Consulo Indicium - 10/16/20

Information for your Consideration… 

Data Speaks – The following graph comes from The New York Times. It is telling. Note that the largest increases in Covid-19 incidence in the October timeframe are emanating from the rural and small metro areas. Therefore the central USA is experiencing a dramatic increase. It is (most) likely that the spread in these areas is coming from the fact that the use of masks is far less frequent than in urban areas. Why? I’ll let you decide…

cases by county

 Data Speaks – Even More!! – And, if the above chart is not enough – YOU DEFINITELY NEED TO CHECK THIS CHART OUT!!  It says it all… It shows the march of Covid-19 through the nation and the incidence of cases. In particular, watch for North Dakota (my home state) as it arrives on the scene on August 8th, then surpasses California on September 12th for total number of cases and by October 2 (the last date of the chart) it is reaching for #1 status to unseat Florida and Alabama as the top producers of Covid-19 cases. It fits with the above chart – and, is a sad commentary. Folks (where I have heard that expression before?) – “Wear Masks!!” Stay tuned… 

The Rising Tide of Telemedicine and Telecare – The Annual Cleveland Clinic 2020 Innovation Summit was recently held, and the prominence of digital care delivery was front and center. Prior to the onset of the pandemic, the use of digital capabilities was percolating along but the outbreak of Covid-19 more than accelerated the consideration and the use of these tools. The tone of the meeting is that the acceleration in use by health care systems is only at the beginning. As an example, one of the speakers – Alistair Erskine, MD, Chief Digital Officer for Mass General Brigham wryly noted, “Virtual is the new black right now. We’re at the top of the curve. We went from 100 visits to 12,000 visits a day. But we still have to digitally upscale our providers and we still have to digitally upscale our patients – the ones that are not used to navigating across all these new technologies themselves.” True – but they are learning very quickly!!

Reskilling – McKinsey released a report on the issue of “reskilling” – or giving workers new skills. Their report comes on the heels of a World Economic Forum report which recently declared a reskilling emergency where they declared that more than one billion jobs are being transformed by technology. The Digital Revolution is essentially the Industrial Revolution on steroids!! Furthermore, the changes are covering the waterfront of jobs ranging from front-line workers to senior executives. Medicine is no exception. Again, the pandemic is touted as one of the major reasons for a heightened sense of urgency in skill building. Check out the McKinsey Report – it’s definitely worth a read.

Personal Protective Measures Make A Difference – A new study coming out of Thailand from the CDC Emerging Infectious Disease Report (November 2020) notes the following derived from a review of 211 case-control cases of the disease and 839 controls. Findings included: 1) Wearing masks all the time during contact was independently associated with lower risk for Covid-19 infection compared with not wearing masks, 2) wearing a mask sometimes during contact did not lower infection risk, 3) maintaining greater than 1 meter distance from a person with COVID-19, having close contact for less than 15 minutes, and frequent handwashing were independently associated with lower risk for infection. In sum: consistent wearing of masks, handwashing, and social distancing were protective against COVID-19!

What Type You Are Makes A DifferenceUSA Today recently reported some good news for people like my brother who have Type O blood. The reported studies come from an article published in the journal Blood Advances in a study out of Denmark. The researchers review over 2 million people in a Danish registry of Covid-19 cases. The study was confirmed by a similar study from Canada which show that blood Types O and B had better outcomes once infected. Long story short – my brother will fare better than me. I’m blood Type A+. Oh well. I’m wearing a mask when out and above (not that much) – see above

Consulo Indicium - 9/29/20

Information for your Consideration…

Where’s The Prevalence? – The Centers for Disease Control recently announced that our nation’s more youthful participants (i.e. “people in their 20s…”) account for the largest number of cases of Covid-19 with the median age dropping from 46 to 38 by early September. While the older populace remains at the “highest risk” of death, the incidence is going way up with other age groups. In fact, Wisconsin in the last week of September had the largest percent increase going from about 700 new cases per week to over 2,000 in a very short period of time. And, importantly, it appears to be among all age groups.

