Disqus - Latest Comments for efalchuk

Re: Big-Bang Disruption - Harvard Business Review

Evan Falchuk — Sun, 10 Mar 2013 09:00:36 -0000

This is very well-done and provocative article.

An example of this dynamic is in politics in America - we have an incumbent two-party system that isn't responding to the needs of the public. A big-bang innovation in the form of a third-party movement that is engaged and responsive can make that established order disappear very quickly.

Re: Doctors: Misdiagnosis Needs Policy Attention

Evan Falchuk — Sun, 10 Feb 2013 14:12:21 -0000

Wow, Trisha, yours is an amazing story. I have of course read about it before, but every time it hits me: what would have happened if you didn't have the moxie to do what you did? It's why it's so important that stories like yours are shared so patients can not only feel comfortable asking questions, but also understand how hugely important it is to do it.

I think doctors really do want to listen - and so many of them do. It's just that they have to work in conditions where you are one of 20 or 30 patients they will see that day. Much of that is a result of policy decisions of the last few decades which hugely undervalue doctors' judgment and the doctor-patient relationship. That needs to change!

Evan

Re: Why isn’t anyone talking about misdiagnosis?

Evan Falchuk — Mon, 01 Oct 2012 15:24:08 -0000

Hi Mike,

It's true that the fundamental problem is that revenue is driven by quantity - not quality. It's why doctors are seeing 30 patients or more a day, and that the quality of care they are able to deliver suffers. It's an untenable situation.

I had the good fortune of working with legislators on both sides of the aisle in Massachusetts to create the first-ever Task Force to study and make recommendations on the problem of diagnostic accuracy. That a state government is taking leadership on this is an encouraging sign.

I emphasize the importance of measuring how often this problem happens because while published studies show misdiagnosis happens distressingly often, there are no standardized data sets on diagnostic accuracy for hospitals or doctors- like there are for process measures like how quickly aspirin is prescribed to potential heart-attack patients.

As the Vice-Chairman of a company that serves 30 million people in more than 40 countries I've got a pretty good sense of the intersection between medicine and business and government - and it's a mix that isn't working very well. If you think about it, if somehow misdiagnosis disappeared tomorrow it would sort of undermine what we do as a business...but this is a public health problem that requires important changes to the way we think about health care. As with many things, the first step to finding good solutions is to recognize there is a problem.

Evan Falchuk

Re: Why Health Care is Not a Consumer Business

Evan Falchuk — Tue, 29 Nov 2011 17:02:19 -0000

Thanks, Fred.

The speech is better in the original, Klingon, version.

Evan

Re: Empowered Patients Get Better Care

Evan Falchuk — Sat, 30 Jul 2011 13:14:47 -0000

Yes, these are all euphemisms, aren't they. Calling doctors 'providers' is great because you get to bunch them in with nurses and other health care professionals, and treat them all the same way....

Re: My Speech on the Intrepid

Evan Falchuk — Mon, 06 Jun 2011 12:10:28 -0000

Thanks so much. The band is great and their work even more so. I'm glad to spread the word about them.

Evan

Re: The Doctor is…Overbooked

Evan Falchuk — Thu, 26 May 2011 12:27:29 -0000

This is definitely a trend, and it works for patients and doctors. On the other hand, if you think of it from a public health standpoint - we simply don't have enough doctors.

Re: The Doctor is…Overbooked

Evan Falchuk — Thu, 26 May 2011 12:26:04 -0000

Thanks!

Re: A Patient is Not a Shunt

Evan Falchuk — Mon, 28 Feb 2011 11:33:57 -0000

Totally agree, Jose. There is no replacement for advocating for yourself, or doing it for a loved one.

Re: How Miracles Happen

Evan Falchuk — Mon, 28 Feb 2011 11:32:50 -0000

Great, Carolann. Thanks for sharing this!

Evan

Re: A Patient is Not a Shunt

Evan Falchuk — Sun, 06 Feb 2011 10:03:12 -0000

Good question - Lou's got the iPhone 4, via AT&T...

I think there's something to what you're saying David. At the end of the day, the problem was that the doctors had decided that the cause of the problem was the shunt, and so they tried to explain everything in that light.

These were smart, highly trained doctors at one of the best hospitals you could go to - but Carlos still ended up in this situation.

As ever, if you or a loved one is sick, advocate for yourself.

Evan

Re: A Patient is Not a Shunt

Evan Falchuk — Sat, 05 Feb 2011 09:13:54 -0000

Hi Sean, I've never heard that, either. But you seem to have missed the point.

Lou with the iPhone is the hero of the story, but not because of his technology. Rather, it is because he asked a thoughtful question.

Indeed, Lou was not even the doctor responsible for Carlos' care. He was just a friend who happened to be visiting at the right moment.

The treating team, with all of their technology, had decided that all roads led to the shunt, and had given up thinking about the case.

That created unnecessary suffering for Carlos- something which could have been avoided by spending some time thinking, and looking at Carlos as a whole patient.

It's one of the important drivers of medical costs. It's easy - as in this case - for a doctor to just order a diagnostic test, rather than spending more time thinking about what could be going on.

Our system doesn't value thinking, and we end up paying for it in avoidable care, and unnecessary suffering.

Evan

Re: Superficial Drivel!

Evan Falchuk — Wed, 26 Jan 2011 14:13:43 -0000

That's funny, David, thanks!

