Past Letters

Choosing Wisely®: It is All About the Conversation

From our communications research, we’ve learned that one of the most difficult challenges physicians say they face in talking to their patients about why a test or procedure is not necessary or will not alter a treatment plan is they simply don’t have enough time during a regular office visit. They often say that if... Read more »

The Words Used to Talk About Use of Resources: What Do They Tell Us?

The words we use to talk about the use of health care resources makes a difference in how we engage physicians, clinicians and patients in thoughtful discussion around the economic sustainability of the current health care system.  These conversations must happen — without hysteria and political motivation. We need attitudinal and political changes before we... Read more »

Stuck in the Muddle of Fee-For-Service Medicine

I was once at a meeting where I heard a national health business leader liken providing additional incentives in a fee-for-service system to putting broccoli on a Big Mac. His point — a volume-based reimbursement system can’t be cured by some incremental bonus plan. While we continue to structure our delivery system around fee-for-service, health... Read more »

The $640 Billion Question

On May 18, Victor R. Fuchs, PhD and Arnold Milstein, MD, MPH published a perspective in The New England Journal of Medicine, titled “The $640 Billion Question –Why Does Cost-Effective Care Diffuse So Slowly?”  I highly recommend reading it. $640 billion is the amount of money saved if health care costs were lessened by 20%... Read more »

My EKG

I rarely get sick and have no known disease. I’m fit as a fiddle for an aging male. I jog four times a week and have strong vital signs (blood pressure is 120/70). I have no family history of heart disease. Besides complying with adult screening recommendations and vaccines, I only see a doctor when... Read more »