Around the Web

Here are more resources we've found helpful

We've included the Research section from Hunter's book below. This is where he'll update and add links. We've also included additional links of interest and will continue to add them over time.  

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Winning Healthcare Food Fights

Research Section

Chapter Two – Step 1

Concepts: Listening and Questions
Search phrase: People hear what they want to hear
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4797953/
https://www.entrepreneur.com/article/254264

iPod Nano Introduction
Steve Jobs unveiling the original iPod Nano in 2005:
https://www.youtube.com/watch?v=7GRv-kv5XEg 

Chapter Three – Step 2

Visualizing Care
Search phrase: Visuals are processed 60,000 times faster in the brain than text

https://www.shiftelearning.com/blog/bid/350326/studies-confirm-the-power-of-visuals-in-elearning 

Chapter Four — Step 3: American Healthcare System Analogy

The rise of Japan’s automakers
https://www.theglobeandmail.com/globe-drive/adventure/red-line/the-rise-of-japan-how-the-car-industry-was-won/article27100187/

Dr. W. Edwards Deming
http://archive.fortune.com/magazines/fortune/fortune_archive/2000/10/30/290646/index.htm

Variability and Process
https://stanfordhealthcare.org/health-care-professionals/medical-staff/medstaff-update/2013-december/201312-sos-training-for-physician-leaders.html

https://www.bizmanualz.com/improve-business-processes/do-you-understand-process-variability-causes.html

US Primary Care to Specialist Ratio
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644012/

https://www.ahrq.gov/research/findings/factsheets/primary/pcwork1/index.html

“We’re from the Government.”

Social Security Supplemental Act of 1965: 
http://www.legisworks.org/GPO/STATUTE-79-Pg286.pdf
See Page 6 of this file. Do note section 1801 about the non-federal interference with the practice of medicine. Ask your physician about it.
https://www.ssa.gov/OP_Home/ssact/title18/1800.htm
Webpage with same text.

Primary care gatekeepers
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC152368/

Medicare Reimbursement Rates
Search phrase: medicare primary care reimbursement rates remain the same

https://www.healthaffairs.org/do/10.1377/hblog20170127.058490/full/#one

Time with Patients
Search phrase: patient time in primary care
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621071/

https://bmjopen.bmj.com/content/7/10/e017902

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617939/

https://www.ncbi.nlm.nih.gov/pubmed/12660210/

Physician Suicide
https://opmed.doximity.com/articles/why-happy-doctors-die-by-suicide

https://www.webmd.com/mental-health/news/20180508/doctors-suicide-rate-highest-of-any-profession#1

https://emedicine.medscape.com/article/806779-overview

https://blogs.bmj.com/bmj/2018/08/31/michael-myers-the-complexity-of-physician-suicide/

https://www.npr.org/sections/health-shots/2018/07/31/634217947/to-prevent-doctor-suicides-medical-industry-rethinks-how-doctors-work

Dr. Pamela Wible's website
http://www.pamelawible.com/category/physician-suicide/

The Tipping Point
human genome June 26 2000
https://www.pbs.org/newshour/spc/images/health/jan-june00/genome_6-26a.html

https://www.youtube.com/watch?v=slRyGLmt3qc

Day of reckoning
https://www.bloomberg.com/news/articles/2019-02-27/a-100-genome-within-reach-illumina-ceo-asks-if-world-is-ready

Genome
https://www.genome.gov/19016903/genomic-medicine-for-patients-and-the-public/

https://www.genome.gov/12011238/an-overview-of-the-human-genome-project/

https://www.nationalgeographic.com/magazine/2019/01/personalized-medicine-transforming-your-health-care/

https://techcrunch.com/2019/03/15/xgenomes-is-bringing-dna-sequencing-to-the-masses/
However . . .
https://www.statnews.com/2017/06/20/human-genome-not-fully-sequenced/

