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• 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 Read More... Posted Wed, Apr 28 2010 6:00 PM by Bob Wachter | 7 Comments Filed under: Efficiency, Information Technology, Nurses/Nursing, Health Policy, Media/Press Coverage

• Verb-alizing

  One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge. Read More... Posted Thu, Mar 04 2010 3:22 PM by Bob Wachter | 14 Comments Filed under: Hospital Care, Medical Education/Academia, Information Technology, Ambulatory/Primary Care

• Substituting Coffee Cake for Journal Articles: Another Unforeseen Consequence of IT

  Late February is the pits for interns – the novelty of being a real-live MD is long gone, and the rebirth of residency is too far beyond the horizon to see. The other day, my wonderful resident Anna brought a coffee cake to my ward team's post-call rounds, Read More... Posted Wed, Feb 24 2010 7:45 AM by Bob Wachter | 3 Comments Filed under: Medical Education/Academia, Information Technology

• Why I Refused to Let Our Medical Grand Rounds Die Off

  Early last year, my boss Talmadge King and I were at an ABIM meeting (we’re both on the board), and the group was debating a controversial topic. Another participant at the meeting, like Talmadge the chair of a prominent department of medicine, said, Read More... Posted Mon, Jan 11 2010 8:21 AM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Medical Education/Academia, Information Technology, Patient Safety/Medical Errors

• December 1, 2009: The Patient Safety Field Turns Ten

  On December 1, 1999, the Institute of Medicine released a report entitled To Err is Human: Building a Safer Health System. Although its authors hoped to spark a national movement, they had little cause for optimism. After all, early efforts by advocates Read More... Posted Tue, Dec 01 2009 7:22 AM by Bob Wachter | 4 Comments Filed under: Hospital Care, Information Technology, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• NY Times Magazine on Brent James’ Quest to Transform Healthcare Quality

  Just a quick heads up on an article in next weekend’s New York Times Sunday Magazine by my friend David Leonhardt. David profiles Intermountain Healthcare’s Brent James, capturing Brent’s (and Intermountain’s) unique and increasingly influential philosophy Read More... Posted Thu, Nov 05 2009 6:16 AM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Quality Measurement, Information Technology, Patient Safety/Medical Errors, Media/Press Coverage

• Is Healthcare IT Ready for its Big Coming Out Party?

  In 2001, when my colleagues and I ranked nearly 100 patient safety practices on the strength of their supporting evidence (for an AHRQ report), healthcare IT didn’t make the top 25. We took a lot of heat for, as one prominent patient safety advocate chided Read More... Posted Sun, Oct 25 2009 9:15 PM by Bob Wachter | 7 Comments Filed under: Hospital Care, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors, Industry/Pharma, Health Policy

• An Overlooked but Dangerous Handoff… of One Million Patients at a Time

  A quick heads up on an article written by a very talented UCSF psychiatrist named John Young, which I had the opportunity to co-author. John observed that, despite all the recent literature about handoffs (such as here and here), no one has given much Read More... Posted Mon, Sep 28 2009 7:44 AM by Bob Wachter | 2 Comments Filed under: Medical Education/Academia, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors

• My Interview on The Health Care Blog

  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... Posted Wed, Aug 19 2009 3:48 PM by Bob Wachter | 2 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Efficiency, Medical Education/Academia, Hospitalists/Hospital Medicine, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors, Health Policy

• A Remarkable Interview: Obama on Healthcare

  I hope you had a chance to read David Leonhardt’s interview with President Obama in last Sunday’s NY Times Magazine. The feel was that of hanging out with two really smart friends discussing the issues of the day over beers. What a treat! In addition Read More... Posted Sun, May 10 2009 6:57 PM by Bob Wachter | 7 Comments Filed under: Quality Improvement, Transparency and Reporting, Quality Measurement, Efficiency, Information Technology, Health Policy, Media/Press Coverage, Medical Ethics

• Hilarious Medical Transcription Snafus: My Faves and Yours

  This is my 100th blog posting, so it seemed like a good time to get a bit frivolous. The NY Times recently ran a front page story about websites that collect user-submitted triviata – such as “Pets Who Want to Kill Themselves” (pictures of bulldogs wearing Read More... Posted Tue, Apr 21 2009 8:15 AM by Bob Wachter | 26 Comments Filed under: Hospital Care, Information Technology

• “Mr. Obama, Tear Down These (Hospital) Walls”: Readmissions in Context

  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... Posted Sat, Apr 04 2009 12:36 AM by Bob Wachter | 10 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Efficiency, Hospitalists/Hospital Medicine, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors, Health Policy

• Can the Physical Examination Save Us From the Technology-Induced Dehumanization of Medicine?

  In last week’s NEJM, physician-author Abraham Verghese paints a disturbing picture of a medical world in which technology has morphed from tool to object, the patient relegated to a supporting role. To me, Abraham has nailed the diagnosis but not the Read More... Posted Thu, Jan 01 2009 4:17 PM by Bob Wachter | 12 Comments Filed under: Hospital Care, Medical Education/Academia, Diagnosis/Clinical Reasoning, Information Technology

• Are We Finally Entering the Golden Age of Healthcare Transparency?

  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 Read More... Posted Sat, Dec 27 2008 3:15 PM by Bob Wachter | 8 Comments Filed under: Hospital Care, Pay-for-performance, Transparency and Reporting, Quality Measurement, Information Technology, Health Policy, Media/Press Coverage

• 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 Read More... Posted Tue, Oct 07 2008 7:39 AM by Bob Wachter | 9 Comments Filed under: Hospital Care, Hospitalists/Hospital Medicine, Information Technology, Industry/Pharma, Media/Press Coverage