Not Enough Data? A National Mask Mandate?  Not to be outdone by the medical journals, Goldman Sachs – an investment bank concerned about the overall economy – recently published a report noting that a national mask mandate would likely increase the percent of people wearing masks by 15% thereby cutting daily growth rate of cases by 0.6% to 1%. That rate of reduction would then save the U.S. economy from a 5% GDP hit in lieu of additional lockdowns. Hmmm. Masks instead of lockdown. Sounds like an attractive option. The current rate of mask wearing (although not always) is around 60% which leaves a very large segment of the populace not wearing masks. And, on top of it – the doctors and epidemiologists were not the ones who thought of it. It was a bunch of economists. Imagine – the confluence of doctors and economists… 

What About Flying? One of my fears relates to the risk of flying. I haven’t been on an airplane since early March and have dropped plans for upcoming flights. Why? Because I’m basically a bit paranoid – as are many of my other elder friends!  In a recent report from the CDC there were more than 1,600 cases of people who flew while at risk of spreading the coronavirus with the potential for infecting about 11,000 fellow travelers. BUT, due to inadequate contact tracing, the spread could not be ascertained. Hmmm. Perhaps my paranoia is well founded…  However, if you do have the itch to travel by air, consider Southwest where the middle seats will always (according to them) be vacant. Here are some helpful hints if you do decide to travel:

  • First and foremost, wear a mask – preferably a surgical mask or a mask that allows you to change a paper filter. All of the major U.S. airlines require the use of face masks, including United, (my favorite)American and Delta who actually ban passengers who refuse to wear them. If you forget your mask, almost all the airlines will provide you with one.
  • Use touchless options as much as possible! For example, use your smartphone to check in advance for your boarding pass (it’s actually far easier than the old process of standing in line!!). Also, you can avoid the wait lines for baggage as well and go through the expedited lines.
  • Open your air vents above your seat. The filters in the planes these days are incredibly good and will remove 99+% of particles. Aerosolized viruses are a bit of a different breed; however. Regardless, keep the air moving.
  • Even though the airlines have committed to a cleanliness policy, be advised to bring your own sanitizer and use it liberally to wipe down your seat, tray table, armrest and other areas around you – as well as your hands. Also, the airlines will allow up to 12 ounces for carry-on of sanitizer.
  • Pack your own food and bring a water bottle (empty of course until you get past security). A number of the airlines have reduced – or even eliminated – their inflight service to reduce the amount of interaction the attendants and the passengers.
  • Some sites suggest that you get a window seat but, I’m an aisle guy. Always have been, always will be. Besides, urgency is more of an issue these days :-)  .

Meanwhile, passenger volume is down 65% with the airlines in total losing about $5 billion per month with a rebound to prior flight levels not occurring for at least another 15 – 18 months according to airline officials.

Toto Has A New Job Opportunity! – Toto (= Toran Tormah) and his new companion (Lole – Lachlan Leigh) are our two Glen of Imaal Terriers. Not only are they absolutely wonderful companions but they also have the best “sniffers” in the world. I’m amazed at how they can identify the deer and fox and other assorted creatures which occupy the nearby woods. So, I was quite taken by a new study coming out of Finland’s Helsinki Airport which has trained dogs to sniff out probable Covid-19 carrying people in less than 10 seconds. The program was initiated on September 22, 2020 as an initial test but due to passport limitations, Toto was not accepted for early entry into the training program. For the test incoming passengers will simply wipe the back of their neck, hand it to the human inspector and the dog says “yea” or “nay” – in dog speak, of course. The researchers have worked out a whole protocol to evaluate the effectiveness of the doggy review. I’m sure it works. After all, Toto (and Lole, of course) seem to be expert trackers in the forest with their noses constantly sniffing one direction or another for a critter to chase. Finland got the idea from Dubai where a similar program found that dogs were 94.5% accurate in identifying Covid-19 positive people. When I approached Toto; however, he didn’t seem very interested. He simply gave me that look, “When’s the next bowl of ice cream coming?”

