I appreciate your heartfelt thoughts that we will learn from our mistakes of a previous century.
Perhaps this is why we talk of the “practice of medicine.”

In theory there is no better call than to find and build mechanisms wherein the alignment of interests and incentives can be effectively deployed – both in terms of mission and JV business plan.

Like you, I was there from the beginning and through the unsightly industry demise (i.e., the unwinding of risk based JVs) in the 90s.

We tried hard, and had like minded senior hospital leadership and “visionary” MDs in the change agent seats. Yet, we failed.

Maybe this time will be different? The strategic imperative is perhaps even weightier now than during the “risk gold rush”. We’ll see. I am skeptical; though hopeful that the industry can no longer hide behind firewalls and moats of separation; and that our “cathedrals of medicine” now must find ways to become both transparent and accountable organizations; lest the drift into a “sea of irrelevance”.

Towards this end, I see much promise from social media as “battering rams” of here-to-for unresponsive, silo driven bureaucracies. Come join the conversation:

http://www.twitter.com/2healthguru