By Evan Falchuk

Pretty well, actually.

As predicted last December, there was no big change to health care reform, doctors still didn’t have enough time with their patients, Microsoft made moves to create a “Windows” for electronic health records, and “ACO” became the hot buzzword in health care.  Some state governments started major redesigns of their benefits programs, saving money in the same ways private sector employers do.  Meanwhile, more than ever, private sector employers are penalizing employees who don’t take care of themselves.

Misdiagnosis finally started to be recognized as a public health problem.  At Best Doctors we got a great deal of press coverage in 2011 on this (for a few examples, go here, here, here, here and here).  I will sneak in a 2012 prediction and tell you that you will hear a lot more about this this year, and not just from us.

What did I get wrong?

Well, I said no major employer would drop their health benefits – and none did, so I didn’t really get this wrong.  But I was surprised to hear some very major employers quietly talking about their plans for dropping coverage in 2014.  It’s a bad idea – and I would have thought its badness would have been enough to keep it off the table.  For some employers, apparently not.

I also can’t point you to signs that the health insurance system is starting to take on the bad aspects of the workers compensation system.  Instead, many of the Fortune 100 employers we work with are trying to make their benefits plans simpler and easier to use.  I’m glad to be wrong about that so far.

Here are the two biggest misses.

First, I predicted a doctor would get sued for offering medical advice to a patient on line.  It didn’t happen in 2011.  Interestingly, there was (finally) a lawsuit claiming gag orders on posting reviews of medical providers on-line were unenforceable, something I thought would have happened a long time ago.

Second, I thought that health care reform would be more popular at the end of 2011 than it was at the beginning.  According to the Kaiser Health Tracking Poll for December 2011, in January, 41% of Americans had a “favorable” opinion of health care reform.  In December?  Forty-one percent.  A better prediction would have been that no one’s minds would be changed….

For my 11 predictions for 2011, I got 8 right.  Not bad, but I have to do better in 2012.

So, for 2012, I will make only one prediction – the world won’t end on December 21, 2012.

I feel good about this one- I’m wrong, no one will be here to see.

By Evan Falchuk

Sunday’s Milwaukee Journal Sentinel published an op-ed I wrote about how you can avoid misdiagnosis.

Published studies show that rates of misdiagnosis in America are a stunning 1 in 5.The good news is there are several steps you can take to protect yourself. They start with understanding why misdiagnosis happens, how you can work with your doctor to avoid it and, above all, playing an active role in your own health care.

Diagnostic errors happen much more often than most people realize. Even doctors are not immune. According to The New England Journal of Medicine, 35% of doctors have reported errors in their own care or that of a family member.

How can this be happening in a time of such great medical advances?

How indeed.  Go to the Journal Sentinel site and find out how you can protect yourself.

By Evan Falchuk

Bill Gates once said:

Success is a lousy teacher. It seduces smart people into thinking they can’t lose.

It’s clever, and it seems right.  Now there is science to prove it.

In a study published last week, scientists studied special imaging scans of doctors brains as they made simulated medical decisions.  Those doctors who paid attention to their mistakes made better decisions than those who were more interested in their successes:

“These findings underscore the dangers of disregarding past failures when making high-stakes decisions,” Montague said in a statement. “‘Success-chasing’ not only can lead doctors to make flawed decisions in diagnosing and treating patients, but it can also distort the thinking of other high-stakes decision-makers, such as military and political strategists, stock market investors and venture capitalists.”

This is just the latest proof of how important it is to interrupt your doctor’s decision-making process.  Leading researchers in the field of medical decision-making have emphasized how easy it is for “overconfidence” to get in the way.  Doctors are neither immune to disease nor the pitfalls of decision-making that plague the rest of us.

By Evan Falchuk

Guatemala is a developing country, with great natural beauty, hard-working people and many challenges.  Most Americans look at places like Guatemala and see only the challenges.  Some see opportunity.

I’ve just returned from Guatemala, where I met with our business partners, government officials, and others.   And I can tell you a universal truth.  People across the world want the best medical care they can get.  They aren’t looking for the latest technologies and drugs and treatments – or, rather, they aren’t looking only for those things.  No, what is most important to whoever I meet, no matter where they live, is that they are able to get the right diagnosis, and the right treatment.