Statins Are Not Just For Cholesterol Control – In a study released in mid-September by American Journal of Cardiology, researchers from the University of California at San Diego announced a discovery that cholesterol-lowering statins reduced the risk of severe COVID-19 infection and reduced recovery times. In fact, statin consuming patients had a 50% reduction in “severe” Covid-19 reactions to the virus. More importantly, their research went beyond mere association between the two findings to actually defining the cellular mechanism explaining why statins are valuable. And the apparent answer: removing cholesterol from cell membranes prevents the Covid-19 virus from entering the cell. The research is compelling, based on science as well as facts. Read the research. You’ll be convinced like me that statins should seriously be consider as a “preventive” measure for inhibiting Covid-19 infections.

In other findings on statins, it’s also been shown that taking statins seems to slow and/or diminish the incidence of Alzheimer’s disease – a familiar trait among the Fickenscher family especially on my Mom’s side. So, in addition to reducing my air travel, I’ve also been bugging my cardiologist about the need for statin coverage – along with the Vitamin D that Dr. Fauci recommends as well as mask-wearing which is de rigueur!! In case it’s not clear, I’m not quite ready to succumb.In Case You Missed It – The Association of American Medical Colleges recently released its annual report on the supply of physicians noting that a U.S. physician shortage of 54,000 to 139,000 is anticipated by 2033. In particular, the shortage of primary care physicians will range from 21,400 to 55,200 based on their study or nearly 1/3 of those providers. The concern is that the rural areas will disproportionately be affected on the primary care front and will far ahead of the curve compared to the whole nation. And [editorial comment] there is no way we can train enough physicians to replace the outgoing group.

Consulo Indicium - 9/3/20

racoonA Proposed Official Mascot for the Ongoing Pandemic – I received a copy of this pic via my Twitter account and felt compelled to pass it along here in the blog. The picture speaks for itself. Pass it along!!

Swamp Happenings – The humidity and heat have been on the rise in Washington, DC as both the Democratic and Republican conventions came together virtually. Of the topics mentioned by each party – there’s one that was on both lists = “health care”. In fact, in mid-August, the Trump Administration launched the Pledge to Embrace Technology to Advance America’s Health. The intent of the pledge was to get ahead of the political dialogue by promoting telehealth as a permanent part of the care delivery for patients and by providers. The response of the telehealth and care delivery communities has been strong with enthusiastic commitment for further expansion of coverage. Reports by The Washington Post have noted a 4300% increase nationwide in the telehealth and telecare utilization compared to pre-pandemic use. In other news, the Trump Administration signed an Executive Order for expansion of telehealth services for rural areas of the nation with the intent that CMS will continue its efforts to expand telehealth on a permanent basis for Medicare and Medicaid. If the big gorillas (= Medicare and Medicaid) go virtual, the rest of the nation will likely follow and, in fact, that seems to be happening.  

Readings to Consider – I don’t usually point to the large number of readings I peruse as part of my literary wanderings. However, there’s a very good overview of the pandemic evolution and projected outcomes in the March 2020 Atlantic. While The Atlantic Perspective is long, it’s definitely worth reading. The article provides an overview of the current state, a perspective on how we are managing the pandemic and projections on the longer term. 