I agree - there are some good comments there. You should go add one of your own. Of course if any of the people there want to talk here, that works, too.

Evan

Re: The Benefits Package: New Year's Edition

Evan Falchuk — Mon, 10 Jan 2011 08:58:03 -0000

Great, job Hank. What a terrific collection of posts. Congratulations.

Re: Why is Health Insurance So Expensive?

Evan Falchuk — Wed, 05 Jan 2011 12:31:54 -0000

Good article, Nancy.

Of course the kinds of mini-med policies you wrote about are approved by insurance regulators, whose job is supposed to be consumer protection. The system doesn't work very well.

You are correct -- if you're going to have guarantee issue, you also have to have an individual mandate. Otherwise the system doesn't work.

One can reasonably ask whether guarantee issue is the right solution to the problem in the first place....

Evan

Re: Why is Health Insurance So Expensive?

Evan Falchuk — Wed, 05 Jan 2011 07:37:04 -0000

Hi Nancy,

Of course, no one would want to buy a policy like that!

The trouble is that the insurance regulatory system in the United States is archaic and bad for consumers. We have 50 state regulators and each one sets its own rules as to the content of insurance policies.

One of the promising things about the reform law is that the exchanges it sets up will have a national scope. Unfortunately, it seems as if the federal government is planning to regulate policies sold on the exchanges in the same way that the states do now. That's not really progress.

It's ironic because you would think that America is the home of free market capitalism, but it's not so in insurance. In other developed countries, like Canada, the government takes a different approach to insurance regulation that allows for far more innovation, competition and creativity.

Evan

Re: Benefits Package due to arrive here on the 10th

Evan Falchuk — Mon, 03 Jan 2011 11:59:22 -0000

Good luck Hank!!

Re: McCarthyism at the Washington Post!

Evan Falchuk — Mon, 03 Jan 2011 10:29:52 -0000

Thanks, Michael!

You're right, these definitions have evolved over time. It's why I think all of us with our megaphones should point out when someone uses a false premise to make an argument.

I liked your post a few weeks ago on the Virgina decision (and the fact that you wrote it in flight - while actually involved in interstate commerce....)

Evan

Re: 11 Predictions for 2011

Evan Falchuk — Fri, 31 Dec 2010 10:39:01 -0000

Interesting find, Michelle, thanks for sharing that!

Re: 11 Predictions for 2011

Evan Falchuk — Fri, 31 Dec 2010 10:37:52 -0000

Thanks- you raise a very interesting point on the difference between a PHR and an EHR.

If PHRs take off, and I'm an EHR developer, I better make sure my EHR connects easily to the popular PHRs...which brings us back to Google and Microsoft.

I'm betting there will be a standard for PHRs before there is one for EHRs. Well, I'm not betting, I'm just publicly saying it which is more risky!

Evan

Re: The Secret to the Virginia Healthcare Decision

Evan Falchuk — Thu, 23 Dec 2010 11:10:25 -0000

Hi PharmerJ,

You're making a policy argument, not a legal one. The Supreme Court would tell you to take that argument to the voting booth, or your Congressman.

Now, of course Farmer Filburn wasn't expressly being fined for *not* doing something.

But you can reason out that he actually was. In other words, the fine was really about his failure to go to the market and buy wheat, which is what the government wanted him and all other farmers to do in order to combat the demand-killing deflation of the Depression.

Good idea, bad idea, whatever, the federal government has the authority to do that.

Now, with health care reform, I'm also not saying I think it's a great idea - you should read what I've written about it. But these policy questions are not relevant to the legal analysis. In that analysis, something like the reasoning I've stated here is what the Court is going to say about the individual mandate.

Evan

Re: The Secret to the Virginia Healthcare Decision

Evan Falchuk — Wed, 22 Dec 2010 12:45:44 -0000

Hi killroy71 - It's a clever turn of phrase. But these are two very distinct issues.

Selling insurance is surely "commerce;" requiring someone to buy insurance, well, that's the open question here.

Re: 11 Predictions for 2011

Evan Falchuk — Thu, 16 Dec 2010 10:26:23 -0000

Hi Michelle, I was surprised to not find a case, either. It doesn't mean there hasn't been a case where it's part of the story, but there's been nothing that's gotten the kind of media attention that you know will happen when there's a straight on "patient follows doctor's emailed advice and dies" story. That's going to be all over the news.

It will be interesting to see what happens with the EHR market. I think that some clever company will come up with something good, and then they will get bought up by Google or Microsoft...or copied. Think of what Facebook "Places" is going to do to Foursquare and Gowalla.

Thanks for reading and for the link to your interesting post!

Evan

Re: The Benefits Package is Here

Evan Falchuk — Mon, 06 Dec 2010 13:15:40 -0000

Thanks, Hank!

Re: Why the Pre-Existing Condition Insurance Plan (PCIP) fails

Evan Falchuk — Sat, 04 Dec 2010 10:56:06 -0000

Ray,

Thanks for the very good post.

The cost may be too high for the target market, but for what you get from the PCIP, it looks like a good deal to me.

Maybe I am a cynic, but I think this PCIP plan is a giant loophole in the reform law.

It makes it easy to force insurers to accept people with pre-existing conditions, while making sure they end up insuring very few of them indeed.

More here: http://bit.ly/cKPsfs

Cheers,

Evan Falchuk