Archive | Health Policy RSS feed for this section

Crowdsourcing My New Book on How Computerization is Changing the Practice of Medicine in Surprising Ways

I have been in blog-silence mode of late, for which I am sorry. Rumors that I’ve taken my Elton John act on the road are, I’m pleased to assure you, incorrect. Instead, I’ve been hard at work on my new book, tentatively titled “Disrupted: Hope, Hype and Harm at the Dawn of Medicine’s Digital Age.” […]

Read full story Comments { 10 } 1,775 views

Hospitalist Potpourri

I’m just back from the annual meeting of the Society of Hospital Medicine and, as usual, I was blown away. I’ve not seen a medical society meeting that is remotely like it. As Win Whitcomb, who co-founded SHM, wrote to me, the meeting is “a mix of love, deep sense of purpose, community, mission, changing-the […]

Read full story Comments { 6 } 2,573 views

Patient Safety’s First Scandal: The Sad Case of Chuck Denham, CareFusion, and the NQF

In retrospect – always in retrospect – it should have been obvious that, when it came to Dr. Charles Denham, something was not quite right. In a remarkable number of cases of medical errors, it’s clear – again, in retrospect – that there were signs that something was amiss, but they were ignored. The reasons […]

Read full story Comments { 81 } 19,207 views

Global Health Hospitalists: Strange but Noble Bedfellows

As my Division of Hospital Medicine has grown – now to about 60 faculty – I spend part of my time figuring out what direction we should go in. At times, the path is obvious. It didn’t take Wayne Gretsky to recognize that we needed expertise in healthcare IT a decade ago, or in cost […]

Read full story Comments { 8 } 1,996 views

Lights, Camera, Action… In Healthcare

About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a First World problem). I decided to try golf camp in Palm Springs for a few days. My sensei, a crusty ex-touring pro named […]

Read full story Comments { 14 } 3,491 views

Diagnostic Errors: Central to Patient Safety, Yet Still In the Periphery of Safety’s Radar Screen

In 2008, I gave the keynote address at the first “Diagnostic Errors in Medicine” conference, sponsored by the Agency for Healthcare Research and Quality (AHRQ). The meeting was filled with people from a wide variety of disciplines, including clinical medicine, education, risk management, cognitive science, and informatics, all passionate about making diagnosis safer. The atmosphere […]

Read full story Comments { 14 } 3,259 views

Medicare’s Most Maddening Policy… and Why CMS’s Attempts to Improve It May Make it Worse

There are tens of thousands of policies in Medicare’s policy manual, which makes for stiff competition for the “Most Maddening” award. But my vote goes to the policy around “observation status,” which is crazy-making for patients, administrators, and physicians. “Obs status” began life as Medicare’s way of characterizing those patients who needed a little more […]

Read full story Comments { 14 } 3,489 views

Reflections On My Year as Chair of the American Board of Internal Medicine

Today is my last day as chair of the ABIM, and the end of my eight-year tenure on the Board. In this blog – a bookend to the one I wrote at the start of the year, which went near-viral – I’ll describe some of our accomplishments this year and a few of the challenges […]

Read full story Comments { 19 } 2,398 views

How UCSF is Solving the Quality-Cost-Value Jigsaw Puzzle

I sometimes explain to medical students that they are entering a profession being transformed, like coal to diamonds, under the pressure of a new mandate. “The world is going to push us, relentlessly and without mercy, to deliver the highest quality, safest, most satisfying care at the lowest cost,” I’ll say gravely, trying to get […]

Read full story Comments { 14 } 2,965 views

The Dangers of Curbside Consults… and Why We Need Them

Everybody hates curbside consults – the informal, “Hey, Joe, how would you treat asymptomatic pyuria in my 80-year-old nursing home patient?”-type questions that dominate those Doctor’s Lounge conversations that aren’t about sports, Wall Street, or ObamaCare. Consultants hate being asked clinical questions out of context; they know that they may give incorrect advice if the […]

Read full story Comments { 13 } 2,228 views