Hi There Mr. Elephant–Let’s Talk about Health Stigma & Privilege

Part 1 of a 3-part series on health stigma and healthy privilege. This post has been kicking around in my head for nearly a month now, the product of conversations with clients, chats with friends, and a professional life in

A Caregiver’s Gift: A Film on Hospice and Palliation

Sometimes the best medicine involves a departure from exhaustive treatment. This wisdom was personally learned by one of OccupyHealthcare’s own contributors, Mark Dimor, whose wife, Donna, experienced Stage IV non-small cell lung cancer. Informed that Donna would have six months

Come Together Right Now: The Mental Health Field Must Unite

Come Together Right Now: The Mental Health Field Must Unite This post was written by Dr. Misty Hook, and was originally published on the Counselling Resource website. It is a followup to her post, The Pay is the Thing. A

The Pay is the Thing: Re-evaluating Mental Health Reimbursement

This post was written by Dr. Misty Hook, and was originally published on the Counselling Resource website. A licensed clinical psychologist in private practice in Texas, Dr Misty Hook received her PhD in counseling psychology from Ball State University. She

Hospitals Evals Are Going Social

For the savvy medical observer, it is commonplace to refer to industry standards of hospital quality in choosing one hospital over another. Those quality measures are set forth by trusted indicators, such as the Hospital Consumer Assessment of Healthcare Providers

Putting the United State healthcare in international context

Just when you thought reports highlighting the US healthcare system could not be more damning, a new report emerges showing that “Americans die sooner and experience higher rates of disease and injury than people in other high-income countries”. Good morning

Let me help: An open letter to the healthcare system

Dear healthcare: I want to help you; really, I do. You see, when tragedy strikes all around us we often look to you. Sometimes in that quick glance we see you as the problem. But yet, more often we look

Complexity in healthcare

“Out of intense complexities, intense simplicities emerge” – Winston Churchill Why is healthcare so complex? Why is transformation in healthcare so hard to achieve? The great healthcare policy mind, Dr. Paul Starr, has written extensively about healthcare. If you are

The Quantified State

While the throngs of zombies, ninjas and superheroes awaited Halloween with baited breath, the health policy wonks of Colorado awaited the following morning for the release of something just as sweet… the Colorado All Payer Claims Database. The release of

What we are about: Occupy Healthcare

A little over one year ago, this website was started in an attempt to become a “location where the community can come to discuss healthcare.” We wanted a “place where meaningful healthcare issues can be raised and worked on together.”

Health insurance and the high deductible option

It has been made very clear that if we do not begin to address the rising cost of health insurance premiums, no one in the middle class will be able to afford any coverage. Consider the following from the Robert

Enhancing healthcare access

What good is health insurance if there are no providers to access? Are we working towards enhancing healthcare access? In a recent article published in the Annals of Family Medicine, authors found that extending office hours can help lower overall

Changing the patient-centered dialogue: Moving the conversation from why to how

Healthcare increasingly has been built around the wrong things. We enhance electronic medical records when the records themselves are mainly built around maximizing revenue (not the patient). We build new healthcare facilities when these buildings simply are another place for

The real pink slip: Giving fakes the boot

This month we have been greeted by the perennial pink ribbons adorning all manner of products and services, enticing consumers to support breast cancer awareness month. This form of marketing has become so ubiquitous that many so-called charities and ostensibly

You can’t square a circle: Healthcare and the economy

Healthcare and the economy are inextricably linked. Simply put, by taking care of healthcare we can positively impact the economy (and vice versa). But yet despite these being inseparable, we sometimes fall guilty of separating out healthcare and the economy

Resources for the revolution

Changing healthcare is a difficult proposition. Here at OH, we spend a lot of time connecting dots. We connect patient stories to policy and we connect larger healthcare policy issues to the evidence. We do all of this because we

Taking primary care to the next level?

How can we take primary care to the next level? Do we need to? It is well established that there is shortage of primary care providers in the country. From the Agency for Healthcare Research and Quality (AHRQ): “In 2010,

My take on healthcare: Wayne Caswell

Many of you who follow this site know that call to action was sent out by Dr. Mark Ryan. Essentially, Dr. Ryan asked readers of OH to share some of their ideas about healthcare and health reform. Below is one

We must change how we pay for healthcare

Is it possible to change how we pay for healthcare? At the center of almost all efforts of healthcare redesign is the need to simultaneously change how we pay for healthcare services while changing how we deliver those services. The

Are we good stewards of healthcare?

Are we good stewards of healthcare? How well do we manage our healthcare resources? In the latest report from the Institute of Medicine, the issue of waste in healthcare was highlighted. The report, entitled “Best Care at Lower Cost: The Path

#HCSM review: Who’s missing in HCSM?

I was surprised when I was asked last week to be the host of this week’s Health Care Social Media Review. I do technically have a blog, but I’m much bigger on guest posting than I am on maintaining my

Storytelling in healthcare

How important is storytelling in healthcare? With any attempts to make change, there is a story helping “ignite the flame“. From Dr. Atul Gawande: “In every industrialized nation, the movement to reform health care has begun with stories about cruelty.

Call for submissions: Who’s missing in HCSM?

