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“Being Mortal”: Atul Gawande’s Most Ambitious – and Important – Book

“I learned about a lot of things in medical school, but mortality wasn’t one of them.” So begins Being Mortal, Atul Gawande’s fourth and most ambitious book. All of Gawande’s prior books – Complications, Better, and The Checklist Manifesto – were beautifully crafted, lyrical, and fascinating, and all were bestsellers that helped cement his reputation […]

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Meaningful Use. Born, 2009, Died, 2014?

The policy known as Meaningful Use was designed to ensure that clinicians and hospitals actually used the computers they bought with the help of government subsidies. In the last few months, though, it has become clear that the policy is failing. Moreover, the federal office that administers it is losing leaders faster than American Idol […]

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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 “The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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