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Where Does It Hurt?
- An Entrepreneur's Guide to Fixing Health Care
- Narrated by: Patrick Lawlor
- Length: 7 hrs and 21 mins
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Publisher's summary
A bold new remedy for the sprawling and wasteful health care industry. Where else but the doctor's office do you have to fill out a form on a clipboard? Have you noticed that hospital bills are almost unintelligible, except for the absurdly high dollar amount? Why is it that technology in other industries drive prices down, but in health care it's the reverse? And why, in health care, is the customer so often treated as a mere bystander - and an ignorant one at that? The same American medical establishment that saves lives and performs wondrous miracles is also a $2.7 trillion industry in deep dysfunction. And now, with the Affordable Care Act (Obamacare), it is called on to extend full benefits to tens of millions of newly insured. You might think that this would leave us with a bleak choice - either to devote more of our national budget to health care or to make do with less of it. But there's another path.
In this provocative book, Jonathan Bush, cofounder and CEO of athenahealth, calls for a revolution in health care to give customers more choices, freedom, power, and information, and at far lower prices.
You’ll learn how:
- Well-intended government regulations prop up overpriced incumbents and slow the pace of innovation.
- Focused, profit-driven disrupters are chipping away at the dominance of hospitals by offering routine procedures at lower cost.
- Scrappy digital start-ups are equipping providers and patients with new apps and technologies to access medical data and take control of care.
- Making informed choices about the care we receive and pay for will enable a more humane and satisfying health care system to emerge.
Bush's plan calls for Americans not only to demand more from providers but also to accept more responsibility for our health, to weigh risks and make hard choices - in short, to take back control of an industry that is central to our lives and our economy.
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Compelled to listen at 2x speed
- By LEE on 09-26-18
By: Kai-Fu Lee
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If I Betray These Words
- Moral Injury in Medicine and Why It's So Hard for Clinicians to Put Patients First
- By: Wendy Dean, Simon Talbot
- Narrated by: Wendy Dean
- Length: 10 hrs and 26 mins
- Unabridged
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Offering examples of how to make medicine better for the healers and those they serve, If I Betray These Words profiles clinicians across the country who are tough, resourceful, and resilient, but feel trapped between the patient-first values of their Hippocratic oath and the business imperatives of a broken healthcare system. If I Betray These Words confronts the threat and broken promises of moral injury—what it is; where it comes from; how it manifests; and who’s fighting back against it. We need better healthcare—for patients and for the workforce. It’s time to act.
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Dust bowl
- By Doc on 04-12-23
By: Wendy Dean, and others
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Data-ism
- The Revolution Transforming Decision Making, Consumer Behavior, and Almost Everything Else
- By: Steve Lohr
- Narrated by: Steve Lohr
- Length: 6 hrs and 33 mins
- Unabridged
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Coal, iron ore, and oil were the key productive assets that fueled the Industrial Revolution. Today data is the vital raw material of the information economy. The explosive abundance of this digital asset, more than doubling every two years, is creating a new world of opportunity and challenge. Data-ism is about this next phase, in which vast, Internet-scale data sets are used for discovery and prediction in virtually every field. It is a journey across this emerging world with people, illuminating narrative examples, and insights.
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More business case than serious analysis
- By Godfried Gubbels on 06-03-15
By: Steve Lohr
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The Why Axis
- Hidden Motives and the Undiscovered Economics of Everyday Life
- By: Uri Gneezy, John A. List
- Narrated by: Eric Martin
- Length: 9 hrs and 8 mins
- Unabridged
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Uri Gneezy and John List are like the anthropologists who spend months in the field studying the people in their native habitats. But in their case they embed themselves in our messy world to try and solve big, difficult problems, such as the gap between rich and poor students and the violence plaguing inner city schools; the real reasons people discriminate; whether women are really less competitive than men; and how to correctly price products and services. Their field experiments show how economic incentives can change outcomes.
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Some Interesting Insights But Poor Science
- By Harold Toomey on 06-09-23
By: Uri Gneezy, and others
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The World Is Flat
- Further Updated and Expanded
- By: Thomas L. Friedman
- Narrated by: Oliver Wyman
- Length: 27 hrs and 15 mins
- Unabridged
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When scholars write the history of the world twenty years from now, what will they say was the most crucial development in the first few years of the twenty-first century? The attacks on the World Trade Center on 9/11 and the Iraq war? Or the convergence of technology and events that allowed India, China, and so many other countries to become part of the global supply chain for services and manufacturing, creating an explosion of wealth in the middle classes of the world's two biggest nations?
