Is it Time to Ditch Medicare?

Having endured the past year of the Presidential campaign — most recently the Obama v. Romney debate — in which Medicare is characterized as the program that will send the United States into bankruptcy, I realize that the question must be asked: why not end it? It is a bold notion — one discussed privately […]

Renegotiating Health Care Waste

The New York Times today cites an Institute of Medicine study with more bad news about waste in the health care system: an estimated 30% of spending was wasted in some way in 2009. That’s about $750 billion. In another study cited, three-quarters of hospitalized patients were unsure who was actually “in charge of their […]

Renegotiating Healthcare Relationships

This is from an article that appeared today on Becker’s Hospital Review: How should bundled payments work? Who should be reporting to whom? Is evidence-based medicine the best way to reduce variation? Will EHRs limit physician decision-making? On occasion, this could lead to tension-producing arguments and unwanted conflicts. However, there is one “given” within this […]

Health Care Reform: Where Do We Go From Here?

From a post we authored for KevinMD.com, a widely read health care blog: The Supreme Court has spoken. The Affordable Care Act is upheld.  So what does this mean for those of us actually involved in health care? First, there is a lot of work to do. The Court has reached its decision with regard […]

The Affordable Care Act: Leadership Challenges after Affirmation

We have two areas of research and teaching: conflict resolution and negotiation in healthcare and crisis leadership. With today’s Supreme Court decision, these two come together in dramatic fashion. One of the lessons that we teach crisis leaders is that each event is actually many events. On its face, the Supreme Court’s decision is a […]

Negotiation and the New Graduates

It is commencement season once again. Here at Harvard the gowns will be donned on May 24. It is always a celebratory event as hopeful graduates take their first steps into the next chapter of their lives. For those of us who teach it is also a time for introspection: have we prepared them for […]

Five ACO Pain Points…and How to Remedy Them

Barry C. Dorn, MD, Leonard J. Marcus, PhD, and Eric J. McNulty contributed to this post. Accountable Care Organizations (ACOs), the latest attempt to control health care costs while ensuring quality, are set to become reality in just a few weeks. Supporters believe that they have at last found the formula that that can deliver […]

Are Urgent Care Centers the Answer?

Primary care docs are over-booked. Emergency rooms are expensive. Are free-standing urgent care centers the answer that can deliver needed care while saving money? This is the question asked by Liz Kowalczyk of The Boston Globe as eastern Massachusetts prepares for up 19 such centers to open in the months ahead. “If they ‘are closely […]

It’s Time for a Public Health President

The discussion of health in the current U.S. presidential race has largely been limited to loud calls for the repeal of the Affordable Care and Patient Protection Act by Republicans. Each has competed to be the loudest and most strident to denounce “Obamacare.” Many on the left are afraid that Obama may have squandered his […]

Can Patients Ban Facebook from the OR?

A couple of years back my wife went in for surgery. Her only request to the surgeon was that healing statements be read. The surgeon generally agreed. Now should either of us need to go in for a serious procedure, I’m going insist on something else: a written pledge against the use of technology for […]