You probably saw yesterday’s hospitalist piece in the New York Times, arguably the best lay article on the movement to date. It hit all the right notes, and did so with uncommon grace and fairness. The piece, written by the Times’ Jane Gross, profiled Dr. Subha Airan-Javia, a young hospitalist at the Hospital of the University of Pennsylvania. ...

One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge. “I stopped her antibiotics, advanced her diet, called her daughter, and YoJo’ed her.” Say ...

A couple of weeks ago, I had the chance to visit Tokyo and Singapore – the former to speak at a conference on “Training of the Generalist Physician,” and the latter as visiting professor at Singapore General Hospital. Today: some observations on the medical scene in Japan; tomorrow, the same viz Singapore. The Tokyo conference was the brainchild ...

In 2001, when my colleagues and I ranked nearly 100 patient safety practices on the strength of their supporting evidence (for an AHRQ report), healthcare IT didn’t make the top 25. We took a lot of heat for, as one prominent patient safety advocate chided me, “slowing down the momentum.” Some called us Luddites. Although we hated to be skunks at ...

Sticking with my recent hand hygiene theme, an interesting study came out last week demonstrating that outpatients were willing to help audit their providers’ hand hygiene practices. The patients felt that snooping on their docs didn’t poison the physician-patient relationship. Moreover, their observations were accurate and the program was dirt ...

A quick heads up on an article written by a very talented UCSF psychiatrist named John Young, which I had the opportunity to co-author. John observed that, despite all the recent literature about handoffs (such as here and here), no one has given much thought to the Mother of all Handoffs: the transition of outpatient panels from graduating ...

If for some reason you haven't gotten enough of me on Wachter's World, I just did a long, fun interview with Matthew Holt on the always-interesting THCB. We cover patient safety, the future of IT, the demise of primary care, Death Panels, and more. I began the interview an optimist and finished it a pessimist, as I reflected on the ongoing ...

I like readmissions. Well, that didn’t come out quite right, did it? What I mean is that I like focusing on readmissions as a potentially actionable quality measure. I believe that it’s possible to prevent many readmissions, thereby improving quality and lowering costs. And compared to mortality (the other hot outcome measure), the need for ...

My father, who celebrated his 79th birthday yesterday, is many things: eccentric, nearly deaf (though he attributes this to my mom being a “low talker”), hilarious, crotchety, and a true mensch. But he’s neither incontinent nor impotent. It might have been otherwise. Like most men over 50, he began having yearly PSAs checked about 20 years ago, ...

A paper in today’s New England Journal proves what we all know – the hospitalist field is the only thing growing faster than the national debt. Even though that’s not news, this elegant biopsy of the Medicare database offers some new insights about our field, the fastest growing specialty in medical history. Briefly, the study used a methodology ...