Wednesday, January 11, 2017

Healthcare Stole the American Dream - Here’s How We Get it Back | Dave C..., Bay Area Cancer Patient.. - gmlevinmd@gmail.com - Gmail

Healthcare Stole the American Dream - Here’s How We Get it Back | Dave C..., Bay Area Cancer Patient.. - gmlevinmd@gmail.com - Gmail



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Healthcare Stole the American Dream - Here’s How We Get it Back |   TEDx TalkThanks to Rob Lambert M.D. a pioneer in direct primary care for bringing this to m.. Read More →
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Something all patients should know if you live in California and five other states, Oregon,  District of Columbia,Vermont, Washington and California. It is an ..Read More →
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Doctors giving regular checkups will get the most bang for their buck if they advise adults to quit smoking, convince teens to never start, and keep children 

Monday, January 2, 2017

Top 12 Inspirational Leadership Quotes For 2017

New Year's is the time for resolutions.  Here is the  checklist for your leadership traits.

A good place to start is to review the qualities and practices of exceptional leaders, which have remained the same since the beginning of civilization, as summarized in a book M.A. Soupios and I co-authored, The Ten Golden Rules of Leadership.

Here are 12 quotes from the book that provide a glimpse into the qualities and practices of great leaders:
  1. Skills and experience might land you a leadership position, but they don’t make you a true leader.
  2. Leadership comes from inside—and the greatest leaders first question themselves before they tackle the world around them. To aid in this critical interrogation.
  3. The "fate" of organizations is not based on the stars. The character of an organization's leadership determines a company's destiny.
  4. The assumption of authority brings out the leader’s inner world.
  5. Leadership cannot be done by the numbers.
  6. Toxic environments are not the result of spontaneous bad fortune. They are the resultof toxic leaders.
  7. Of all the many potential shortcomings an assumed leader might bring to an organization, nothing is more lethal than the arbitrary application of power.
  8. Supervisors who constantly micromanage, who second-guess every subordinate decision, who gleefully await any and all opportunities to criticize and bully, are a toxic presence in any environment.
  9. The most lethal distortions come not from the lips of our opponents or competitors. They tend to flow, instead, from our own hearts.
  10. Truth is an invaluable corporate asset. Don’t let it go waste. Embrace it.
  11. Never underestimate the power of personal integrity; always set an honorable agenda; adhere to a code of professional conduct; never try to justify dishonesty and deceit; rather fail with honor than win by cheating.
  12. Honest assessment is an essential requirement of effective leadership….The problem is that the higher up the ladder you go, the less likely it is that you will receive complete and accurate information.

The Ten Golden Rules Of Leadership

The answers to these questions are condensed in a little book The Ten Golden Rules Of Leadership (New York: AMACOM, 2015) I co-authored with Michael Soupios.
Rule 1 Know Thyself
Rule 2 Office Shows The Person
Rule 3 Nurture Community In The Workplace
Rule 4 Do Not Waste Energy On Things You Cannot Change
Rule 5 Always Embrace The Truth
Rule 6 Let Competition Reveal Talent
Rule 7 Live Life By A Higher Code
Rule 8 Always Evaluate Information With A Critical Eye
Rule 9 Never Underestimate The Power of Personal Integrity
Rule 10 Character Is Destiny

True leadership is ultimately traceable to factors of character and personal integrity; much of what called “destiny” lies in our hands, not in mysterious forces beyond our control.








