David W. Johnson

About the Author

David W. Johnson

Latest Work

Fortune-telling healthcare’s dismal future

January 1970 was a long time ago. Richard Nixon celebrated the first anniversary of his presidency. The Vietnam War was raging. The Paris Peace Accords, the Arab oil embargo, stagflation, wage and price controls, devaluation of the dollar, the creation of the Environmental Protection Agency and the Occupational Safety and Health Administration, Nixon’s historic trip…

Array February 23, 2024

David Johnson: Right-sizing physician training? The case for surgical mechanics

American healthcare reputedly confronts a monumental physician shortage. A highly publicized 2021 report by the Association of American Medical Colleges (AAMC) forecasts that shortage to be as high as 180,000 physicians by 2034.a That’s out of a total population of roughly one million physicians. A breathless commentary on the AAMC report by the American Medical Association…

Array October 27, 2023

David Johnson: The perils and possibilities of healthcare apps

In March of 2022, I coauthored a commentary titled “Healthcare’s final frontier: Engaging customers.” It contained this tongue-in-cheek Star Trek reference: “[H]ealthcare is now boldly going where most industries have gone before — into full-fledged consumer engagement.” Wanting full-fledged consumer engagement and making it happen are not synonymous. In the best of healthcare times, providers…

Array September 22, 2023

Dave Johnson: Diagnostic determinism — How precision diagnostics will reinvent medicine

In the movie “Star Trek IV:  The Voyage Home,” the spaceship Enterprise travels back in time to San Francisco in the mid-1980s. Its mission is to transport humpback whales into the 23rd century to redirect a space probe heading to destroy earth. It’s a complicated story. While trying to escape police custody, crewmember Pavel Chekov…

Array June 12, 2023

David Johnson: Academic medicine, where privilege compounds dysfunction

Academic medicine combines healthcare with higher education, the two U.S. economic sectors that have exhibited outsized cost growth over the past 50 years. The result is a stunning disconnection between academic medical center (AMC) business practices and the supply-demand dynamics reshaping healthcare delivery. Market, technological and regulatory forces are pushing the healthcare industry to deliver…

Array April 14, 2023

AI and the rise of human-machine collaboration in healthcare

Commentators, researchers and academics can’t stop finding applications for ChatGPT.a Two of its recent claims to fame include passing all three medical licensing exams and the final exam for a core MBA class at Wharton.b ChatGPT, short for Chat Generative Pre-Trained Transformer, is a form of conversational artificial intelligence (AI). The concept is not new.…

Array February 24, 2023

David Johnson: Rewiring healthcare’s smartest professionals (Hint: It’s not physicians)

I won’t keep you in suspense. Healthcare’s smartest professionals are the tens of thousands of individuals who populate its revenue cycle operations. Revenue cycle professionals determine how much payers fork out and how much providers receive for healthcare treatments. They constitute the beating heart of the nation’s transactional healthcare system. Their ingenuity knows no bounds.…

Array November 1, 2022

David Johnson: Cracks in the foundation (Part 4): Overcoming a brittle business model

U.S. health systems’ rely on centralized, high-cost platforms (e.g., hospitals) to deliver routine care in an approach focused on optimizing revenues under fee-for-service payment. Yet this approach is inefficient and asset-heavy. To build less brittle, more consumer-centric delivery platforms, health systems must decant procedures to more convenient, lower-cost locations as they pursue full-risk contracting.

Array April 25, 2022

David Johnson: Cracks in the Foundation (Part 3): Overcoming healthcare’s services-need mismatch

Clinical care only accounts for 20% of health outcomes, yet this area is where America disproportionately invests its healthcare resources. To overcome U.S. healthcare’s services-need mismatch, there should be a greater investment in healthy multipliers that help to address the social and economic factors, health behaviors and the physical environment that drive the remaining 80% of health outcomes.

Array April 4, 2022

David Johnson: Cracks in the foundation, Part 2: Overcoming healthcare’s artificial economics

In normal markets, demand for services at given prices drives supply. Healthcare reverses the equation so demand for services is driven by the supply of healthcare facilities and practitioners, says hfm columnist David Johnson. In this second column in his series examining structural defects of the U.S. healthcare system, Johnson challenges these “artificial economics” and describes how cutting-edge health systems will apply new, more customer-focused economics to become the future market leaders.

Array March 2, 2022