So, it looks like I’ll be hosting the next edition of the Health Care Social Media Review (HCSM Review) next week, Wednesday, September 5th.  HCSM Review is a bi-weekly blog carnival for everyone interested in health care social media.  Its

Why healthcare workforce issues should matter to everyone

What healthcare workforce issue? Imagine this, you are new to healthcare insurance. For the first time in your life you are going to be able to go see a provider without worrying about if you can afford the outcome of

Healthcare innovation and social media

How can we connect healthcare innovation and social media? When I asked myself this question, the only answer I could come up with was that we already have. Consider the following example: #hcsm, or Healthcare Communications & Social Media:  This

It just doesn’t add up: Saving premature babies only to risk their health later

By Deb Discenza Each of us knows someone that had a preemie and a tale to tell about the roller-coaster of the early birth.  The stories often liken preemies to warriors and fighters as they struggle to live against all

The history of the American railroad system and why this matters for healthcare

What does the history of the American railroad system and healthcare have in common? Growing up, I always found trains and the railways to be fascinating. I remember my Uncle had a model train set in his basement that weaved

Integrated healthcare and its importance: Separating the inseparable

In today’s healthcare climate, policy makers are looking for ways to create a more efficient and effective integrated healthcare delivery systems. We have Accountable Care Organizations that are trying to pull partners together to hold each other accountable for the

Decisions, decisions, decisions

Some of us may take it for granted that we have health insurance. Having a consistent peace of mind that comes with knowing no matter how sick we are we have some form of coverage that assures that not all

Occupy medical and healthcare knowledge

Have we begun to bend the cost curve in healthcare? Will this continue? And how can we make it a great reality? Steven Tucker, MD linked to a recent article in The Atlantic titled, ‘The Exponential Growth in U.S. Health-Care

Immunizing ourselves from ourselves

For the uninitiated, August is National Immunization Awareness Month. It is a time for parents to think ahead about the new school year and to prepare their children by getting them up to date on their shots. It is time

The change we need: hospice and palliative care, and patient empowerment

From Mark Dimor: My key reform would be to emphasize palliative and hospice care, because it has a huge impact on the care of terminally ill patients, and those who are the caregivers and survivors. It is important that more

The change we need: universal healthcare

From Carmen Gonzalez: One of the core reasons for health care reform was to stop the runaway train of rising health expenditures. Those costs won’t level off until everyone is covered and the middle-man (a.k.a. insurance companies) are taken out

The change we need: what next?

It has been nearly a year since the Occupy Healthcare community came together.  During this time, we have sought to demonstrate the flaws in our current healthcare system: lack of integration, lack of patient focus, lack of coordination, inefficiency, etc. 

To go or not to go, that is the question

Healthcare is expensive. In fact, if you do not have health insurance, healthcare may seem like a luxury; something you would like but cannot afford. If you have no health insurance you sometimes have to make difficult decisions about your

How doctors should talk to your son…and to you

A recent post on our blog highlighted the challenges patients all too often face when they are communicating (or attempting to communicate) with physicians.  As a doctor, and as a teacher who has as a goal training empathic, patient-focused, humanistic

A history of reform: Political pundits or patients?

Attempts to change healthcare are not new to this day and age. It just takes a minute to see where the trends emerge throughout our history as our country has tried to work on healthcare. For an exhaustive timeline of

Medicaid, Mortality, and Massachusetts

In a recent study out of Harvard, researchers found that when Medicaid is expanded, and more people are covered, fewer people die. This is a good thing, right? As has been discussed many times on this website, health insurance is

Personal doctoring

Having a meaningful relationship with a personal physician or other healthcare provider can improve patient health outcomes; however, achieving and sustaining these type of relationships are often not possible in the current healthcare system. But yet in the face of

Communication: The cornerstone of healthcare

Communications and sharing of information between HCP (healthcare providers) and patients is a fundamental building block of good patient care and key to improving our healthcare system. The gold standard for this type of communication is shared decision making  (SDM).

When tragedy strikes close to home

I live in Denver. I work in Aurora. I know exactly where the Century 16 theater is located; I live approximately 8 miles from there. When horrific scenes like this unfold as they did last night and this morning, it

If it is a problem, why don’t you have a solution?

Just about three weeks ago, the Supreme Court ruled that the Patient Protection and Affordable Care Act (ACA) was constitutional in its requirement that all Americans have health insurance.  However, the court also decided that the ACA’s expansion of Medicaid

The passion to change healthcare

What is your passion? For some, their passion is changing healthcare. Take for example today’s story – the third in our series and partnership with the Health & Justice project. Dr. Myron Glick, founder of Jericho Road Family Practice, shares

Why behavior matters in healthcare

When was the last time you went to your healthcare provider and you walked away with nothing to do? Chances are even if you were the epitome of “good health,” your provider likely encouraged you to “keep eating healthy” or

Taking advantage of Medicaid to make a political point

It’s no surprise that politics are being played with Medicaid. As we have discussed before, there is a history of playing politics with Medicaid. This is nothing new; however, subsequent to the Supreme Court Decision last week, we are about

The challenge of health insurance

Navigating healthcare is a challenging proposition. When one considers the often necessary role of health insurance in accessing healthcare, it becomes increasingly complicated and challenging. From previous studies, like those done by the Rand Corp. in the 1970s, we know

The everything to your nothing

Sometimes those in front of the cameras and those writing for the press get the most attention. For example, part of what we decide to write about each day on OH usually comes from something we read somewhere in the

Your Affordable Care Act Toolkit: Preparing for the Assault

As my esteemed colleagues have written on this topic about what was passed and what lies ahead (see Ben Miller’s post and Mark Ryan’s post), there remains a need describe what to do. Below, I have indicated the likely scenario

