Archive | April, 2010

What’s Behind Today’s Primary Care Crisis: You Don’t Know the Half of It

If you’ve ever been on a diet, you know that it really helps to keep a food log. Seeing your consumption chronicled in one place is illuminating – and often explains why those love handles aren’t melting away despite two hours on the treadmill each week. In today’s issue of the New England Journal of […]

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The New Joint Commission: Much Improved, With Room for More

Until about 8 years ago, inspections by the Joint Commission (TJC) were predictable and fairly silly. Hospitals were given a couple of years’ notice of the week that “The Joint” would be visiting. Everybody scurried around preparing – waxing the floors, locking up all the medications, that sort of thing. (It always struck me as […]

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Hope for the Future: The Society of Hospital Medicine’s Annual Meeting

I vividly recall attending a faculty meeting at San Francisco General Hospital in the mid-1990s, soon after I joined the UCSF faculty. Our late, great chief of medicine Merle Sande was chronicling all the recent and predicted changes in the healthcare landscape: managed care, more transparency, new regulations, and more. The meeting turned glum; we […]

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A quick note of thanks: The annual list of the “50 Most Powerful Physician Executives in the U.S.” was released today by Modern Healthcare magazine, and yours truly clocks in at number 10, just behind the Surgeon General and the heads of the NIH, CDC, FDA, AHRQ, and Joint Commission. In fact, #10 makes me […]

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Show Me the Money: Can We Afford Education-Oriented Residency Programs?

In the early 90s, I had the privilege of directing UCSF’s exceptional internal medicine residency program. It was a time of transition. A decade earlier, residency accreditation requirements (dictated by the Accreditation Council for Graduate Medical Education, ACGME) were fairly benign and largely ignored – marquee programs like ours were generally given carte blanche to […]

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