Responses on Partisanship –As my regular leaders know, I recently experienced some backlash because I was accused of being “too partisan” – so, I ask the readers. I really do try to stick to the facts but at the same time believe that health care – how we fund it, how we deliver it, how to regulate it, etc. is a highly political concern and will be so increasingly in the years to come. The U.S. Congress recently passed a 3 trillion dollar (yes, that’s a “t”) mega-spending bill in an effort to help those who are suffering economically from the effects of the pandemic. I’m fully supportive. Now, they are looking at an additional $2 trillion package. That total investment of $5 trillion will go on top of the largest deficit in U.S. history – about $1+ trillion – accumulated by our last 3 Presidents. Now, if you were a legislator trying to stem the tide of deficits and examined the U.S. budget, it would become clear that just shy of 50+% is consumed by health care and entitlements. Hmmm. It seems to me that healthcare has a big target on its back. Change is coming…

Now – as for comments on my “partisanship”, here are a couple that I thought I should share that point in the direction of my sentiments:

  • It’s okay to be partisan if you are partisan for science, evidence, fair process, compassion, empathy. If that leads you to support one person or ideology over another, so be it. To not take a stand is to take a stand. 
  • It cannot be accepted that talking about facts is partisan. Mentioning a person who is partisan who has made facts a partisan issue is not a partisan comment, it is a fact about reality. We cannot let ourselves be drawn into an argument over whether facts are partisan. We must continue to state facts, including facts about what people are saying about facts, the lies they are promoting, and be unashamedly clear that we are NOT being partisan. Disagreeing with a lie is not partisan. Lies and facts DO NOT warrant equal time in a discussion, any discussion.
  • Don’t flog yourself about others concerns about the two sidism trap. Hate to break it to everyone but healthcare is political and economic. It has always been and will always be. Certainly in this pandemic we are seeing even more nakedly the confluence of healthcare, politics and economics. 

Thanks to all the readers for your ongoing comments, thoughts, perspective and ideas. Also, a little secret. The best read portion of the blog is “The Weekly Whisk” where I share my favorite restaurant of the last couple of weeks or, more recently, my favorite recipe. The recipes have taken over because of the pandemic. For the first time in more than 35 years, I’ve been home for more than 3 months at a single stretch. It’s a new life without travel. And, I’m lovin’ it!! More later…

Covid-19 Research Findings for Your Consideration – It seems like on a daily basis there are new findings on the way we should be managing the pandemic crisis. Here are a few miscellaneous items you may want to have the organizations you are involved with consider as part of their protocols:

  • The Pharos Global Health Advisors, a Boston-based not-for-profit focused on global health issues recently announced that indoor dining has been linked to 10% of new infections in various states around the nation. Disease experts in the state have also pointed to indoor dining as an area of concern, with some calling for a rollback of reopening.
  • In a study reported in Health Affairs by Lyu and Wehby the effects of state government mandates in 15 states related to the use of masks were studied in the period of April to May. The researchers reviewed the rate of county-level increases in in Covid-19 incidence in the 1-5, 6-10, 11-15, 16-20 and 21 or more days following the state order to use masks. Based on the study, it was estimated that more than 200,000 infections were averted through the use of masks. For details review the study.
  • One of the findings from research is how Covid-19 is spreading. In the vast majority of cases where an individual becomes infected, they infect – on average – one to two other individuals – but that’s it! So where are all of the cases coming from? It seems that “superspreader events” are the primary source. Evidence from around the world is showing that the superspreader events are the source for 80+% of all Covid-19 infections. So, what are these events? They are the typical indoor gathering = large events (e.g. rallies for political candidates, the Sturgis gathering of motorcyclists in South Dakota), churches (e.g. yes – all of them: Protestant, Catholic, Jewish, Muslim – pick your favorite faith), bars (e.g. especially those packed with younger folks having the time of their life late in the evening), restaurants (e.g. closely packed ones are especially vulnerable), confined locations where people are together for protracted periods of time (e.g. cruise ships, Navy carriers, etc.), worker commons or those open area work places where large numbers of co-workers gather to connect and work on projects; and, other similar venues. I know that for our family, we’ve gone from 1 – 2 meals out at a restaurant per week to only 2 outings since February – AND, both were at outside venues a bit after hours when the vast majority of people had gone home for the evening. An example of such a superspreader event was the Biogen conference held at a hotel in Boston in late-Februaryfor the biotech company Biogen. Researchers in a study of the conference looked at the specific genetic mutation of the virus among those who became infected at the conference. Through that analysis, they were able to determine that this one event led to an estimated 20,000 Covid-19 cases across the county. in total. BTW, I was at a different conference at the same hotel just a few days after the Biogen conference in the same area of the same hotel. Whew!!! Missed it…

