In this month’s Archives of Internal Medicine, my colleagues and I report the results of our early experience with hospitalist co-management of neurosurgery patients. We found stratospheric satisfaction among neurosurgeons and nurses, as well as impressive cost reductions ($1400/admission). At the same time, there was no impact on quality or safety, at least as judged [...]
Archive | 2010
Letter From London
I’ve just returned from a few days in London, scoping things out for a planned sabbatical next fall. In what may be a pale echo of the late Alistair Cooke’s always fascinating “Letters From America,” here are a few of my initial observations: The dominant issue, of course, is the Cameron government’s new austerity program, [...]
Could It Be That Patients Aren’t Any Safer?
On the occasion of last year’s tenth anniversary of the IOM Report on medical mistakes, I was asked one question far more than any other: after all this effort, are patients any safer today than they were a decade ago? Basing my answer more on gestalt than hard data, I gave our patient safety efforts [...]
The Decade-Long Journey To NEJM Case 34-2010
The most popular article in last week’s New England Journal of Medicine did not tout the discovery of a novel gene, nor describe a cardiology clinical trial with a clever acronym as its title. Rather, it was the report of a case in which a surgeon at the Massachusetts General Hospital performed the wrong operation [...]
Three Short Stories That Illustrate Key Healthcare Lessons
In my travels, I frequently hear short stories that help illuminate my work and world. Here are three recent examples; think of them as little health policy tapas. I recently spoke in a session with Peter Pronovost, the Johns Hopkins intensivist who is the world’s top researcher in safety and quality. We were talking about [...]
Torture!
Well, it’s over. A ragtag group of has-beens, oddballs, castaways, newbies, and misfits combined grit, teamwork, flawless decision-making and jaw dropping pitching to bring the World Series crown to the Bay, the first time ever. Just last week, we wondered why Renteria hadn’t been cut; tonight, he’s the toast of the town and there’s dancing [...]
Teamwork Training in Healthcare: More Than Just Kumbaya
One of the central tenets of the patient safety movement is that modern medicine is a team sport. Unfortunately, its players – particularly physicians – were trained and socialized to be free-spirited individualists. We need the Celtics of the 80s; what we have is a collection of young John McEnroes. While this theory has been [...]
Tugging on Superman’s Cape
Several years ago, I spoke at Baylor College of Medicine in Houston, where Michael DeBakey, the legendary heart surgeon, was master of the universe for nearly half a century. I heard lots of DeBakey stories during my visit, but one in particular really stuck with me. “A few years back,” someone told me in a [...]
“What is… Wegener’s Granulomatosis?”
A terrific article in The New York Times Magazine this summer described the decade-long effort on the part of IBM artificial intelligence researchers to build a computer that can beat humans in the game of “Jeopardy!” Since I’m not a computer scientist, their pursuit struck me at first as, well, trivial. But as I read [...]
On Teachers, Baseball Players, WAR, and My Son’s Blog
When I launched Wachter’s World three years ago, I was aiming for a narrow sweet spot: I wanted the writing to have an unmistakable “voice” (that would be mine) without being too personal. Not to put too fine a point on it, but I remember telling a friend at the time, “If you catch me [...]
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