Top 12 Inspirational Leadership Quotes For 2017

Monday, November 16, 2015

Teaching Doctors the Art of Negotiation - The New York Times



Doctors negotiate every day, almost constantly — sometimes dramatically, often imperceptibly. They hold family meetings to resolve sensitive end-of-life issues. They address barriers to medication adherence. They encourage patients to receive uncomfortable screenings like colonoscopies and mammograms. They refuse treatments that are requested but not medically indicated. Yet they receive almost no formal instruction in how to do so.
Dealing with medical colleagues creates an additional layer of negotiating complexity—especially in busy academic centers with competing demands on specialists’ time. Medicine is increasingly a team sport. In 1970, only about 2.5 full-time clinical staff cared for the average hospital patient; today, that number is greater than 15.
Doctors consult other doctors many times a day to discuss potential treatment options and decide on the best course of action. They work closely with residents, students, nurses, physician assistants, care coordinators and others to implement those plans. At each interaction, opportunities for collegiality and efficiency — or rancor and resentment — abound. That can mean the difference between a timely or delayed blood draw, accepting or refusing a consult, or getting those biopsy results today versus tomorrow.
Recognizing the importance of negotiation, medical schools are starting to invest in communication training for students — and it seems to be paying off. Research suggests communication training can improve patient adherence, diagnostic accuracy and chronic disease management. But good communication, by itself, is only part of the solution. We need to teach doctors how to negotiate.
Negotiation, in this context, is not about winning or losing, or haggling over price or scare resources. It’s about exploring underlying interests and positions to bring parties together in a constructive way. It’s about creative, innovative thinking to create lasting value and forge strong professional relationships. It’s about investigating what is behind positions that may seem irrational at first to understand the problem behind the problem.
The medical profession is no longer one in which doctors dictate a given treatment course to patients, who are then expected to follow it. Rather, clinicians and patients deliberate about treatment options, weigh costs and benefits together, and determine the best course of action. This approach requires eliciting patient concerns and addressing underlying fears to arrive at the most effective strategy for maximizing health and well-being. As diseases like H.I.V. and some cancers that were once uniformly fatal become chronic conditions, and a greater diversity of treatment options becomes available, the ability to negotiate long-term care plans will only grow in importance.
Physicians are also increasingly assuming leadership roles. They are expected to negotiate with a vast array of third parties, including health plans, governments and pharmaceutical companies. Health care changes double down on this expectation. The Affordable Care Act creates incentives for doctors and hospitals to band together to create networks known as Accountable Care Organizations — provider groups responsible for caring for an assigned patient population. Under new Medicare rules, providers can be paid less if they have low patient satisfaction scores or excessive readmissions. As quality metrics and cost-effectiveness play a larger role in reimbursement, physicians will need to negotiate with governments and insurers to establish fair and reasonable performance measures.
Each medical encounter, then, becomes a multiparty mini-treaty signed by doctor, patient and family members — and sometimes, consulting physicians, ancillary staff, insurers, hospitals and governments. Law, business and public policy schools all offer classes in negotiation, recognizing the interdisciplinary and interdependent nature of their professions. Isn’t it time medical schools did, too?
Remember, almost everything is negotiable.

Dhruv Khullar is a dual degree candidate at the Yale School of Medicine and Harvard Kennedy School, where he is a fellow at the Center for Public Leadership. Follow him on Twitter:@DhruvKhullar.










Teaching Doctors the Art of Negotiation - The New York Times

Landlocked Islanders | Hakai Magazine



Landlocked Islanders

Can Marshall Islanders whose lives are tied to the sea maintain their culture in Oklahoma?
Published November 16, 2015
The amount of water is incomprehensible. We’ve been flying for hours, and just when we’re about as far from a landmass as you can possibly get—a spot where the curving, wave-flecked Pacific Ocean stretches thousands of kilometers in every direction—an island slides into view. It’s no more than a snippet of sand and palm trees, a snake winding through the blue plain of the Pacific. Fanning out around it are 1,200 similar islands, some inhabited, others not, arranged into a constellation of 29 atolls like stars in a universe of ocean. For every square kilometer of land in the Republic of the Marshall Islands, there are 10,732 square kilometers of ocean.

For every square kilometer of land in the Marshall Islands, there are 10,732 square kilometers of ocean. The islands are mostly ring-shaped, inviting a unique system of direction: lagoon-side and ocean-side. Photo by Greg Vaughn/VWPics/Newscom
By the year 2100, it’s conceivable that climate change will force the entire population of the Marshall Islands to US shores. Already, more than 25,000 Marshallese—over a third of the population—have left the islands, many in the last 15 years. Among them was Sarah Joseph, now 22 and a resident of Enid, Oklahoma.
Through all of this, Marshallese culture adapted and survived. But today, it’s facing the one battle that might be impossible to win. Climate experts predict that because of rising sea levels caused by greenhouse gas emissions, the Marshall Islands could be uninhabitable by the end of this century.
As the ocean seeps into homes and buckles roads, it’s shifting from a source of inspiration to one of fear. 
Infant mortality is high, and celebrating the first year of life is an event which is special to Marshall Islanders

Unlike many Marshallese-Americans of her generation, though, Marla will later be able to say that once, she knew the ocean. She sat on her mother’s lap at the edge of the lagoon and felt the tropical water tickle her legs. She took her first steps in her paternal grandparents’ gecko-green house that rises from the sea on a piece of land sprouted from oil drums and old tires. She looked into the eyes of the sea turtle that the men speared for her first birthday feast. And, the night before her first birthday, just before midnight, she watched quietly, her brown eyes wide, as a chorus of women and children streamed into the house strumming ukuleles and singing, welcoming her to the world. To her home.
Paradise lost


Landlocked Islanders | Hakai Magazine