Category Archives: General Interest
General Shineski Needn’t Have Been Ousted – He Was Betrayed
At the end of May, after a series of exposés and congressional hearings, General Eric Shinseki, was pressured to resign as Secretary of the Department of Veterans’ Affairs… Could the VA scandal have been prevented? – In all likelihood yes. Would it have been easy to prevent? – No. Continue reading
What is Quality? It Depends on Who Does The Measurement
There are more than a dozen sets of publicaly reported quality metrics … with between 8 & 80 individual components to each set. It is small wonder that they don’t agree. Continue reading
Providers, Patient Care Delivery and Policy: Hospitalist story
There are often perverse incentives in health care. These incentives can, at times, create competing drives where providers are encouraged to do things that directly increase the costs of care. Consider the reaction to the mandate to cut down hours … Continue reading
Who worries about physician behavior? Who is ultimately responsible?
There is a true story of a 30 yo woman who has a history of rheumatoid arthritis, and who developed unusual eye symptoms. She went to a physician who referred her to a neurologist (both were “independent medical practitioners”). The … Continue reading
Who is responsible? Is there Enough Accountability in Medicine?
The Alligator Allegory reads: “ The objective of all dedicated employees should be: To thoroughly analyze all situations, Anticipate all problems prior to their occurrence, Have answers for these problems, And Move swiftly to solve these problems when called upon. … Continue reading
What does the Patient Protection and Affordable Care Act (PP ACA; PL 111-148) say about Alignment?
The PP ACA, stored as HR 3590 and signed into law on March 23, 2010, is 906 pages long. Most of the bill consists of amendments to other portions of the Laws of the United States as enumerated in the … Continue reading