Archive | International Comparisons RSS feed for this section
A Pay Within a Play: The Awkward World of Private Insurance in the UK

A Pay Within a Play: The Awkward World of Private Insurance in the UK

I remember reading an article that observed that systems of universal insurance – which need to put their energy into providing a “decent minimum” for the masses – must also offer a “safety valve for the wealthy disaffected.” Canada bans private insurance for basic hospital and medical care services. So, when affluent Canadians want “the […]

Read full story Comments { 6 } 998 views

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 […]

Read full story Comments { 15 } 2,006 views

“I’m the Main Breadwinner”: The British Primary Care System and Its Lessons for America

I’ve heard a lot of shocking things since arriving in England five months ago on my sabbatical. But nothing has had me more gobsmacked than when, earlier this month, I was chatting with James Morrow, a Cambridge-area general practitioner. We were talking about physicians’ salaries in the UK and he casually mentioned that he was […]

Read full story Comments { 13 } 3,895 views
Acute Physicians: Hospitalists Bounded by Time and Space

Acute Physicians: Hospitalists Bounded by Time and Space

Besides studying patient safety and watching all five seasons of The Wire, my other major goal for my London sabbatical was to understand the way the Brits organize hospital care. Mirroring the U.S. hospitalist movement, a new field—called “acute medicine”— emerged about 15 years ago and became the country’s fastest growing specialty. But there is […]

Read full story Comments { 11 } 1,537 views
Patient Safety in the US and UK, Part II: Top-Down vs. Bottom-Up

Patient Safety in the US and UK, Part II: Top-Down vs. Bottom-Up

In my last post, I discussed the role of physicians in patient safety in the US and UK. Today, I’m going widen the lens to consider how the culture and structure of the two healthcare systems have influenced their safety efforts. What I’ve discovered since arriving in London in June has surprised me, and helped […]

Read full story Comments { 7 } 1,140 views
Patient Safety in the US and UK, Part I: The Doctors

Patient Safety in the US and UK, Part I: The Doctors

A little more than a decade ago, the patient safety movement hit both the United States and the United Kingdom like twin avalanches. In both countries, high profile cases of medical mistakes led to growing anxiety, and early research outlined the vast scope of the problem and identified some solutions. All this was prelude to […]

Read full story Comments { 9 } 1,917 views
Summer in London: First Impressions

Summer in London: First Impressions

First of all, let’s get the important stuff out of the way. Mom, I’m fine. Thanks for your concern. Really. I’ve now been in London for about 6 weeks on my sabbatical. The recent riots here are all folks are talking about and the trauma is real. One wonders whether the inevitability of budget cuts, […]

Read full story Comments { 11 } 923 views

Am I A Socialist?

Am I a socialist? I don’t think so, but I did inch in that direction during the four days I spent in northern Norway last week, visiting the local hospital in Bodø and speaking to about 20 of the nation’s hospital CEOs. Here’s what I learned. First, a word on visiting northern Norway – above […]

Read full story Comments { 8 } 462 views