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 […]
by Bob Wachter on October 19, 2013 in Health Policy, Information Technology, Medical Education/Academia, Patient Safety/Medical Errors, Quality Improvement, Quality Measurement, Transparency and Reporting
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 […]
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 […]
In the past, neither hospitals nor practicing physicians were accustomed to being measured and judged. Aside from periodic inspections by the Joint Commission (for which they had years of notice and on which failures were rare), hospitals did not publicly report their quality data, and payment was based on volume, not performance. Physicians endured an […]
The debate over pay for performance in healthcare gets progressively more interesting, and confusing. And, with Medicare’s recent launch of its value-based purchasing and readmission penalty programs, the debate is no longer theoretical. Just in the past several months, we’ve seen studies showing that pay for performance works, and others showing that it doesn’t. We’ve […]
In his new book, Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care, Johns Hopkins surgeon Marty Makary promises a “powerful, no-nonsense, nonpartisan prescription for reforming our broken health care system.” And he partly delivers, with an insider’s and relatively unvarnished view of many of the flaws in modern hospitals. Underlying […]
On September 10, 1986, soon after I completed my residency in internal medicine, I “took the Boards” – the certifying examination administered by the American Board of Internal Medicine (ABIM). A few months later, I learned that I passed the exam, and that success, combined with an attestation by my residency program director, rendered me […]
I knew it would happen sooner or later, and earlier this week it finally did. In 2003 US News & World Report pronounced my hospital, UCSF Medical Center, the 7th best in the nation. That same year, Medicare launched its Hospital Compare website. For the first time, quality measures for patients with pneumonia, heart failure, and […]
by Bob Wachter on March 19, 2012 in Ambulatory/Primary Care, Health Policy, Hospital Care, Information Technology, Pay-for-performance, Quality Measurement, Transparency and Reporting, United Kingdom Healthcare System
These days, I’d never consider trying a new restaurant or hotel without reading the on-line ratings on TripAdvisor or Yelp. I seldom even bother with professional restaurant or travel critics. Until recently, there was little patient-generated information about doctors, practices or hospitals to help inform patient decisions. But that is rapidly changing, and the results […]
During my med school psychiatry rotation, I was taught not to shy away from discussing suicide with a depressed patient. “You won’t be suggesting something they haven’t thought about,” my professor told me back in 1982. “By not raising it, you add to the sense of stigma and it just becomes the elephant in the […]
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