Category: Amusements

Judgment day at Planet Fitness

published date
February 13th, 2020 by
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No judgment

My hotel in NYC has a decent gym, but I was looking for something more. So I visited the Planet Fitness right on the same block. I’d never been to a Planet Fitness before, but right away I noticed something odd. “Judgement free zone,” is plastered all over the place. It’s on the walls and every piece of equipment –pretty much everywhere.

Back in the day (before spell checkers) I was a good speller. I did well in the spelling bee at summer camp as a kid. (I didn’t win, because I got nervous and misspelled the word “recommend,” even though I knew better.) Still, I can usually spot a typo, and I didn’t think the American version needed that extra “e.”

Sure enough, Easy Street blogged about this very topic five years ago.

Misspellings provoke judgment from readers who catch errors. However, as with most misspellers, Planet Fitness had moved on. According to a spokesperson, “Spelling judgement with an ‘e’ started out as a mistake. Back in 1998 we considered changing it to the traditional spelling, but decided to keep it because it fit with our brand personality—we are judgment free on all matters, so what better way to demonstrate this than by keeping the original incorrect spelling.”

Who really cares? No one.

But it did get me thinking about how computerized tools and artificial intelligence can rob us of certain skills and brain function, even a they relieve drudgery and improve quality and consistency. Think about the GPS. On the one hand, it guides me to the optimal route and gives me the confidence to explore unknown areas. On the other hand, I can barely read a map these days or learn new routes on my own.

The same problems apply to healthcare providers, and I first wrote about this issue nine years ago: Are decision support tools turning doctors into idiots? If every answer is a click away or embedded into automated decision support tools, it’s hard to think for oneself.


By healthcare business consultant David E. Williams, president of Health Business Group.

Health disparities: You ain’t seen nothing yet

published date
January 22nd, 2020 by
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Welcome to the machine

A survey in the UK showed that the gap in health between rich and poor is widening. From the US perspective that comes as a bit of a surprise. After all, don’t the Brits have universal healthcare through the NHS?

But of course, social determinants of health such as diet, exercise, stress, access to transportation, and education play a bigger role in health than the healthcare system. With socioeconomic disparities widening, it serves to reason that health disparities will grow, too.

So where do things go from here? They probably get worse –that’s my guess. Current political and economic forces in the US, UK and elsewhere point toward an exacerbation of current gaps. And as climate change makes the world a generally harsher environment it’s the poor who will be more adversely affected by floods, fires, air pollution, etc.

But in a decade or two that will be nothing compared with the haves and have nots wrought by the advancement of medical technology. Expect the well off to increasingly invest in tools that let them get further ahead: for example cyborg inventions that augment intelligence, strength, vision, hearing and more. Not to mention artificial organs and genetic interventions to greatly extend life.

Will such modifications make people happy? Maybe not. But it will enable them to lord it over the rest of society to an increasingly greater degree.

Enjoy!

Partners dissolves into Mass General Brigham. I’m quoted in the Boston Globe

published date
December 4th, 2019 by

Massachusetts General Hospital and the Brigham and Women’s Hospital joined together as Partners HealthCare 25 years ago. Now they’re changing the name to Mass General Brigham, spending up to $100 million in the process. I’m quoted on the subject in a recent front page Boston Globe article (In major rebranding, Partners HealthCare to change name to Mass General Brigham).

What’s in a name, you may ask? In this case it’s worth parsing the change and exploring the history.

What does Partners mean anyway?

Partners HealthCare never had much brand equity. The word “partners” really described the decision of the two hospitals to partner with one another to offset the power of managed care organizations to play them off against one another. All HMOs needed one of those hospitals in their network, but not both. With Partners it was all or nothing. Partners had no problem playing “take it or leave it” right from the get go, nearly bringing Tufts Health Plan to its knees in the late 90s.

So unlike your typical business combination, which relies on elimination of duplication and other efficiencies to be successful, Partners succeeded right away by virtue of its enhanced market power and high pricing. Duplication remained –and remains to this day. MGH and the Brigham continued to move forward on their own while a new Partners overhead was introduced. No one –not patients, not doctors, not nurses– developed any attachment to Partners as an entity.

Why keep General?

Massachusetts General Hospital has kept the same name since its charter was granted by the Commonwealth of Massachusetts in 1811. It’s a proud name, and maybe sometimes a little too proud. (Some say MGH stands for Man’s Greatest Hospital.)

“Massachusetts” is shortened and “Hospital” is omitted from the new name. Of all the words to keep, why was “General” left intact? It seems so… generic. But it also reminds us of the grand era of American industry. General Motors. General Electric. General Atomics. (Remember that one.) The idea was that the one General company could dominate the industry and we’d all be the better for it.

