My blog represents my personal experiences and perspectives. This includes many anecdotes from my medical practice. I have been scrupulous to anonymize these anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)

The need for failure

At recent meetings, senior leadership and management have spoken eloquently and forcefully about the huge challenges we in health care face from the perfect storm combination of an ongoing national financial crisis, the health care reform act with its unknown and largely unknowable changes, and our local revenue shortfalls. They emphasize the need for innovations that are carefully considered, centrally controlled, and rapidly developed and deployed. The theme is: “Major change is inevitable, and mistakes are not an option. We have to get it right the first time.” 

Snowstorm epiphanies

Every year, as winter approaches, I look forward to big snowstorms. Not just because I love Nordic skiing - though I do. Not just because the individually tiny flakes and their accumulation into deceptively gentle drifts are such a useful reminder of the importance of soft power. Not just because of the quiet, or the magic of moonlight glistening on fresh powder, or even the knowledge that the piles of snow against the foundation will help insulate the basement and protect our pipes.