The Cincinnati Enquirer was kind enough to run a guest column as the lead opinion piece in their print and online editions.  The column makes the case for why overcoming misdiagnosis should be getting much more attention in today’s health care climate and debate, and challenges policy makers and health care stakeholders to make the changes needed to help more patients get the right diagnosis and treatment.

Go read the op-ed here, and let the readers of the Enquirer know what you think of this public health crisis.

Millions of patients still are getting the wrong diagnosis and treatment worldwide, despite the “latest and greatest” medical advances.  At Best Doctors, our 2011 data from the US showed 29% of cases came to us having been misdiagnosed, while another 60% required a change or improvement in treatment.  How can this still be happening so often?

The Seattle Times is carrying an editorial I wrote which explores what we see as the root causes of so many patients being misdiagnosed every year; related costs and wasteful spending; and the core changes we believe need to happen in today’s health care approach to address what we view as a public health crisis.

Check it out and share your thoughts.

I’ve just finished up speaking at the Conference Board’s Employee Health Care Conference in New York.  I presented with Sandra Morris of Best Doctors client P&G, and we talked about how companies are keeping health care costs under control.  They’re doing it in a surprising way.

Like a lot of American companies they’re bringing the know-how that made them successful to the problem of health care costs.  P&G – a company that knows branding inside and out – used branding to get its employees to take an active interest in their health.  They got employees to eat better, smoke less, exercise more, and make smart decisions about the medicines they buy.  Once they had their employees engaged, they focused helping each and every one make sure they were getting the right medical care.

That’s where Best Doctors came in, and the results have been very much like what we see at other employers – changed diagnoses in more than 25% of cases, employee satisfaction levels over 95%, and direct impact on health care costs.

But the presentation wasn’t about Best Doctors, it was about how these results come from getting employees engaged in their care.  Many companies do it well, and now, they want to do more, by directly involving themselves how care is delivered to their members.  Some are setting up special networks of providers, special plan designs and other very targeted ways to make sure employees get better care.

Today, we talked about how getting the groups that manage employees’ care to actually work together, focused on the right diagnosis, that it’s possible to make an important impact on the quality – and cost – of care.

At a time when so many complain about the rising cost of health care, it’s refreshing to see old-fashioned American ingenuity making a difference.

The March issue of MORE magazine dedicates its “Medical Mystery” column to the problem of misdiagnosis.  Here’s a taste:

Americans believe that diagnosis is the cornerstone of medical care: You go to a doctor, who labels your problem and prescribes a treatment that makes you well. But what if the process gets stuck at the labeling stage? “We have a fantasy that as soon as we describe our symptoms, the doctor will know what is wrong with us. But the reality can be much more complicated,” says Evan Falchuk. . . . You don’t expect the doctor to be stymied, particularly after extensive testing. But failures to find a diagnosis do occur—and while no one knows exactly how often, 10,000 patients contact Falchuk’s firm for help every year.

Go ahead and read the whole thing.

The March issue of MORE magazine dedicates its “Medical Mystery” column to the problem of misdiagnosis.  Here’s a taste:

Americans believe that diagnosis is the cornerstone of medical care: You go to a doctor, who labels your problem and prescribes a treatment that makes you well. But what if the process gets stuck at the labeling stage? “We have a fantasy that as soon as we describe our symptoms, the doctor will know what is wrong with us. But the reality can be much more complicated,” says Evan Falchuk. . . . You don’t expect the doctor to be stymied, particularly after extensive testing. But failures to find a diagnosis do occur—and while no one knows exactly how often, 10,000 patients contact Falchuk’s firm for help every year.

Go ahead and read the whole thing.

Pretty well, actually.

As predicted last December, there was no big change to health care reform, doctors still didn’t have enough time with their patients, Microsoft made moves to create a “Windows” for electronic health records, and “ACO” became the hot buzzword in health care.  Some state governments started major redesigns of their benefits programs, saving money in the same ways private sector employers do.  Meanwhile, more than ever, private sector employers are penalizing employees who don’t take care of themselves.

Misdiagnosis finally started to be recognized as a public health problem.  At Best Doctors we got a great deal of press coverage in 2011 on this (for a few examples, go here, here, here, here and here).  I will sneak in a 2012 prediction and tell you that you will hear a lot more about this this year, and not just from us.

What did I get wrong?

Well, I said no major employer would drop their health benefits – and none did, so I didn’t really get this wrong.  But I was surprised to hear some very major employers quietly talking about their plans for dropping coverage in 2014.  It’s a bad idea – and I would have thought its badness would have been enough to keep it off the table.  For some employers, apparently not.

I also can’t point you to signs that the health insurance system is starting to take on the bad aspects of the workers compensation system.  Instead, many of the Fortune 100 employers we work with are trying to make their benefits plans simpler and easier to use.  I’m glad to be wrong about that so far.

Here are the two biggest misses.

