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• Will Knols and Blogs Upend the Cozy World of Medical Publishing?

  Yesterday, Google launched Knol, immediately branded as Google’s answer to Wikipedia. As healthcare advisor to the project, I’ll say a few words about Knol, but focus on how it – and other forms of electronic self-publishing – may signal the end of medical Read More... Posted Fri, Jul 25 2008 6:03 AM by Bob Wachter | 2 Comments Filed under: Medical Education/Academia, Information Technology, Industry/Pharma, Health Policy, Media/Press Coverage

• The Long Awaited Crisis in Primary Care: It’s Heeere!

  I recently heard from a UCSF physician who was flabbergasted when he sought an appointment in our general medicine practice and was told it was “closed.” Turns out we’re not alone: there are also no new PCP slots available at Mass General. The primary Read More... Posted Sun, Jul 20 2008 7:36 PM by Bob Wachter | 9 Comments Filed under: Medical Education/Academia, Ambulatory/Primary Care, Health Policy, Media/Press Coverage

• The New (CMO) Math: Passion + Power = Progress

  In his five years on the job, Dr. Ernie Ring taught me why the Chief Medical Officer role is crucial, and how to do it right. Since Ernie is retiring at week’s end, it seems like an opportune time to share what I’ve learned.A bit of background. UCSF Medical Read More... Posted Wed, Jun 25 2008 8:36 AM by Bob Wachter | 3 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy

• Why Diagnostic Errors Don’t Get Any Respect… And What Can Be Done About It

  I gave a keynote yesterday to the first-ever meeting on “Diagnostic Error in Medicine.” I hope the confab helps put diagnostic errors on the safety map. But, as Ricky Ricardo would say, the experts and advocates in the audience have some ‘splainin’ to Read More... Posted Mon, Jun 02 2008 4:20 AM by Bob Wachter | 4 Comments Filed under: Quality Measurement, Medical Education/Academia, Diagnosis/Clinical Reasoning, Information Technology, Patient Safety/Medical Errors, Industry/Pharma, Health Policy, Media/Press Coverage

• A Quick Thanks for a Very Nice Honor

  Today, Modern Healthcare released its yearly list of the 50 most influential physician-execs in the U.S. I have to believe that you, my readers, are at least partly responsible (along with my parents and their pals in Boca) for my #19 position, the highest Read More... Posted Tue, Apr 08 2008 5:35 AM by Bob Wachter | 5 Comments Filed under: Medical Education/Academia, Health Policy, Media/Press Coverage

• The Great Quality Debate: Berwick’s Plea for Action vs. Evidence-Based Medicine

  In this week’s JAMA, Dr. Don Berwick, CEO of the Institute for Healthcare Improvement, argues that evidence-based standards should be relaxed for quality improvement practices. Ironically, a few pages away, a Swiss study finds than an IHI-endorsed MRSA Read More... Posted Mon, Mar 17 2008 11:59 PM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy

• The Checklist Saga: Victory!

  I must admit, I didn’t hold out high hopes that a ragtag band of committed clinicians and other quality improvers could change federal policy. But we’ve done just that. If the Feds are capable of rectifying this mistake, who knows what might be next! Read More... Posted Sat, Feb 16 2008 7:24 PM by Bob Wachter | 5 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy

• Time to Write Congress re: The Checklist Debacle

  Thanks to all of you who have taken the time to write, blog, and rant about the OHRP's horrific decision to shut down the Hopkins-Michigan ICU checklist study, a decision that threatens the future of quality improvement and safety efforts in American Read More... Posted Fri, Feb 15 2008 5:52 AM by Bob Wachter | 1 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy

• More Consequences of IT: The Disappearance of Radiology Rounds

  When I was a med student, the Beating Heart of the Hospital of the University of Pennsylvania (HUP) was not the CEO’s suite, the neurosurgeon’s OR, or the Dean’s lair. It was the seat of one Wallace Miller, Sr., in the decidedly unglamorous Chest Reading Read More... Posted Thu, Jan 31 2008 6:11 AM by Bob Wachter | 7 Comments Filed under: Hospital Care, Medical Education/Academia, Information Technology, Health Policy, Outsourcing/Medical Tourism

• Did I Violate Federal Regulations Today? (I Hope So)

  The patient safety and quality movements are precious and fragile. Just as IOM reports I and II spawned these modern, life-saving revolutions, the Federal shutdown of the Hopkins/Michigan checklist program may help extinguish them. After all, Tipping Read More... Posted Wed, Jan 16 2008 7:39 AM by Bob Wachter | 8 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Bureaucracy Run Amok: Can Checklists Kill?

  As you may know, I’ve argued that that the quality and safety of healthcare have traditionally been underregulated. But regulators are like patients with Parkinson’s: it’s hard to get them unglued, but once they’re moving, it’s hard to stop them. Welcome Read More... Posted Fri, Jan 11 2008 4:16 AM by Bob Wachter | 10 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Today’s New England Journal Hospitalist Study

  Today my pals Peter Lindenauer and Andy Auerbach (and colleagues) published the largest hospitalist outcomes study to date, in the New England Journal of Medicine. It is a rigorous, important piece of work. Let me try to add a bit of context. First, the Read More... Posted Thu, Dec 20 2007 9:05 AM by Bob Wachter | 2 Comments Filed under: Hospital Care, Quality Measurement, Efficiency, Medical Education/Academia, Hospitalists/Hospital Medicine, Ambulatory/Primary Care, Health Policy

• The UCSF-Kessler Saga and the Press

  I've not been posting regularly on this story (as you might imagine, it's a bit tricky for me to do so), but for those following it from near and far (I've received emails from friends in Europe and Asia) there have been a number of interesting articles, Read More... Posted Tue, Dec 18 2007 5:19 PM by Bob Wachter | 2 Comments Filed under: Medical Education/Academia, Health Policy, Media/Press Coverage

• The Termination of UCSF Dean David Kessler

  Well, today the great Mecca of medical care and innovation that is UCSF all but ground to a halt. Our Dean was just let go under very odd circumstances, and everyone’s flocking to water coolers and Starbucks around the city to find out who knows what. Read More... Posted Fri, Dec 14 2007 8:45 PM by Bob Wachter | 3 Comments Filed under: Medical Education/Academia, Health Policy, Media/Press Coverage

• More on Quality Reports: Lessons From SAT Scores

  My older son is gearing up to apply to college (:-\ and so I bought him one of the Bibles, the Fiske Guide. The book is cleverly written – enough academic factoids to get parents to spring for it, leavened with enough social scene skinny to get kids to Read More... Posted Fri, Dec 14 2007 2:42 AM by Bob Wachter | 1 Comments Filed under: Transparency and Reporting, Quality Measurement, Medical Education/Academia, Health Policy