Be prepared for the battle of misinformation

Yesterday’s monumental Supreme Court (SCOTUS) decision assured us that there indeed would be an ongoing health reform effort in this country through the Patient-Protection Affordable Care Act. Dr. Mark Ryan has written extensively about the decisions of yesterday also on

The healthcare aftermath of June 28, 2012: What we protected, what is missing, and what we still need to do

Yesterday, the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). After nearly 2 1/2 years of partisan misinformation, the Court has established the law’s legitimacy. This is an enormous step forward. The PPACA incorporates

Occupy Healthcare is not for sale

Every so often, we at Occupy Healthcare receive an email asking us for a guest post spot. Sometimes these posts are great, but all too often they see the Occupy movement as an opportunity to hawk their wares, promote their

A rebel with a clue

Transforming healthcare will take time, energy, and the knowledge to know what to do. There is no doubt that we are taking our revolution to a new level in healthcare. We are challenging the status quo whether that be in

Keeping it simple

Creating a healthcare system that is centered on the needs of patients and their families is a key to the kind of transformation that is needed in the United States.  Patient-Centered Care is both very simple and very complex.  Creating

The “token” patient

Being patient-centered is all the rage. Healthcare organizations make a big deal about having “patient involvement;” We have an entire center focused on patient-centered outcomes; We see federal agencies releasing reports on patient-centered care and empowerment; and, We even have

Healthcare affordability, please

In a recent poll conducted by Harvard School of Public Health, 14% of sick adults in Massachusetts were unable to get the healthcare they needed in the past year. Further, “more than 7 in 10 of those who said they

Why politics and SCOTUS will not interfere (too long) with healthcare innovation

It’s impossible to avoid all the politics in the news surrounding the Patient-Protection and Affordable Care Act. Since its 2010 passage, we have had political parties fighting to maintain and to repeal the law. And now, we have the Supreme

Innovation can be hard: The importance of having help and resources

Here at Occupy Healthcare, we recognize that we all need to work towards changing healthcare, but sometimes change can we hard. While we talk about complex health policy and systems issues, we understand that these changes are not simple and

What do we do about mental health?

We talk a lot here at Occupy Healthcare about the importance of redesigning the healthcare system. We have discussed in great detail the importance of primary care and the need to have robust primary care services to truly help impact

Plugging the holes in a sinking ship

The U.S. healthcare system is a complex beast.  There are some aspects that are really, really working and others that are really, really not working.  Mostly it depends on your perspective, whether you have good health insurance and can afford

Our need for immediate gratification in healthcare

Sometimes in healthcare, our need for immediate gratification causes more problems than solutions. We want something “fixed” instantly and want care available “immediately” regardless of the cost or effectiveness of the treatment. We are a society of “now.” Technology has

A new payment model? The push for single payer state by state

In case you haven’t been keeping track, the movement for single-payer health coverage has been characterized by a series of close encounters with success, only to be trumped by the narrowest margins of failing political will. The most recent debacle

Healthcare workforce (and access)

There are over 11 million individuals employed in healthcare, and 5 million of these healthcare professionals are providing direct care. This massive workforce continues to grow, but yet we still have issues with access to healthcare providers in our communities.

Help! My patient’s suicidal: How the US healthcare system is failing people in acute crisis

DocForeman: I’m here with Dr. Bill Schmitz, Licensed Psychologist, Suicidologist, and past board member of the American Association of Suicidology. Dr. Schmitz is a recognized national expert on suicide and primary and mental health care integration. Dr. Schmitz, if you

Health 2.0: Who’s not at the table?

Health 2.0- Who’s Not at the Table? On May 14 and 15 of this year, I had the opportunity to attend the Health 2.0 Spring Fling conference in Boston, MA. According to their website, Health 2.0 is about bringing “together

Experiencing the healthcare system when you are sick can be a different story

For those who have not had the time to dig into the survey results from yesterday’s NPR, Harvard School of Public Health and the Robert Wood Johnson’s “Poll: Sick in America,” do yourself a favor and do. The poll examined

The march

Like soldiers marching, we each charge ahead to our own cadence. And like soldiers, we have a mission. Our goal and focus is to be seen, heard, treated with respect and to be happy and healthy. No matter where we

Looking at what’s to come: Accountable care organizations

Accountable Care Organizations (ACO), according to NPR, takes “up only seven pages of the massive new health law” yet has become one hot topic in healthcare circles. What are ACOs and what implications do they have on the community? Well

Healthcare is a team sport

In healthcare one of the key issues we often have to address is fragmentation. When we deliver care, often we do it in silos with little or no incentive to work with other disciplines. Much of this behavior is driven

The primary care love affair

Here at Occupy Healthcare we spend a great deal of time talking about primary care. There are many reasons for this, but the main reason is that primary care is the largest platform of healthcare delivery in the country. When

Access to health information

Access to information for patients and their family members is one of the most important steps in the transformation of the U.S. healthcare system.  Increasingly patients want access to information about their own healthcare. There may have been a time

Supporting the cause: The importance of research and partnerships

For the past several posts, we have discussed the importance of stories in moving healthcare policy. Each of these stories are precious and deserve to be told and heard. Policy makers often take great comfort in knowing what is really

Healthcare leaders from near and far must innovate together

In a recent article in the Atlantic on why our “best and brightest” end up in Silicon Valley and not Washington, D.C., the author describes a shift where historically the “up and coming” would enter politics to make a difference,

Introducing “Our Stories”

Here at Occupy Healthcare we have always been about transformation. We know that creating the healthcare system the community deserves is obtainable, and we want to work collectively towards that system. Our team has spent considerable time discussing the importance

Changing practice is hard: The AHA case study on meaningful use

When the news hit that that the over 80 percent of hospitals have yet to achieve the requirements for the first stage of meaningful use, the blogosphere erupted. However, what garnered more attention is what came next when the American

The primary care cooperative extension service and beyond

Discussions around healthcare usually come back to the importance of primary care. We have written about primary care extensively on this site, and one cannot look through the news of late and not see primary care somewhere in the conversation.

