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Home > Financial Management
The Health Reform Maze: A Blueprint for Physician Practices
The Health Reform Maze: A Blueprint for Physician Practices
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The path to reform has been caught in an unstable world between acceptance and rejection. This book compiles one physician's view of the political and practice environment for health reform to date. This book dissects the complex topic of heath reform in a straightforward manner guaranteed to get your attention.

March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (PPACA). The various effects of the law are producing confusion, contradictions, and ambiguities in the healthcare system. How do physicians and practice executives navigate through the confusion? The answers are in The Health Reform Maze: A Blueprint for Physician Practices by Richard L. Reece, MD.

This is your roadmap for health reform to date. Although clear exits and destinations remain murky, Dr. Reece has managed to create a statistically entertaining map for health reform. The Health Reform Maze: A Blueprint for Physician Practices contains many entries that Dr. Reece has composed over the last four years on his MedInnovation blog.

What makes this book so unique is Dr. Reece's keen insight and understanding of both physicians' and patients' value system.

"When it comes to trying to understand the current healthcare reform, this book covers it all in easily understandable language," says Nancy Collins, president of Greenbranch Publishing and publisher of the Journal of Medical Practice Management®. “Dr. Reece approaches the unclear issue from the patient and the physician perspectives while still managing to stay compelling, engaging, and even entertaining."

This book is ideal for:

  • Practice managers
  • Physicians
  • Medical directors
  • Insurers
  • Policy makers
  • Business schools
  • Health manager programs
  • Government administrators
  • Healthcare Finance Administrators
  • Legislators
  • Patient/Consumers
It is a must-read when trying to tackle the questions surrounding health reform.



The Health Reform Maze: A Blueprint for Physicians Practices contains blog entries that deliver comprehensive but easy to read discussions concerning the uncertainty, the threat of lower reimbursements, and what practices can do in response to reform. The entry format allows the reader to even pick and choose from the sections without having to read straight through. Dr. Reece delivers a balanced (and less judgmental) overview of the reform. This book breaks the trend of specialized, narrow healthcare reform reports. Because of its multiple points of view and various perspectives, it tells you everything you may want to know about health care reform but were afraid to ask.



Table of Contents:

PART ONE: Culture and Politics, the Reform Law, Costs and Demands, and Unforeseen Consequences



  • Culture and Politics
  • Blue Monday for ObamaCare
  • Political Chickens Coming Home to Roost
  • Obama Rope-a-Dope
  • Tipping Point
  • Reform Storm
  • U.S. Exceptionalism
  • American Heritage
  • Ask Not: Health Reform Propositions
  • Pig in a Poke
  • A Favor You Can’t Understand
  • Reform and Repeal Odds
  • Massachusetts and Indiana Experiments
  • Romney’s Legacy
  • Center-Right Nation
  • Americans and Their Medical Machines
  • Comparative Health Statistics between Nations
  • The Reform Law
  • “Fiendishly Complicated”
  • Fast-Baked Reform Cake-Off
  • A Tangled Web
  • Winners and Losers
  • Known and Unknown Consequences of Reform Law
  • Vast Law, Half-Vast Consequences
  • Positives and Negatives
  • Checks and Balances
  • Correctness and Incorrectness
  • Wisdom of Crowds
  • Constitutionality
  • If Not Constitutional, What Then?
  • No Compelling Story
  • Big Brother Is Watching
  • Costs and Demands
  • Big “D”
  • Everything Has a Price
  • It Ain’t the System, It’s Aging
  • Doing the Math
  • Health Costs and Human Nature
  • SNAFU (Situation Normal All Funds Up)
  • Hospital “Facility Fees”
  • Unforeseen Consequences
  • Waive Obamacare Goodbye
  • Costs of Consolidation
  • Reform Holes You Can Drive a Truck Through
  • Health Reform Dislocations
  • Will Public Hospitals be a Health-Reform Causality?
  • Death Knell of Independent Health Agents?

