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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My New Job

I have a new job! It requires me to be sophisticated but accessible, assertive but diplomatic, literary but not highfalutin. Unfortunately, it comes with no office, no salary, and no chance for promotion. No, after nearly 30 years at UCSF, I haven’t quit my day job. But I have taken on a moonlighting gig. I’m […]

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How UCSF is Solving the Quality-Cost-Value Jigsaw Puzzle

I sometimes explain to medical students that they are entering a profession being transformed, like coal to diamonds, under the pressure of a new mandate. “The world is going to push us, relentlessly and without mercy, to deliver the highest quality, safest, most satisfying care at the lowest cost,” I’ll say gravely, trying to get […]

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The Dangers of Curbside Consults… and Why We Need Them

Everybody hates curbside consults – the informal, “Hey, Joe, how would you treat asymptomatic pyuria in my 80-year-old nursing home patient?”-type questions that dominate those Doctor’s Lounge conversations that aren’t about sports, Wall Street, or ObamaCare. Consultants hate being asked clinical questions out of context; they know that they may give incorrect advice if the […]

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When I Was In the Final Four

I don’t follow much basketball these days. But the week of the NCAA finals always takes me down memory lane. For I, you see, was in the Final Four, thirty-four years ago. Funny thing is, I am an awful basketball player. My role will come to you if you answer the following trivia question: Who […]

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Measuring the Quality of Doctors and Hospitals: When Is Good Enough, Good Enough?

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 […]

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HIT Job: How the New York Times Blew it on Healthcare IT

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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Is the Patient Safety Movement in Danger of Flickering Out?

These should be the best of times for the patient safety movement. After all, it was concerns over medical mistakes that launched the transformation of our delivery and payment models, from one focused on volume to one that rewards performance. The new system (currently a work-in-progress) promises to put skin in the patient safety game […]

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Doctors, Tend to Your Online Reputations. KevinMD’s Terrific New Book Tells How

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 […]

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“Doctor, Step Away From That Cookbook!”

A middle-aged man develops chest pain at home. Minutes after calling 911, he’s in an ambulance, whizzing through traffic to the nearest emergency room. The paramedics radio ahead, and by the time the patient arrives in the ER, the hospital’s heart attack team has been activated. A stat electrocardiogram shows an ST-elevation myocardial infarction (STEMI), […]

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