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I woke up this morning and realized that we have been dealing with Covid-19 for about six months.  I closed the Fulcrum offices and sent my people to work from home on March 13th.  I started thinking about all that we have learned about the virus and ourselves over the last six months—looking back I…

I have worked in health care for over 30 years.  I have worked on the payer side, in medical group operations, and as a consultant for physician groups.  I have interacted with literally thousands of physicians over the last 30 years.  The most amazing thing about my career is that every single doctor I have…

Anyone who has worked in health care or has even a moderate interest health care has heard that the US health care system is the most expensive in the world and we don’t get much for our money.  Usually, when people make that statement, they use the World Health Organization’s ranking of the US as…

Remember 2019?  What was that about 10 years ago?  I remember it like it was just last year.  Back then before all this Covid mess we were worried about health care and how we needed to do something to reform our health care system.  We had polls showing that health care would be the number…

For years, if not decades, we have been hearing about healthcare reimbursement transitioning from a fee for service system to a value-based system.  Until recently these predictions were much like the song “tomorrow” from the movie Annie, where tomorrow is “always a day away.”  Oddly enough, it may be the Covid-19 pandemic that creates the…

Throughout history major events have produced lasting impacts on this country often times bringing about quick, dramatic changes in many aspects of our lives.  9/11 forever changed how we travel in this country.  World War II made this country into a world superpower and gave birth to our current system of employer-based health insurance.  It…

Covid-19.  Get ready for the Second Wave.     I wrote a blog post on March 23rd about Covid-19 and the concern for what could happen.  That was just over 3 months ago.  On March 23rd we had 34,000 cases in this country and our case count was increasing by 9,000 case per day.  The…

As states open up and restrictions lessen, physician offices are starting to return to somewhat normal schedules.  Most of my clients report steady increases in patient volumes.  Some approaching pre-Covid levels.  This begs the question, what are things going to look like 6 month or even a year from now.   While we can’t be…

At some point in the future we will come out of this pandemic and things will try to return to some form of normal.  We will develop a vaccine and/or treatment which will eliminate or at least significantly alleviate the clinical risk of Covid-19.  When that happens, the world will try to pick up the…

Consumerism.   The Role of The Consumer in Healthcare     Historically the role of the consumer in health care has been one of a passive participant.  This passive participation was caused by the fact that the doctor was rarely questioned or challenged by the patient, there was limited access to information outside of the…