It’s a harder thing to get in some places than in others.  Americans don’t realize that one of our great exports is our health care.  Not our system – but our know-how, education, medications, devices, techniques.  In many ways, health care promises to be the economic engine of 21st century America.  And getting access to it doesn’t necessarily mean getting on a plane and coming to the states.  At Best Doctors this is what we do – bring the expertise of the world’s leading doctors to where – and when – it’s needed.

After a speech I gave in Guatemala one of the audience members came to me and said she thought something I said was very important.  “Every person deserves the right diagnosis and treatment,” she said.  It’s a simple concept that is much harder to make reality.  But it should be the basis on which any health care program, health care provider – or health care system – must be built.

By Evan Falchuk

What does it mean to be an entrepreneur in health care?

Twice in the last two weeks I had the honor of speaking at Northeastern University’s Health Sciences Entrepreneurs Program. It’s a terrific program, dedicated to fostering the creation of health care businesses by helping the people who build them figure out how to do it. That it exists is a testament to how strong the American spirit of entrepreneurship really is – and how the 21st century economic engine is going to be health care.

But the hundreds of students and alumni who attended the events already knew this. What they wanted to know were the answers to more practical questions – how do I know if it’s a good idea to try something? What happens if I make mistakes, or fail? Do I really need to start a business to be an entrepreneur? What opportunities does the changing world of health care create?

They’re the right questions because they’re hard. Being an entrepreneur means you’re willing to look at the world as it is and want to make it as you think it should be. It means being willing to take risks, try new things, and not being afraid to fail. In fact, if you listened to the panels of highly successful entrepreneurs, you’d think failure was a big part of what entrepreneurs do. You can’t create something new without making mistakes along the way.

At the end, we were all asked to give one piece of advice to the budding entrepreneurs.

Mine was this: Do Something Cool. Always put yourself in a position where you’re doing something that is so cool you want to tell people about it. When you don’t think it’s cool anymore, leave, and find something else that you think is cool. Don’t worry about whether it means starting your own business or working with someone else who has. Put yourself someplace where you think you are changing the world.

If you can do that, you’ll be an entrepreneur.

By Evan Falchuk

Atul Gawande says that we’re used to doctors working like “cowboys” – rugged individualists who are responsible for making sure your care gets done right.  We don’t need cowboys, he says.  We need “pit crews” – teams of doctors working together toward a common goal, with each playing their own role.

It’s an appealing idea.  Pit crew-like teams work, and work well, in trauma units across the country.

But there’s a problem: if you haven’t just been airlifted to a hospital after a horrible accident, you’re not going to be treated by a pit crew.  You’re going to be on your own, shuffled from one 15-minute specialist visit to the next, likely with no one person in charge of your care.

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By Evan Falchuk

Health care expenses are hurting businesses and governments around the world.

But why?

There are a lot of reasons, but the most overlooked is this:  people demand life-saving medical care.  There is a basic, human desire to want to live long, healthy lives.  And so, will health care be the engine of the 21st century economy?

Go to the Washington Times to read my op-ed on it.

By Evan Falchuk

Billionaire Teddy Forstmann has apparently been diagnosed with a serious form of brain cancer.  There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis.

ABC News wonders:

How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests?

They’re missing the point.  Misdiagnosis happens with shocking regularity – as much as 44% of the time, depending on the illness.

I’m sure that, as with most things, being a billionaire is better.  But as a neurosurgeon quoted by ABC News points out, even for a billionaire, getting the right care is “still a bit of a crap shoot.”

So how can you improve your odds?  Here are 5 tips that work.

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By Evan Falchuk

I’m in Israel, home to some of the most innovative care in the world.  Doctors here wanted to know if the high-tech tests that are an increasing part of their work help.  A couple of weeks ago, they published their results.

It turns out that in about 90% of cases, it didn’t matter.

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By Evan Falchuk

Government can be like the weather – everyone complains about it but no one does anything about it.

At Best Doctors we like to look at obstacles as opportunities to make things better.  In this case, I had the chance to help change an old law in Florida that made it hard for companies like ours that serve the international health insurance markets to do business.

It’s exciting to report that we got the law changed.  Now, I can also tell you that a major Florida paper, the St. Petersburg Times, published my story yesterday.

Read the story here, it’s a reminder that government really can work.