I’m well aware that a good fraction of the people in this country – let’s call them Rush fans – spend their lives furious at the New York Times. I am not one of them. I love the Grey Lady; it would be high on my list of things to bring to a desert island. But [...]
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Saying “No” While Being NICE
A wise man once quipped that saying that we may need to ration healthcare is like saying that we may need to respect the laws of gravity. In other words, when societies have more healthcare needs and wants than resources (and all societies do), rationing is inevitable. The question of how to ration used to [...]
Leaders and Leadership in Hospital Medicine: The Story Behind the IPC-UCSF Fellowship
This is a tale of leaders and leadership. And about keeping an open mind. I first met Adam Singer in 1996, when the hospitalist field still had its training wheels on. A pulmonary/critical care physician by training, Adam had become a physician-entrepreneur and was now focused on making his new enterprise, IPC, the nation’s preeminent [...]
A Game-Changing Statistic: 1 in 250
Although the medical profession has been harming unlucky patients for centuries, the patient safety movement didn’t take flight until 1999, when the Institute of Medicine published its seminal report, To Err is Human. And that report would have ended up as just another doorstop if not for its estimate that 44,000-98,000 Americans each year die [...]
“What is… Wegener’s Granulomatosis?”
A terrific article in The New York Times Magazine this summer described the decade-long effort on the part of IBM artificial intelligence researchers to build a computer that can beat humans in the game of “Jeopardy!” Since I’m not a computer scientist, their pursuit struck me at first as, well, trivial. But as I read [...]
UCSF Benioff Children’s Hospital: A Tale of Great Leadership in Three Acts
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 first time I met Marc Benioff – in 2007 – he [...]
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 me, “slowing down the momentum.” Some called us Luddites. Although [...]
"This American Life" on Why the Healthcare System is Out of Control
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 here and here) does a superb job illustrating how we got into the [...]
Welcoming UCSF’s New Chancellor, My Friend Sue Desmond-Hellmann
Reunions are fun, but they can make you feel old. I remember strolling around Penn’s campus for my 25th reunion, and seeing several buildings named for people I knew in college. Wow, I thought, that’s when you know you’re ancient. Another way is when the chancellor of your university – the senior official at UCSF [...]
Are We Mature Enough to Make Use of Comparative Effectiveness Research?
Thanks to White House budget director Peter Orszag, a Dartmouth Atlas aficionado, $1.1 billion found its way into the stimulus piñata for “comparative effectiveness” research. Terrific, but – to paraphrase Jack Nicholson – can we handle the truth? In other words, are we mature enough to use comparative effectiveness data to make tough decisions about [...]
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