PART TWO: Physicians, Hospitals, Patients, Access to Doctors, Medicare, Medicaid, Government Bureaucracy


  • Physicians
  • Doctors in America
  • Talk Is Cheap
  • The Physician Organizational Inferiority Complex
  • Primary Care Revolt against RUC
  • Survey: Two-Thirds of Doctors Fear or Oppose Health Reform Law
  • The Future of Accountable Care Organizations
  • The Elephant in the Room: Small Physician Practices
  • Pay-for-Performance, Not so Fast McDuff!
  • Stalking the Noncompliant Physician
  • A Physician’s Manifesto
  • Impact on Doctors
  • Physician Gratitude List
  • Reaping Tort Reform Benefits
  • Congress Hoisted on Its Own Petard
  • Who Speaks for Physicians?
  • A Remarkable Document
  • Primary Care in the Dumps
  • Scuttlebutt
  • Monstrous Implications
  • Physician Sentiment Index
  • Doctors’ Dilemmas
  • The Future Ain’t What It Used to Be
  • Feminization of Medicine
  • Who Decides - Government or Doctors?
  • Hospitals
  • Chain Reaction of Consolidation
  • Hospital-Doctor Hiring Wave
  • Disgruntled Physicians and Unhappy Hospitals
  • Accountable Care Organizations: Negative Reaction among Physicians
  • Accountable Care Organizations as Private Practice Killers
  • Resolving Hospital-Physician Conflicts
  • Patients
  • “I Told You I Was Sick”
  • Resuscitation of Death Panels
  • "I Feel Like a Million Dollars"
  • “Patient-Centered Care” and What Patients Want
  • Heart Disease and Health Reform
  • More Private, Personal, Home, and Decentralized Care
  • A Physical Exam Tale
  • Access to Doctors
  • Playing the Percentages
  • Will Doctors Be There?
  • Access Mess
  • And Who Shall Care for the Sick?
  • I Told You So
  • Victims of Health Reform
  • Medicare
  • Ba-Ba-Ba-Ba Boom!
  • Health Reform Impact, as Cited in the Medicare Chief Actuary’s Report
  • Fraud and Abuse
  • Skepticism among Seniors
  • Government Bureaucracy
  • Res Ipsa Loquitur
  • Reasons behind Growing Bureaucracy
  • Where Has All the Trust in Government Gone?
  • Sickness of Government
  • Berwick Quote
  • More Berwick in His Own Words
  • Harvard-Driven Health Care
  • Berwick on the Virtues of the Health Reform Law

PART THREE: Innovation, Electronic Health Records, the Internet and Social Media, and Miscellany


  • Government “Innovation”
  • Innovation: Last Great Hope
  • Health Reform, the Blogosphere, and Search Engine Optimizations
  • Irresistible Force
  • Seek and Find: Googling of Disease and Health
  • Why Not More Innovation?
  • Balancing Reform and Medical Innovation
  • Top Ten Innovators
  • Getting Your Care at Work
  • No Miracles among Friend
  • How To’s of Healthcare Innovation
  • Electronic Health Records
  • Bonanza or Boondoggle?
  • “Inevitability” and “Waiting Game”
  • Is a “Free” EHR for Real?
  • Seek, Speak, and Ye Shall Find
  • The Janus of Health Reform
  • Unnatural Human Communication
  • Talking to Your EHR
  • Patients and Wikileaks
  • Need for Physician-Friendly and Physician-Useful Information
  • Hospitals and Doctors Not Walking the EHR Line
  • The Internet and Social Media
  • Coming Out of the Electronic Wilderness
  • Twittering Down, How Tweet It Is
  • Internet Groundswell
  • The Computer Is a Moron
  • Sermo - Physician Social Networking
  • Miscellany
  • Grace-Marie Turner and the Galen Institute
  • The Medical Industrial Complex
  • Too Many Rocks in Physician Knapsacks
  • Why the Political Sea Is Boiling Hot and Pigs Have Wings
  • Pruning the Reform Christmas Tree
  • Consequences of Health Reform
  • Epilogue
  • Eight Health Reform-Driven Physician Trends
  • Doctors Make a Difference for the Poor
  • The Doctor Is In

About the Author

Richard L. Reece, MD, pathologist, writer, and editor, is former Editor-in-Chief of Minnesota Medicine and Physician Practice Options. He has written 10 books on the healthcare system. For the last four years, he has written a blog, MedInnovationblog, which includes 1,700 entries on healthcare innovation and reform.