First, I predicted a doctor would get sued for offering medical advice to a patient on line.  It didn’t happen in 2011.  Interestingly, there was (finally) a lawsuit claiming gag orders on posting reviews of medical providers on-line were unenforceable, something I thought would have happened a long time ago.

Second, I thought that health care reform would be more popular at the end of 2011 than it was at the beginning.  According to the Kaiser Health Tracking Poll for December 2011, in January, 41% of Americans had a “favorable” opinion of health care reform.  In December?  Forty-one percent.  A better prediction would have been that no one’s minds would be changed….

For my 11 predictions for 2011, I got 8 right.  Not bad, but I have to do better in 2012.

So, for 2012, I will make only one prediction – the world won’t end on December 21, 2012.

I feel good about this one- I’m wrong, no one will be here to see.

Sunday’s Milwaukee Journal Sentinel published an op-ed I wrote about how you can avoid misdiagnosis.

Published studies show that rates of misdiagnosis in America are a stunning 1 in 5.The good news is there are several steps you can take to protect yourself. They start with understanding why misdiagnosis happens, how you can work with your doctor to avoid it and, above all, playing an active role in your own health care.

Diagnostic errors happen much more often than most people realize. Even doctors are not immune. According to The New England Journal of Medicine, 35% of doctors have reported errors in their own care or that of a family member.

How can this be happening in a time of such great medical advances?

How indeed.  Go to the Journal Sentinel site and find out how you can protect yourself.

Bill Gates once said:

Success is a lousy teacher. It seduces smart people into thinking they can’t lose.

It’s clever, and it seems right.  Now there is science to prove it.

In a study published last week, scientists studied special imaging scans of doctors brains as they made simulated medical decisions.  Those doctors who paid attention to their mistakes made better decisions than those who were more interested in their successes:

“These findings underscore the dangers of disregarding past failures when making high-stakes decisions,” Montague said in a statement. “‘Success-chasing’ not only can lead doctors to make flawed decisions in diagnosing and treating patients, but it can also distort the thinking of other high-stakes decision-makers, such as military and political strategists, stock market investors and venture capitalists.”

This is just the latest proof of how important it is to interrupt your doctor’s decision-making process.  Leading researchers in the field of medical decision-making have emphasized how easy it is for “overconfidence” to get in the way.  Doctors are neither immune to disease nor the pitfalls of decision-making that plague the rest of us.

Guatemala is a developing country, with great natural beauty, hard-working people and many challenges.  Most Americans look at places like Guatemala and see only the challenges.  Some see opportunity.

I’ve just returned from Guatemala, where I met with our business partners, government officials, and others.   And I can tell you a universal truth.  People across the world want the best medical care they can get.  They aren’t looking for the latest technologies and drugs and treatments – or, rather, they aren’t looking only for those things.  No, what is most important to whoever I meet, no matter where they live, is that they are able to get the right diagnosis, and the right treatment.

It’s a harder thing to get in some places than in others.  Americans don’t realize that one of our great exports is our health care.  Not our system – but our know-how, education, medications, devices, techniques.  In many ways, health care promises to be the economic engine of 21st century America.  And getting access to it doesn’t necessarily mean getting on a plane and coming to the states.  At Best Doctors this is what we do – bring the expertise of the world’s leading doctors to where – and when – it’s needed.

After a speech I gave in Guatemala one of the audience members came to me and said she thought something I said was very important.  “Every person deserves the right diagnosis and treatment,” she said.  It’s a simple concept that is much harder to make reality.  But it should be the basis on which any health care program, health care provider – or health care system – must be built.

What does it mean to be an entrepreneur in health care?

Twice in the last two weeks I had the honor of speaking at Northeastern University’s Health Sciences Entrepreneurs Program. It’s a terrific program, dedicated to fostering the creation of health care businesses by helping the people who build them figure out how to do it. That it exists is a testament to how strong the American spirit of entrepreneurship really is – and how the 21st century economic engine is going to be health care.

But the hundreds of students and alumni who attended the events already knew this. What they wanted to know were the answers to more practical questions – how do I know if it’s a good idea to try something? What happens if I make mistakes, or fail? Do I really need to start a business to be an entrepreneur? What opportunities does the changing world of health care create?

They’re the right questions because they’re hard. Being an entrepreneur means you’re willing to look at the world as it is and want to make it as you think it should be. It means being willing to take risks, try new things, and not being afraid to fail. In fact, if you listened to the panels of highly successful entrepreneurs, you’d think failure was a big part of what entrepreneurs do. You can’t create something new without making mistakes along the way.

At the end, we were all asked to give one piece of advice to the budding entrepreneurs.

Mine was this: Do Something Cool. Always put yourself in a position where you’re doing something that is so cool you want to tell people about it. When you don’t think it’s cool anymore, leave, and find something else that you think is cool. Don’t worry about whether it means starting your own business or working with someone else who has. Put yourself someplace where you think you are changing the world.

If you can do that, you’ll be an entrepreneur.