From Lewis and Clark to Our Front Door: The Long Shadow of Rationing

The sight of a frustrated motorist, struggling at the side of a dusty road to remove a tire whose inner tube had been patched once too often, was anything but unusual in the summer of 1943. Military occupation of Malaya and the East Indies in early 1942 had eliminated more than 90% of America’s rubber supply. Scrap drives for everything from raincoats to tin cans became increasingly common as the country dealt with the challenges of scarcity. More

Joy to the Workforce

It’s December. All around us are reminders that this is the season for joy: colorful lights, familiar carols and cherished family and friends. But if you read health care news, or speak with your staff, you know that joyful isn’t always the way our workplaces are described. Almost weekly, we see new and startling studies stating how burnout has taken root in our hospitals, stealing the joy from one of the most noble career pursuits - being a caregiver. A few fast stats reveal: More

Can’t They All Just Get Along?

If last Tuesday’s election results are any indication, then the answer to that is a solid “maybe.” While the 2018 midterms produced some confusing results, they did offer some clarity with respect to health care policy. First, a recap More

Fender Benders and the Road to Single Payer Health Care

My new automobile insurance card arrived in the mail recently. My old card was made of sturdy plastic. The new card was made of paper. As I turned the card over in my hands, hoping that the lightweight construction was not a harbinger of thinner coverage, something caught my eye that made me stop and think. On the back of the card was a code referring to “uninsured motorist” protection. A portion of my auto insurance premium covers me in the event that I am involved in an accident... More

Empowering Leaders to Lead the Lean Way


Going Lean can be a challenge. After all, it’s a leadership and performance improvement style that may not easily fit within every organization’s management philosophy. Across the country, 75% of all health care providers have tried the Lean method and struggled with it. But there are success stories, most recently by leadership at New Hanover Regional Medical Center (NHRMC) in Wilmington, N.C.


Demographic Data Collection and Use: Pandora’s Box or Treasure Trove?


Health care organizations collect patient demographic data including race, ethnicity and language (REAL) to fulfill meaningful use attestation, meet federal accreditation requirements and adhere to CLAS standards (Culturally and Linguistically Appropriate Services). How organizations use this data, however, varies greatly. Many organizations are beginning to use the information with their clinical quality and safety improvement efforts.


Mozart and Medicine: The Inherent Cost of the Human Touch

In December 1913 Henry Ford introduced the assembly line, revolutionizing the production of automobiles. For the first time, cars moved while the workers and their tools did not. Productivity increased dramatically, as the time required to produce an automobile dropped from 12 hours to two hours. Manufacturing would never be the same. A few weeks later, in February 1914, the Detroit Symphony Orchestra reemerged, having ceased operations in 1910. It’s a good bet that Mr. Ford was... More

Campaign Lip Service

It seems just like yesterday when then-presidential candidate George H.W. Bush uttered the infamous words, “Read my lips: no new taxes.” What followed was President Bush doing something we rarely see these days – compromising with Congress and the other political party – to negotiate a budget that did, among other things, increase some taxes. Some analysts believe that his seeming failure to keep his word was partly to blame for losing his reelection bid. More

Why Patient Outcomes Must Drive Clinical Decisions

I live in a growing and desirable part of southeastern United States. To get just about anywhere by car however I have to drive through rural America. Recently, I stopped at a small, independently owned gas station and noticed something strange behind the counter. There was only one choice of cigarettes. In my experience, tobacco sales were a big business in this part of the country and gas stations made a pretty good margin on every pack sold. I asked the attendant if those were the only... More

Jurassic Park, The Big Short and The Wizard of Oz

Just before the financial meltdown of 2008, a neurologist named Michael Burry – who managed an investment hedge fund – foresaw the implosion of the mortgage-backed securities market and began investing heavily in what are known as credit default swaps. For years, banks had been making mortgage loans to people who were borrowing far beyond their means. Lenders were then bundling risky loans into mortgage-backed securities and selling those securities to investors ranging from large... More