Dr. Reece stresses that physicians and patients must work together more closely to build a more personal, patient-centered system without massive interventions by third parties.  Dr. Reece was educated at Duke University School of Medicine with postgraduate training at Hartford Hospital and had training at Harvard Business School.

Reviews

"Healthcare Reform: an oxymoron that is almost impossible to understand. Dr. Richard Reece is making an effort to bring some semblance of understanding to this situation. He backs up his comments with statistics, facts, and his experience as a doctor. He also adds a dash of humor, as this is pretty strong stuff for most of us physicians who are eyeball to eyeball with patients to digest. Dr. Reece uses wonderful metaphors and sprinkles his chapters with quotes from the literature, which makes reading this book so enjoyable. If you are looking for some insight from one of our colleagues, and an enjoyable style of writing that borders on entertaining, then I highly recommend you read The Health Reform Maze: A Blueprint for Physician Practices. You won't be disappointed, and you will enhance your understanding of a problem that affects every physician and every American citizen."

Neil Baum, M.D.

"Dick Reece is a prolific health writer with a keen sense of what is happening in the nation's healthcare sector. His new book is further testament to his uncanny understanding of the effects of health reform efforts on patients, physicians, and hospitals alike. His firm grasp of these many important and complicated healthcare issue makes this book a must reading for all those interested in U.S. healthcare policy."

Tim Norbeck, CEO, The Physicians Foundation

"Richard Reece, MD, is well known for his numerous and cogent writings on America's healthcare issues, as well as his keen insight and understanding of both patients' and physicians' value systems. In his latest book, The Health Reform Maze: A Blueprint for Physician Practices, Dr. Reece has made another major contribution in bringing forth a unique understanding of how reforms impact upon all affected parties. This book is a vital must read for all of those who wish to better comprehend our complex and complicated healthcare system as well as for those who entertain efforts to reform it.

Walker L. Ray, MD, vice president, The Physicians Foundation, and former president, Medical Association of Georgia

"In the midst of the confusion and haze of the Affordable Care Act comes a book that peers behind the curtain to see what healthcare reform really means to doctors, patients, and our country. Dr. Reece has gathered his writings into a readable and sometimes humorous compilation of fact, fiction, and anecdote that helps us to understand the turmoil our healthcare system will be experiencing over the next decade. His blog entries trace the evolution of the new law and what people say, think, and may do about its octopus-like reach. I recommend this book to anyone interested in their own healthcare and our evolving healthcare system.">

Lou Goodman, PhD, CEO, Texas Medical Association

"Dr. Reece sees America as a "diverse, center-right, capitalistic country" governed by a constitutional "balance among the executive, legislative, and court branches." He shows that accountable care organizations, exchanges, and endless new federal health insurance rules will certainly not bring about national healthcare Nirvana, but asks, "What will?" Reece had it right in his 1988 book, and he dramatically demonstrates it in this new book. “This struggle is mainly between the management of corporations and physicians. It is a struggle for power.” The struggle of 1988, however, has moved out of corporate offices and into Congressional lobbies and the Oval office. The government’s healthcare plan is to be administered by “remote bureaucrats” that “will never be able to gauge the hopes, feelings, and consequences of their remote judgments when a patient and a doctor meet in the exam room to decide what is best for the patient.” Ergo, politics cannot heal what ails us, but it can most certainly make it far worse. With this book, Reece has brought focus to the 2011 and 2012 health reform debate. I expect his yet unwritten sequel to be released soon after the 2012 election, and hope it reports on the political movement back toward market-based reform and away from government-demand systems."

