sites like this could threaten the stranglehold that traditional medical journals have had on emerging information. As Wikipedia has so effectively demonstrated, Wikis can become go-to authorities o... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1660695 Mon, 28 Jul 2008 12:58:22 +0100 1660695 http://www.medworm.com/index.php?rid=1642536&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F07%2Flately-ive-been.html By Brian Klepper Lately, I've had interesting discussions with a thoughtful exec. at a major Western health system about the ferocious challenges facing hospitals and health systems. Her organization's internal conversations at the moment are centered, in part, on what... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1642536 Tue, 22 Jul 2008 04:00:00 +0100 1642536 http://www.medworm.com/index.php?rid=1634844&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F7%2F17%2Fis-meaningful-health-care-or-any-other-kind-of-reform-possib.html Brian KlepperThose who wait, ever hopefully, for real health reform might want to take a deep breath and take stock of a few realities.First, think about the fact that when the Democrats retook Congress, they tweaked but did not fundamentally change the lobbying rules that trade money for influence over policy. In fact, most contributors have now adjusted their contributions to favor the current, rather than the past, majority party. As it turns out, Democrats, like Republicans, are only too eager to allow special interests to trump the common interest, so long as the transactions fetch a good price. Take a long hard look at the chart below, taken from an April 15th report published by OpenSecrets, which tracks the impacts money has on politics and policy, put together by the Center for Re... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1634844 Thu, 17 Jul 2008 14:43:00 +0100 1634844 http://www.medworm.com/index.php?rid=1436715&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F05%2Fmore-on-physici.html by ROY POSES, MD (Note by Brian Klepper: At Health Care Renewal, Dr. Roy Poses, a Clinical Associate Professor at Brown University's School of Medicine, writes a consistently excellent blog on health care financial conflict . Both he and I... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1436715 Mon, 12 May 2008 04:00:00 +0100 1436715 http://www.medworm.com/index.php?rid=1428872&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F05%2Fhealth-20-consc.html by BRIAN KLEPPER Next Thursday, Matthew, Michael Millenson and I are converging at a Robert Wood Johnson Foundation conference on public reporting of health care pricing/performance information in Amelia Island, FL, three short barrier islands north of my home in... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1428872 Thu, 08 May 2008 04:00:00 +0100 1428872 http://www.medworm.com/index.php?rid=1416204&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F5%2F2%2Fa-hat-tip-to-pediatrician-dr-benjamin-spock.html Brian Klepper Here's one of today's entries in The Writers' Almanac, the wonderful daily newsletter sent out by Garrison Keillor on NPR. Parents of boomers like me were big fans of Dr. Spock, treating him with an almost cult-like reverence for his sensible wisdom about child care. He later parted ways with some of his more conservative followers, when he became an iconic protester against America's war in Viet Nam. Be sure to note the last line of the blurb below. This is the same message Jane Sarasohn-Kahn related recently in The Wisdom of Patients. We stand on the shoulders of giants. It's the birthday of Dr. Benjamin Spock, (books by this author) born in New Haven, Connecticut (1903). His Common Sense Book of Baby and Child Care (1946) was a best seller during the period after World War... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1416204 Fri, 02 May 2008 09:00:25 +0100 1416204 http://www.medworm.com/index.php?rid=1406938&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F4%2F29%2Fthe-state-of-employer-sponsored-coverage.html Brian Klepper A detailed new study from the Economics Policy Institute confirms what many of us suspect but haven't had the data to easily nail down. This weightily-titled report by Jared Bernstein and Heidi Shierholz - A Decade of Decline: The Erosion of Employer-Provided Health Care in the United States and California, 1995-2006 - provides more granular information about the enrollment dynamics over time in employer-sponsored health coverage than we've seen in a while. Based on an analysis of the March 2007 Current Population Survey, the numbers reported here are mostly in sync with (but deeper than) similar studies that have attempted to size the enrollment and erosion characteristics of the employer-sponsored coverage market. Strap yourself in; this isn't pretty.There are two important... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1406938 Tue, 29 Apr 2008 17:17:55 +0100 1406938 http://www.medworm.com/index.php?rid=1390997&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F4%2F22%2Fan-open-response-to-hhs-secretary-mike-leavitt.html Brian Klepper and Michael Millenson A few months ago, the two of us – both long-time advocates for transparency and accountability – posted separate comments on Secretary Mike Leavitt’s blog.  Brian asked Secretary Leavitt to square his support of "Chartered Value Exchanges” with the attempt to block release of physician-specific Medicare claims data to Consumers’ Checkbook, which wants to rate doctors. After a court ruled that the data should be provided to the group, HHS appealed. Michael urged the secretary to go beyond supporting Consumers’ Checkbook and use his “bully pulpit” to promote sophisticated data analysis that could be used to create national quality comparisons. Secretary Leavitt graciously asked us to consider and co... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1390997 Tue, 22 Apr 2008 15:40:04 +0100 1390997 http://www.medworm.com/index.php?rid=1390864&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F04%2Ftune-into-the-k.html Exclusive to THCB: A couple weeks ago I pointed to a new study, commissioned by Kroll Fraud Solutions and conducted by HIMSS Analytics, that makes startlingly clear the gap between what most health systems are doing to comply with HIPAA,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1390864 Tue, 22 Apr 2008 04:00:00 +0100 1390864 http://www.medworm.com/index.php?rid=1390861&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F04%2Fan-open-respons.html A few months ago, the two of us – both long-time advocates for transparency and accountability – posted separate comments on Secretary Mike Leavitt’s blog. Brian asked Secretary Leavitt to square his support of "Chartered Value Exchanges” with the attempt... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1390861 Tue, 22 Apr 2008 04:00:00 +0100 1390861 http://www.medworm.com/index.php?rid=1355935&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F04%2Fthe-safety-of-h.html EXCLUSIVE TO THCB: HIMSS Analytics, the research arm of the powerful, thoughtful and highly regarded Health Information Management Systems Society, has published a sobering study, Security of Patient Data - see here - that highlights the gap between hospital patient... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1355935 Tue, 08 Apr 2008 04:00:00 +0100 1355935 http://www.medworm.com/index.php?rid=1353935&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F4%2F7%2Fknowledge-like-clear-clean-water-muir-gray-on-health-cares-p.html Brian KlepperOver the last year or so, I've written a lot about how health care will become increasingly available to consumers and health care business, and how this access will drive new decision-support capabilities that will profoundly change how health care works, eliminating many of the problems that have placed health care in crisis. So imagine my delight when a colleague forwarded this quote. Sir Muir Gray is Chief Knowledge Office of Britain's National Health Service. His wonderfully clear explanation of how health care knowledge will become guidance - that is, decision-support - makes a compelling case for the transformative power of Health 2.0.Check it out. The future is something we make, not something we discover. And the future is easy to make because as William Gibson has sa... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1353935 Mon, 07 Apr 2008 15:29:31 +0100 1353935 http://www.medworm.com/index.php?rid=1355937&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F04%2Fknowledge-like.html Over the last year or so, I've written a lot about how health care information will become increasingly available to consumers and health care business, and how this access will drive new decision-support capabilities that will profoundly change how health... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1355937 Mon, 07 Apr 2008 04:00:00 +0100 1355937 http://www.medworm.com/index.php?rid=1347318&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F4%2F3%2Fhealth-wonk-review-is-up.html Brian Klepper Over at The Health Care Blog, I'm host of this edition of Health Wonk Review, an eclectic collection of articles delving into a variety of topics on science, medicine, health policy and market dynamics. Included in the 19 posts reviewed is Dov's column here on TDWI, "Old Drugs, New Insights." Looking for some quick, wide-ranging and fascinating reads? Head on over. (Source: The Doctor Weighs In) The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1347318 Thu, 03 Apr 2008 09:06:40 +0100 1347318 http://www.medworm.com/index.php?rid=1347215&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F04%2Fhealth-wonk-rev.html HWR has clearly arrived, at least in the sense that all KINDS of columnists are clamoring to be read here. More than thirty submissions arrived in my inbox, a collection of the utilitarian, the thoughtful and sometimes the downright ridiculous.... