We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right - one after the other, no slipups, no goofs, everyone pitching in.

If the conversation people think is coming is the 'death panel' conversation, that's a total failure.

The Affordable Care Act also offered protections that allow for preexisting conditions, as people know, that you're provided coverage and you can maintain steady coverage. And that's an important part of being able to stay in care and do better over the long run.

Writing lets you step back and think through a problem. Even the angriest rant forces the writer to achieve a degree of thoughtfulness.

Culture matters. Of course, if physicians are rewarded or penalized for their service and results, the culture will change. But the key values we doctors are being pressed to embrace are humility, teamwork, and discipline.

The definition of what it means to be dying has changed radically. We are able to extend people's lives considerably, including sometimes, good days.

At times, in medicine, you feel you are inside a colossal and impossibly complex machine whose gears will turn for you only according to their own arbitrary rhythm. The notion that human caring, the effort to do better for people, might make a difference can seem hopelessly naive. But it isn't.