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If you like cliches...
- By Jonathan Shultz on 09-08-07
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Attacker's Advantage
- Turning Uncertainty into Breakthrough Opportunities
- By: Ram Charan
- Narrated by: Mark Bramhall
- Length: 6 hrs and 8 mins
- Unabridged
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In The Attacker's Advantage, Charan reveals the upside of uncertainty for those leaders who are nimbly positioned to anticipate the catalysts of disruption and embrace change. He updates and adapts the principles of his previous best sellers to address the current turbulent business environment, cutting through the veil of complexity to concentrate on the new customer needs and expectations and providing the tools for corporate leaders to take their companies to a higher level.
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Fantastic book - volume lower than usual
- By James Gajewski on 06-14-15
By: Ram Charan
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Epic Measures
- One Doctor. Seven Billion Patients.
- By: Jeremy N. Smith
- Narrated by: Patrick Lawlor
- Length: 10 hrs and 12 mins
- Unabridged
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Moneyball meets medicine in this remarkable chronicle of one of the greatest scientific quests of our time - the groundbreaking program to answer the most essential question for humanity: How do we live and die? - and the visionary mastermind behind it.
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Fabulously insightful read!
- By Dr. Jack E. Fincham on 10-08-15
By: Jeremy N. Smith
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The Prosperity Paradox
- How Innovation Can Lift Nations out of Poverty
- By: Clayton M. Christensen, Efosa Ojomo, Karen Dillon
- Narrated by: Mike Chamberlain
- Length: 9 hrs and 37 mins
- Unabridged
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Clayton M. Christensen, the author of such business classics as The Innovator’s Dilemma and the New York Times best-seller How Will You Measure Your Life, and coauthors Efosa Ojomo and Karen Dillon reveal why so many investments in economic development fail to generate sustainable prosperity and offers a groundbreaking solution for true and lasting change.
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Simplistic, lack of insights
- By D. Cameron on 05-24-21
By: Clayton M. Christensen, and others
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What to Do When Machines Do Everything
- How to Get Ahead in a World of AI, Algorithms, Bots, and Big Data
- By: Malcolm Frank, Paul Roehrig, Ben Pring
- Narrated by: Eric Jason Martin
- Length: 7 hrs and 28 mins
- Unabridged
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What to Do When Machines Do Everything is a guidebook to succeeding in the next generation of the digital economy. When systems running on artificial intelligence can drive our cars, diagnose medical patients, and manage our finances more effectively than humans, it raises profound questions on the future of work and how companies compete.
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Assumes that machine learning will grow very slow
- By Nathan Burnham on 05-06-17
By: Malcolm Frank, and others
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The Automatic Customer
- Creating a Subscription Business in Any Industry
- By: John Warrillow
- Narrated by: Don Hagen
- Length: 5 hrs and 15 mins
- Unabridged
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The lifeblood of your business is repeat customers. But customers can be fickle, markets shift, and competitors are ruthless. So how do you ensure a steady flow of repeat business? The secret--no matter what industry you're in--is finding and keeping automatic customers. These days virtually anything you need can be purchased through a subscription, with more convenience than ever before.
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Can be applied to almost any business
- By C Mason on 02-25-15
By: John Warrillow
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The Reinventors
- How Extraordinary Companies Pursue Radical Continuous Change
- By: Jason Jennings
- Narrated by: Jason Jennings
- Length: 6 hrs and 10 mins
- Unabridged
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Eventually every job and every business will become irrelevant. According to Jason Jennings, the past few decades have seen unprecedented shifts: former third-world nations have transformed themselves into high-tech manufacturing powerhouses; technology has democratized business and increased competition in ways never before seen; and customers, used to getting exactly what they want when they want it, are no longer beholden to the corporate giants.
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Good advice
- By Myers on 07-28-18
By: Jason Jennings
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Small Giants
- Companies That Choose to Be Great Instead of Big, 10th Anniversary Edition
- By: Bo Burlingham
- Narrated by: Bo Burlingham, Sean Pratt
- Length: 10 hrs and 47 mins
- Unabridged
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It's an axiom of business that great companies grow their revenues and profits year after year. Yet quietly, under the radar, a small number of companies have rejected the pressure of endless growth to focus on more satisfying business goals. Goals like being great at what they do, creating a great place to work, providing great customer service, making great contributions to their communities, and finding great ways to lead their lives. In Small Giants, veteran journalist Bo Burlingham takes us deep inside 14 such remarkable companies.
