When will patients start reviewing quality data before choosing their doctors and hospitals? The answer has been “soon” for several years, but “soon” may finally be the right answer. If you doubt it, check out the Commonwealth Fund’s new site, “Why Not The Best?” The central premise of the healthcare transparency movement has been that [...]
Archive | 2008
The Hospitalist as Bed Czar: Indispensability, But At What Cost?
In last week’s Annals of Internal Medicine, Eric Howell and colleagues describe an innovative experiment in which the hospitalists at Johns Hopkins Bayview became the institution’s bed czars. It worked. So should my program and yours take this one on? Hopkins Bayview is a 335-bed teaching hospital affiliated with Johns Hopkins. The Chief of Medicine, [...]
Resident Duty Hours and Patient Safety: Did The IOM Get It Right?
The Institute of Medicine just released its long-awaited report on trainee duty hours. It is well researched and balanced, and its recommendations appropriately reflect what we know vs. what we believe. Now the fun begins. Let’s start with a little background, some of it drawn from my book Understanding Patient Safety: Let’s be honest. Traditional [...]
My Patients Are Dying… And I’ve Never Been Prouder
I’m on clinical service now and my patients are dying left and right. And I’ve never been prouder of my own care, and that delivered by my colleagues and hospital. When I was in training, a patient’s death was invariably considered a medical failure, and thus an occasion for shame and silence – the Outcome-That-Must-Not-Be-Named. [...]
Are Hospitalists Recession-Proof?
Hospitals aren’t the first businesses hurt when the economy sours, but they get hurt nonetheless, as an article in last week’s NY Times points out. But hospitalists have never lived through a massive downturn. What happens to them when the economy tanks? Let’s start with hospitals. Unlike new cars and Starbucks drinks – “discretionary” purchases [...]
Can a Hospital Afford to Share Its Warts With the Public?
Paul Levy, the blogging CEO at Boston’s Beth Israel Deaconess Medical Center, has staked his – and his hospital’s – reputation on a culture of transparency. Although no doubt partly driven by Paul’s ethical compass, he must also hope that his unique brand of openness will be good for business. But will it be? An [...]
What a Week! The 1st Hospitalist Mini-College and our Annual Hospital Medicine CME Course
Rolling out a new “product” in a nasty economy is usually a formula for disaster. But last week we held the first-ever “Hospitalist Mini-College,” and it was an rousing success. The idea was this: hospitalists have lots of places to go to hear clinical lectures, and now a few options for leadership training and to [...]
How the Newly Vigorous Patient Safety Regulatory Environment May Be Harming the Cause of Safety
In responding to dysfunctional systems, America instinctively turns to “more regulation” (Exhibit A: today’s Wall Street). But regulation can, and often does, go too far, and – in patient safety – I believe that it now has. Note that this comes from someone who believes that healthcare was under-regulated until recently, not a popular viewpoint [...]
A Shout Out to Adam Singer, Physician Entrepreneur of the Year
Modern Physician just named Adam Singer, the founder of IPC-The Hospitalist Company, its first annual Physician Entrepreneur of the Year. Adam and I don’t always see eye to eye, but I want to congratulate him and highlight some of his contributions. When the hospitalist field launched in the mid-1990s, Adam was there – I recall [...]
A Year of Blogging Dangerously
Well, folks, time flies. Today marks the first anniversary of the launch of Wachter’s World. I’ve learned a lot in a year. For example, a year ago, I thought you became a Russia expert by reading books and newspapers, not by trans-waterway osmosis. Anyway, I thought I’d use the occasion of the anniversary to recount [...]
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