Why Are Superspreader Events a Problem? – If we look at how the Covid-19 virus spreads, researchers have determined that the “primary” (i.e. not only but “most often” by a long shot) mode of transmission is through microscopic droplets that are spewed forth when an infected person coughs or sneezes — or even speaks. The people close to these individuals then breathe in the droplets and become infected. This the is reason that the CDC has stipulated that we should maintain “social distancing” of at least 6 feet away from people AND wear a mask in public. The microdroplets generally do not travel in the air further than about 4 – 5 feet creating a “bubble” near a person. So, if we stay outside of the bubble range – the odds of infection are markedly reduced. But, that’s not the end of the story. Researchers have more recently discovered that the Covid-19 virus also spreads through even smaller, longer-lasting aerosols particles caused by simply breathing, speaking or, even flushing the toilet [Commentary: Oy Vey!!]. The aerosols are so small they can hang in the air after an infectious person has left the room for a period of up to three hours [Commentary: Double Oy Vey!!!!]. This may be the reason that the superspreader events are such a significant reason in the spread of Covid-19 – which brings me to my last point – the asymptomatic or pre-symptomatic individuals. In particular, this group of people are the highest risk for the rest of us. It is these individuals that unwittingly spread the virus among those who don’t quite get it and refuse to wear masks. We, in general, are wearing masks even among family members on the notion that if members have been out and about, they may have been exposed So, consider it.

The Alzheimer’s Horizon Holds a Glimmer of Hope – Alzheimer’s Disease is absolutely the worst disease in the world. Our family is afflicted with my Mom suffering from the ravages of end-stage disease. I’ve been a physician and worked in lots of situations both traumatic, chronic, acute and the like but – in my personal experience – Alzheimer’s is the worst!! But, there is hope on the horizon. The New York Times and other news outlets recently reported that researchers have developed a diagnostic blood test that can accurately determine the presence of Alzheimer’s. It measures the level of a tau protein (= p-tau217) that is linked to the presence of Alzheimer’s in patients. The new test is just as accurate as the more expensive or invasive diagnostic procedures used in today’s encounters. But, the added fact is that the new blood tests can make the diagnosis up to two years earlier than the other procedures! The findings were published in JAMA.  

Consulo Indicium - 7/29/20

Information for your Consideration… 

To Mask Or Not To Mask, That Is The Question! – “The Mask” has taken on new meaning in society writ large. We can now order masks that convey our favorite symbol or topic du jour. There are Trump masks and Joe masks. There are peace masks, BLM masks, puzzle masks, and the latest – “your face” masks which duplicate the bottom half of your face as a mask. Then, there are just plain old blue surgical masks, N95 masks and an assortment of other personal protective gear designed for those with chronic exposure to the Covid-19 virus.

Now the question you should be asking when it comes to wearing a mask is: What do the studies show? The problem with most of the studies is that there are no controls for comparative purposes so the data needs to be extrapolated. Regardless – the data is very clear: USING MASKS MAKES A DIFFERENCE! Here are the studies:

  • A report this Spring from Nature Medicine(2020-0401) reviewed the effect of mask use on the seasonal flu. It revealed that masks blocked almost all of the larger contagious droplets and many – but, not all – of the aerosolized tiny droplets or, the kind from coronavirus. Long-story-short (LSS) = Masks work.
  • The BMJ Global Health (2020-0515) reviewed mask use in China, specifically related to home use and household spread among family members. Use of masks in the home resulted in a 79% reduction in viral transmission. LSS = Masks work.
  • Again, in late May, a study in Cell,described the finding that the Covid-19 virus may attack the nasal cavity first, get planted (my wording) before moving on to more vulnerable tissues (i.e. the lungs) and causing severe respiratory problems. Again, LSS = Masks work!
  • And aProceedings of the Royal Society (2020-0701) early last month concluded that if the majority of a population wore face masks in public regardless of type, the reduction in viral transmission would be dramatic and prevent continuation or expansion of the pandemic. LSS = Masks work!!

