Archive for July, 2010

Gary Oftedahl: Getting our ACT Together

“It’s all about the culture.” How many times have we heard that statement when trying to address the changes necessary in health care? In fact, isn’t it likely that irrespective of the arena, a disconnect between strategy and culture is a recipe for failure, and often disaster. To paraphrase many who work in this area, “culture eats strategy for lunch everyday.” Yet over my career in health care, and more specifically in the area of quality improvement, we have continued to attempt to implement new programs, new strategies, new approaches, only to see them disappear into the abyss of “failed opportunities” and lamented the lack of a culture that supports the activities.

Continue Reading July 29, 2010 at 12:09 pm

Gary Oftedahl: When Being Special is Possibly Partial…

(Warning: The following may cause some to develop an uncontrolled spike in blood pressure, and incite a feeling of frustration with the author)

We’re all competitive, wanting to be the best. Heavens, I’m from Minnesota, home of Lake Woebegon, where everyone is above average. At times, I feel a sense of pride in being in the top 10, and being referenced as coming in 7th is often enough to justify a bit of puffery. So when a recent Commonwealth Fund report, MIRROR, MIRROR ON THE WALL http://bit.ly/FaSnK noted the United States had finished 7th in it’s health system performance in a recent survey, taken out of context, this might sound encouraging. But we all know the real story is that this ranking places us 7th out of 7 countries. And it wasn’t even close!!!

Continue Reading July 19, 2010 at 9:57 am 2 comments

Kent Bottles: Will CER Really Make a Difference if the Public Doesn’t Want It?

Yesterday I was lucky to be invited to a New England Healthcare Institute discussion entitled “From Evidence to Practice: Making CER Findings Work for Providers and Patients “ in Washington, DC.

How to disseminate and implement Comparative Effectiveness Research (CER) so that patient care is really improved was the first topic tackled by the expert panel and the moderator, Clifford Goodman of The Lewin Group.

Continue Reading July 9, 2010 at 8:29 am 2 comments

Kent Bottles: Maybe Being Wrong is Better and More Human than Being Right

St. Augustine: “Fallor ergo sum”

When I was in charge of the medical residency programs in Grand Rapids, Michigan, David Leach introduced me to the expanded Dreyfus Model of how physicians can progress from beginners to masters. I was always struck by how master physicians freely admitted their mistakes and used them as a teaching tool. As a young surgical and cytopathologist, my sanity was saved more than once by University of California San Francisco’s Dr. Theodore R. Miller, a true master of cytology, being willing to share with me some of his mistakes.

Continue Reading July 6, 2010 at 8:14 am 12 comments

Gary Oftedahl: Empowerment/Engagement…Easy Does It

love a good discussion, especially when someone I respect causes me to flinch, and rethink an area of interest. Such is the follow-up to my discussion of empowerment in my last blog. I knew I was being more than “just clever” when I used the (pre)cautionary term in my title. While the term “empowerment” is indeed prevalent in many discussions regarding health care reform and patient involvement, it’s outlawed in some arenas. At least according to Jessie Gruman, CEO of CFAH (Center For Advancing Health), with whom I had a most engaging conversation earlier this week.

Continue Reading July 1, 2010 at 10:18 am 4 comments


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