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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 Read More...
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If you can spare 2 hours, do yourself a favor by listening to the two-part healthcare series on NPR's extraordinary show, This American Life. By using examples that are memorable for their simplicity and lack of hyperbole, the series (the episodes are Read More...
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Much has been made of the superior performance – on both cost and quality – of integrated healthcare organizations like the Mayo and Geisinger Clinics. But since the defining characteristic of these standout systems is at least 50 years of integrated Read More...
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If for some reason you haven't gotten enough of me on Wachter's World, I just did a long, fun interview with Matthew Holt on the always-interesting THCB. We cover patient safety, the future of IT, the demise of primary care, Death Panels, and more. I Read More...
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I’m just back from the ABIM Foundation’s Summer Forum in New Mexico, increasingly a who’s who of the health policy world, our Davos. I came away from the meeting with a new framework for thinking about the sticky issue of physician payment reform – specifically, Read More...
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I just finished reading Atul Gawande’s June 1st New Yorker piece – it's the Talk of the Health Policy Town – on healthcare’s “Cost Conundrum.” Like most of Atul’s work, the article is lyrical, powerful, insightful, and correct.As you’ve probably heard, Read More...
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I like readmissions. Well, that didn’t come out quite right, did it? What I mean is that I like focusing on readmissions as a potentially actionable quality measure. I believe that it’s possible to prevent many readmissions, thereby improving quality Read More...
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Until now, medical tourism has been a curiosity, an iconic “Wow, Look How Flat the World Is Becoming,” fodder for stories on 60 Minutes. But as health insurers and employers get into the act, get ready for some Battles Royale.Of course, it was only a Read More...
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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 Read More...
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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 Read More...
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A few random observations from the Society of Hospital Medicine’s annual meeting in San Diego: There are about 1600 people here, most of whom I don’t know. How did this happen? People still seem pretty jazzed about their jobs and lives. The meeting has Read More...
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Do you get as annoyed as I do about being pressured on your “Time of Discharge?” I just received my monthly report, and we’re in The Doghouse again: our average TOD – 3:28 pm – is hours after “check-out time.” But when did we turn into the Holiday Inn? Read More...
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Today my pals Peter Lindenauer and Andy Auerbach (and colleagues) published the largest hospitalist outcomes study to date, in the New England Journal of Medicine. It is a rigorous, important piece of work. Let me try to add a bit of context. First, the Read More...
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In an article in this month’s Journal of the American College of Surgeons (with a companion cover piece in the ACS’s Bulletin), four of my surgical colleagues – and this internist, perhaps to add a “cognitive” spin – describe UCSF’s “surgical hospitalist” Read More...
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Last week, another study was published (this one in the Archives of Internal Medicine) documenting a hospitalist efficiency advantage. Coming on the heels of more than 20 studies with similar results (see, for example, this and this), one might ask how Read More...
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