Five things healthcare leaders can do right now

Transforming the U.S. healthcare system may seem like a daunting task; however, there are steps that can be taken now that can help further change and transformation. Here are five things healthcare leaders and organizations can do right now: 1.

The Clementi case and the desperate need for a criminal justice paradigm shift

Violence is a critical public health issue and one that contributes to an astounding number of years of life lost, with homicide and suicide among the top 5 causes of death for those aged 1-44. Yet our response to violence

The cost depends on the value

Does the cost depend on the value? Today, Medscape released the results of their 2011 survey of physician compensation: I share this post here to point out the discrepancy in physicians’ average salaries based on their specialties.  In particular, I


Sometimes news items pop up that remind us why we so desperately need change in healthcare. Many of you may have seen the New York Times article: “Debt collector is faulted for tough tactics in hospital.” If you have not

The kryptonite to money in politics: Stories, stories and stories

Ah yes, kryptonite. For those not as familiar with Superman lore, allow me to explain. First of all, Superman for all intents and purposes is invincible. He is the “man of steel” after all. However, this all changes when he

It was Professor Plum in the observatory

In healthcare, sometimes we look for someone to blame. This is not uncommon. Blame happens in all walks of life. The assignment of “fault” to another individual; the need to point a finger. Whose fault is it that healthcare is

What’s in a name?

There is power in a name. There is power in branding that name. There is power in recognition. When we started Occupy Healthcare, we did so because we wanted to bring attention to so many of the issues plaguing us

Returning to our roots: Healthcare in our community

Not too long ago in the history of our country, there existed physicians who would travel around seeing patients. These physicians would do such things as make “house calls” or “home visits”. They were there in the home when the

Rural health, primary care and the importance of workforce

According to the Agency for Healthcare Research and Quality (AHRQ; 2011), in 2010, there were approximately 209,000 practicing primary care physicians in the United States. AHRQ reported that of the 624,434 physicians delivering direct patient care only less than one-third

In support for a better tomorrow

Healthcare as we know it will change. The above picture was modified from a PowerPoint created for the Patient-Centered Primary Care Collaborative (PCPCC) to show how the current system (usual care) is fragmented and incapable of truly meeting the needs

The black hole known as the emergency room

Spend enough time in healthcare circles and you will find that folks talk a lot about the “ER”. Yes, the emergency room, one of the most costly places to receive healthcare services in the entire US healthcare system. From the

We know how to be patient-centered, we just forgot

If you ask any random person on the street who the healthcare system is built around, they are likely to tell you many things, but very few of them will tell you the system is built around the patient. The

Moving pictures: Healthcare and “data viz”

My older brother got all of the drawing talent. I remember watching him – when I wasn’t being shooed out of his room – occasionally glance down at his Topps football card of Lynn Swann and gradually turn a blank

Healthcare is a moral issue

Have you considered if healthcare is a moral issue? With recent arguments made in the Supreme Court about the constitutionality of the 2009 healthcare reform law, it is time to again consider this question. Arguments in the Supreme Court primarily

National Public Health Week April 2-8, 2012: A Healthier America Begins TODAY. Join the Movement!

National Public Health Week kicks off today! Let’s start with the basics: what is public health? Ultimately, public health is about prevention at the population level. As the Johns Hopkins Bloomberg School of Public Health’s motto so fittingly states, public

Reintegrating healthcare: Primary care and public health

Those of you who visit this site often know that we often highlight the importance of primary care and public health (amongst other things). One of the reasons we do this is that 1) primary care is the largest platform

Spider-Man, the Fantastic Four and President Roosevelt’s almost healthcare revolution

Growing up, I remember reading comic books that went something like this: “What if Spider-Man joined the Fantastic Four?” The premise of these books was to take an idea that was pretty solidified in the comic book world (e.g. there

Fee for service (whether or not it works)

Much of the current healthcare payment system is built around what is known as “fee for service”. Chances are that many of you in the healthcare sector are very familiar with what this means, but for those of you not

Humanizing healthcare

One of the core principles of Occupy Healthcare is that “patients, families and communities should be at the center of all healthcare.” In many ways over the last several decades patients and those who support them have been marginalized in

The ongoing political battle for healthcare

As much as we talk about the importance of changing healthcare policy on this website, there remains the underlying fact that healthcare is a highly volatile political issue that is often thrown around political circles with reckless abandon. While there

The story on all our backs

This past week while on a trip to Washington DC, I had the opportunity to visit Regina Holliday’s amazing “73 cents” mural. For me, this is something I had always wanted to do since learning of Regina and her story.

