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 [...]
Measuring the Quality of Doctors and Hospitals: When Is Good Enough, Good Enough?
by Bob Wachter on April 1, 2013 in Health Policy, Hospital Care, Pay-for-performance, Quality Improvement, Quality Measurement, Transparency and Reporting
Doctors, Tend to Your Online Reputations. KevinMD’s Terrific New Book Tells How
by Bob Wachter on January 30, 2013 in Book Review, Information Technology, Media/Press Coverage, Transparency and Reporting
Kevin Pho, better known as KevinMD, is the nation’s leading physician-social media guru. He and his colleague Susan Gay were nice enough to invite me to write the foreword to their book, “Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices,” which was published today. I think it’s [...]
Pay for Performance in Healthcare: Do We Need Less, More, or Different?
by Bob Wachter on November 27, 2012 in Health Policy, Hospital Care, Medical Ethics, Pay-for-performance, Quality Improvement, Quality Measurement, Transparency and Reporting
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 [...]
“Unaccountable”: An Important, Courageous, and Deeply Flawed Book
by Bob Wachter on November 2, 2012 in Book Review, Health Policy, Patient Safety/Medical Errors, Quality Improvement, Quality Measurement, Transparency and Reporting
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 Becoming Chair of the ABIM: Why the Board Matters More Than Ever
by Bob Wachter on August 14, 2012 in Diagnosis/Clinical Reasoning, Efficiency, Health Policy, Medical Education/Academia, Quality Measurement, Transparency and Reporting
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 [...]
The US News “Best Hospitals” List: In God We Trust, All Others Must Bring Data
by Bob Wachter on July 19, 2012 in Health Policy, Hospital Care, Media/Press Coverage, Patient Safety/Medical Errors, Quality Measurement, Transparency and Reporting
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 [...]
Why the Supreme Court’s Healthcare Decision Will Mean a Lot… and Not So Much
by Bob Wachter on June 18, 2012 in Health Policy, Patient Safety/Medical Errors, Quality Improvement, Transparency and Reporting
Like waiting outside the Vatican for the puff of white smoke, the nation sits on edge awaiting the Supreme Court’s ruling on the Affordable Care Act. The ruling, which is likely to be announced next week, could toss out the entire healthcare reform bill, chop off one of its limbs (probably the so-called individual mandate), [...]
The Patient Will Rate You Now
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 [...]
Never Say Never (Events)
by Bob Wachter on June 30, 2011 in Health Policy, Hospital Care, Patient Safety/Medical Errors, Pay-for-performance, Quality Measurement, Transparency and Reporting, Uncategorized
Earlier this month, the National Quality Forum released its revised list of “Serious Reportable Events in Healthcare, 2011,” with four new events added to the list. While the NQF no longer refers to this list as “Never Events,” it doesn’t really matter, since everyone else does. And this shorthand has helped make this list, which [...]
The New and Improved AHRQ WebM&M and Patient Safety Network
by Bob Wachter on March 29, 2011 in Information Technology, Media/Press Coverage, Patient Safety/Medical Errors, Transparency and Reporting
This is a quick note to let you know that the two patient safety websites that I’m privileged to edit for the U.S. Agency for Healthcare Research and Quality – AHRQ WebM&M and AHRQ Patient Safety Network – were relaunched this week after extensive makeovers. The sites already receive more than 2 million visits each [...]
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My New Job
June 2, 2013
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How UCSF is Solving the Quality-Cost-Value Jigsaw Puzzle
May 27, 2013
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The Dangers of Curbside Consults… and Why We Need Them
April 29, 2013
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When I Was In the Final Four
April 5, 2013
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