Outside of this state, errr… Commonwealth, “Mass” doesn’t necessarily mean Massachusetts. It could mean a Catholic Mass or a big pile of something. But MGH is so often referred to here and abroad as Mass General that it must have seemed safe to trim it down officially, since the whole name is long anyway.

Where did the Women go?

How did Brigham and Women’s Hospital (BWH) get its name? Unlike MGH, BWH went through some name changes, although none recently. The Boston Lying in Hospital was founded in 1832 and the Free Hospital for Women came about in 1875. They merged in 1966 to become the Boston Hospital for Women. (Apparently that name didn’t stick right away, since I was always told I was born in the Lying in Hospital –even though I was born after the merger.)

In 1980, the Peter Bent Brigham Hospital, Robert Breck Brigham Hospital and Boston Hospital for Women merged (not partnered) to become BWH.

If they had called it the Women’s and Brigham the Women’s name might have survived the latest consolidation rather than being unceremoniously lopped off.

GSK not G SK

Back in the 1980s and 1990s a lot of big pharmaceutical companies merged. It was typical for them to drop the last name of their multiword names when they did. For example, SmithKline & French became SmithKline Beckman after merging with Beckman and then SmithKline Beecham after merging with Beecham.

When Glaxo Wellcome and SmithKline Beecham came together they followed a similar path. But you may notice they went with GlaxoSmithKline rather than Glaxo SmithKline, because the SmithKline people thought that would make it harder to get rid of their name later on. That’s a true story. I was there.

The stratagem has worked so far.

I wonder whether the BWH folks lobbied for MassGeneralBrigham to avoid a similar fate down the road.

When did Hospital become a bad word?

Remember when there were doctors and hospitals? Now it’s providers, medical centers and health systems. Hospitals still dominate economically and politically, but there is a general (and welcome) shift to lower acuity settings of care. Meanwhile Partners has vacuumed up so many other hospitals, physicians and other players that “hospital” no longer belongs in the name.

An interesting marker of the new company’s brand equity and name recognition is that unlike virtually every other new healthcare organization or company, it omits the word “health” from its name. People already understand it’s a healthcare organization.

What about Harvard?

MGH and BWH are both Harvard hospitals. So why not just call it the Harvard Hospital System or Harvard Health System? The use of the Harvard name could be a topic for its own post (Harvard Pilgrim –originally Harvard Community Health Plan and soon to merge with Tufts but with no name announced yet– is a great example) but the simple answer is that while MGH and BWH are Harvard hospitals, there are others like Beth Israel Deaconess and Boston Children’s that are also affiliated with the University.

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By healthcare business consultant David E. Williams, president of Health Business Group.

The healthcare cost revolution will not be televised either

published date
November 6th, 2019 by
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Coming to a TV near you

The quote at the end of yesterday’s Boston Globe article (Consumers struggle to find information on health care costs, poll shows) made me laugh.

“We’re seeing more and more consumer awareness every year,” [an insurance executive] told the Globe. “It’s a revolution that’s occurring, but it occurs over time.”

When I read about this ‘revolution’ it brought to mind an expression/poem/song from long ago: The Revolution Will Not Be Televised! The timeframe for the healthcare cost ‘revolution’ is on the order of decades, and I don’t think anyone will be able to sit still for a TV show of that length!

Not surprisingly, the Pioneer Institute’s survey demonstrated that while people with commercial insurance are interested in obtaining  price information before receiving a healthcare service, they don’t often get it. Only 2 to 7 percent of people check costs on insurers’ websites, according to the Attorney General.

Although that number seems crazily low, it’s actually easy to understand once you consider the multitude of the barriers:

  1. Patients don’t know what services they’re going to need
  2. Choice of provider often trumps cost as a factor
  3. Their health plans may not reward or punish them for saving or spending more money
  4. Next year’s insurance premiums are unaffected by what they do this year
  5. Those with a high deductible plan are likely to blow through the deductible anyway if they have serious medical expenses
  6. Insurers’ cost estimators aren’t easy to use
  7. The estimates may not be accurate anyway
  8. People haven’t heard about the available tools

I’m an educated consumer with a high deductible plan but I don’t try to check the costs ahead of time.

So there’s no need to be glued to your TV (or other device) watching this ‘revolution.’


By healthcare business consultant David E. Williams, president of Health Business Group.

Drug testing –the new back to school ritual

published date
November 1st, 2019 by

I guess I spaced out and forgot to post this episode of #CareTalk back in September, when it came out! I thought I could John to partake of the specimen cup but he refused.

In this video we cover Trump’s “phenomenal” health plan, drug testing of students, medical tourism, obesity and back to school resolutions.

Enjoy!