The four critical items we must address to change healthcare

One driver of problems we see in healthcare is fragmentation. There is fragmentation between the patient and the provider; There is fragmentation between systems (e.g., mental health);and There is fragmentation between primary care and specialty care. If you want to

“Feel Rich – Health is the new wealth”: Moving beyond raising awareness to creating culture change

In our attempts to encourage people to lead healthier lives, we often make the mistake of bombarding them with facts and stats, do’s and don’ts, assuming the problem is a lack of knowledge. But let’s be honest – most people

How much do you cost?

Have you ever thought about your “financial footprint” on the healthcare system? Yes, unless you are invincible at some point of time over the past months or year you have likely sought out some type of healthcare service. Some of

Decisions, decisions, decisions

In the current political climate, healthcare is often brought up as a talking point. It is brought up to point out the flaws of the “other persons” healthcare plan, and it is brought up because it is a highly sensitive

Vermont: Everybody In…Well, Not Yet

Free from the tyranny of health insurers combined with the unity of coverage for all sounds a lot like Vermont’s ethos. “Freedom and Unity” is the state’s motto, so it should come as no surprise that they are taking the

Connecting to your community

How well do you know your community? Sure, there are your neighbors and the like, but how well do you know the health of your community. Do you know the areas that have better health? Poorer health? Do you know

Sometimes the connection really matters

In healthcare, there are new technologies and innovations that emerge almost daily. Science and advances through our research have made our healthcare system cutting edge in with technology. Consider the increase in mobile health; What about our increasingly sophisticated electronic

Healthcare and the Airlines

There has been much talk over the last several years of the need to bring more of the quality initiative and approaches to safety that have been so successful in the airline industry into the practice of healthcare.  The notion

Regina Holliday: Truth is Truth to the End of Reckoning

Regina Holliday tweeted earlier:  “#occupyhealthcare If you want to find one of the worst ways we are failing the 99%, start looking into autopsy rates nationwide. #EBM” So being the curious, one, I asked for Regina to educate us. Here

Reforming Our Healthcare System *MUST* Include Expanding Access to Care

Without significant changes, healthcare spending in the United States (already one of the highest rates in the world per capita) will continue to increase at an unsustainable rate (PDF).  Whatever one’s opinion of the Patient Protection and Affordable Care Act

Innovation, innovation everywhere

Look around you. When was the last time you recognize something innovative in healthcare? The Harvard Business Review has an entire section of posts looking at innovation in healthcare. The Agency for Healthcare Research and Quality (AHRQ) has an Innovations

Satisfied with healthcare? If not, do something.

Are you satisfied with healthcare? Haven’t we had enough talk? Aren’t there enough facts? Something needs to be done, and it is up to you. Actually, it is up to us, but I am starting with you because you are

Occupy healthcare and palliative care: Part three – high quality and affordable healthcare lives in palliative care

Returning to my review of palliation and how it can lower cost and improve care for patients with serious illness. Again my thanks to Diane Meier, MD, PACP, Director, Center to Advance Palliative Care at the Mt. Sinai School of

Healthcare (re)design

You get up early in the morning and you work all day. That’s the only secret. – Philip Glass The healthcare system needs your help. You see, the system as it stands is fundamentally flawed it its design. The system

Kick the can: A possible model for occupy healthcare’s next step?

The recently launched “Kick the Can” website, a project of the California Center for Public Health Advocacy aiming to “give the boot” to sugary drinks, is cleanly designed, intuitive to use, and provides important and actionable information organized into the

The value of two votes: California’s story

Last month, California came close to passing Senate Bill 810, otherwise known as the Medicare for All bill. It would have created a single-payer healthcare system that covered all Californians and eliminated the need for healthcare insurance. Given the Democratic

Occupy healthcare and palliative care: Part two – spend more, die sooner

Continuing my review of palliation and healthcare, I want to begin to examine our healthcare system and how it is simply not meeting the needs of our community. Again, I want to thank Diane Meier, MD, PACP, Director, Center to

Building a healthier community: An Omaha case study

Building healthy communities is one element of a transformed healthcare system in the U.S.  Among other things, healthy communities help to reduce overall healthcare costs, decrease morbidity, increase the quality of life and the life span of every citizen. A

The role of income in healthcare coverage

A new report released today from the Commonwealth Fund highlights how those who are earning less than 133 percent of the federal poverty level were uninsured for significant chunks of time in 2011. While reports like this are helpful in

Occupy healthcare and palliative care

“Life is pleasant. Death is peaceful. It’s the transition that’s troublesome.” Isaac Asimov This post will be the first of a series examining palliative care and its importance to the future of healthcare for those with serious illness, and those

The “Money Pit” redux

Readers of this site know that just a few days ago, I wrote a post about healthcare costs and used the movie the Money Pit as an example. Today’s post is an updated “Money Pit” with new information and points

On the shoulders of giants

Dr. Barbara Starfield died in 2011.  For many people, her name will not stand out.  For those of us looking to improve our healthcare system, however, her work is of critical importance. Dr. Starfield is best known for her work

The “Money Pit”

It is impossible to get away from conversations on healthcare without talking about money. There is good reason for this. Unless we start to understand the “economic engine” of healthcare, it is hard to make an argument about what needs

There is something wrong

I got an email yesterday. A patient needed to cancel their session, and delay therapy indefinitely. Not because they don’t believe that they are benefiting from therapy. Not because they don’t need an additional layer of support. But because this

