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Skin in the Game

I recently read Skin in the Game: How Putting Yourself First Today Will Revolutionize Health Care Tomorrow by John Hammergren & Phil Harkins. I will give the disclaimer up front that I work for McKesson. Furthermore I will point out that I actually purchased this book with my own money – it was not given to me. The book is not really about McKesson – it's about us as Americans and the health care system we flow in and out of. Read on and I will explain.

There has been much talk, dating back to the early days of the Clinton white house, about health care reform. If you've been to the doctor's office lately, filled a prescription, or heaven forbid visited the emergency room, you have witnessed the need for systematic and behavioral changes first hand. I remember days in the E.R., intensive care, and later the neurological ward with my dad when we would answer the same questions over and over again. At the time I tried to look at it along the lines of police questioning where they interrogate you numerous ways to make sure you are giving the complete story. Over time I have come to realize that this was not the case. These different providers did not have an efficient way to communicate with one another. On the neuroscience floor, there was a huge (and I mean HUGE) chart that sat outside the patient's room that all the doctors and nurses would share, but even this was a paper system that stayed put. With all of the advances of modern technology there is surely a better way.

In 2001 I changed dentists and started visiting one near my home in Cumming, GA. When the assistant went to take my x-rays, there was a slight change. Instead of biting down on a piece of film, I bit down on a sensor with a cord coming out of it. The rest of the aparatus appeared the same (including the heavy lead blanket draped across me). The instant the button was pressed, an image of my teeth appeared on the screen. Instant x-rays – no developing required. This was awesome – but not pervasive. In 2007 I visited an orthopedist's office about a tracking issue with my knee. It was a new office – however the same OLD x-ray equipment. They had to take several pictures – but of course we did not know that until the first batches were developed. If only the orthopedist had the same x-ray apparatus in 2007 that my dentist had in 2001!

So what does this have to do with the book? Everything. Skin in the Game begins by giving some historical context of our system of healthcare starting in the 1800s. The media pundits are quick to talk about a crisis but do little to explain its origins – this book helps fill the gap. It then goes on to lay out ideas for ways to improve the delivery of healthcare and our access to it as consumers. Along the way you learn about innovative solutions that are already available in the marketplace to doctors, hospitals, pharmacies and clinics. Throughout the book Hammergren lays out the key to advancing health care in this country each one of us being the center of care and in control. This concept is very straightforward, but requires a fundamental shift from our present day way of thinking.

Overall I give the book 4 stars – meaning I liked it and would recommend it. It does an excellent job of framing the present state of affairs in America and provides thoughtful insight to drive conversations towards a positive change in our systems and behaviors. There are several pages of reference for further reading as well as an appendix filled with "resources, web sites, tips and guidelines."

P.S. If you are the kind of person that doesn't want to buy a book because you believe it further enriches CEOs – do not let that stop you from purchasing this book. All of the author's proceeds are donated to charity as noted in the foreward. Next week I'll review The Audacity of Hope: Thoughts on Reclaiming the American Dream (Vintage), a book whose author I am pretty sure spent all those profits on getting elected.

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