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1347215 Thu, 03 Apr 2008 04:00:00 +0100 1347215 http://www.medworm.com/index.php?rid=1346097&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F04%2Fon-corporate-me.html Maggie Mahar, the former Barron's journalist, author of Money Driven Medicine, and Health Policy Fellow at The Century Foundation and frequent THCB contributor chewed on my piece about Walgreen's recent acquisition of worksite clinic firms, and wrote a strong response... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1346097 Wed, 02 Apr 2008 04:00:00 +0100 1346097 http://www.medworm.com/index.php?rid=1340527&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F3%2F31%2Fon-corporate-medicine-a-response-to-brian-klepper-and-his-re.html Maggie Mahar and Brian Klepper Maggie Mahar, the former Barron's journalist, author of Money Driven Medicine, and Health Policy Fellow at The Century Foundation chewed on my piece about Walgreen's recent acquisition of worksite clinic firms, and wrote a strong response outlining why she believes that for-profit medicine should be abandoned in the US. I urged her to publish that comment here as its own post. It is below, followed by my reply. Brian, I agree with 90 percent of what you say—particularly when you write so eloquently about what has happened to primary care. I believe that we need to make primary care far more attractive to doctors. One way to do it would be to forgive all med school loans for students who choose to go into primary care (or become family doctors, pediatric... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1340527 Mon, 31 Mar 2008 19:32:50 +0100 1340527 http://www.medworm.com/index.php?rid=1329944&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F3%2F27%2Frebuilding-the-medical-home-what-walgreens-surely-sees.html Brian Klepper Though it probably went mostly unnoticed in the cacophony of health care stories, last week's news that Walgreen's had bought the two largest and most well-established worksite clinic firms, iTrax and Whole Health Management, was a harbinger of very big changes in health care. Walgreens, the ubiquitous drugstore company that, with Wal-Mart and CVS, has already leveraged its pharmacy platform to establish a strong footprint in retail clinics, undoubtedly startled many health care observers with its announcement. After all, isn't the company doctor a relic? Actually, no. The worksite clinic - and by way of disclosure for the better part of the last year I have worked closely with a small, very innovative, Orlando-based startup worksite clinic firm, WeCare TLC  - has been r... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1329944 Thu, 27 Mar 2008 08:41:32 +0100 1329944 http://www.medworm.com/index.php?rid=1331260&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F03%2Fwhat-walgreens.html Though it probably went mostly unnoticed in the cacophony of health care stories, last week's news that Walgreen's had bought the two largest and most well-established worksite clinic firms, iTrax and Whole Health Management, was a harbinger of very big... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1331260 Thu, 27 Mar 2008 04:00:00 +0100 1331260 http://www.medworm.com/index.php?rid=1306017&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F3%2F16%2Floving-our-children.html Brian KlepperAmong its many less-noticed accomplishments, this Administration has strangled funding for comprehensive sex education. Instead, it has thrown the immense weight of the US government behind abstinence-based education, an impractical ideological approach rooted in religious zealotry and a romantic notion of social mores that no longer exists for most young Americans. In 2005 and 2006, the Bush Administration spent $170 and $178 million, respectively, more than double the 2004 expenditure, much of it allocated to mostly conservative Christian organizations, to encourage children to refrain from sex without explaining the fundamentals of contraception and sexually-transmitted disease (STD). In 2004, a Minority Staff Special Investigations report prepared at the request of Rep. He... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1306017 Sun, 16 Mar 2008 00:00:00 +0100 1306017 http://www.medworm.com/index.php?rid=1303081&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F03%2Floving-our-chil.html Among its many less-noticed accomplishments, this Administration has strangled funding for comprehensive sex education. Instead, it has thrown the immense weight of the US government behind abstinence-based education, an impractical ideological approach rooted in religious zealotry and a romantic notion... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1303081 Fri, 14 Mar 2008 04:00:00 +0100 1303081 http://www.medworm.com/index.php?rid=1268260&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F02%2Fhealth-care-and.html Here are two very interesting and frightening charts that my good friend Warren Brennan, the CEO of SMA Informatics in Richmond, passed along this AM, with this question, aimed at the CFOs of hospitals and other health care organizations: What... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1268260 Fri, 29 Feb 2008 05:00:00 +0100 1268260 http://www.medworm.com/index.php?rid=1230267&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F02%2Flets-all-ask-se.html Regular readers will know that, last Sunday, I posted a column that pointed to HHS' schizophrenic behavior when it comes to the release of Medicare physician data. First they fight the consumer advocacy group Checkbook.org's lawsuit demanding the release of... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1230267 Wed, 13 Feb 2008 05:00:00 +0100 1230267 http://www.medworm.com/index.php?rid=1225241&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F2%2F12%2Flets-all-ask-secretary-leavitt-to-explain-hhs-schizophrenia.html Brian Klepper Regular readers will know that, last Sunday, I posted a column that pointed to HHS' schizophrenic behavior when it comes to the release of Medicare physician data. First they fight the consumer advocacy group Checkbook.org's lawsuit demanding the release of data in 4 states and DC. (The AMA's Board Chair has admitted that they lobbied HHS to appeal the court's finding that they should make the data public.) Then, a week ago last Friday, HHS announced a new program that would identify Chartered Value Exchanges (CVEs) in 14 communities - these are coalitions of employers, payers, providers and consumers - and then hand over the same physician data they've been fighting the courts to keep secret so these groups can combine them with data available from the private sector and cre... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1225241 Tue, 12 Feb 2008 20:57:35 +0100 1225241 http://www.medworm.com/index.php?rid=1220794&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F02%2Fwhats-hhs-real.html Here's a classical example of a federal regulatory agency holding fast to two opposing ideas at the same time. I wonder what it means? Last week the Department of Health and Human Services posted an interesting notice announcing a new... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1220794 Sun, 10 Feb 2008 05:00:00 +0100 1220794 http://www.medworm.com/index.php?rid=1217903&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F2%2F8%2Fwhats-hhs-real-position-on-releasing-medicare-physician-data.html Brian KlepperHere's a classical example of a federal regulatory agency holding fast to two opposing ideas at the same time. I wonder what it means? Last week HHS posted an interesting notice announcing a new program that recognizes 14 (presumably) forward-thinking health care coalitions of providers, employers, insurers and consumers, which it refers to Chartered Value Exchanges, or CVEs. (Who comes up with these names?!) HHS promises that, by summer of 2008, it will provide "access to information from Medicare that gauges the quality of care physicians provide to patients." This "physician-group level performance information...can be combined with similar private-sector data to produce a comprehensive consumer guide on the quality of care available" in each community. ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1217903 Fri, 08 Feb 2008 17:49:17 +0100 1217903 http://www.medworm.com/index.php?rid=1188555&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F30%2Fplumpynut.html Brian Klepper The NY Times has an important op-ed today by Susan Shepherd, a pediatrician and medical advisor to Doctors Without Borders. The core of her message is that as the farm bill progresses through Congress, we should focus not only on the quantity of food that is produced and that we export for relief to underdeveloped nations, but on its quality as well. Dr. Shepherd describes the difficulties in treating children who are victims of severe malnutrition, particularly in areas like Africa and South Asia where milk and clean water can be scarce. The US and other international donors current supply fortified blended flours for moderately malnourished children. Much better and more accessible nutrition is available through a ready-to-use food called Plumpy'nut (or Plumpy). But Plumpy ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1188555 Wed, 30 Jan 2008 11:49:00 +0100 1188555 http://www.medworm.com/index.php?rid=1184648&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F28%2Ffamilies-usa-health-action-2008-an-alternative-plan.html Brian Klepper A wonderful meeting (Full disclosure: They brought me in to blog my impressions.), The Families USA conference that ended Saturday brought together some impressive Congressional politicians - Nancy Pelosi, Tom Daschle, Ken Salazar, Blanche Lincoln - and true health care experts - Don Berwick, Tony Fauci - with "consumer advocates" from around the country. I thoroughly enjoyed the people at the conference. They were, for the most part, knowledgeable about health care and committed to driving a better system. (My favorites were a group of California Gray Panthers, all of whom were VERY up on the issues). There were also bright young people relatively early in their careers, and representatives from community health advocacy organizations around the country, all f... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1184648 Mon, 28 Jan 2008 20:51:46 +0100 1184648 http://www.medworm.com/index.php?rid=1184649&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F28%2Ffamilies-usa-health-action-2008-berwick-on-everything-health.html Brian Klepper  One of the pleasures of the Families USA Health Action conference was that the speakers represented a nice blend of top politicians and genuine health care experts. Tony Fauci MD, the wonderful head of NIH's National Institutes for Allergies and Infectious Diseases, who talked about Global Health, was followed by the equally impressive Don Berwick MD, the Founder and leader of the Institute for Healthcare Improvement. I've heard Dr. Berwick speak several times and am always delighted by his cogent, comfortable, sensible presentations. I can think of several people who, if they gave one, deserve a health care Nobel Prize for the positive impact they've had on millions of people through their work to change the industry. Dr. Berwick is one. (Others include Jack Wenn... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1184649 Mon, 28 Jan 2008 20:48:00 +0100 1184649 http://www.medworm.com/index.php?rid=1182764&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F28%2Ffamilies-usa-health-action-2008-anthony-fauci-md-on-global-h.html Brian Klepper I first met, heard and came to admire Tony Fauci several months ago at the Aspen Health Forum. Dr. Fauci heads the National Institute of Health's National Institute of Allergy and Infectious Diseases. In addition to his spectacular medical contributions, he is, equally importantly, a passionate and wonderfully articulate explainer of the importance of infectious disease and global health to common people. Unfortunately, I was called unexpectedly out of the meeting for a call, but here are my notes on his comments. They provide a clear view of the value of his work. Plagues and epidemics have shaped societies since the beginning of civilization. Gradually, though, and with progress in hygiene and the management of disease, the dangers from infectious diseases to ordinary ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1182764 Mon, 28 Jan 2008 12:20:22 +0100 1182764 http://www.medworm.com/index.php?rid=1182765&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F28%2Ffamilies-usa-health-action-2008-tom-daschle-on-health-care-r.html Brian Klepper Former Senator and Majority/Minority Leader Daschle gave the opening address on the 2nd day of the Families USA Health Action conference. Mr. Daschle has a new book coming out in March on America's health system and our past efforts to fix it. I was honestly impressed with Mr. Daschle's grasp of the sweep of health care problems and how they play out. Mostly importantly, he was clearly aware of the deep challenges associated with getting meaningful change, given the industry's control of Congress and the policy-making process. "One of the biggest tactical mistakes we've made, the opponents of health reform have defined the debate. As a result, we've lived under a number of myths. Perhaps the biggest myth of all is that the US has the best health system in the world... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1182765 Mon, 28 Jan 2008 12:16:44 +0100 1182765 http://www.medworm.com/index.php?rid=1182689&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Ffamilies-usa--2.html One of the pleasures of the Families USA Health Action conference was that the speakers represented a nice blend of top politicians and genuine health care experts. Tony Fauci MD, the wonderful head of NIH's National Institutes for Allergies and... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1182689 Mon, 28 Jan 2008 05:00:00 +0100 1182689 http://www.medworm.com/index.php?rid=1182688&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Ffamilies-usa--3.html A wonderful meeting (Full disclosure: They brought me in to blog my impressions.), The Families USA conference that ended Saturday brought together some impressive Congressional politicians - Nancy Pelosi, Tom Daschle, Ken Salazar, Blanche Lincoln - and true health care... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1182688 Mon, 28 Jan 2008 05:00:00 +0100 1182688 http://www.medworm.com/index.php?rid=1179593&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Ffamilies-usa--1.html Former Senator and Majority/Minority Leader Daschle gave the opening address on the 2nd day of the Families USA Health Action conference. Mr. Daschle has a new book coming out in March on America's health system and our past efforts to... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1179593 Sat, 26 Jan 2008 05:00:00 +0100 1179593 http://www.medworm.com/index.php?rid=1179592&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Ffamilies-usa-he.html I first met, heard and came to admire Tony Fauci several months ago at the Aspen Health Forum. Dr. Fauci heads the National Institute of Health's National Institute of Allergy and Infectious Diseases. In addition to his spectacular medical contributions,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1179592 Sat, 26 Jan 2008 05:00:00 +0100 1179592 http://www.medworm.com/index.php?rid=1174877&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F24%2Ffamilies-usa-health-action-2008-nancy-pelosis-health-care-ad.html Brian Klepper The featured highlight address at the opening session of the Families USA conference is by Nancy Pelosi, Congress' first woman Speaker. In person, Speaker Pelosi clearly comes across as a brilliant and warm woman, a friend of Families USA, and she was introduced as a champion of social justice and equality in the 110th (2007) Congress, passing the first minimum wage increase in a decade and making college more affordable for working families. While I'm not certain this is true, I heard comments beforehand that this speech was slated as a major health care policy statement by the Speaker. In it, she succinctly laid out several core principle of her view of reform. "I want to start by talking about something that we all agree on: that everybody in America has a right... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1174877 Thu, 24 Jan 2008 15:40:59 +0100 1174877 http://www.medworm.com/index.php?rid=1174879&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F24%2Fthe-cost-of-diabetes.html Yesterday the American Diabetes Association released a report updating their estimate of the economic toll that disease is taking on the country. According to the study, in 2007 diabetes cost America $174 billion, with $116 billion of that in direct medical expenditures. As if there were any question that our obesity epidemic is out of control and that it threatenes America's future, these costs have grown by almost one third (32%) over the last 5 years. To those of us who follow this sort of thing, this news isn't really anything new. But its certainly an important trend that bears watching and campaigning out. Go check it out. (Source: The Doctor Weighs In) The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1174879 Thu, 24 Jan 2008 13:57:10 +0100 1174879 http://www.medworm.com/index.php?rid=1174808&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Ftwo-distinct-pe.html Along with other familiar voices like Maggie Mahar and Ezra Klein, I'm in DC today writing from the Families USA Health Action 2008 conference. Families USA is a progessive (liberal) consumer advocacy organization dedicated to universal coverage, driven by mobilizing... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1174808 Thu, 24 Jan 2008 05:00:00 +0100 1174808 http://www.medworm.com/index.php?rid=1174807&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Fnancy-pelosi-he.html The featured highlight address at the opening session of the Families USA conference is by Nancy Pelosi, Congress' first woman Speaker. In person, Speaker Pelosi clearly comes across as a brilliant and warm woman, a friend of Families USA, and... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1174807 Thu, 24 Jan 2008 05:00:00 +0100 1174807 http://www.medworm.com/index.php?rid=1153924&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Ffour-big-trends.html Several events and trends emerged over the last year that will reverberate throughout the health care marketplace in 2008 and going forward. While none of these dominated the trade press like some other issues - electronic and personal health records,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1153924 Wed, 16 Jan 2008 05:00:00 +0100 1153924 http://www.medworm.com/index.php?rid=1150640&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F15%2Ffour-big-trends.html Brian KlepperSeveral events and trends emerged over the last year that will reverberate throughout the health care marketplace in 2008 and going forward. While none of these dominated the trade press like some other issues - electronic and personal health records, RHIOs, the evolving labor shortage, pay-for-performance reimbursement - these manifestations of change are occurring in the marketplace as well as through policy, and are moving health care forward in fundamentally positive and far-reaching ways. Health 2.0The most significant for the long term in terms of its capacity to change how health care works is the Health 2.0 movement, which Matthew Holt and Indu Sabaiya have played a central role in facilitating and explaining. In some ways, Health 2.0 is simply a continuation of what h... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1150640 Tue, 15 Jan 2008 08:15:52 +0100 1150640 http://www.medworm.com/index.php?rid=1146241&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F12%2Fa-clear-steady-song.html Brian Klepper In a particularly thoughtful feature in the American Chronicle, my dear lifelong friend Steve Gladstone, an actor, describes steps that might acculturate future generations to relax around people with disabilities. Afflicted with retinitis pigmentosa, a progressive disease that affects the eyes' rods and cones, Steve's sight gradually faded until he became fully blind in his mid-20s.“The able-bodied public still meets a disabled person and they tense up. A wall goes up, the voice changes, and some recoil. There are a lot of assumptions made that I have half a life as a sighted person. The mindset tends to be, 'If he has a disability, the rest of him must be disabled.' Same thing with some directors. I show up to an audition for a director and they think, ‘Wha... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1146241 Sat, 12 Jan 2008 14:24:25 +0100 1146241 http://www.medworm.com/index.php?rid=1140918&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F10%2Fleveraging-the-doctor-as-a-trusted-authority.html Brian Klepper I was on the phone with my good friend, fellow TDWI columnist Bill Bestermann MD yesterday.  Dr. B, a preventive cardiologist who is passionate about the underlying mechanics of cardiovascular disease and the horrific toll the American diet and lack of exercise is taking on everyday people, lives in spectacularly beautiful, rural Kingsport TN. He told me he was driving through town, channel surfing on his radio, and he happened upon the station that broadcasts information for the local schools. They were announcing the menu in the school cafeterias. He said it was appalling. "Honeybuns and processed foods. It was all the stuff I tell my patients to avoid." Never one to shrink from suggesting that other people embark on courageous courses of action, I ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1140918 Thu, 10 Jan 2008 07:17:01 +0100 1140918 http://www.medworm.com/index.php?rid=1142235&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Fleveraging-the.html I was on the phone with my good friend Bill Bestermann MD yesterday. Dr. B, a preventive cardiologist who is passionate about the underlying mechanics of cardiovascular disease and the horrific toll the American diet and lack of exercise is... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1142235 Thu, 10 Jan 2008 05:00:00 +0100 1142235 http://www.medworm.com/index.php?rid=1142234&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Fhealth-wonk-rev.html Our good friend Bob Laszewski is host of this edition of Health Wonk Review, which consistently displays a collection of the best, most insightful health care writing around the Web. Maggie Mahar and yours truly are represented from THCB. Drop... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1142234 Thu, 10 Jan 2008 05:00:00 +0100 1142234 http://www.medworm.com/index.php?rid=1138033&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Fover-at-health.html Now that health care reform is once again an active, visible issue in state governments and the presidential campaigns, the ideas are flying fast and furious. Predictably, some ideas are better than others. Over at Health Care Policy and Marketplace... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1138033 Wed, 09 Jan 2008 05:00:00 +0100 1138033 http://www.medworm.com/index.php?rid=1136803&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F8%2Fon-practical-reforms.html Brian Klepper Now that health care reform is once again an active, visible issue in state governments and the presidential campaigns, the ideas are flying fast and furious. Predictably, some ideas are better than others. Over at Health Care Policy and Marketplace Review, Bob Laszewski asks an important, practical but vexing question for universal coverage advocates: Can you really mandate people to buy health insurance? Mandated health insurance is a plank in the Clinton campaign's health care reform plan and is a key way that Ms. Clinton and Mr. Obama differ on that issue. (I don't know why Presidential candidates should provide this level of operational specificity at this point in the game - there are lots of different ways to skin the universal coverage cat - but they have.) Under... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1136803 Tue, 08 Jan 2008 21:53:38 +0100 1136803 http://www.medworm.com/index.php?rid=1131928&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F6%2Fjack-la-lanne.html Brian Klepper Some things are timeless. I remember watching Jack La Lanne, the TV health fitness evangelist, when I was a boy, 45 years ago. My Mom would turn him on, and would occasionally bend and stretch with his show. You couldn't help but admire his strength and vitality. It was clear he was doing something that everyone ought to do.It turns out, of course, that his advice - exercise and diet - was solid then and is solid now. Now 93, Mr. La Lanne's life and achievements are chronicled in, of all places, the Costco Connection. If nothing else, in checking out this article you'll learn, for example, that in 1956, at age 42, he set a new world record by doing 1,033 pushups in 23 minutes on the TV show You Asked For It. Or that in 1984, at age 70, handcuffed and shackled, he swam 1.... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1131928 Sun, 06 Jan 2008 06:32:17 +0100 1131928 http://www.medworm.com/index.php?rid=1129328&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Fon-medical-mira.html Now and then, amid the stories of financial conflict, medical errors and political intrigue that so often undermine health care, comes a story of the miraculous, where patients in impossible conditions not only survive, but thrive, due to the skill... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1129328 Fri, 04 Jan 2008 05:00:00 +0100 1129328 http://www.medworm.com/index.php?rid=1128656&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F4%2Fon-medical-miracles.html Brian KlepperNow and then, amid the stories of financial conflict, medical errors and political intrigue that so often undermine health care, comes a story of the miraculous, where patients in impossible conditions not only survive, but thrive, due to the skill and resources of many dedicated clinicians, due to luck and due to who knows what extraordinary circumstances that are still beyond our understanding.The New York Times has a story like this today. On December 7th, Alcides Moreno and his brother Edgar, window washers, fell 47 stories down the side of the Upper East Side apartment building they were working on. His brotherwas killed instantly, but Alcides survived, consuming 24 units of blood and 19 units of plasma. In a coma, he went through 9 orthopedic operations, and then amazing... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1128656 Fri, 04 Jan 2008 01:36:39 +0100 1128656 http://www.medworm.com/index.php?rid=1128657&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F3%2Fthe-politics-of-publicly-funded-health-care.html Brian Klepper Over at Health Care Policy and Marketplace Review, the always insightful Bob Laszewski walks us through the mechanics of the just-passed federal budget and its health care financing implications for SCHIP, physicians, hospitals, Medicare Advantage plans. This clear, common sense analysis is a must-read for anyone interested in how the federal budget process actually works. The final bill had 12,000 earmarks, testimony to continuing special interest domination over the public interest. Everyone facing a cut got a reprieve, but all the same issues (and cuts) will be on the table in the near future. Here's one of Bob's summary paragraphs. Late in 2008, the docs will be facing a 15% Medicare fee cut on January 1, 2009, SCHIP will be out of money a few months later on March 1, 20... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1128657 Thu, 03 Jan 2008 16:02:37 +0100 1128657 http://www.medworm.com/index.php?rid=1128525&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2008%2F01%2Fthe-politics-of.html Over at Health Care Policy and Marketplace Review, the always insightful Bob Laszewski walks us through the mechanics of the just-passed federal budget and its health care financing implications for SCHIP, physicians, hospitals, Medicare Advantage plans. This clear, common sense... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1128525 Thu, 03 Jan 2008 05:00:00 +0100 1128525 http://www.medworm.com/index.php?rid=1124843&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2008%2F1%2F2%2Fan-eaters-manifesto-eat-food-not-too-much-mostly-plants.html Brian Klepper Monday's Morning Edition on NPR had an interview with Michael Pollan, the author of the bestselling "In Defense of Food." When asked to summarize what he has to say about the subject, Pollan says, "Eat food. Not too much. Mostly plants." He adds, "That's it. That is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy." You can spend a very worthwhile 6 minutes listening to the interview here.Pollan's advice is a mix of common sense and hard science, and it is long overdue, part of the difficult consciousness-raising that's necessary for us to overcome the epidemic of obesity and chronic disease that now plagues developed and developing nation's.  ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1124843 Wed, 02 Jan 2008 12:59:27 +0100 1124843 http://www.medworm.com/index.php?rid=1112636&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F12%2Fmy-nomination-f.html I was reading through other peoples’ blog posts yesterday when amazingly enough, I was here on THCB and came across this straightforward statement by Paul Levy, the CEO of Beth Israel Deaconess Medical Center in Boston. Of course, many readers... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1112636 Sat, 22 Dec 2007 05:00:00 +0100 1112636 http://www.medworm.com/index.php?rid=1111797&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F12%2F21%2Fhealth-care-quote-of-the-year.html Brian Klepper I was reading through some other peoples' blog posts yesterday and came across this straightforward statement by Paul Levy, the CEO of Beth Israel Deaconess Medical Center in Boston. Paul made news by establishing a blog called Running a Hospital. I think he's probably taken some good-natured ribbing by his more straightlaced colleagues. But I admire that fact that he's broken the bounds of decorum and speaks openly about the many tremendously difficult issues that face hospital executives. While many many hospitals (and doctors and health plans and...) are still doing everything possible to hold back the transparency tide, here's his take, published yesterday on Matthew Holt's Health Care Blog:The main value of transparency is not necessarily to enable easier consumer c... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1111797 Fri, 21 Dec 2007 20:49:30 +0100 1111797 http://www.medworm.com/index.php?rid=1109756&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F12%2Fbusiness-as-usu.html In the world of health reform wonks - the writers on this blog qualify in spades - all eyes are on California at the moment. His Republicanism notwithstanding, Governor Schwartzenegger has developed a generous $14 billion bill that would extend... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1109756 Fri, 21 Dec 2007 05:00:00 +0100 1109756 http://www.medworm.com/index.php?rid=1108571&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F12%2F20%2Fbusiness-as-usual-californias-reform-proposal.html Brian Klepper In the world of health reform wonks - I qualify in spades - all eyes are on California at the moment. His Republicanism notwithstanding, Governor Schwartzenegger has developed a generous $14 billion bill that would extend universal coverage to all Californians by 2010. Now that the plan is set, the special interests are lining up. Most of the health care groups - the physicians, hospitals, the health plans (with the interesting exception of Wellpoint) - are supportive, fully aware that if more money can be found for health care, they'll be the recipients. Also in the mix are two prominent unions: SEIU (the Service Workers' International Union) and the American Federation of State, County and Municipal Employees. They are both key supporters, each with health care workers... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1108571 Thu, 20 Dec 2007 22:56:31 +0100 1108571 http://www.medworm.com/index.php?rid=1106183&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F12%2F19%2Fshannon-brownlees-overtreated.html In yesterday's New York Times , the economics columnist David Leonhardt wrote a nice tribute to Shannon Brownlee's Overtreated, an explanation of how and why American health care is out of control. Ms. Brownlee, a Fellow at the New America Foundation, wrote me that she wrote this book for her mother. (Can there be a better motivation? I'm reminded here of JD Salinger's Raise High The Roof Beams, Carpenters and its tribute to the hero's librarian, Ms. Overman.) Leonhardt suggests that Overtreated should win the award for "economics book of the year."Shannon sent me her book, and it is as deeply interesting and important as Leonhardt claims it is. For those of you genuinely interested in health care, its a worthwhile expenditure of your time. Take a leap, buy it and immerse yoursel... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1106183 Wed, 19 Dec 2007 23:45:49 +0100 1106183 http://www.medworm.com/index.php?rid=1101107&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F12%2Fpolicy--vs-mark.html As Anonymouse insightfully commented, the Harvard team's RHIO study in Health Affairs is very telling about the barriers facing do-gooder health care projects. That said, I wanted to add two comments. First, while RHIOs are unquestionably good public policy, what... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1101107 Tue, 18 Dec 2007 05:00:00 +0100 1101107 http://www.medworm.com/index.php?rid=1100076&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F12%2F17%2Fpolicy-vs-market-based-reform-rhios-as-a-case-study.html In Health Affairs, a Harvard team has published an important review 0f the current state of RHIOs (Regional Health Information Organizations), many of which are failing. Of 145 efforts identified in 2006, nearly one in 4 had closed by early 2007, only 20 were actually exchanging clinical information and most of those were very narrow in their scope.It's a telling analysis. But what caught my attention was a sentence that nails the core of the problem. The authors write, “Whether RHIOs represent small businesses that need viable business models, which requires the ability to generate profits as well as value for participants, or public goods that require funding is an important unresolved issue.” RHIOs, like many other important health care initiatives, are unquestionably a good... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1100076 Mon, 17 Dec 2007 16:37:03 +0100 1100076 http://www.medworm.com/index.php?rid=1096264&cid=t_140090_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F200451112%2F Over at The Health Care Blog, Brian Klepper has written an excellent article entitled “Bad Medicine: How The AMA Undermined Primary Care in America.” His essay could just as easily been entitled “How the AMA Undermined Chronic Disease Care in America” — it’s very informative reading. Share This (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1096264 Fri, 14 Dec 2007 19:56:08 +0100 1096264 http://www.medworm.com/index.php?rid=1093037&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F12%2F13%2Fbad-medicine-how-the-ama-undermined-primary-care-in-america.html Brian Klepper On Tuesday’s Wall Street Journal website, Dr. Benjamin Brewer describes physicians’ reactions to the 10.1% cut in Medicare physician payments that will take effect January 1. He argues that the onus will fall, once again, disproportionately on primary care physicians, who are already losing the struggle to keep their heads above water. He is right, of course. There is no question that Medicare must rein in cost. But the cuts are approximately the same across specialties and therefore regressive. Insensitive to its distinct role, its lower revenues and its high operational costs, they hit primary care harder than they do specialties. Given its already battered status, the cuts’ impact on primary care could translate to real consequences this time. American... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1093037 Thu, 13 Dec 2007 22:16:53 +0100 1093037 http://www.medworm.com/index.php?rid=1058230&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F11%2Fif-grady-fails.html In an extraordinary move earlier this week, the politically-appointed Fulton-DeKalb Hospital Authority, the governing body over Atlanta's Grady Health System, unanimously and voluntary stepped aside, to be replaced by a new non-profit corporation. Projecting a $55 million deficit this year,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=1058230 Thu, 29 Nov 2007 05:00:00 +0100 1058230 http://www.medworm.com/index.php?rid=1057284&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F11%2F28%2Fif-grady-fails.html Brian KlepperMonday's news carried a story that will probably go mostly unnoticed as just another hospital in financial straits. In an extraordinary move, the politically-appointed Fulton-DeKalb Hospital Authority, the governing body over Atlanta's Grady Health System, unanimously and voluntary stepped aside, to be replaced by a new non-profit corporation. With a $55 million deficit this year, the hospital had just 3 weeks of cash left on hand. It needs $300 million immediately for sorely-needed renovations, and must deal with $63 million in accumulated debt to its biggest creditors, Emory University Medical School and Morehouse School of Medicine. New oversight was the requirement for a financial bailout that might come from business, philanthropies and financial institutions. Other Atl... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=1057284 Wed, 28 Nov 2007 23:19:28 +0100 1057284 http://www.medworm.com/index.php?rid=964540&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F10%2F18%2Faspen-report-3-removing-the-blinders-dr-kelmans-wonderful-co.html Brian KlepperOne of the most fascinating and moving experiences at the Aspen Health Forum – Given the quality of the content there, this is saying something. The audience was rapt – was a talk by Neen Hunt, Executive Director of the Lasker Foundation. Each year this organization bestows a hugely prestigious prize to individuals who have made significant contributions to scientific medicine, clinical medicine and public service. Dr. Hunt’s talk focused on combating the geeky stereotypes that often are associated with people with dedicated passions, and on conveying their broad humanity. Her vehicle was a character portrait of Dr. Charles D. Kelman, an ophthalmologist practicing in Manhattan during the latter half of the 1900s, who in an incredibly bold stroke, blew pa... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=964540 Sat, 20 Oct 2007 00:00:14 +0100 964540 http://www.medworm.com/index.php?rid=961628&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2Fwe-are-what-we-eat-where-is-americas-leadership-brian-kleppe.html One of the attributes of a great image is its ability to convey vast amounts of information and meaning quickly and simply. Here's a terrific example. In one of his typically astute comments, Barry Carol alerted us to a wonderfully clever graphic by Wellington Gray - the image needs more space to be viewed properly than this blog allows, so you'll have to click on the link - displaying the percentage of people older than 15 in different developed countries with a Body Mass Index greater than 30. In other words, the percentage of fat adults. At 31% of our adult population, the US has the most obesity by far, fully 20-25 percent higher than our closest competitors in the race to lifestyle oblivion, Mexico and the UK. At the skinny end of the scale, France, Austria and Italy are at 9%, and N... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=961628 Thu, 18 Oct 2007 21:18:58 +0100 961628 http://www.medworm.com/index.php?rid=961539&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F10%2Faspen-report-3-.html One of the most fascinating and moving experiences at the Aspen Health Forum – Given the quality of the content there, this is saying something. The audience was rapt – was a talk by Neen Hunt, Executive Director of the... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=961539 Thu, 18 Oct 2007 04:00:00 +0100 961539 http://www.medworm.com/index.php?rid=957156&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F10%2Fwe-are-what-we-.html One of the attributes of a great image is its ability to convey vast amounts of information and meaning and simply. Here's a terrific example In one of his typically astute, thoughtful comments, Barry Carol alerted us to a wonderfully... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=957156 Wed, 17 Oct 2007 04:00:00 +0100 957156 http://www.medworm.com/index.php?rid=955975&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F10%2Fwhat-obesity-re.html Any lingering doubts that America's cavalier attitude toward lousy food and obesity is draining the nation's health and economic vitality should have been laid to rest a couple weeks ago. Two important studies were released that quantified just how much... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=955975 Tue, 16 Oct 2007 04:00:00 +0100 955975 http://www.medworm.com/index.php?rid=950848&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2Fhealing-unbound-the-promise-of-advancing-computational-power.html Laptop-attached ultrasound units that produce startlingly clear internal images for five dollars in the field. Organs that re-generate inside scaffolds.  Drugs tailored to an individual’s biology. Micro-images of cancerous cells lit up by bio-chemical markers. Decision support tools that scan the physiological values in electronic health records for patterns too complex to be detected by an unaided clinician.The advances available from dramatic improvements in computational capabilities were a recurring theme at the Aspen Health Forum, with experts from each discipline describing where the technology was leading us. I attended two sessions featuring Star Trek clips that predicted realities now within at least theoretical reach. (Prescient and corny, audiences nodded nostalgicall... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=950848 Mon, 15 Oct 2007 11:24:57 +0100 950848 http://www.medworm.com/index.php?rid=949890&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F10%2F14%2Fa-rage-to-know-a-few-days-at-the-aspen-health-forum.html Brian Klepper At one of the opening sessions of the Aspen Health Forum, Peter Agre and Michael Bishop, both physician researchers and Nobel laureates, recounted their childhoods, their families, their likes and dislikes, their school experiences, and the barriers, successes and lucky breaks that led them into lives of discovery. Dr. Agre won the award for identifying the mechanisms that allow water to cross the cell membrane. Dr. Bishop won for discovering how certain defects in genes can lead to cancer. Those of us in the audience were struck by the commonness and good humor of their stories, but also by these individuals’ profound humility and, most of all, their passion. What Neen Hunt, Director of the Lasker Foundation, the third speaker on that panel, in her description of ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=949890 Sun, 14 Oct 2007 16:07:05 +0100 949890 http://www.medworm.com/index.php?rid=949855&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F10%2Fa-rage-to-know-.html At one of the opening sessions of the Aspen Health Forum, Peter Agre and Michael Bishop, both physician researchers and Nobel laureates, recounted their childhoods, their families, their likes and dislikes, their school experiences, and the barriers, successes and lucky... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=949855 Sun, 14 Oct 2007 04:00:00 +0100 949855 http://www.medworm.com/index.php?rid=947940&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F10%2F13%2Fa-broad-vision-of-health-20.html Brian KlepperThree weeks ago Pat and I attended a fascinating conference in San Francisco on Health 2.0, an emerging industry that promises to change the ways patients manage their own health, and the ways that clinicians and purchasers of all types make clinical and management decisions. The term Health 2.0 refers to Web 2.0, the idea that, in social networking, people will use Web-based platforms to reformulate data for their own purposes.Jane Sarasohn-Kahn is a highly-respected health economist and commentator working at the intersection points of health care and technology. Jane and I worked together to describe the elements and functions we believe will be integrated to constitute Health 2.0's real value. We've posted this narrative and an accompanying image - its an animated PowerPoi... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=947940 Sat, 13 Oct 2007 05:22:44 +0100 947940 http://www.medworm.com/index.php?rid=938718&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F10%2F9%2Fwhat-obesity-really-costs.html Brian KlepperAny lingering doubts that America's cavalier attitude toward lousy food and obesity is draining the nation's health and economic vitality should have been laid to rest last week. Two important studies were released that quantified just how much our inability to resist fast food is costing us. In Health Affairs, the premier journal of health care market dynamics, economics and policy, Professor Ken Thorpe and colleagues from Emory reported on a study comparing incidences of chronic disease in the US and in 10 European countries.  They found strong evidence that Americans have much higher levels of lifestyle-related chronic disease than do Europeans - in other words, we're sicker - that American medicine tends to identify and treat disease more aggressively than does E... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=938718 Tue, 09 Oct 2007 22:14:42 +0100 938718 http://www.medworm.com/index.php?rid=925134&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F10%2Fbogle-on-the-fi.html Some years back I was mortified to realize that it would be all-but-impossible to fix health care without first fixing America's patronage system, that puts virtually all policy up for sale to the highest bidder. In 2006, American corporations spent... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=925134 Wed, 03 Oct 2007 04:00:00 +0100 925134 http://www.medworm.com/index.php?rid=916043&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F10%2Fgoldsmiths-wisd.html Last week, Jeff Goldsmith, who enjoys a reputation as one of health care's more thoughtful commentators and advisors, wrote a curious post on this site. He puzzled over Kaiser Family Foundation Chairman Drew Altman's failure to gush that the 2007... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=916043 Mon, 01 Oct 2007 04:00:00 +0100 916043 http://www.medworm.com/index.php?rid=915323&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F9%2F30%2Fa-red-tide-bloom.html Brian KlepperEveryone in my Northeast Florida beachside neighborhood has been coughing as soon as they step outside. The mailman wears a breathing mask. People with respiratory problems have been warned to stay inside. Local acute care centers and hospital emergency departments are standing by for patients. The beach is nearly empty of the walkers, sunbathers and fishermen who normally inhabit it.A few days ago our beach was afflicted with a red tide. In this area, red tides are blooms of the highly toxic alga Karenia brevis, a particularly nasty single-celled, photosynthetic organism. Each cell has two flagella that it uses to swim in a spinning motion. More to the point, though, K. brevis naturally produces potent neurotoxins called brevetoxins. These brevetoxins are responsible for larg... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=915323 Sun, 30 Sep 2007 13:31:02 +0100 915323 http://www.medworm.com/index.php?rid=888524&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F9%2F20%2Fhealthcare-is-a-hair-ball-and-other-learnings-from-health-20.html By Pat Salber, MD (aka The Doctor Weighs In) and Brian Klepper, PhD (aka The Fake Doctor) We are in a conference room in San Francisco with about 500 people at the first ever Health 2.0 conference co-sponsored by the Great Health Care Blogger, Matthew Holt (The Health Care Blog) and Indu Subaiya, MD of Etude Scientific.We are hearing about (and salivating) over the possibilities of user-generated healthcare – web-based consumer driven health care and health support programs. This stuff is real patient-centric health care (as opposed to other things like “consumer-driven health care” that we sometimes call patient-centric, but that are really just less a bit less physician or health plan-centric).The title of this post comes from one of the opening pane... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=888524 Thu, 20 Sep 2007 22:29:27 +0100 888524 http://www.medworm.com/index.php?rid=886212&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F9%2F20%2Fhow-might-information-technology-actually-change-health-care.html Brian KlepperToday I’m in San Francisco for the Health 2.0 conference, billed as “User-Generated Health Care.” Organized by my pal Matthew Holt and his partner, Indu Subaiya, "Health 2.0" references "Web 2.0," social networking, applied to health care.  The meeting will feature top executives from high and low profile IT firms that either are already dedicated to or hope to play an important role in health care, like Google, Microsoft, Yahoo, Intel, Cisco, WebMD, Revolution Health, AthenaHealth, Sermo, and many other lesser known organizations, all discussing their strategies for leveraging data in new ways to create value for all health care constituencies.Elsewhere, I’ve referred to this as a “significant portion of market-based heal... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=886212 Thu, 20 Sep 2007 04:31:08 +0100 886212 http://www.medworm.com/index.php?rid=867248&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F9%2F12%2Ftaking-obesity-seriously.html Brian Klepper Over at Health Care Policy and Marketplace Review, the always insightful Bob Laszewski drew my attention to the release of a new report from The Trust for America's Health , F as in Fat: How Obesity Policies Are Failing in America. This 120 page document, funded by the Robert Wood Johnson Foundation, provides an update on how obesity is ravaging America's health and productivity.The facts about America's obesity problem aren't new.  They continue to be grim and worsening:Two thirds of American adults are now overweight or obese.Adult obesity rates exceed 20 percent in 47 states.In the past year,  the obesity rates increased in 31 states; no state improvedObesity is at the root of an array of our most expensive major diseases that will generate huge costs for ca... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=867248 Wed, 12 Sep 2007 06:35:14 +0100 867248 http://www.medworm.com/index.php?rid=827970&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F28%2Fconfessions-of-a-walking-fool.html Brian Klepper How do you live a long life? Take a two-mile walk every morning before breakfast.Harry Truman33rd US President, who lived to 88DAWN, n. The time when men of reason go to bed. Certain old men prefer to rise at about that time, taking a cold bath and a long walk with an empty stomach, and otherwise mortifying the flesh. They then point with pride to these practices as the cause of their sturdy health and ripe years, the truth being that they are hearty and old, not because of their habits, but in spite of them. The reason we find only robust persons doing this thing is that it has killed all the others who have tried it.Ambrose Bierce, The Devil's Dictionary  I started taking long walks with my close friend Bob thirty-five years ago when we were students in Holla... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=827970 Tue, 28 Aug 2007 18:28:12 +0100 827970 http://www.medworm.com/index.php?rid=821202&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fevaluating-the-.html Thomas Wilson PhD is on a mission that's important to health care. Tom, a respected epidemiologist particularly well-known in disease management circles, founded the Population Health Impact Institute (PHII), a not-for-profit devoted to establishing clear, objective rules to evaluate claims... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=821202 Fri, 24 Aug 2007 04:00:00 +0100 821202 http://www.medworm.com/index.php?rid=821201&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fwhat-are-they-t.html I'm sure I don't really get the deeper issues involved here, but sometimes its hard to not have your breath taken away by some people's notion of a good idea. Maybe its because I'm not a true geek, but what... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=821201 Fri, 24 Aug 2007 04:00:00 +0100 821201 http://www.medworm.com/index.php?rid=813956&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fwhy-do-we-have-.html I sit on the Dean's Advisory Councils of the Colleges of Health at two public universities in Florida. Both Colleges are led by extremely capable PhD nurses, and have a variety of programs that train students to be health professionals,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=813956 Tue, 21 Aug 2007 04:00:00 +0100 813956 http://www.medworm.com/index.php?rid=811045&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2Ffive-things-that-everyone-with-diabetes-should-know.html Brian Klepper Today's New York Times has a brief but very pointed article summarizing the recommendations of Dr. John Buse, director of the Diabetes Care Center at the University of North Carolina, Chapel Hill, and president-elect for science and medicine at the American Diabetes Association. The language below, all sensible shoes advice, is a straight extract from the article. 1. If you are overweight, get screened for diabetes with a fasting glucose test, starting at puberty, at least every three years. If you are not, start at age 45. A normal result is less than 100 mg/dl.2. If you have diabetes or prediabetes, engage in moderate-intensity exercise like brisk walking for at least 30 minutes at least five days a week. If you are overweight, reduce calories with a goal of losing at ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=811045 Mon, 20 Aug 2007 17:04:31 +0100 811045 http://www.medworm.com/index.php?rid=810970&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fomni-the-oncolo.html An innovative Ft. Worth consulting firm comprised of experienced oncology professionals, Oncology Metrics, has linked private oncology practices throughout the country in a collaborative, knowledge-sharing enterprise, called the Oncology Circle. The first round of information brought together 22 practices containing... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=810970 Mon, 20 Aug 2007 04:00:00 +0100 810970 http://www.medworm.com/index.php?rid=804345&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fcan-we-talk-fra.html Over at The Doctor Weighs In, Bill Bestermann literally grabs our attention and forces feeds us a highly informative, and, dare I say, USEFUL physiology lesson in If You Want To Get It Up - You've Got To Get It... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=804345 Fri, 17 Aug 2007 04:00:00 +0100 804345 http://www.medworm.com/index.php?rid=802199&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F16%2Fin-mcdonalds-vs-kids-guess-whos-ahead.html Brian Klepper Here's news to warm the heart of every fast food executive, but that, if the world were a sensible place, should jolt parents, school administrators and non-food industry business leaders out of their nutritional malaise. The New York Times reported this morning on a small sample taste test with 63 children ages 3-5. When presented with different foods - hamburgers, chicken nuggets, french fries, carrots - the kids invariably thought the ones in McDonald's packaging tasted better.Naturally, the McDonald's people were thrilled, and at the ready with corporate spin. The goal, you see, is to have kids associate good tasting foods with McDonald's, and then McDonald's will gradually introduce foods that aren't so terrible  for them.  Clever, huh? From the article:Wa... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=802199 Thu, 16 Aug 2007 11:36:25 +0100 802199 http://www.medworm.com/index.php?rid=802200&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F16%2Fthe-father-of-physical-culture.html Brian KlepperOne of my early morning pleasures is reading the day's edition of Garrison Keillor's Writer's Almanac - click on the link to sign up for the daily email newsletter - which contains a poem and then usually several short summaries of writers' lives. They always manage to focus on the particularly human part of each subject. More often than not, I think to myself that each entry is a gem. One of today's entries was new to me. Born on this day in 1868, Bernarr Mcfadden, was an early popular fitness advocate, and a website about him refers to him as "The Father of Physical Culture." Since the heart of TDWI is health, nutrition, fitness and all the social dynamics that swirl around those values, I thought this might be a nice entry. It's the birthday of the man who cr... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=802200 Thu, 16 Aug 2007 10:27:25 +0100 802200 http://www.medworm.com/index.php?rid=803476&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fpodcast-mello-o.html Professor Michele Mello, an expert on the health care justice system at the Harvard School of Public Health, has an interesting 9.5 minute audio podcast on why health courts would be an improvement over the current medical liability system. The... