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October 2007 - Posts
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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: Read More...
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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 Read More...
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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." Read More...
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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 Read More...
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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 Read More...
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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” Read More...
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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 Read More...
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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 Read More...
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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 Read More...
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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. Read More...
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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 Read More...
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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 Read More...
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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 Read More...
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Last week, another study was published (this one in the Archives of Internal Medicine) documenting a hospitalist efficiency advantage. Coming on the heels of more than 20 studies with similar results (see, for example, this and this), one might ask how Read More...
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