But, unfortunately, our messaging has been mixed at best. Near the beginning of the pandemic, I remember talking with a group of colleagues that meets by Zoom and telling them that the contribution of masks was “marginal”. A week later, the CDC came out with their recommendations “suggesting” the use of masks. I reviewed the data and reversed course by calling my colleagues to apologize for getting ahead of the curve. I told them: “Masks work.” Consistency of messaging with each state doing its own thing for different purposes at different times has created a morass. But, I digress. Review the above data and you’ll see the same results I’ve found…

Now – what types of masks should you be wearing? The issue is the ability to block the aerosolized droplets (the tiny ones where Covid-19 hangs out). Here’s the advice I’ve found:

  • While the N95 masks are exceptionally effective in blocking aerosolized droplets (i.e. up to 95%) – they are in very short supply and generally held back for health care providers and the emergency medical technicians. So, good luck…
  • The surgical masks are designed to prevent the wearer (e.g. the surgeon) from spreading germs to others (e.g. the surgical patient). They tend to be a bit looser than other types so the wearer can obtain unfiltered air from the sides of the mask – making them more susceptible to breathing in viral droplets from the air from others. But, according to tests, they block out about 75% of aerosolized droplets.
  • Cloth masks seem to be the rage at the moment. In fact, my favorite mask is a cloth one with “peace signs” all over it (i.e. retro 1960’s type mask). But according to reported research they are only 30 – 50% effective – especially if only a single layer. Mine is multi-layer by folding over the material on top of itself to create double & triple layers. I’ve gone to adding a folded up paper towel under my cloth mask when I use it for added protection.

The biggest problems with masks is finding ones that fit over your entire face. For example, I have a relatively long face and many of the masks only go to the bottom of my chin thereby exposing me to inhaling air from below the mask as well as from the sides. But, regardless, LSS = Wear masks. The final thought is to review the New York Times page that provides an overview by county of mask use across the entire country as of July 17, 2020. It’s worth taking a long review…

Disturbing Social Disparities – The graph below speaks for itself and is disturbing beyond words. Think about it for a moment in the context of our current national conversation on race.

coronacases

Kudos – We should all send a note of thanks to the Nebraska Medical Association for the risk level chart which they recently published. You can be the judge as to when you want to use a mask. While I’m compulsive and wear a mask for 1 and above – you be the judge!

 coronarisk

The Coming Primary Care Confrontation –If health care providers and systems thought there were challenges coming at the traditions of care delivery from private equity groups, insurance companies and for-profit chains – as the saying goes, “…they ain’t seen nothin’ yet”. Why? It’s because three of the largest retail and financial organizations in the nation – CVS Health, Walmart Boots and the triad of Amazon-JPMorgan Chase-Berkshire Hathaway – have all made recent moves into the primary care space. The triad is focused on primary care for the workers – as a starter project for expansion to others down the road. CVS Health is adding primary care “HealthHUBs” to 1500 of their existing store operations across the country; and, Walmart Boots (the most recent entrant) announced an affiliation with VillageMD to place primary care offices adjacent to existing operations in over 700 locations.

Why is all of this action concerning? It’s because the studies to date have shown that the retail clinics do not lower cost and, more importantly, the evolution of these sites is continuing the slow moving tsunami of disintermediation of the primary care process. Actually – to be honest – this has been my mantra for the last decade. The problem is not in providing retail services. Actually convenience would be enhanced if it were done properly. The problem is in the fact that the retail services are done to the exclusion of a comprehensive oversight of the care delivery process – something that has traditionally been the purview of the primary care provider. I drank the Kool-Aid on this one back in the late 1970s when I became a resident in Family Practice. I believe then, and I still believe now – that a comprehensive coordinated care model by a primary care provider is the most effective model for enhancing quality and reducing costs. There are many studies on the topic but the National Institutes of Health provides one of the best overviews on the topic if you’re interested in diving deeper into the topic.