Unicorns, my anus*, and healthcare for all: Three things adults don’t discuss in polite conversation

Or: Eight things I learned about healthcare when my daughter got sick today. “I’d like socialized medicine. Of course I’d also like Unicorns to fall out of my anus*; but today, all I really need is a referral to some

Including the voice of the patient in healthcare part 2: Organizational decision making

While including the voice of the patient in decision making during their healthcare and treatment is essential, it is also important to find ways to bring the voices of patients into organizational decision making. While not as critical in many

Improved Medicare For All Is Within Reach for the Golden State

California Senate Bill 810 (Improved Medicare for All) would create a single-payer health care system in the state of California.[1] On January 19th, the California Senate Appropriations Committee approved this bill, meaning it now goes to the full Senate for

The role of relationship building in creating change

I came across this post by Craig Lefebvre last year, blogged about it at the time, and have since printed out his list and put it up by my desk – it so eloquently captures what I think should be some of

Why engagement in healthcare will change the game

It is well established that relationships have a certain healing power. Relationships are often built on trust, and that trust is often built on time. Spend some time in social media land for a bit and you will see that

Including the voice of the patient in healthcare part 1: The patient’s voice at the point of care

Note: This is part 1 of a 2 part series on the voice of the patient.  In this post we will look at the patient’s voice at the point of care.  In the second part we will look at the

Occupy Healthcare: The dream continues

As we celebrate Martin Luther King day, it is important to remember that the groundswell of support for the  Occupy Healthcare movement has deep roots in the American consciousness. Reverend King spoke to the Medical Committee for Human Rights in

Veterans healthcare: A bright spot in U.S. healthcare

An important part of transforming systems is identifying bright spots that can inspire us and helps create a map of where we want to go.  The U.S. healthcare system is plagued by inefficiency, fragmentation and other deep seated problems.  On

No more “partialty” care in healthcare: Fighting fragmentation at the clinical level

We are rerunning this post as more and more news events are drawing the attention to healthcare costs. Let us know what you think. The current healthcare system is inherently fragmented with all the various pieces vying for attention. The

The tobacco industry, graphic labels, and the “nanny state”

The CDC calls tobacco use “the single most preventable  cause of disease, disability, and death in the United States” with an estimated 443,000 smoking related premature deaths and 8.6 million living with serious illnesses caused by smoking. In addition, according

Healthcare policy, politics, and Medicaid

Medicaid has a critically important role within the expansion of healthcare as spelled out in the Patient Protection and Affordable Care Act (PPACA). However, as a state run health program, Medicaid is often used as a political tool. It is

Why the U.S. healthcare system is un-American

The United States was founded on the ideal of democracy.  The founders believed that individuals had certain natural rights as humans.  Among those rights was the belief that each person should be able to make choices about their life and

Giving Wisely in 2012 – tips for donating and volunteering

Speaking of New Year’s Resolutions, here’s another one to add to our lists: give wisely. With the holiday season just behind us, many have volunteered time and/or donated money, and perhaps even made resolutions to do a better job of

New Year’s Resolutions to Occupy Health

We are all familiar with the well-worn pattern of making New Year’s resolutions only to abandon them a few weeks out of the gate. What if we decided to re-set the clock on our resolutions once a month and in

The primary care challenge (and solution?)

There is no doubt of the importance of primary care in healthcare. As the graph above shows, primary care is the largest platform of healthcare delivery in the country. This fact was not lost on those who were instrumental in

Junk food marketing to children: How it works and the price we pay

I have written about the behavior shaping role of the entertainment and news media before, but of course, marketing plays a huge role too. And the behavior shaping role of marketing has been in the spotlight this past month, specifically

Transparency in healthcare: What you don’t see can hurt you

There has been a slow, but steady movement to bring greater transparency into the healthcare market to afford patients a means to evaluate quality and value of the services they receive. It is astonishing in this day and age that

An unbalanced, unfair system–a case study (N=1)

About six weeks ago, while in clinic, I developed pain in my stomach–specifically, in my right upper quadrant, just below the ribs.  I had experienced this a few times before, but this time it seemed more persistent than usual.  Following

How well do you know Grand Junction, Colorado?

Grand Junction, Colorado has important lessons to teach the country about healthcare. These lessons have very real and practical implications for any redesign of healthcare. In fact, some may say that many of the answers to the unanswerable question of

Why do I Occupy Healthcare?

Last week on this blog we asked you to help occupy healthcare and put a face on healthcare in America. Back in October many of us displayed our commitment to healthcare transformation through pictures like these. Now I want to

Building a healthier, brighter future: Positive childhood and youth development

As this video from the Center on the Developing Child illustrates, in looking at determinants of health and well being, it is important to consider the enormous influence early childhood and later youth development have on children’s futures. Physical, social,

How big a problem is healthcare?

