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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The Shameless Commerce Division

Sorry, but today is the day for a tiny bit of Shameless Commerce – a quick plug for my new book, Understanding Patient Safety. I wouldn’t normally do this – I’m as brazenly promotional as anybody, mind you, but it does seem a bit cheesy – but then I saw Robert Reich promote his new […]

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Should We Retrofit our Buildings or our Healthcare System?

Last night, my house shook for 10 seconds or so in a 5.6 earthquake. I’ve felt a couple of dozen of them since moving to San Francisco in the mid-80s. When the rumbling begins, the thought chain is always interesting. It goes like this: Initial Thought: Hey, is that an earthquake, or is the subway […]

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Rating Doctors Like Restaurants

So Zagat will now be rating doctors, using the methods it perfected helping you find the best sushi in Brooklyn Heights. What’s next, Consumer Reports rating grad schools? Fodor rating auto mechanics? Whatever you think of Zagat’s cross-dressing, it again demonstrates the bottomless market for doctor rankings. HealthGrades, the Colorado company that breathlessly delivers its […]

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Are Hospitalists Killing Primary Care, Redux

The comments to my original post on this topic are so striking and passionate that I wanted to answer them in a new post rather than as another comment. First, “LPrieto” wrote, “I think the death of outpatient general Internal Medicine is inevitable.”  Then “C33333″ wrote that 16/17 of his or her (hard to sort […]

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Canadian Hospitalists: A North-of-the-Border Lesson in Negotiation

In late September, I had the honor (or honour, I guess) of speaking at the 5th Annual Canadian Hospitalist Conference, held in beautiful Vancouver. It was an eye-opener. About 150 hospitalists from all over Canada were there, and they really are delightful people: enthusiastic, energetic, and really jazzed about doing something new and important. Whereas […]

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