Atul Gawande’s "The Checklist"

Let’s make this short and sweet. In this week’s New Yorker, Atul Gawande describes Peter Pronovost’s crusade to improve the safety of intensive care through the use of checklists. If it sounds dull, it’s not. In fact, it is thrilling and inspiring. Gawande glides effortlessly from microscopic detail to panoramic view and back again to […]

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Can a Medical Center Be Too Rich?

The University of Pittsburgh Medical Center announced today that it will donate up to $100 million over the next decade to fund college scholarships for Pittsburgh public school students. This is a magnificent gesture, but it left me scratching my head: I thought hospitals were supposed to absorb charity, not dole it out. I already […]

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Adventures in Bizarro Land: My Don Imus Interview

Adventures in Bizarro Land: My Don Imus Interview

I had mixed emotions this morning when I heard that radio shock-jock Don Imus had returned to the airwaves. My 2004 interview with Imus was perhaps the wackiest experience of my life. It also made Internal Bleeding into a bestseller. Here’s the story: When Internal Bleeding came out, the book’s publicist, a lovely South African […]

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The Weekly Roundup…

Stuff this week that caught my eye: Does medical tourism harm the natives? Are all those CT scans destroying more than our budgets? Are nocturnalists at risk for more than decubs? Will Medicare need to cut hospital payments to fuel P4P? Answers: yes, yes, probably, and duh. Yesterday, NPR’s All Things Considered described the dark […]

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Rapid Response Teams: Ready for Prime Time?

Last year, I (with Peter Pronovost) wrote the toughest paper of my life – one that critiqued the Institute for Healthcare Improvement’s 100,000 Lives Campaign. This is the healthcare equivalent of criticizing both Mother Teresa and your local food bank in a single sitting (you can also read Don Berwick and his team’s response here). […]

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Dennis Quaid’s Kids: Are VIPs Safer?

The Entertainment Blogosphere was atwitter yesterday with the story of actor Dennis Quaid’s twin newborns, who reportedly received a 1000-fold heparin overdose at Cedars-Sinai Medical Center in La La Land. Cedars’ Chief Medical Officer Michael Langberg may win this year’s Oscar for fastest public apology – having learned the lesson from the 2003 Duke transplant […]

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The Surgical Hospitalist

In an article in this month’s Journal of the American College of Surgeons (with a companion cover piece in the ACS’s Bulletin), four of my surgical colleagues – and this internist, perhaps to add a “cognitive” spin – describe UCSF’s “surgical hospitalist” program. It is an impressive story. When Dr. John Maa and his friends […]

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Perioperative Beta Blockers, Redux

Earlier this week, I discussed the preliminary results of the POISE trial, the blockbuster that showed that perioperative beta blockers may cause more harm than good. I’ve asked my UCSF colleague Andy Auerbach, one of the nation’s experts on this intervention, to help us understand these truly surprising results. Andy’s comments follow: “The POISE trial […]

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Three Remarkable Articles Last Week

As I mentioned when we launched, this blog won’t be your destination for a weekly journal update (there are plenty of sites for that). But I will keep an eye on the literature and let you know when I see something remarkable. And then I’ll try to put it in context. Last week, there were […]

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When is a Medical Error a Crime?

The first commandment of the modern patient safety movement was “Thou Shalt Not Blame.” Old-Think: errors are screw-ups by “bad apples,” and can only be prevented by some combination of shaming and suing the doctor or nurse holding the smoking gun. New-Think: errors represent “system problems;” any attempt to assess blame will drive providers underground, […]

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