A recent write up in California Healthline speaks to the amount of waste in the healthcare system and how this is a significant driver of cost. They suggest that: “1) Our health system is wasteful. 2) We must do more

What we need is a new tire

I like to use the analogy that the U.S. Healthcare system is like an old tire which has been patched time and time again.  While at times the tire served us well at other times its gone flat and stranded

Help Occupy Healthcare put a face on healthcare in America

Do you have a story about healthcare in America? Do you believe America deserves a better healthcare system? Have you had to choose between healthcare and survival? If you’ve answered yes or know someone who would answer yes, Occupy Healthcare

Place matters: A look at urban planning and its impact on health

An op-ed in the New York Times last week described the United States’ disproportionate spending on healthcare in comparison to other social services that have an impact on health – a characteristic that puts us in the minority, as one

Patient Inertia: One size fits none

in·er·tia noun \i-ˈnər-shə, -shē-ə\ 1a : a property of matter by which it remains at rest or in uniform motion in the same straight line unless acted upon by some external force 1b : an analogous property of other physical

Back to basics: Coverage for all

At its core, this Occupy Healthcare movement stands for providing healthcare for all. The clarity of this conviction should serve as our guide for all future efforts. Rather than see our momentum dissipate across a seemingly endless archive of blog

Be seen and heard (but know what you are saying)

How well do you know your healthcare lingo? Do you understand the reasons the patient-centered medical home (PCMH) is all the buzz in healthcare? How does one become a medical home? How does one measure being a medical home? While

Why social media will allow Occupy Healthcare to be successful

This past week at the Society of Teachers of Family Medicine Practice Improvement Conference, I had the opportunity to experience one of the most significant benefits of social media – the connections. Many of us involved in social media often

How will you occupy World AIDS Day?

The theme for this year’s World AIDS Day on December 1st  is “Leading with Science, Uniting for Action.” While the vision for the National HIV/AIDS Strategy is commendable and details action steps, what is missing is a mandate for congressional

Creating a new “whole person” healthcare system

“Between April 2010 and March 2011, about 200 people across the state who were so mentally ill they posed a threat of serious harm to themselves or others were turned out on the street because no private psychiatric facility was

Knowing is half the battle

They say knowledge is not indicative of change. Anyone who has tried to work on changing their own health behavior or worked with someone trying to help them change their health behavior knows this. We know what is good for

Healthcare and revolution – Who’s afraid of Cuba?

I’m tired of hearing about the next new revolutionary drug that’s going to change the face of medicine. I’m tired of hearing about how the iPad is going to revolutionize healthcare. I’m tired of hearing about the social media revolution

Occupy Thanksgiving for Occupy Healthcare

As you visit family and friends this Thanksgiving day, the occupy healthcare team wants to offer up a challenge. While sitting around the dinner table, consider bringing up issues of healthcare that include health justice and health equity. These are

Understanding healthcare info: What are you talking about?

Healthcare information in our everyday lives often falls short of helping people understand their conditions and how to treat their ailments. The same is true for broader health care system information, including lab results and prescription scripts. How often have

Healthcare insurance, providers & patients: The blind men and the elephant

Almost everyone has heard the story – the blind men and the elephant. If you haven’t you can read it here. In our occupy healthcare version, the blind men are insurance companies, healthcare providers, and patients. Healthcare is the elephant.

Measurable change

“What gets measured, gets done” – Peter Drucker When one sets out to occupy healthcare, what is the end goal? How will we know we have successfully made a difference in healthcare and created the system we all want and

Our challenge

Silencing the cacophony can be deafening. In healthcare, there are many competing voices all vying for attention. These voices all are shouting as loud as they can hoping to be heard; hoping, that someone will take a moment and look

Answer the call to save graduate medical education!

At this moment, Congress is considering steep cuts to graduate medical education (GME) programs in the interest of balancing the budget.  This is a classic short term answer: cutting funding to graduate medical education will reduce the number of physicians

New to health insurance? Why Occupy Healthcare is critical to you

Are you a young adult who just received health insurance, or not? This past year 900,000 more young adults like you were added to health insurance policies. Most of this was due to the Affordable Care Act allowing people

Should we occupy medical schools to effectively occupy healthcare?

A social media movement is happening before our eyes with action starting to take shape.  The occupy healthcare movement has begun within to the blogosphere and through various areas of social media by storm, including a recent demonstration on the

Why we need to Occupy Healthcare now

The CEO of WellPoint, the second largest health insurer in the US explained why so eloquently in a quote from a 2008 quarterly earnings update. “We will not sacrifice profitability for membership.” An example of a dutiful employee fulfilling her

Why social determinants of health matter, and how to take action

(Cross-posted in a slightly modified form at the Life in Underserved Medicine blog) Recently, my friend Carmen Gonzalez wrote a post for the Occupy Healthcare site in which she highlighted the state of healthcare inequities in the United States.  Carmen’s

Healthcare and bankruptcy: Gimme shelter

The facts are brutal and show a direct tie between the impact of medical expenses on American families trying to keep a roof over their heads. According to the New York Times in 2009, 2 out of every 3 bankruptcies

Land of the free, home of healthcare inequality

Every report of late confirms what we already know about health disparities: they are growing worse. A cursory view of the figures below show how on each factor of comparison, including gender, race, and economic status, we as Americans are

Occupying for health – success stories

In my last post, I wrote about the importance of occupying an array of fields that impact our country’s health. Lest this task seem too daunting to be accomplished, I thought I’d take a moment to highlight some success stories

What does it mean to be a healthcare revolutionary?

Recently at the Planetree Annual Conference Planetree’s President Susan Frampton defined attendees as revolutionaries.  It was a gathering of more than 1400 individuals highly engaged with changing our healthcare delivery system.  But what does it mean to be a healthcare

A better healthcare system for humanity

For one to be a revolutionary doctor or to be a revolutionary at all, there must first be a revolution. Isolated individual endeavour, for all its purity of ideals, is of no use, and the desire to sacrifice an entire

Why do we need to occupy healthcare?