Dave Racer, St. Paul, Minnesota, a supporter of health savings accounts

"This book is an interesting patchwork of individual thoughts on healthcare reform— highlighting some of the best and noting some of the worst ideas that have been presented in the last few years on what is right, wrong, and needed in order for our healthcare system to advance."

Matthew Katz, executive director, Connecticut State Medical Society

"This is a must read collection of essays that gives the good, the bad, and the ugly of the new healthcare law, PPACA. Dr. Reece shares a balanced presentation of proponents and opponents of the law and gives hope for a better way to reform the system."

Donald J. Palmisano, MD, JD, FACS, former president of American Medical Association, and author of On Leadership

"An eagle-eyed observer of the healthcare scene, Dr. Reece offers up the messy banquet of health reform in chewy but digestible bites. There is plenty here for healthcare professionals and policy wonks to sink their teeth into, but Dr. Reece’s clear, punchy style also invites the general reader to the table. Anyone looking for an engaging, even-handed (but hardly un-opinionated) examination of healthcare reform is encouraged to sample this very tasty new book."

Phillip Miller, vice president, Merritt Hawkins, and author of Will the Last Physician in America Please Turn Off the Lights

Dr. Reece, in his book The Health Reform Maze: A Blueprint for Physician Practices, writes about a complex topic in a straightforward manner that grabs your attention. Throughout the book, various perspectives and facts are presented that clearly show the pros and cons of healthcare reform initiatives; particularly how physicians, patients, and America are being affected now, and will be in the future. His use of humor and thought-provoking quotes applied toward today’s issues keeps the reader looking forward to the next chapter. If you like a book that takes a commonsensical view of a subject, you will enjoy reading this one."

Mike Martin, president, Practice Support Resources, Inc.

"This is a book that is of value to all the players—doctors, insurers, health planners and government administrators of health care and finance, as well as hospital leaders, legislators and the patient/consumer. Dr. Reece, trained as a pathologist, has been a writer of distinction for all of his professional life."

"He was editor of the respected Minnesota Medicine for over twenty years, and in recent years has written ten books examining the American healthcare system and its effect on the sick and the well, the rich and the poor, the doctors and the bureaucrats, the government and the people. This latest effort is his reading of the impact of the Affordable Care Act since its passage, as derived from his blogs entered on the web from March, 2010 to January 2011.

"The author believes that reform of health care has been designed by a politically center-left Congress and President, for a center-right more conservative nation. He makes it clear that what was needed was stepwise evolutionary change and what we have with “Obamacare” is a revolution in the provision of and payment for healthcare in the U.S. The appointed leader of the Center for Medicare/Medicaid Services (CMS), Dr. Donald Berwick, is, in the view of the author, committed to the central control of healthcare policy rather than one likely to rely on market forces. Since passage of the law, two camps have marshaled their forces—those on the left who argue that government must participate (further) in the system of healthcare, and those on the right who want less government, lower taxes, less debt and preservation of the right of individuals to decide for themselves. The accusatory rhetoric heats up on both sides and Dr. Reece, through his reading of the published media, the blogosphere, and interviews with recognized thinkers and actors on the healthcare stage, delivers facts and candid appraisal of the ongoing debate in plain language."

Valid concerns are expressed that the law as it stands will leave us short of doctors, thus short of access for those gaining insurance coverage. The emphasis on Accountable Care Organizations, and the efforts to diminish fee-for service payment systems and bundle payments to doctors and hospitals are pushing amalgamation into larger systems with doctors as salaried workers. These phenomena are dissected and exposed in easily understandable language, sometimes with a touch of humor: "Don't launch vast projects with half-vast ideas." Dr. Reece’s book is a lively, practical and valuable contribution to today’s ongoing discussion.

David Crombie, M.D. editor, Connecticut Medicine, The Journal of the Connecticut State Medical Society

Publication Date: August 2011
Number of Pages: 290
ISBN 10: 0982705549
ISBN 13: 9780982705544
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