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fantastic book for small company builders
- By Amazon Customer on 08-01-17
By: Bo Burlingham
What listeners say about Where Does It Hurt?
Average customer ratingsReviews - Please select the tabs below to change the source of reviews.
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- Jorge Rojas
- 08-27-18
Data?
Unfortunately data is not all it takes. Great ideas but misguided. Should have interviewed more prating physicians not only administrators.
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- HB
- 06-25-16
Really enjoyed this book
Appreciated very much that the candid though biased approach of the book. Unique point of views articulated very well about different parts of the industry.
Provides a great guide for innovation for the next few years.
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- Dave deBronkart
- 04-15-16
if this ain't JBush, nothing is. Spot on.
I found myself saying "Exactly!" over and over. Same as Gawande said about Bob Wachter's "Digital Doctor," which I also love. Bush is crazy and right.
Note - in a different industry (typesetting) I was disrupted 30 years ago (by desktop publishing), so I know the signs and I know how incumbents can't see it coming. Power to the users!
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- Peter
- 03-12-16
Very thought provoking
I am very involved in health care IT and I have to say this was an excellent book. Very accurate and thought provoking.
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- Steve
- 12-05-17
Superb and Informative Reading
Has the drive and data of Tom Peters’ Liberation Management and the soul of Tracy Kidder’s Soul of a New Machine. Thank you.
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- Steve from MD
- 07-31-14
No critical thinking
In the introduction he states that our health care system is expensive and not as good at delivering results as other countries. His conclusion is to introduce free market economics as the solution. So the answer to fixing the only health care system which operates on free market principles is to double down. We operate in a free market he might not like the market or the rules since he failed at running his first business.
He harps on several points but does not seem to have any knowledge of the realities.
1. Overpriced hospitals. Here he is confused by costs vs charges. Hospitals are required by law to care for all patients regardless of their ability to pay. Since at many emergency departments over a third of all patients do not pay. So the hospital must raise charges to cover these patients. As specialty hospitals grow taking away paying patients this only makes it worse. Hospitals are struggling throughout the country. Many are closing or selling themselves because they can not survive.
2. Customer satisfaction is bad because there is no free market. If you look at press ganey the largest surveyor of patient satisfaction doctors and hospitals are doing great. Over 90 percent of hospitals and 99 percent of doctors score over 4 on a 5 point scale. Much better than Airlines which have been deregulated and are more free market or restaurants as a group.
3. There is no innovation. This is just looking at the facts he wants and ignoring all others. there has been great innovation. Pick a specialty cardiology has gone from 2 weeks bed rest for myocardial infarction to stents in 90 minutes from arrival. We have better tests to find heart attacks. Surgery has gone from large incisions to laparoscopic and in some cases robotic.
4. If only people could choose things would be better. This is nonsense. When someone is sick they rely on doctors to help guide them. Also many would say that they do not feel spending 100$ more on a meal which might increase there chance of enjoyment of the meal by 1% is clearly not worth it to them however, spending money on a better chance to survive an illness? They would spend that. Also look at all the money spent on alternative medicine. Here people have the freedom to choose and they choose options that offer no benefit. The National Institute of Alternative medicine just completed a 10 year review and found no evidence to support use of anything tested as alternative medicine.
5 Choices are needed in insurance. Health insurance is not like cable TV. I do not know which illness I am going to get this year. I am sure if I do not want ESPN today I will not want it later this year. People will opt out of lots of choices then when they become ill they get covered by the either the government or the hospitals that provide the service. We removed the moral hazard. I am not advocating not treating people I am saying that if we are arguing for free markets you are arguing for letting people suffer because of their choices which we do not do.
I do agree with him when he talks about information, reducing overhead and getting rid of fee for service. A free market tries to maximize one thing and that is profit. If it can do it my delivering expensive less effective health care it will as it has proven. So eliminating fee for service is a start. Going to a single payer is another good step. Less paperwork and back office support is needed with a single payer. However, these will not reduce lawsuits which contribute to costs of healthcare. Doctors win about 90% of malpractices cases so most cases are about poor outcomes not medical care. The free market would say if we can make money by suing we will sue. Many cases are settled to avoid the years of pretrial and trial costs which only encourages more lawsutis.
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6 people found this helpful