Gut Microbiome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566439/

Proteomics
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117667/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120780/

https://hupo.org/What-is-Proteomics

Information Glut: Medical Information Overload
https://www.vchri.ca/stories/articles/2018/11/02/information-overload-tsunami-personal-health-data-new-wearables
https://medium.com/medcurbside/information-overload-in-medicine-its-getting-worse-fa73c8de9d07
https://www.medpagetoday.com/blogs/revolutionandrevelation/72029
https://www.forbes.com/sites/brucelee/2016/09/07/doctors-wasting-over-two-thirds-of-their-time-doing-paperwork/#87f0a475d7b4

IBM Watson medical information doubling
https://www.ibm.com/industries/healthcare/datadilemma
https://www.pcworld.idg.com.au/article/553586/paging_dr_watson_ibm_medical_adviser_future/

Viewing Today’s American Healthcare System:

Fee for service American care
https://www.forbes.com/sites/robertpearl/2017/09/25/fee-for-service-addiction/#50e8418fc8ad

32 Roaring Mouse Clicks
Search phrase: doctor overload mouse clicks
https://www.reuters.com/article/us-usa-healthcare-burnout/counting-the-costs-u-s-hospitals-feeling-the-pain-of-physician-burnout-idUSKBN1DL0EX

Primary care office overhead
https://www.wphealthcarenews.com/understanding-the-complexities-of-overhead-in-a-physician-practice/

I’m an Infomaniac. Where can I learn more?
Simply put, this: Fixing the Primary Care Crisis
by Stephen Schimpff, MD
https://www.amazon.com/Fixing-Primary-Care-Crisis-Patient-Doctor-ebook/dp/B00XD5EMXU/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1547842726&sr=1-1&keywords=fixing+the+primary+care+crisis

What It Should and Could Look Like
80 percent rule and Primary care

https://www.hindawi.com/journals/scientifica/2012/432892/
https://www.physicianspractice.com/blog/emergency-rooms-continue-serve-patients-primary-care-provider 

Chapter Five — Step 4 — How We View Care

Concept: Country Healthcare Comparisons
Search phrase: Comparing US Healthcare with other countries

https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-hospital-admissions-preventable-diseases-frequent-u-s-comparable-countries

For those wishing to do a deep dive into country comparisons, I use the Organization for Economic Cooperation and Development (OECD) online library:
https://www.oecd-ilibrary.org/social-issues-migration-health/data/oecd-health-statistics/health-care-resources-edition-2018-1_a8d27f72-en

International infant mortality rate measurement 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193257/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/

England’s Ten-minute GP patient visits
https://www.gponline.com/10-minute-gp-consultations-disaster-says-rcgp-vice-chair/article/1463627
http://www.pulsetoday.co.uk/news/gp-topics/access/gps-have-chosen-10-minute-consultations-claims-nhs-england-lead/20035493.article

Waiting times
https://www.telegraph.co.uk/news/2019/05/01/cancer-patients-waiting-see-specialist-record-numbers-winter/
https://www.cbc.ca/news/health/wait-times-cihi-commonwealth-1.3984920
https://globalnews.ca/news/3251833/canada-has-some-of-the-longest-wait-times-to-see-doctors-specialists-report/
https://www.mirror.co.uk/news/politics/more-250000-patients-waiting-four-16485318

Canadians Heading South for Care
https://www.usnews.com/news/best-countries/articles/2016-08-03/canadians-increasingly-come-to-us-for-health-care
https://www.ctvnews.ca/health/63-000-canadians-left-the-country-for-medical-treatment-last-year-fraser-institute-1.3486635 

Chapter Six — Step 5: Flashpoints

“The first thing we do, let’s kill all the lawyers”
From William Shakespeare’s Henry VI, Part 2, Act IV, Scene 2

Malpractice claims
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496869/
Communication
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201002/

No Insurance, No Care
https://www.cdc.gov/nchs/data/nhis/earlyrelease/emergency_room_use_january-june_2011.pdf

Big Pharma!
https://medium.com/@geoffreychaiken/the-rebate-game-how-consumers-lose-and-pbms-win-6ab777f54c3d

Illegals Receiving Free Healthcare!

Healthcare is a Right!

