You cannot have your news instantly and have it done well. You cannot have your news reduced to 140 characters or less without losing large parts of it. You cannot manipulate the news but not expect it to be manipulated against you. You cannot have your news for free; you can only obscure the costs. If as a culture we can learn this lesson, and if we can learn to love the hard work, we will save ourselves much trouble and collateral damage. We must remember: There is no easy way.

Of the many ‘firsts’ with which I have been involved at the Texas Heart Institute -including the first successful human heart transplant in the United States and the first total artificial heart transplant in the world-the achievement that may have the greatest impact on health care did not occur in the operating room or in the research laboratory. It happened on a piece of paper… when we created the first-ever packaged pricing plan for cardiovascular surgical procedures.

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