Why do we need to occupy healthcare?  Why are we here, on this website, calling for change?  We are so often told that America has the best healthcare system in the world.  If that were so, then there would be

Join the movement

Occupy healthcare has always been about movement. It has been about drawing attention to the issues in healthcare that plague us all. It is about doing something, together, to create a system that actually works for addressing all the health

Rise up

Who controls the American healthcare system? “we do” You might ask, who is the “we”? In a recently released report, it was found that 1 out of every 2 jobs for physicians is in a hospital. “The era of the

The fatal flaw in American healthcare

“Insanity is doing the same thing over and over again but expecting different results.” In discussions of the healthcare system we have in the U.S., much of the talk is centered around the idea that the system is broken. The

When the going gets tough – innovate

Meeting the healthcare needs of the community often requires innovation and creativity. Take for example the barbershop in Harlem that serves double duty as a health clinic. Or, what about when school based health clinics start serving the surrounding community

Disrupting the healthcare business model

With the federal debt ceiling at 14 trillion, this allows us an opportunity to reflect on where our money goes and what is driving much of our debt. From the Center for American Progress: “Our nation’s long-term federal budget deficit

Do we operate under the assumption that help is not on the way?

Changing healthcare must be a highly complicated process or else it would have likely been changed by now. Right? Maybe we should do ourselves a favor and consider that the current system is broken, and it may be time to

Healthcare: Break-downs, workarounds, and upgrades

When I was in college I had this car. Her name was Betsy. She was a 1985 Mustang hatchback…She was small, zippy, and I could fit everything I owned into her, a prized feature for someone living a nomadic student

It’s time for democracy in healthcare

The Occupy Wall Street movement has brought renewed attention to the voices of ordinary people.  Healthcare in the U.S. historically has not been open to the voices of consumers. However, the transformation of the U.S. healthcare system requires the inclusion

What are you doing to change healthcare?

In healthcare, it is one thing to complain about the problems – it is something quite different to do something about it. Let me give an example of a problem, and then let me offer an example of what was


If there is one thing that the recent events on Wall Street have taught us, it is that our voices are strongest when we use them together. How satisfied are we with our current healthcare system? How satisfied should we

Beyond healthcare, occupying for health

Certainly, there is a need to occupy healthcare. Healthcare is essential, and the prevention and treatment that happens in clinics and hospitals, emergency rooms and community health centers, is integral to improving and saving lives. Yet, while medical care is

Whole people deserve whole health

What is an Occupy Healthcare post? If you’ve listened to any news outlet in the United States (and more than a few world-wide), you cannot have missed hearing at least something about the “Occupy Wall Street” movement. This is a

Patient-centered healthcare is essential

I have been working in healthcare for more than a decade.  During much of that time my work has been focused in one way or another in building more patient-centered cultures with in healthcare.  From hospice to acute care I

Fragmentation as a never event

In healthcare, fragmentation is on of the more pervasive drivers of inefficiency and ineffectiveness. Take for example the following well-written piece by Dr. Kurt Stange published in Annals of Family Medicine: “A wealthy man I know went from doctor to

Healthcare in America: All safety nets and no trapeze

“Some men look at things the way they are and ask why? I dream of things that are not and ask why not?” — Robert Kennedy I remember watching a live trapeze act at the Ringling Brother’s circus as a

Knowledge is power

I’ll never tire of watching Schoolhouse Rock! As a kid in the 1970s, I looked forward to each episode as much, if not more so, than the Saturday morning cartoons that surrounded them… with my parents taking in a few

The line between radicalism and realism in healthcare

Is it possible to be too radical in one’s thinking when it comes to changing healthcare? I guess with most things there is likely a fine line. Let’s dissect our words for a second: rad·i·cal adj \ˈra-di-kəl\ 3a : very

Community empowerment

Last week, there was post on this website discussing how to create a community contagion. The point of the contagion post was to think through ways the community can begin to work together and spread their message. While this remains

Money matters

In a recent Harvard Business Review article on solving the cost crisis in healthcare, the following was written: “Making matters worse, participants in the health care system do not even agree on what they mean by costs. When politicians and

Where is the wildfire?

One of the amazing aspects to the occupy Wall Street movement is the spread. The movement has gone from a few on Wall Street to thousands in other cities nationally. As of yesterday, the Occupy Wall Street movement is in

Your role in healthcare

What role should the individual have in their own health and healthcare? If we operate under the assumption that healthcare is not meeting our needs, then who is really to blame? It seems that there is often a balance between

Welcome to the world of workaround

Healthcare is full of examples where clinicians on the ground try to do good quality care, but inevitably are faced with barriers. This is the world of workaround. It is a world where common sense is often not encouraged, and

Is healthcare too important to fail?

“The U.S. health care delivery system does not provide consistent, high quality medical care to all people. Americans should be able to count on receiving care that meets their needs and is based on the best scientific knowledge–yet there is

Creating a community contagion

How can the healthcare community be best positioned to create a contagion of change? According to Merriam-Webster dictionary definition #3: con·ta·gion a : rapid communication of an influence (as a doctrine or emotional state) Is it possible to create a

It begins

When will healthcare have its “Occupy Wall Street” moment? In order to answer this question, let us first define what the occupy wall street movement is about. According to ABC News: “Their [Occupy Wall Street] causes include everything from global