Wachter's World

Berwick, Pronovost, and the Non-Scalability of Charisma

Bob Wachter — Fri, 23 Jul 2010 16:10:00 GMT

Early on, many social movements depend on a charismatic leader to focus attention, build a burning platform, and inspire people to action. You know when the movement has made it when it no longer needs such a leader for fuel.The safety and quality movements...(read more)

Why Obama Made the Right Call on Berwick

Bob Wachter — Thu, 08 Jul 2010 17:25:00 GMT

The recess appointment of Don Berwick to lead CMS can be seen as a cynical act of political opportunism, sidestepping the Congressional approval process using a tactic worthy of Machiavelli, or Karl Rove. Or it can be viewed as a pragmatic decision by...(read more)

Dr. Rand Paul: Not All Board Certifications Are Created Equal

Bob Wachter — Thu, 24 Jun 2010 20:33:00 GMT

After serving on the board of the American Board of Internal Medicine for the past few years, I’ve come to truly appreciate the value of board certification in demonstrating – and enhancing – our competence and commitment to professionalism. But not all...(read more)

Today’s Big ACGME and Joint Commission Announcements: The Courage To – and Not To – Change

Bob Wachter — Wed, 23 Jun 2010 18:18:00 GMT

One of the mantras of performance improvement is that caregivers and provider organizations should learn from their experiences. That’s all well and good, but how about policy-setting organizations?A few moments ago in the on-line version of the New England...(read more)

UCSF Benioff Children’s Hospital: A Tale of Great Leadership in Three Acts

Bob Wachter — Thu, 17 Jun 2010 07:33:00 GMT

This is an amazing tale of leadership – by my hospital CEO, our former chancellor, and, most importantly, a remarkable philanthropist. I’ll start with the latter, veer off to describe the former two, and then return, on this special day, to the philanthropist.The...(read more)

Announcing This Year’s UCSF Hospital Medicine CME Course and Hospitalist Mini-College

Bob Wachter — Mon, 14 Jun 2010 15:57:00 GMT

It’s that time again – here’s the brochure and course information for the Management of the Hospitalized Patient (MHP) conference, October 14-16 at the Fairmont Hotel in beautiful, fog-free (at least in October) San Francisco.This will be our 14th annual...(read more)

Cheating on the ABIM Boards

Bob Wachter — Sat, 12 Jun 2010 06:39:00 GMT

As a member of the executive committee of the American Board of Internal Medicine, I can’t provide too much of the inside scoop, so I’ll mainly point you to the published descriptions of a remarkable case: that of one Dr. Arora, who ran an ABIM board...(read more)

Dave Barry On “24” And Our Healthcare System

Bob Wachter — Wed, 02 Jun 2010 21:48:00 GMT

This past Monday was a sad night for me: no “24” on Fox, and no more installments in the works until the (inevitably disappointing) movie comes out. Watching Jack Bauer's derring-do with my sons has been one of my can’t-miss-it rituals for nearly a decade....(read more)

The Times Hits the Right Notes on Hospitalists

Bob Wachter — Fri, 28 May 2010 07:05:00 GMT

You probably saw yesterday’s hospitalist piece in the New York Times, arguably the best lay article on the movement to date. It hit all the right notes, and did so with uncommon grace and fairness. The piece, written by the Times’ Jane Gross, profiled...(read more)

In Defense of Paul Levy

Bob Wachter — Mon, 24 May 2010 06:07:00 GMT

Paul Levy, the blogging CEO of Boston’s Beth Israel Deaconess Medical Center, found himself in hot water last month over an inappropriate relationship with a female subordinate. While some of the details of the transgression remain sketchy, I think I...(read more)

Badness in Baltimore: Can Peer Review Catch Rogue Doctors?

Bob Wachter — Tue, 11 May 2010 05:42:00 GMT

A couple of months ago, a Baltimore reporter called to get my take on a scandal at St. Joseph’s Hospital in Towson, an upscale suburb. A rainmaker cardiologist there, Dr. Mark Midei, had been accused of placing more than 500 stents in patients who didn’t...(read more)

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

Bob Wachter — Wed, 28 Apr 2010 09:00:00 GMT

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)

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

Bob Wachter — Fri, 23 Apr 2010 05:06:00 GMT

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,...(read more)

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

Bob Wachter — Sat, 17 Apr 2010 10:13:00 GMT

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...(read more)

#10

Bob Wachter — Tue, 13 Apr 2010 03:37:00 GMT

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,...(read more)