“LegalCare” for All?
https://www.medicaleconomics.com/authors/craig-m-wax-do

What is MLR?
https://www.healthcare.gov/glossary/medical-loss-ratio-mlr/

What is the Solution?
Comprehensive Primary Care
https://www.nap.edu/read/5152/chapter/5#54

A unique perspective about patient time and care
https://www.newyorker.com/magazine/2011/01/24/the-hot-spotters
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3926992/
https://www.hindawi.com/journals/scientifica/2012/432892/ 

Chapters Seven and Eight

LA Times August 9, 2009
https://www.latimes.com/archives/la-xpm-2009-aug-05-na-obama-healthcare5-story.html

The White House Doctor, My Patients Were Presidents By Dr. Connie Mariano

Cost of state funerals
https://www.upi.com/Business_News/2004/06/16/The-cost-of-pomp-for-Reagans-funeral/14211087417177/
http://www.businesspundit.com/5-most-ridiculously-expensive-funerals/

High Accessibility Factor
https://www.hindawi.com/journals/scientifica/2012/432892/

Steps Away Care and Technology
https://medwand.com/
See Dr. Gerald Cox and Dr. Robert Darling, at the 1:44.50 mark through 1:46.38:
www.c-span.org/video/?191866-1/25th-anniversary-reagan-assassination-attempt

Patient Privacy – Medicine’s Jesus Nut

Adoption and societal pressure:
“The Girls Who Went Away” by Ann Fessler
“Look at You Now” by Liz Pryor

Medical records breach at Tampa General, USF exposes woman’s secrets
http://www.tampabay.com/news/health/medical-records-breach-at-tampa-general-usf-exposes-womans-secrets/2129083

It’s Raining Men, Hallelujah. Maybe Not
https://www.hipaajournal.com/largest-healthcare-data-breaches-2017/

“Toto, we’re not in Kansas anymore.”
Singapore HIV data leak shakes a vulnerable community
https://www.bbc.com/news/world-asia-47288219

We’d Like to Recall an Email! (Really!)
https://www.dailyrecord.co.uk/news/scottish-news/nhs-staff-health-secrets-revealed-16523625
https://twnews.co.uk/gb-news/nhs-staff-health-secrets-leaked-in-data-breach-bungle

More examples:
https://www.fiercehealthcare.com/tech/oig-found-cybersecurity-gaps-nih-s-all-us-precision-medicine-research-project

Dark Web Value of medical information
https://www.experian.com/blogs/ask-experian/heres-how-much-your-personal-information-is-selling-for-on-the-dark-web/
https://www.channelnewsasia.com/news/singapore/singhealth-health-system-hit-serious-cyberattack-pm-lee-target-10548318
https://www.trendmicro.com/vinfo/us/security/news/cyber-attacks/healthcare-under-attack-stolen-medical-records

Just How Private Is U.S. Care?
Do note the word “surveillance” within the text:
https://www.federalregister.gov/documents/2016/10/19/2016-24908/onc-health-it-certification-program-enhanced-oversight-and-accountability

CMS “Without Patient Authorization” Office of Civil Rights:
https://www.federalregister.gov/d/2016-25240/p-244
Note: Be patient while the above page fully loads.
“Surveillance” wasn’t a typo. Use your browser Find word box (ctrl+f) and you will see the word is used 224 times:
https://www.federalregister.gov/documents/2016/10/19/2016-24908/onc-health-it-certification-program-enhanced-oversight-and-accountability

Reuters Health: Anonymous patient data may not be as private as previously thought
https://www.reuters.com/article/us-health-privacy/anonymous-patient-data-may-not-be-as-private-as-previously-thought-idUSKCN1OK24O

Hackers are coming for your healthcare records -- here’s why
https://www.computerworld.com/article/3090566/hackers-are-coming-for-your-healthcare-records-heres-why.html

A Deeper Dive into U.S. Privacy
https://thedatamap.org/index.php

The butler did it!
Verison 2018 Data Breach Investigations Report https://enterprise.verizon.com/resources/reports/DBIR_2018_Report_execsummary.pdf

How about the U.S. government’s record on protecting highly sensitive records?
https://www.lawfareblog.com/why-opm-hack-far-worse-you-imagine

Small-Scale Violations of Medical Privacy Often Cause the Most Harm
https://www.propublica.org/article/small-scale-violations-of-medical-privacy-often-cause-the-most-harm

DHS Breach Report to Congress (Note: This is supposed to be an annual report.)
https://www.hhs.gov/sites/default/files/breach-report-to-congress-2015-2016-2017.pdf

Patient Advocacy and Focal Point for Care
https://www.kevinmd.com/blog/2015/07/the-physician-is-the-ultimate-patient-advocate.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661729/

Thank God, It’s Not Rocket Science!

