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 […]
One of the more interesting recent concepts in the healthcare IT world is that of the “RHIO”: a Regional Health Information Organization. The idea is that – while we’ll never overcome the legal and privacy concerns to create a single national electronic healthcare record (at least not in my lifetime) – we might be able […]
Primary care is tanking. Job dissatisfaction is high, burnout is rampant, residents are voting with their feet in droves, and most primary care confabs have become sky-is-falling angst-a-thons. Since many people identify me as “the guy who invented hospitalists” (to which my stock reply is “just like Al Gore invented the Internet”), I have had […]
Just a quick heads up re: an article that Peter Pronovost (the world’s best patient safety researcher, in my judgment), Marlene Miller (both of Johns Hopkins) and I have in today’s JAMA. In it, we argue that there is now suffficient skin in the quality game that the time has come for there to be […]
The pharmaceutical industry’s influence in clinical care is increasingly being viewed under a high-powered microscope, and the result is tightening restrictions on what pharma can do with/for/to doctors. Having lived through the era of sun-baked golf and beach “conferences” (with the invited physicians paid handsomely as “consultants”), this extra scrutiny has been long overdue. And […]
The rate of fatal domestic airline crashes has fallen by 65% in the past decade – from an amazingly low rate of one fatal accident in about 2 million departures in 1997, to a breathtakingly low rate of one in 4.5 million departures this year. Flying just keeps getting safer and safer. Beginning with the […]
A humorous and telling story about quality measurement, decision support, and human nature: I was visiting professor at a very good academic medical center a year or so ago. On these trips, one of the fun things I get to do is meet with the residents. Sometimes they present a clinical case to me, but […]
While driving into work earlier this week, I heard a wonderful interview with Jim Dierke, principal of Visitation Valley Middle School here in San Francisco. VV is one of the poorest neighborhoods in the city, and this gentleman – who recently won a national middle school “principal of the year” award – has managed to […]
At my just-completed annual hospital medicine CME course, we held a fascinating session on the future of quality measurement, transparency, and pay for performance (P4P). The discussants – Andy Auerbach, Peter Lindenauer, and Kaveh Shojania – all emphasized the limits of process measurement, particularly noting the problems of unforeseen consequences, playing for the test, and […]
In 1997, I launched the nation’s first hospital medicine continuing medical education (CME) course (that year, we had about 100 attendees, including a few homeless people who wandered into our seedy hotel to see what the fuss was about; here’s a fuller history if you’re interested). Today, we finished our 11th annual meeting, now at […]
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