Primary Care Improvement is Not Static – Summit on Redesigning the Office Practice, Vancouver, BC

I recently returned from Vancouver, BC, where I was able to attend the International Summit on Redesigning the Office Practice , hosted by the Institute for Healthcare Improvement. I tended to drift toward the sessions that focused on LEAN transformations in primary care, with a lot of impressive teaching about impressive work in a host of organizations.

At very large conferences like this one is, it’s useful to spend time with innovation happening within your own organization, which is the case with the session called “New Challenges, New Tools, New Work, and New Outcomes,” facilitated by Leslie Francis, MBA/MHA, and taught by Kathleen Mayer, MD and Michael Pate from Kaiser Permanente, Colorado, and Kellie Takashima, NP, Kaiser Permanente, Hawaii. Jack Cochran, MD, CEO of The Permanente Federation, was also present with us and added insights for the audience.

I’m glad I attended because the talk was a reminder that visiting any organization at a point in time is just that – a point in time. See for yourself in the slides below – the problems that we thought were problems the last time we checked in may have been solved the day after we left….


Wow. I think that all of this 'improvement' is a conflict of interest if it is being directed and financed by medical manged care and insurance companies. All of this "improvement" malarkey started with Kaiser, HCA, Frist and the flag is now carried by Dodd ,Grassley and Berwick. There has been a formal effort by the banking industry ( think insurance companies and managed care) to take over continuing medical education for decades and to get more control of all things medical. It is the same players all sleeping in the same big global banking bed. Lots of lobbies, money to be had, lots of special interest and agendas to be hawked. This new model of educational support will be worse than big pharma grant-supported CME because the insurance companies call all the shots in health care not only the pharmacologic decision-making. Wake up everyone and read between the lines. This is a hijacking in progress. Just look on the IHI web site to see who is grant-supporting the IHI School. Big bucks from insurance companies and the Macy Foundation (yet another non profit arm of the Frist team). It all sounds so innocent…a nice NONPROFIT! is anything BUT! Write to your government representatives and tell them you don't want insurance companies teaching physicians how to practice medicine, even if they are behind the scenes of a innocuous non profit sounding organization. What a crock! It is the wolf in sheep's clothing to be sure.

Hi MedWoman,

Well…as someone who trained and practiced in these systems I would say that my experience was not at all as you described.

Talk more about your experience – where in your mind is the right kind of care happening and what defines that for you?

Thanks for taking the time to comment,


Ted Eytan, MD