By Evan Falchuk
Here’s a round-up of some recent posts worth reading from around the web:
1. Market failure -> New entrants?
Paul Levy is the CEO of Boston’s Beth Israel Deaconess Medical Center, and he blogs regularly about how he sees health care from that perspective. He is always insightful and candid in his observations about health care. In this post, you can read how the uncompetitive market for private insurance looks from the perspective of the CEO of a major, Harvard-affiliated teaching hospital. By the way, although he never mentions who the “dominant provider,” he means Partners. And although he never says who dominates the Massachusetts insurance market, he means Blue Cross Blue Shield of Massachusetts.
One quibble I would have with Levy is this. He’s right, the BI Deaconess is at a disadvantage compared to Partners in terms of its negotiating leverage with Blue Cross, but the BI Deaconess is still one of the best hospitals with some of the best doctors in the world. Perhaps it’s more of a statement of the high quality of academic medicine in Massachusetts that a hospital like his can be considered second to anyone. I’ve posted previously on some of Levy’s good work on health care quality here.
2. Duty Hours, the ACGME and the Surgeons.
At Medrants, Dr. Robert Centor talks about how well-intentioned duty-hour limits on surgical residents are leading to a poorer quality educational experience for surgical residence. It puts the quality of care these doctors will deliver at risk. Money quote from Dr. Centor:
I want a physician who trains in a tough, demanding residency. You cannot learn medicine without appropriate volume. No one makes you become a physician. If you want a less stressful residency, then you can choose one.
He thinks residents should be able to choose, rather than being placed in a one-size fits all kind of a program. He still thinks we may be surprised at what kind of training most would prefer.
3. Reality Check: Doctors Can’t Fix Everything.
On the Commonhealth blog, Dr. Annie Brewster writes a heartfelt and meaningful post about how sometimes there are no easy choices – or good answers – in medicine. She says she is writing the post as much to convince herself of her point as she is her readers, which I think is always a sign you are about to read something very thoughtful. Go there and read the whole thing.
4. Why Errors Happen.
A new study takes strides in creating a taxonomy of diagnostic error in medicine. This was interesting. A study was performed that asked doctors to recall instances in which they had made diagnostic errors, and to classify what the cause of the errors were. Three quarters of all errors were either because the clinician neglected to properly order a follow-up, or because the clinician failed to properly assess data.
5. Should the character in “Glee” that uses a wheelchair actually be played by an actor who uses a wheelchair?
I have no idea. But I feel obligated to link to any story about my brother’s show that is published in the “Health” section of a major national newspaper. By the way, the character, named Artie, is played by an actor named Kevin McHale. No, not that one.
6. Did you know?
Did you know that outside of Washington, DC, on September 1, 1926, a baseball team made up of Ku Klux Klansmen played a game against a team of local Jewish all-stars?
You do now. The Klan won, 4-0, but the game was called by rain in the 7th inning.