NASA Engineer’s and their blank canvas
https://gizmodo.com/why-kennedys-moon-speech-was-crazy-and-how-the-us-could-5805457

HEMS Flight Safety
Search terms: HEMS Accidents and weather
Ira J. Blumen, MD, and the UCAN Safety Committee, “A Safety Review and Risk Assessment in Air Medical Transport.” Supplement to the Air Medical Physician Handbook, (November 2002)
https://www.skybrary.aero/index.php/HEMS_Safety_Risks

And Those Undocumented Immigrants?

On a More Encouraging Note

The Naysayers
https://dpcalliance.org/blog/2018/7/29/e83z8x5sdlah02stgq2w10y8ka383o
https://www.kevinmd.com/blog/2014/12/direct-primary-care-setting-record-straight.html
https://www.jabfm.org/content/jabfp/28/6/793.full.pdf 

Detaching Coverage from Employers
Individual coverage HRA rules
https://home.treasury.gov/news/press-releases/sm708
https://www.peoplekeep.com/blog/what-is-the-individual-coverage-hra-ichra

Let Specialists Practice their Specialty
Ambulatory care provided by office-based specialists in the United States
https://www.ncbi.nlm.nih.gov/pubmed/19273864

Malpractice and Communication
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201002/

Poly Who?
https://www.pharmaceutical-journal.com/opinion/insight/how-polypharmacy-has-become-a-medical-burden-worldwide/20201251.article

Care Coordination & Continuity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572662/
https://www.nextgen.com/insights/pcmh/patient-centered-medical-homes

How can we provide care to people needing help?
https://blog.hint.com/what-qliance-taught-me-about-healthcare
https://video.hint.com/dr-erika-bliss-the-qliance-experience
See 45:45 for Medicaid reference.

https://www.modernhealthcare.com/article/20181020/NEWS/181019908/primary-care-companies-cut-costs-through-preventive-models
https://www.forbes.com/sites/katherinerestrepo/2017/02/06/states-prove-why-direct-primary-care-should-be-a-key-component-to-any-health-care-reform-plan/#de394ad419b7

Government Intrusion into Your Healthcare: 

Silent Survivors
http://www.annfammed.org/content/15/1/77.full#ref-1

Enter the Ponytail and Sandals Crowd
‘Big data’ could mean big problems for people’s healthcare privacy
https://www.latimes.com/business/lazarus/la-fi-lazarus-big-data-healthcare-20161011-snap-story.html
https://www.reliasmedia.com/articles/140405-big-data-in-healthcare-privacy-is-major-ethical-concern

Catastrophic care plan cost
https://www.trustedchoice.com/health-insurance/coverage-types/catastrophic-major-medical/ 

In Closing
https://www.emedevents.com/medical-conferences/medical-conferences-by-country 

Dr. Stephen Schimpff

The first of a 13 part series, Dr. Stephen Schimpff describes how America has both the best and worst healthcare system in the world.

These Doctors Got Fed Up With Insurance

The Affordable Care Act drove thousands of independent doctors to throw in the towel and join large hospital networks. However, a growing movement of doctors are fighting back against the bureaucratic system.

A Response to Naysayers

Dr. Paul Thomas responds:  This week, JAMA wrote an article on Direct Primary Care. One of my colleagues in medicine wrote me to ask a few follow up questions about DPC. If more doctors leave fee-for-service medicine and transition into DPC roles, will there be less capacity for patient care? ie will there be more patients without a dedicated Primary Care Physician? What about Medicaid and Medicare patients? Many medical students, residents, and practicing physicians feel an obligation to care for Medicaid/low income patients. As a DPC physician, are you abdicating your responsibility to these patients?

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