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=803476 Thu, 16 Aug 2007 04:00:00 +0100 803476 http://www.medworm.com/index.php?rid=803475&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fconsultants-to-.html We must view and treat the community as the owner to whom we are fully accountable. Aggregate financial performance data, aggregate productivity performance and aggregate quality and patient satisfaction data belong in the public realm. How else can consumers make... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=803475 Thu, 16 Aug 2007 04:00:00 +0100 803475 http://www.medworm.com/index.php?rid=801279&cid=t_140090_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2007%2F08%2Fmanaged-care-re.html Like democracy, managed care is a great idea. It's just that its rarely been tried. Even so, my guess is that its about to re-emerge in a new, improved form, and possibly with some other name. If the signs around... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=801279 Wed, 15 Aug 2007 04:00:00 +0100 801279 http://www.medworm.com/index.php?rid=799201&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2Fbrokers-as-a-mirror-of-the-health-system.html Brian KlepperOver at The Health Care Blog, while my pal Matthew Holt is honeymooning with his lovely bride Amanda for the next week and a half, I've taken on a share of the guest cage-rattling responsibilities. Yesterday and today, I'm presenting the case against broker's excessive compensation and their financial conflicts with health plans. At the same time, though, I also point to their roles as sin-eater/intermediary in an increasingly contentious health plan - benefits manager/enrollee relationship.So its not either/or. Stop in here first and then visit there.  There's plenty of rabble rousing to go around.  (Source: The Doctor Weighs In) The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=799201 Tue, 14 Aug 2007 13:24:31 +0100 799201 http://www.medworm.com/index.php?rid=795062&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F13%2Fhealth-care-reform-whither-thou-goest.html Primary season is in full swing with each candidate promising a better deal than the others.  Healthcare reform is one of the top three or four concerns, depending upon your socioeconomic group and political affiliation.  The last time this concern was front and center was in the 1992 Presidential election, extending into President Clinton’s first years in office.  I was still practicing medicine and did my best to care for my friends.  An artist friend and his wife called me around that time to tell me they were expecting their first child and had no health insurance.  They were also struggling with paying their rent and buying food.Over the years I had arranged medical care for several people who needed more care than I could provide, but this was the first... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=795062 Mon, 13 Aug 2007 07:40:03 +0100 795062 http://www.medworm.com/index.php?rid=792798&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2Fcheck-out-health-wonk-review.html Those of you interested in the deeper mysteries of health care might want to check out Health Wonk Review, an occasional gathering of some of the most knowledgable and thoughtful health care watchers.  This edition, hosted by Julie Ferguson at Workers Comp Insider, includes TDWI's own Brian Klepper. Expand your horizons. Check it out! (Source: The Doctor Weighs In) The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=792798 Fri, 10 Aug 2007 19:38:57 +0100 792798 http://www.medworm.com/index.php?rid=790533&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F9%2Fshow-me-yours-and-ill-show-you-mine-transparency-and-health-.html Brian Klepper Mention a health plan to doctors or hospital administrators, and they’ll likely bend your ear about how the performance feedback data they get from them are wrong, how their reimbursements are based on inaccurate data, and how they think the inaccuracies are intentional.Because they aggregate huge volumes of claims, health plans have the best patient and provider information. While many providers dismiss claims data as wholly inaccurate, they in fact contain a wealth of useful information about patients and their care that can be teased out using the very sophisticated analytical tools that are now readily available. These techniques permit credible evaluation of the relative performance of doctors by specialty and hospitals by service.  Virtually all analytic... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=790533 Thu, 09 Aug 2007 22:41:34 +0100 790533 http://www.medworm.com/index.php?rid=773302&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F1%2Fwe-must-be-stupid-stupid-stupid-mega-life-and-health.html Brian KlepperI’ve filled a lot of airtime and column inches over the last couple years talking about the financial conflicts that characterize so much of health care. I’ve focused on topics like oncology drug rebates, Medicare D drug plan scams and unnecessary care by doctors and hospitals, but the truth is that these unethical and abusive practices abound in virtually every area of health care. These outrages are often glossed over because they’re perpetrated by respectable people presumably working under the mantle of a higher mission. Of course many health care professionals are mortified by these practices and know that the system must change. I recently did a video commentary on financially conflicted care on Medscape and expected a physician backlash. What arrived i... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=773302 Wed, 01 Aug 2007 11:06:44 +0100 773302 http://www.medworm.com/index.php?rid=764183&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F27%2Fdont-invite-anyone-from-health-care.html Brian KlepperLast year the Nevada Health Care Coalition in Reno asked me to work with them on a mid-October health care conference. They wanted to grow their coalition, and encourage their members to fund a data-mining project that would allow them to develop performance ratings on the region’s doctors (by specialty) and hospitals (by service).Typically in meetings like this, the host group invites a representative sampling of all the different major constituencies: doctors, hospitals, health plans and employers. I suggested an alternative. “Only invite the employers, and the C-suite executives, the corporate decision makers, at that. Don’t allow the employers to just send their benefits managers.”“Don’t invite anyone from health care. They’re too ... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=764183 Fri, 27 Jul 2007 23:10:38 +0100 764183 http://www.medworm.com/index.php?rid=755588&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F24%2Fmr-bushs-health-care-reform-proposal.html Brian Klepper The Wall Street Journal (subscription required) ran an op-ed yesterday by Allen Hubbard , Director of the National Economic Council and the President’s Assistant for economic policy. The piece supported President Bush’s health care reform proposal that would offer tax deductions for individual purchasers of coverage. It also supported the President’s objection to increasing funding and eligibility for the S-Chip program – this is a federal-state program for children’s health coverage – but I’ll talk about that another time.On the face of it, the President is right.  It doesn’t make sense that corporations buying employee health insurance receive tax credits, but that individuals buying it for themselves do not. This ha... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=755588 Tue, 24 Jul 2007 23:56:19 +0100 755588 http://www.medworm.com/index.php?rid=748890&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F22%2Fcrabby-doctors-and-the-explosion-of-big-practices.html Brian KlepperDoctors are a cranky bunch these days, and justifiably so. Their world is changing. Its undoubtedly less fun to be the object of a paradigm shift than its driver or observer.A recent survey showing healthy 2007 income increases across specialties notwithstanding, physicians are besieged by increasing patient loads, a torrent of new information, Byzantine administrative requirements, demands for new technology investments and the very real likelihood that their incomes will plummet under Medicare and commercial coverage P4P programs. Despite the apparently rosy survey numbers, its clear that many primary care physicians are having trouble making ends meet.  Many specialists are seeing their incomes drop as well. So its striking that, unlike a decade ago, there are rel... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=748890 Sun, 22 Jul 2007 00:27:45 +0100 748890 http://www.medworm.com/index.php?rid=744793&cid=t_140090_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F7%2F19%2Fshould-we-have-health-care-performance-transparency-by-whom-.html Brian Klepper Last week the New York Times reported that the state's Attorney General (AG) office threatened UnitedHealthcare (UHC) with a lawsuit if it proceeded with the September release of a physician profiling report. The details were fuzzy, but apparently the AG was responding to charges by different physician groups – the AMA and the St. Louis Metropolitan Medical Society were named  - that UHC's methodology is based purely on cost and does not consider quality. The Times piece includes this snippet:Linda A. Lacewell, a senior lawyer in the office of Attorney General Andrew M. Cuomo, wrote in the letter that the ranking would apparently be used to steer consumers toward selected doctors. “To compound the situation,” she wrote, “we understand that em... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=744793 Thu, 19 Jul 2007 23:30:07 +0100 744793