Finally, while out-of-pocket expenses are a growing component of the overall health care spend, it is not necessarily on the primary care front. As a result, these initiatives will require the same negotiations with insurers that other physician and system providers must consider. The insurance companies could potentially latch on to the idea – if it reduces their overall cost. Alternatively, if we move toward more value-based care delivery, the importance of primary care as the “coordinator” of care delivery becomes considerably more important. In that case, these new entrants could have some advantages – primarily due to access considerations. Regardless, there is a coming confrontation. Is it the insurance companies, the existing health systems or the insurers who will be responsible for comprehensive coordinated care? We need to keep a watchful eye…

Federal Government Continues to Open the Telehealth Door – There is clearly growing support for a permanent expansion for using the telehealth approach as part of our care delivery armamentarium. With the announcement in mid-June that the Center for Medicare and Medicaid Services (CMS) proposed making a permanent change in the reimbursement rules – we should anticipate that the other health insurers are not far behind. In fact, the Association of Health Insurance Plans, in a study funded by the Aetna Foundation, outlines an increasing number of plans that now offer telehealth coverage. In addition, Senator Lamar Alexander (R-TN) who chairs the Senate HELP (Health, Education, Labor and Pensions) committee has introduced legislation that would require CMS to make permanent the home health telehealth provisions which were part of the COVID-19 relief regulation from March. The Federal Communications Commission has also gotten into the swing of changes by setting aside $200M from the CARES Act provided by Congress specifically for telehealth expansion – which will be particularly important for the rural areas of the nation. It has already processed more than 500 applications which can be used for platforms, training of state and physicians and other similar initiatives. 

Who Are The Better Leaders? – My wife provided me the following material from an article that asked the question: Which countries have been the most affected by the Covid-19 pandemic and who were their leaders? VERSUS which countries have been the most successful in preventing the spread of Covid-19? You be the judge on what this all means…

THE COUNTRIES WITH THE GREATEST SPREAD OF VIRUS FROM THE PANDEMIC

spread

 THE COUNTRIES WITH THE MOST SUCCESS IN MANAGING THE PANDEMIC

countries

Health Care, We’ve Got A Problem –First, let me be clear that I’ve been an advocate for women leaders in health care for a long time. Second, we are not making sufficient progress in supporting the movement of women of health care into leadership roles as effectively as we should be doing. The data shows very clearly that while women make up the vast majority of the health care workforce, they only hold 19% of the CEO positions across the nation. Furthermore, only 4% of the health care companies that support the industry have women CEOs. It’s why we need to do a better job of supporting leadership development for women in healthcare and, of course, the nation! 

A Slight Change

For the evolving blog…

Taking the Feedback – A number of colleagues have recently written to me noting that over the last six months, my blog has become a bit more partisan in nature. The breadth of the pandemic tsunami carried me away as I sheltered away up in Maine. If any of my facts were wrong – please point them out. I will make corrections like I noted in the above commentary on the use of masks where my initial understanding was incorrect (SEE above on wearing masks). I’ve been at the blog now for nearly 12 years and the readership has been long and loyal. Let me give a shout out and note of thanks to those who have given me feedback.

As a result of the feedback, I’m moving any “commentary” to the end so that those who do not want my “opinions” (except non-controversial ones, of course – like wearing masks or at least not medically controversial :-)  ) they will not have to consider them. I hope this slight change will allow the readers to still take advantage of all the information I pull together on the directions of the health care industry.  Any other feedback from readers is always appreciated at my regular email address = This email address is being protected from spambots. You need JavaScript enabled to view it..  Have a good day, stay well and be safe!!!

Healthcare Consultants

    ...Inspiring creative change to benefit the human condition