As I said recently, I’ve been writing less here for a number of reasons. One is that I’ve been asked to write on other sites. Another, a sobering factor, as that after years of study, I’ve concluded that the American healthcare system has tied itself in a fatal knot. The post shown here, on the Patient Power blog, is an example of both.
“Only two of our sewage leaks were in ORs.” KNOW YOUR HOSPITAL’S SAFETY GRADE.

I am way behind in things I want to blog about – I started this post eight weeks ago. It’s been a combination of crazy travel, lack of sleep, and a head-spinning disbelief about how messed up medicine is, on so many things, while in other cases it accomplishes stunning saves (like saving my life). Such wild swings in quality always mean a system is out of control, which means you better make a point of learning what you can about who manages things best.
Here’s one of those topics. I hope to be able to dump out all these thoughts, good and bad, in the coming weeks.
Larry Weed, 1975: “The patient must have a copy of his own record”
This week I’ve had two new blog posts published on other blogs. This one’s close to my heart.
Dr. Larry Weed, who died in June, was a legendary physician, way way WAY ahead of his time in his vision for computers in healthcare, but also for his clear vision that if it’s your health, you need to be actively involved in managing it. AthenaHealth, a medical records system vendor, commissioned me to write a post about him, and it went live yesterday.
I had found a copy of his amazing 1975 book Your Health Care and How To Manage It, and found some astounding things in it. Please go read the post and see the quotes.
Bringing method to medical practice
Essential e-patient training: the uncertainty of all information

Below is a long comment I posted Wednesday on my neighbor @KevinMD’s blog. (Most of his widely read blog is articles he’s found elsewhere; he’s cross-posted some of mine.)
The post I replied to is a thoughtful submission by two grad students (one business school, one med school). Their thoughts are valid but as you’ll see, the issue isn’t apps – this is part of a broader issue that every engaged patient (you!) should understand. Here’s my reply.
See my cousin @McCullohMD on a special ABC 20/20 Weds night
Wednesday night (Sept 13) at 10pm ET, a special edition of ABC 20/20 will air, promoting a new series called “Good Doctors.” I’m thrilled to learn that my cousin Chris McCulloh, a third year surgical resident, will be featured.
I’d be thrilled to have anyone I know on such a highly visible show, but the extraordinary thing about Chris is that he almost didn’t enter medical school because a few months earlier he fell at home and end up with a spinal cord injury, paralyzing him below the waist.
Well, not only did he enter medical school, he’s a surgery resident now, planning to specialize in pediatric surgery! You’ll see he’s got a “standing wheelchair” and a whole lot of unstoppable e-patient baked in. Check it out! Watch! Be inspired like me! Links:
- ABC’s Facebook post for this show, with preview video
- Their Facebook page for the new series “The Good Doctor”
- Follow him on Twitter
- His occasional blog
- His original blog, back to 2008, about his injury and such.
https://twitter.com/McCullohMD/status/907642507571462144
Rice bytes: best way I’ve seen to understand giga, mega, peta and such
I love anything that makes it easier for people to know what’s going on. Case in point: this tweet yesterday from Twitter friend David Grayson @Sasanof, from the IBM Watson Summit in New Zealand.
You can use this to understand enormous sums of money, too:
$1 = one grain of rice
$1000 = cup of rice
$1 million = 8 bags of rice
$1 billion = 3 trailer trucks of rice
$1 trillion = 2 ocean freighters (3,000 truckloads)
$3 trillion (the US healthcare budget) = 6 ships (9,000 truckloads)
When someone says a health improvement project will save (or cost us) $100 million a year, it’s a lot, but think:
- The proposed amount is like 800 bags of rice.
- The US health budget is 9,000 truckloads of rice
Puts it in perspective.
Thanks to @Green_Goddess, Caroline Taylor, CMO of IBM Global Markets, for the visualization, and to @Sasanof for tweeting it. Don’t I love how social media helps ideas spread??
Update next day:
One of my very early blog posts, on my old blog, was on this same subject. March 9, 2009: Comprehending the US healthcare budget. Here are the graphics from that one:
Here’s a million bucks’ worth of $100 bills. (That’s 100 packets of 100 $100 bills; each packet is 1/2″ thick.)
Here’s 100 times as much – a million hundred-dollar bills, $100 million:
Ten of those – a billion:
And a thousand of those – a trillion. Check out the little dude, who’s now in the bottom left corner:
And US healthcare is three times that size.
This helps me, for one, start to comprehend the magnitude of the problem. Something like that does not shrink willingly: lots of people would lose their jobs, including CEOs etc. That’s why I liken US healthcare to “a tumor that doesn’t know how to stop growing and killing its host.”
Go back up and take a look at the size of one million in this picture. Urk.
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